Sentinel-Lymphknoten-Biopsie des Melanoms mittels Indocyaningrün und "FOVIS"-System.

PubMed

Göppner, Daniela; Nekwasil, Stephan; Jellestad, Anne; Sachse, Alexander; Schönborn, Karl-Heinz; Gollnick, Harald

2017-02-01

Der Nachweis metastatischer Infiltrate im Sentinel-Lymphkoten (SLN) gilt als wesentlicher prognostischer Faktor des Melanoms. Alternativ zur Farbstoffmethode mit Patentblau zum Goldstandard der SLN-Biopsie (SLNB) mittels Radiokolloid wird die fluoreszenzoptische Darstellung mit Hilfe von Indocyaningrün (ICG) und Nahinfrarot (NIR)-Kamerasystem kommuniziert. Im Vergleich zur konventionellen Methode wurde die Wertigkeit des ICG-/NIR-Verfahrens in Abhängigkeit vom Body-Mass-Index (BMI) des Patienten und der Konzentration von ICG bezüglich der Visualisierung des Lymphabstroms und des SLNs untersucht. An zehn Patienten wurde die SLNB mittels Technetium-99m, Patentblau und ICG durchgeführt. Die Fluoreszenz-Darstellung von Lymphbahnen und SLN erfolgte in Echtzeit mittels der NIR-Kameratechnik "FOVIS". Je nach erzielter Bildqualität wurde ICG in einer Dosis von 0,25 mg bis 2,5 mg intrakutan appliziert. Neun der zehn SLN wurden fluoreszenzoptisch identifiziert (90 %), alle zehn radioaktiv (100 %), nur acht (80 %) mittels ICG-Grünfärbung bzw. Patenblau-Markierung. Transdermal wurde ein SLN dargestellt (10 %). In Korrelation zum BMI waren höhere ICG-Mengen, bis zu 2,5 mg intrakutan absolut, in der Darstellung der Lymphbahnen von Vorteil. Die SLN-Fluoreszenzmarkierung mit dem ICG/NIR-Kamera-System "FOVIS" stellt eine sichere Alternative zur Farbstoffmethode mit Patentblau ergänzend zur Radiokolloidmethode mit Technetium-99m dar. Weitere Studien zur optimalen Dosierung von ICG und transdermalen Bildgebung in Relation zum BMI sind notwendig. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Einsatz molekularer Methoden für Starterkulturen

NASA Astrophysics Data System (ADS)

Ehrmann, Matthias A.; Pavlovic, Melanie

Unter Starterkulturen versteht man Mikroorganismen (Bakterien, Hefen, Pilze), die pflanzlichen bzw. tierischen Rohstoffen zur gezielten Veränderung ihrer chemischen Zusammensetzung zugesetzt werden. Sie dienen im Wesentlichen der Aromabildung, der Strukturveränderung und der Konservierung der Lebensmittel und werden aufgrund spezieller, funktioneller Eigenschaften selektiert. Die Zugabe von Starterkulturen erfolgt in der Regel in relativ hohen Keimzahlen in Form von Rein- oder Mischkulturen. Die zum Einsatz kommenden Mikroorganismen sind ebenso zahlreich wie die daraus resultierenden Produkte und reichen von der Fermentation von Milchprodukten, Fleisch und Gemüse durch Milchsäurebakterien über die Essigsäureherstellung bis hin zum Einsatz von Hefen in der Brau- und Weinindustrie. Hieraus ergibt sich auch eine zunehmende Bedeutung schneller und zuverlässiger Methoden zur taxonomischen Identifizierung, aber auch zur Charakterisierung des genetischen Potenzials der jeweiligen Starterkulturen.

Re-Imagining "Bildung Zur Humanität": How I Developed the Dialogos Approach to Practical Philosophy through Action Inquiry Research

ERIC Educational Resources Information Center

Helskog, Guro Hansen

2015-01-01

This paper presents an account of how I developed the Dialogos approach to practical philosophy through action inquiry research. The process of development is understood as a contribution to the reconstruction of the notion "Bildung zur Humanität" as an ideal in education. Core perspectives, traditions and purposes involved in the action…

Craniota, Wirbel- oder Schädeltiere

NASA Astrophysics Data System (ADS)

Schultze, Hans-Peter

Zu den Craniota zählen alle Chordatiere, die eine dreiteilige Regionalisierung des Körpers in Kopf, Rumpf und Schwanz aufweisen. Der Kopf umfasst (1) das Neurocranium mit Gehirn und komplexen Sinnesorganen zur Wahrnehmung der Umgebung, (2) das Viscerocranium zur Nahrungsaufnahme und zur Ventilation der Kiemen bei den primär wasserlebenden Craniota und (3) das Dermatocranium (S. 38). Letzteres entsteht durch Verknöcherungen im Bindegewebe des Integuments, es dient dem Schutz des Kopfes und trägt im Mundbreich die Zähne. Zusammen bilden die drei Skelettstrukturen die funktionelle Einheit Schädel (Cranium). Außer der (somatischen) Rumpfmuskulatur und dem Axialskelett liegen im Rumpf Kreislauf-, Atmungs-, Verdauungs-, Exkretions- und Fortpflanzungsorgane. Der Schwanz, der Abschnitt hinter der Afteröffnung, die das Ende der Leibeshöhle markiert, dient mit Muskeln und Schwanzflosse der Fortbewegung.

The East-German Research Landscape in Transition. Part C. Research at East-German Universities

DTIC Science & Technology

1993-03-10

Software-Systemlosungen fUr Aufgaben der Qualit ~ tssicherung und Pr~zisionsmeBtechnik. Beratung zur automatisierten ProzeBsteuerung und rechnergestUtzten... Qualit ~ tssicherung Beratung zu Schnittstellenproblemen und zur Lichtzeichentechnik Beratung zu Auswahl und Einsatz von metrischen Bi...49 (351) 463-2786 with seventeen institutes. C45.wp-09 05 MAR 93 #4350 DEPARTMENT FOR CIVIL ENGINEERING. WATER- AND FOREST TECHNOLOGY Fakult~t fUr Bau

Safety and Suitability for Service Assessment Testing for Shoulder Launched Munitions

DTIC Science & Technology

2014-11-07

Registrierung und Auswertung von Waffen -und Detonationsknallen 31 Motor Case Burst Probability ARO Report 75-2, SMC-S-001 Def Stan 07-85 32...détonation Vorschriften und Richtlinien zur Registrierung und Auswertung von Waffen und Detonationsknallen and STANAG 4569 with references...l’exploitation des bruits d’armes et des bruits de détonation Vorschriften und Richtlinien zur Registrierung und Auswertung von Waffen und

Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen.

PubMed

Mammas, Ioannis N; Spandidos, Demetrios A

2017-10-01

Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on 'Paediatric Virology and Oncology: Virus persistence and the important first years of life'.

Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen

PubMed Central

Mammas, Ioannis N.; Spandidos, Demetrios A.

2017-01-01

Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on ‘Paediatric Virology and Oncology: Virus persistence and the important first years of life’. PMID:29042913

Atmosphärisches Plasma in der Medizintechnik

NASA Astrophysics Data System (ADS)

Beer, Thomas; Knospe, Alexander; Buske, Christian

Bei der Fertigung komplexer Bauteile werden immer häufiger unterschiedlichste Materialien zur Erfüllung der Funktion kombiniert. Kunststoff, Metall, Glas oder Keramik müssen miteinander verbunden werden. Dies gilt für die unterschiedlichsten Industriebereiche; von der Halbleiter-/Elektronikindustrie [1, 2] über die Automobilindustrie [3, 4] bis hin zur Medizintechnik werden für Verklebungs- [5], Bedruckungs-, Lackier- [6] und Anspritzprozesse optimal vorbehandelte Oberflächen benötigt.

Konrad Adenauer’s Military Advisors

DTIC Science & Technology

1989-02-13

Ausgabe. Hans-Peter Schwarz and 45 Rudolf Morsey, Hg. Vol. 1, Briefe 1945-1947 hg. v. Hans Peter Mensing. Berlin: Siedler Verlag, 1983. Vol. 2, Briefe 1949...Dietrich, Rudolf Morsey and Hans-Peter Schwarz, ed. Quellen zur Geschichte des Parlarnentarismus und der politischen Partein. Bd. 3, Auftakt zur Ara...New York: Penguin, 1982. Steiner , Jirg. European Democracies. New York: Longman, 1986. Taylor, A.J.P. The Origens of the Second World War. 2d. ed. New

Kraft-Wärmekopplung und Blockheiz-Kraftwerke BHKW

NASA Astrophysics Data System (ADS)

Zahoransky, Richard; Allelein, Hans-Josef; Bollin, Elmar; Oehler, Helmut; Schelling, Udo

Die thermischen Wirkungsgrade von Kraftwerken zur Stromerzeugung sind relativ gering. Beispielsweise erreichen moderne Kohlekraftwerke heute bis etwa 45 %, Gasturbinen maximal 40 % und Diesel-Motoren nicht über 50 %. Kombinations-Kraftwerke, Gas- und Dampfturbinen-Prozesse können an die 60 % thermischer Wirkungsgrad bei der Umwandlung der zugeführten Wärme in mechanische bzw. elektrische Energie erzielen. Ein ähnlich hoher Wert wird in Zukunft von den Brennstoffzellen erwartet. Der nicht in Arbeit umgewandelte Anteil der zugeführten Wärme fällt als Abwärme an und geht ungenutzt in die Umgebung. Ein Teil dieser Abwärme lässt sich durch entsprechende Installationen bei allen Kraftwerksprozessen zur Wassererwärmung oder zur Dampferzeugung für industrielle Zwecke nutzen. Für Heizzwecke genügt eine Temperatur der Abwärme von 60 %C bis 80 %C, während die Erzeugung von Industriedampf deutlich höhere Temperaturen voraussetzt.

[ICD-10 diagnosis and quality of life. A pilot study of quality of life of children and adolescents with psychiatric disorders].

PubMed

Schubert, M T; Herle, M; Wurst, E

2003-11-01

The present study examined whether the quality of life in children and adolescents with psychological disorders, as judged by the patients themselves and their mothers, differed according to the various ICD-10 diagnoses or the number of axes involved. 151 children/adolescents and 125 mothers, referred consecutively to the clinic, completed the Inventory for Evaluation of Quality of Life in Children and Adolescents (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen; ILK) by Mattejat et al. ICD-10 diagnoses were grouped for evaluation. No significant interaction between the five diagnostic axes and the several domains of quality of life was found. However, mothers of children and adolescents with attention deficit/hyperactivity disorders and/or conduct disorder more often tended to judge their children's quality of life as unsatisfactory in all domains, while the patients themselves did not. Thus, rather than the children themselves it seems to be the children's environment which considers "external disorders" to be distressing. The authors conclude that the quality of life as measured by the ILK cannot be captured by ICD-10 criteria. Apparently it is not so much the diagnosis itself but its subjective meaning that has the most essential impact on an individual's assessment of quality of life.

Liquid Biopsy zur Überwachung von Melanompatienten.

PubMed

Gaiser, Maria Rita; von Bubnoff, Nikolas; Gebhardt, Christoffer; Utikal, Jochen Sven

2018-04-01

In den letzten sechs Jahren wurden verschiedene innovative systemische Therapien zur Behandlung des metastasierten malignen Melanoms (MM) entwickelt. Die konventionelle Chemotherapie wurde durch neuartige Primärtherapien abgelöst, darunter systemische Immuntherapien (Anti-CTLA4- und Anti-PD1-Antikörper; Zulassung von Anti-PDL1-Antikörpern erwartet) und Therapien, die gegen bestimmte Mutationen gerichtet sind (BRAF, NRAS und c-KIT). Daher stehen die behandelnden Ärzte neuen Herausforderungen gegenüber, beispielsweise der Stratifizierung von Patienten für geeignete Behandlungen und der Überwachung von Langzeit-Respondern auf Progression. Folglich werden zuverlässige Methoden zur Überwachung von Krankheitsprogression oder Behandlungsresistenz benötigt. Lokalisierte und fortgeschrittene Krebserkrankungen können zur Bildung zirkulierender Tumorzellen und Tumor-DNA (ctDNA) führen, die sich in Proben von peripherem Blut nachweisen und quantifizieren lassen (Liquid Biopsy). Im Fall von Melanompatienten können die Ergebnisse von Liquid Biopsy als neuartige prädiktive Biomarker bei therapeutischen Entscheidungen hilfreich sein, insbesondere im Zusammenhang mit mutationsbasierten zielgerichteten Therapien. Die Herausforderungen bei der Anwendung der Liquid Biopsy beinhalten strikte Kriterien für den Phänotyp der zirkulierenden MM-Zellen oder ihrer Fragmente und die Instabilität von ctDNA im Blut. In diesem Übersichtsartikel diskutieren wir die Beschränkungen der Liquid Biopsy hinsichtlich ihrer Anwendung in der Routinediagnostik. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Anbindung des SISIS-SunRise-Bibliothekssystems an das zentrale Identitätsmanagement

NASA Astrophysics Data System (ADS)

Ebner, Ralf; Pretz, Edwin

Wir berichten über Konzepte und Implementierungen zur Datenprovisionierung aus den Personenverwaltungssystemen der Technischen Universität München (TUM) über das zentrale Metadirectory am Leibniz-Rechenzentrum (LRZ) in das SISIS-SunRise-Bibliothekssystem der Universitätsbibliothek der TUM (TUB). Es werden drei Implementierungsvarianten diskutiert, angefangen von der Generierung und Übertragung einfacher CSV-Dateien über ein OpenLDAP-basiertes Konzept als Backend für die SISIS-Datenbank bis zur endgültigen Implementierung mit dem OCLC IDM Connector.

Digitalisierung in der Energiewirtschaft - empirische Untersuchung und Wertschöpfungskette

NASA Astrophysics Data System (ADS)

Dell, Timo

Die Energiewirtschaft nutzt seit je her digitale Strukturen zur Umsetzung ihrer Prozesse. Durch den (neuen) verabschiedeten politischen Ordnungsrahmen - dem Gesetz zur Digitalisierung der Energiewende - und durch die rasante Fortentwicklung technologischer Strukturen ergeben sich jedoch die Wertschöpfungsstufen erweiternde, diversifizierende und innovative Möglichkeiten für Energieversorger (EVU) Geschäftsfelder auszubauen bzw. neue zu erschließen. Dabei ist die digitale (R)Evolution keine rein technische Umsetzung, sondern insbesondere auch eine unternehmensinterne, strategische und intern-kulturelle Herausforderung.

25 Jahre - Institut fuer Geodaesie, Teil 3: Aus dem Leben des Instituts (25 Years - Institute of Geodesy, Part 3: The Life of the Institute)

DTIC Science & Technology

2000-01-01

Kraftwerk Qinshan, VR China 0 1984 bis 1987 Studiumn des Markscheidewesens am Shandong Institute of Mining and Technology, VR China * 1984 bis 1993...die zur Wasserversorgung eines Kraftwerkes der ALCAN dienen sollte. Verbunden mit dem Tunnelprojekt war auch der Bau einer 80 km langen Hoch...spannungsleitung durch unverdorbene Wildnis vom Kraftwerk zur Aluminium-Schmelze in Ki- timat. Zu dieser Zeit war es das gr66Bte hydro-elektrische Projekt, das

Einsteins Spuren in den Archiven der Wissenschaft: Physikgeschichte

NASA Astrophysics Data System (ADS)

Marx, Werner

2005-07-01

Die Erwähnungen und Zitierungen von Einsteins Arbeiten dokumentieren lediglich den quantifizierbaren Anteil von Einsteins Beitrag zur Physik. Gleichwohl belegen sie die außergewöhnliche Resonanz und Langzeitwirkung seiner Arbeiten. Die Häufigkeit der Zitierungen entspricht nicht der allgemeinen Einschätzung ihrer Bedeutung. Insbesondere die Pionierarbeiten werden inzwischen als bekannt vorausgesetzt und nicht mehr explizit zitiert. Interessanterweise ist seine nach 1945 meist zitierte Arbeit nicht eine der Pionierarbeiten zur Quantenphysik oder Relativitätstheorie, sondern jene aus dem Jahr 1935 zum berühmten Einstein-Podolsky-Rosen-Paradoxon.

Hinderniserkennung und -verfolgung mit einer PMD-kamera im automobil

NASA Astrophysics Data System (ADS)

Schamm, Thomas; Vacek, Stefan; Natroshvilli, Koba; Marius Zöllner, J.; Dillmann, Rüdiger

Die Detektion von Hindernissen vor dem Automobil ist eine Hauptanforderung an moderne Fahrerassistenzsysteme (FAS). In dieser Arbeit wird ein System vorgestellt, das mit Hilfe einer PMDKamera (Photomischdetektor) Hindernisse auf der Fahrspur erkennt und deren relevante Parameter bestimmt. Durch die PMD-Kamera werden zunächst 3D-Tiefenbilder der Fahrzeugumwelt generiert. Nach einem initialen Filterprozess werden im Tiefenbild mit Hilfe eines Bereichswachstumsverfahrens Hindernisse gesucht. Zur Stabilisierung des Verfahrens und zur Parameterberechnung wird ein Kaiman Filter eingesetzt. Das Ergebnis ist eine Liste aller Hindernisse im Fahrbereich des Automobils.

Physik

NASA Astrophysics Data System (ADS)

Gerthsen, Christian; Vogel, Helmut

Die siebzehnte Auflage des Gerthsen ist zugleich die sechste in der Bearbeitung Helmut Vogels. Der Autor bereichert das klassische Studien- und Nachschlagewerk mit einem neuen Kapitel zur nichtlinearen Dynamik (auch Chaos und Fraktale werden besprochen) sowie acht instruktiven Farbtafeln. Daneben gibt es wieder kleinere Ergänzungen und Korrekturen. Wo die Darstellung wegen der selbstauferlegten Beschränkung im Umfang nicht alle Themen behandeln kann, helfen die mehr als zahlreichen Übungsaufgaben, die im Band Vogel, Probleme aus der Physik, ISBN 3-540-51217-9, mit Beiheft nun auch zur 17. Auflage verwendbar, ausführlich besprochen werden.

Hardware-Abbildung eines videobasierten Verfahrens zur echtzeitfähigen Auswertung von Winkelhistogrammen auf eine modulare Coprozessor-Architektur

NASA Astrophysics Data System (ADS)

Flatt, H.; Tarnowsky, A.; Blume, H.; Pirsch, P.

2010-10-01

Dieser Beitrag behandelt die Abbildung eines videobasierten Verfahrens zur echtzeitfähigen Auswertung von Winkelhistogrammen auf eine modulare Coprozessor-Architektur. Die Architektur besteht aus mehreren dedizierten Recheneinheiten zur parallelen Verarbeitung rechenintensiver Bildverarbeitungsverfahren und ist mit einem RISC-Prozessor verbunden. Eine konfigurierbare Architekturerweiterung um eine Recheneinheit zur Auswertung von Winkelhistogrammen von Objekten ermöglicht in Verbindung mit dem RISC eine echtzeitfähige Klassifikation. Je nach Konfiguration sind für die Architekturerweiterung auf einem Xilinx Virtex-5-FPGA zwischen 3300 und 12 000 Lookup-Tables erforderlich. Bei einer Taktfrequenz von 100 MHz können unabhängig von der Bildauflösung pro Einzelbild in einem 25-Hz-Videodatenstrom bis zu 100 Objekte der Größe 256×256 Pixel analysiert werden. This paper presents the mapping of a video-based approach for real-time evaluation of angular histograms on a modular coprocessor architecture. The architecture comprises several dedicated processing elements for parallel processing of computation-intensive image processing tasks and is coupled with a RISC processor. A configurable architecture extension, especially a processing element for evaluating angular histograms of objects in conjunction with a RISC processor, provides a real-time classification. Depending on the configuration of the architecture extension, 3 300 to 12 000 look-up tables are required for a Xilinx Virtex-5 FPGA implementation. Running at a clock frequency of 100 MHz and independently of the image resolution per frame, 100 objects of size 256×256 pixels are analyzed in a 25 Hz video stream by the architecture.

Ökophysik: Plaudereien über das Leben auf dem Land, im Wasser und in der Luft

NASA Astrophysics Data System (ADS)

Nachtigall, W.

Prof. em. Dr. rer. nat. Werner Nachtigall, geb. 1934, war als Zoophysiologe und Biophysiker Leiter des Zoologischen Instituts der Universität des Saarlandes in Saarbrücken. In Forschung und Ausbildung hat er sich insbesondere mit Aspekten der Technischen Biologie und Bionik befasst und mit seinen Forschergruppen viele Basisdaten insbesondere zur Ökologie, Physiologie und Physik des Fliegens und Schwimmens aber auch zur Stabilität beispielsweise der Gräser erarbeitet. Lebewesen überraschen immer wieder durch ihre "Biodiversität", ihre hochspezifischen Ausgestaltungen und Anpassungen.

Ein Konzept für den energieeffizienten Betrieb von Mobilfunknetzen

NASA Astrophysics Data System (ADS)

Bayer, N.; von Hugo, D.

2015-11-01

Der flächendeckende Betrieb mehrerer Mobilfunknetze unterschiedlicher Technologie in einem Land sorgt aufgrund der ständigen Bereithaltung von Übertragungskapazität für Dienste mit zunehmend höherem Datenvolumenbedarf für einen erheblichen Energieverbrauch. Das Forschungsförderungsprojekt ComGreen hat sich zur Aufgabe gesetzt, durch lastadaptiven Betrieb und intelligente dynamische Rekonfiguration des Funkzugangsnetzes zur Energieeinsparung beizutragen. Konzept, Herausforderungen, ausgewählte Ergebnisse von Simulationen und prototypischem Betrieb werden ebenso wie typische Erwartungswerte des künftigen Energieverbrauchs im Mobilfunkbereich vorgestellt. Sowohl Berechnungen als auch Messungen zeigen, dass durch kontext-basierte dynamische Rekonfiguration von zellularen Funknetzen Energieeinsparungen im Bereich von 25-40 % ermöglicht werden.

Identifikationsverfahren zur Analyse von EEG-Signalen bei Epilepsie mit Reaktions-Diffusions Netzwerken

NASA Astrophysics Data System (ADS)

Gollas, F.; Tetzlaff, R.

2007-06-01

Partielle Differentialgleichungen des Reaktions-Diffusions-Typs beschreiben Phänomene wie Musterbildung, nichtlineare Wellenausbreitung und deterministisches Chaos und werden oft zur Untersuchung komplexer Vorgänge auf den Gebieten der Biologie, Chemie und Physik herangezogen. Zellulare Nichtlineare Netzwerke (CNN) sind eine räumliche Anordnung vergleichsweise einfacher dynamischer Systeme, die eine lokale Kopplung untereinander aufweisen. Durch eine Diskretisierung der Ortsvariablen können Reaktions-Diffusions-Gleichungen häufig auf CNN mit nichtlinearen Gewichtsfunktionen abgebildet werden. Die resultierenden Reaktions-Diffusions-CNN (RD-CNN) weisen dann in ihrer Dynamik näherungsweise gleiches Verhalten wie die zugrunde gelegten Reaktions-Diffusions-Systeme auf. Werden RD-CNN zur Identifikation neuronaler Strukturen anhand von EEG-Signalen herangezogen, so besteht die Möglichkeit festzustellen, ob das gefundene Netzwerk lokale Aktivität aufweist. Die von Chua eingeführte Theorie der lokalen Aktivität Chua (1998); Dogaru und Chua (1998) liefert eine notwendige Bedingung für das Auftreten von emergentem Verhalten in zellularen Netzwerken. Änderungen in den Parametern bestimmter RD-CNN könnten auf bevorstehende epileptische Anfälle hinweisen. In diesem Beitrag steht die Identifikation neuronaler Strukturen anhand von EEG-Signalen durch Reaktions-Diffusions-Netzwerke im Vordergrund der dargestellten Untersuchungen. In der Ergebnisdiskussion wird insbesondere auch die Frage nach einer geeigneten Netzwerkstruktur mit minimaler Komplexität behandelt.

Zinc-Responsive Regulation of Alternative Ribosomal Protein Genes in Streptomyces coelicolor Involves Zur and σR▿ †

PubMed Central

Owen, Gillian A.; Pascoe, Ben; Kallifidas, Dimitris; Paget, Mark S. B.

2007-01-01

Streptomyces coelicolor contains paralogous versions of seven ribosomal proteins (S14, S18, L28, L31, L32, L33, and L36), which differ in their potential to bind structural zinc. The paralogues are termed C+ or C− on the basis of the presence or absence of putative cysteine ligands. Here, mutational studies suggest that the C− version of L31 can functionally replace its C+ paralogue only when expressed at an artificially elevated level. We show that the level of expression of four transcriptional units encoding C− proteins is elevated under conditions of zinc deprivation. Zur controls the expression of three transcriptional units (including rpmG2, rpmE2, rpmB2, rpsN2, rpmF2, and possibly rpsR2). Zur also controls the expression of the znuACB operon, which is predicted to encode a high-affinity zinc transport system. Surprisingly, the zinc-responsive control of the rpmG3-rpmJ2 operon is dictated by σR, a sigma factor that was previously shown to control the response to disulfide stress in S. coelicolor. The induction of σR activity during zinc limitation establishes an important link between thiol-disulfide metabolism and zinc homeostasis. PMID:17400736

Zinc-responsive regulation of alternative ribosomal protein genes in Streptomyces coelicolor involves zur and sigmaR.

PubMed

Owen, Gillian A; Pascoe, Ben; Kallifidas, Dimitris; Paget, Mark S B

2007-06-01

Streptomyces coelicolor contains paralogous versions of seven ribosomal proteins (S14, S18, L28, L31, L32, L33, and L36), which differ in their potential to bind structural zinc. The paralogues are termed C(+) or C(-) on the basis of the presence or absence of putative cysteine ligands. Here, mutational studies suggest that the C(-) version of L31 can functionally replace its C(+) paralogue only when expressed at an artificially elevated level. We show that the level of expression of four transcriptional units encoding C(-) proteins is elevated under conditions of zinc deprivation. Zur controls the expression of three transcriptional units (including rpmG2, rpmE2, rpmB2, rpsN2, rpmF2, and possibly rpsR2). Zur also controls the expression of the znuACB operon, which is predicted to encode a high-affinity zinc transport system. Surprisingly, the zinc-responsive control of the rpmG3-rpmJ2 operon is dictated by sigma(R), a sigma factor that was previously shown to control the response to disulfide stress in S. coelicolor. The induction of sigma(R) activity during zinc limitation establishes an important link between thiol-disulfide metabolism and zinc homeostasis.

Virtuelle Kraftwerke für Smart Markets

NASA Astrophysics Data System (ADS)

Dürr, Thomas; Heyne, Jean-Christoph

In den zurückliegenden Jahren haben insbesondere zwei Trends die Stromversorgung bestimmt: der starke Anstieg der dezentralen und der Ausbau der regenerativen Stromerzeugung, die vor allem in den Verteilnetzen stattfinden. Angesichts dieser Entwicklung gewinnen virtuelle Kraftwerke (VK) immer mehr an Bedeutung. In der frühen Phase waren VK insbesondere eine Möglichkeit, kleine dezentrale Erzeuger zu einer größeren Einheit zu bündeln und sie so marktfähig zu machen. Heute werden sie - überwacht und gesteuert über ein Dezentrales Energie-Management-System (DEMS) - gemeinsam mit Demand Response betrieben, also dem Reagieren eines Energieabnehmers auf Marktpreise. Das Demand Side Management soll zur Flexibilisierung der Industrie beitragen. Da der Ausbau der Übertragungsnetze nur schleppend vorankommt, kann die Nutzung von lastseitiger Flexibilität einen wichtigen Beitrag zur Versorgungssicherheit leisten. Im zweiten Teil des Beitrags geht es um die Entwicklung der Märkte. Großes Interesse besteht immer noch an der Regelenergie, zumal der Bedarf bis 2050 deutlich steigen wird. Die Spotmärkte Intraday und Day-Ahead wachsen kontinuierlich, deshalb werden sie für VK immer wichtiger. Am Ende gibt der Beitrag einen Ausblick auf die künftige Entwicklung, in der Regelenergie- und Spotmärkte noch eine Rolle spielen, aber andere Geschäftsmodelle wichtiger werden. Darüber hinaus geht es um langfristige Entwicklungen, die z. B. zusätzliche Serviceleistungen durch VK betreffen.

Medizintechnik in der Tumororthopädie

NASA Astrophysics Data System (ADS)

Burgkart, Rainer; Gollwitzer, Hans; Holzapfel, Boris; Rudert, Maximilian; Rechl, Hans; Gradinger, Reiner

Die Behandlung der Knochentumoren unterlag in den letzten 20 Jahren einem raschen und stetigen Wandel, was zum einen auf die verbesserten Therapieerfolge durch den Einsatz von neoadjuvanten Therapieformen zurückzuführen ist, und andererseits von medizintechnischen Entwicklungen bezüglich moderner Schnittbilddiagnostik, neuer 3D Operationsplanungsverfahren wie das Rapid Prototyping und adaptiv modularer Tumorendoprothesensystemen u. a. begleitet wurde. Gerade die technischen Entwicklungen haben dazu geführt, daß im Bereich der Extremitäten und der Wirbelsäule radikalere Eingriffe durchgeführt werden können, was die lokale Tumorkontrolle wesentlich verbessert hat. In zunehmenden Maße werden deshalb nicht nur Kurzzeiterfolge sondern auch mittel- und langfristige Fortschritte bei der Behandlung der malignen Knochentumoren einschließlich der Metastasenbehandlung erreicht. Grundlage der Therapie ist dabei immer primär die Sicherung der Diagnose mittels Biopsie und die bildgebende sowie histologische Stadieneinteilung des malignen Tumors. Nach der Tumorresektion kann die Rekonstruktion biologisch oder mit Endoprothesensystemen erfolgen. Gerade die weiterentwickelten modularen Systeme führen zu guten funktionellen Ergebnissen mit langen Standzeiten und einer reduzierten Komplikationsrate. Individuell angefertigte Implantate sind vor allem im Bereich der Rekonstruktion komplexer Beckentumoren von großer klinischer Bedeutung.

Auf dem Weg zur digitalen Fakultät - moderne IT Infrastruktur am Beispiel des Physik-Departments der TU München

NASA Astrophysics Data System (ADS)

Homolka, Josef

Der Geschäftsbetrieb einer Universität ist durch zunehmende Digitalisierung und Nutzung elektronischer Medien gekennzeichnet. Die Einführung immer leistungsfähigerer zentraler IT-Systeme führt zu einer komplexen Vielfalt heterogener Benutzer- und Administrationsschnittstellen. Zur Schaffung einer umfassenden benutzerfreundlichen und nahtlosen IT-Infrastruktur ist die Beteiligung aller organisatorischen Einheiten und Ebenen erforderlich. Am Physik-Departement der Technischen Universität München wurden unter Integration eigener Ressourcen mit zentralen Ressourcen, die im Rahmen des IntegraTUM Projektes entwickelt und bereitgestellt wurden, existierende Dienste weiterentwickelt und neue Angebote aufgebaut. Das System, bestehend aus den Komponenten Netzwerk, Arbeitsplatzrechner, Serverinfrastruktur, E-Mail-Service, WWWDienst, Datenhaltung und Software wurde für die Nutzerkreise Studenten und Mitarbeiter im Hinblick auf Anwenderfreundlichkeit und nahtlosen Zugriff optimiert.

Molecular and cellular characterisation of the zinc uptake (Znu) system of Nostoc punctiforme.

PubMed

Hudek, Lee; Pearson, Leanne A; Michalczyk, Agnes; Neilan, Brett A; Ackland, M Leigh

2013-11-01

Metal homoeostasis in cyanobacteria is based on uptake and export systems that are controlled by their own regulators. This study characterises the zinc uptake (Znu) system in Nostoc punctiforme. The system was found to comprise of three subunits in an ACB operon: a Zn(2+)-binding protein (ZnuA18), a transmembrane domain (ZnuB) and an ATPase (ZnuC). These proteins are encoded within the znu operon regulated by a zinc uptake transcription repressor (Zur). Interestingly, a second Zn(2+)-binding protein (ZnuA08) was also identified at a distal genomic location. Interactions between components of the ZnuACB system were investigated using knockouts of the individual genes. The znuA08(-), znuA18(-), znuB(-) and znuC(-) mutants displayed overall reduced znuACB transcript levels, suggesting that all system components are required for normal expression of znu genes. Zinc uptake assays in the Zn(2+)-binding protein mutant strains showed that the disruption of znuA18 had a greater negative effect on zinc uptake than disruption of znuA08. Complementation studies in Escherichia coli indicated that both znuA08 and znuA18 were able to restore zinc uptake in a znuA(-) mutant, with znuA18 permitting the highest zinc uptake rate. The N. punctiforme zur was also able to complement the E. coli zur(-) mutant. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

Resistivity Changes Due to Precipitation Effects in Fibre Reinforced Mg-Al-Zn-Mn Alloy

NASA Astrophysics Data System (ADS)

Kiehn, J.; Kainer, K. U.; Vostrý, P.; Stulíková, I.

1997-05-01

The change of electrical properties of alumina short fibre reinforced Mg-Al-Zn-Mn alloy AZ91D during isochronal annealing up to 300 °C is discussed. The Saffil® fibres were incorporated into the magnesium alloy by direct squeeze casting. The fibre distribution is random planar parallel to the flat faces of the dc four-point resistivity specimens machined from the solution treated castings. A sharp drop of resistivity between 140 and 260 °C is explained by the formation of incoherent -phase particles. Some practical recommendations concerning the use of alumina short fibre reinforced AZ91 alloy are made on the basis of the results obtained. Es werden die Änderungen der elektrischen Eigenschaften der aluminiumoxid-kurzfaserverstärkten Mg-Al-Zn-Mn Legierung AZ91D während isochroner Wärmebehandlungen bis 300 °C diskutiert. Das direkte Preßgießverfahren diente zur Herstellung der Saffil®-Faser Magnesium Verbundwerkstoffe. Die Proben zur Widerstandsmessung nach der Vier-Punkt Methode wurden durch spanende Bearbeitung aus den lösungsgeglühten Preßgußstücken herausgearbeitet, so daß sie regellose Faserverteilung in den Ebenen parallel zu den flachen Probenseiten aufwiesen. Ein starker Abfall des elektrischen Widerstands im Temperaturbereich zwischen 140 und 260 °C wird durch die Bildung inkohärenter β-Phase erklärt. Auf Grundlage der Ergebnisse werden einige Empfehlungen zur Anwendung der kurzfaserverstärkten Legierung AZ91 gegeben.

[Assessment of parental stress using the "Eltern-Belastungs-Screening zur Kindeswohlgefährdung" (EBSK) - association with emotional and behavioral problems in children].

PubMed

Eichler, Anna K; Glaubitz, Katharina A; Hartmann, Luisa C; Spangler, Gottfried

2014-07-01

Parental stress is increased in clinical contexts (e.g., child psychiatry) and correlates with behavioral and emotional problems of children. In addition, parental stress can result in a biased parental perception of child's behavior and emotions. These interrelations were examined in a normal (N = 320) and a clinical (N = 75) sample. The "Eltern-Belastungs-Screening zur Kindeswohlgefährdung" (EBSK; Deegener, Spangler, Körner & Becker, 2009) was used for the assessment of parental stress. As expected, increased EBSK scores were overrepresented in the clinical sample. In both samples stressed parents reported having children with more behavioral and emotional problems. Children of stressed parents in turn reported significantly less problems than their parents did. The rating of independent third persons, e.g. teachers, was not available and should be added in future research. Restrictions in methodology and conclusions for practice are discussed.

Biokompatible Implantate und Neuentwicklungen in der Gynäkologie

NASA Astrophysics Data System (ADS)

Jacobs, Volker R.; Kiechle, Marion

Für den Einsatz in der Gynäkologie stehen heute eine Vielzahl unterschiedlicher, biokompatibler Materialien und Implantate zur Verfügung. Auf eine Auswahl soll hier näher eingegangen werden, die die verschiedenen Materialien und Bauweisen repräsentieren. So sind Brustimplantate seit fast vier Jahrzehnten im Gebrauch für die Brustvergrösserung und den Brustwiederaufbau. Material, Bauweisen und medizinische Aspekte einschliesslich der kontroversen Diskussion um Silikon werden im folgenden erläutert. Neuere Entwicklungen von Verhütungstechniken für permanente Sterilisation wie den Filshie ClipTM für transabdominalen und den STOPTM für intraluminalen Verschluss der Eileiter oder die intrauterin plazierte Hormonspirale MirenaTM für zeitlich begrenzte Verhütung werden beschrieben. Eine neue Perspektive zur Verhinderung postoperativer intraabdominaler Adhäsionen stellt Spray-GelTM, ein Zweikomponenten Hydrogel aus Polyethylenglykol, dar.

Energy as a Service

NASA Astrophysics Data System (ADS)

Pell, Wolfgang

Energie wird zum Gebrauchsgegenstand, zur Commodity und rückt doch in den Blickpunkt der Aufmerksamkeit. Volkswirtschaftliche, politische, gesellschaftliche und betriebswirtschaftliche Ansprüche lassen Services rund um die Energieversorgung (Energy-related Services) entstehen. Convenience Services, die den Ansprüchen der Konsumenten gerecht werden, wie Visualisierung von (dezentraler) Energieerzeugung und -verbrauch auf Basis digitaler Smart Meter, die den analogen Ferraris-Zähler ersetzen, sowie optimierter Energieeinsatz halten in Haushalten als digitalisierten Standorten (Smart Sites) Einzug. Energieoptimierung auf Basis des Paradigmas "Verbrauch folgt Erzeugung" stellt Nachfrageflexibilität industrieller Prozesse (Demand Response) als Energie-Effizienz-Faktor in den Vordergrund und lässt Services wie ihre Vermarktung als Regelenergie zur Stabilisierung der Netzfrequenz entstehen. Ein Innovation Action Plan liefert einen Ausblick, wohin die Integration neuer Technologien, die Steigerung der Kundennähe und die Entwicklung neuer Geschäftsmodelle die Energiewirtschaft führen kann. Mit Eco-Home und Power-Pool werden zwei konkrete Beispiele für Energy as a Service vorgestellt.

Professionelles Learning Service Management an Hochschulen

NASA Astrophysics Data System (ADS)

Baume, Matthias; Rathmayer, Sabine; Gergintchev, Ivan; Schulze, Elvira

Aufbauend auf den Großteils bereits geschaffenen eLearning Infrastrukturen für eine moderne Organisation stehen nahezu alle Hochschulen vor der Aufgabe, geeignete Lern- und Wissensmanagementkonzepte in Hinblick auf die Dienstgüte und den Anwenderbezug zu realisieren. Ein möglicher Lösungsansatz ist dabei die Entwicklung und Umsetzung eines Rahmenkonzeptes zur Verbesserung und Weiterentwicklung der Lehr-/Lernprozesse für Dozenten und Studenten am Beispiel bereits vorhandener und etablierter Service-Management-Konzepte. Übertragen auf die universitäre Organisation und Lehre, wäre ein derartiges Rahmenwerk zur Planung, Erbringung und Unterstützung von Lehr-/Lerndienstleistungen mit Einbezug der wichtigsten Lehr-/Lernprozesse ein dringend benötigter und fundamentaler Schritt hin zu einer schrittweisen Professionalisierung und Verbesserung der Hochschullehre. Der Beitrag erschließt eine Konzeptskizze für professionelles Learning Service Management an Hochschulen und gibt einen Ausblick auf die mögliche Vorgehensweise bei dessen Implementierung und Evaluierung.

Bildbasierte Navigation eines mobilen Roboters mittels omnidirektionaler und schwenkbarer Kamera

NASA Astrophysics Data System (ADS)

Nierobisch, Thomas; Hoffmann, Frank; Krettek, Johannes; Bertram, Torsten

Dieser Beitrag präsentiert einen neuartigen Ansatz zur entkoppelten Regelung der Kamera-Blickrichtung und der Bewegung eines mobilen Roboters im Kontext der bildbasierten Navigation. Eine schwenkbare monokulare Kamera hält unabhängig von der Roboterbewegung die relevanten Merkmale für die Navigation im Sichtfeld. Die Entkopplung der Kamerablickrichtung von der eigentlichen Roboterbewegung wird durch die Projektion der Merkmale auf eine virtuelle Bildebene realisiert. In der virtuellen Bildebene hängt die Ausprägung der visuellen Merkmale für die bildbasierte Regelung nur von der Roboterposition ab und ist unabhängig gegenüber der tatsächlichen Blickrichtung der Kamera. Durch die Schwenkbarkeit der monokularen Kamera wird der Arbeitsbereich, über dem sich ein Referenzbild zur bildbasierten Regelung eignet, gegenüber einer statischen Kamera signifikant vergrößert. Dies ermöglicht die Navigation auch in texturarmen Umgebungen, die wenig verwertbare Textur- und Strukturmerkmale aufweisen.

Spirituelles Wohlbefinden und Coping bei Sklerodermie, Lupus erythematodes und malignem Melanom.

PubMed

Pilch, Michaela; Scharf, Sabina Nadine; Lukanz, Martin; Wutte, Nora Johanna; Fink-Puches, Regina; Glawischnig-Goschnik, Monika; Unterrainer, Human-Friedrich; Aberer, Elisabeth

2016-07-01

Religiös-spirituelles Wohlbefinden ist verbunden mit höherer Vitalität und verminderter Depressionsneigung. In unserer Studie untersuchten wir die Strategien zur Krankheitsbewältigung und die Rolle von Religiosität-Spiritualität (R-S) zur Verbesserung des subjektiven Wohlbefindens. 149 Patienten (107 Frauen), 44 mit systemischer Sklerodermie (SKL), 48 mit Lupus erythematodes (LE) und 57 mit malignem Melanom (MM), Stadium I-II, wurden mittels eines selbstentwickelten Fragebogens zum subjektiven Wohlbefinden, zu den mit der Erkrankung einhergehenden Umständen sowie mit dem Multidimensionalen Inventar (MI-RSB) zu R-S befragt. LE-Patienten sind zum Zeitpunkt der Diagnosestellung stärker belastet als SKL- und MM-Patienten. SKL- und LE-Patienten können erst nach Jahren die Erkrankung akzeptieren. Der Gesamtscore des religiös-spirituellen Befindens liegt bei LE-Patienten signifikant unter dem Wert der Normalbevölkerung. Fotosensitivität und Gelenksschmerzen sind bei LE-Patienten negativ assoziiert mit der Fähigkeit Vergeben zu können. SKL-Patienten mit Gesichtsveränderungen und Lungenbeteiligung zeigen höhere allgemeine Religiosität. MM-Patienten haben höhere Werte für transzendente Hoffnung. Vorträge über die Krankheit und psychologische Betreuung sind die wichtigsten Bedürfnisse von Patienten mit SKL, LE und MM an ihre Betreuer. Religiös-spirituelle Angebote zur Krankheitsverarbeitung scheinen derzeit eine untergeordnete Rolle zu spielen, könnten aber eine wichtige Ressource sein, der man in Zukunft mehr Aufmerksamkeit schenken sollte. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Monetary and Fiscal Policy Interactions in the Euro Area

DTIC Science & Technology

2004-03-01

Balassa - Samuelson -Effekt, Nr. 3/2002, erschienen in: Stefan Reitz (Hg.): Theoretische und wirtschaftspolitische Aspekte der internatio- nalen Integration...156, 2000, S. 646-660. Friihere Diskussionsbeitriige zur Finanzwissenschaft Josten, Stefan, Crime, Inequality, and Economic Growth. A Classical Argument

Design of the optical communication system for the asteroid impact mission

NASA Astrophysics Data System (ADS)

Heese, C.; Sodnik, Z.; Carnelli, I.

2017-09-01

The Asteroid Impact Mission (AIM) is part of the joint Asteroid Impact and Deflection Assessment (AIDA) project of ESA, DLR, Observatoire de la Côte d'Ázur, NASA, and Johns Hopkins University Applied Physics Laboratory (JHU/APL).

Atmospheric Turbulence Research at DFVLR

DTIC Science & Technology

1988-07-01

DFVIR - ein mxteoroloisches Y system zur Untmrwxfszq der abm *iprisdcn Grenzschiidt. DWIR-Fbrschungsbericht FB 84-50, 150pp. English translatian: ESA... sytem Litton 72. " Temperature: Humidity - Two probes Rosemount 102 (fast and 0 ERC Lyman-alpha hygrometer slow). 0 Vaishla humicap relative humidity

Ueben-Pruefen. Zur Klaerung zweier zentraler Begriffe (Drilling-Testing. On the Clarifications of Two Central Concepts)

ERIC Educational Resources Information Center

Arendt, Manfred

1976-01-01

It is shown that drilling tends to become contaminated with elements of testing. The two activities are defined, and suggestions are given for designing drills free of testing. (Text is in German.) (IFS/WGA)

Normung (Standardisierung)

NASA Astrophysics Data System (ADS)

Kostmann, Dirk

Normung ist aus dem täglichen Leben nicht wegzudenken. In allen Bereichen des Lebens begegnet man Normen, die Aktivitäten reichen von Festlegungen für Kindersitze im Auto über Implantate zum Gelenkersatz bis zu Schraubengrößen oder Verfahren zur Optimierung von Unternehmen.

Zur Problematik der Plansprachen (Issues Concerning Artificial World Languages)

ERIC Educational Resources Information Center

Mayrhofer, Manfred

1972-01-01

The reasons for creating international auxiliary languages, such as Esperanto, are examined. The study of the synthesis of such languages is considered useful for linguistic theory. (Text is in German.) Available from Humanities Press, Inc., Atlantic Highlands, N.J. 07716. (TL)

SURFACTANT-ENHANCED EXTRACTION TECHNOLOGY EVALUATION VERSUCHSEININCHTUNG ZUR GRUNDWASSER-UND ALTLASTENSANIERUNG (VEGAS) FACILITY, STUTTGART, GERMANY

EPA Science Inventory

This innovative technology evaluation report (ITER) summarized the results of an evaluation of a surfactant-enhanced extraction technology. This evaluation was conducted under a bilateral agreement between the United States (U.S.) Environmental Protection Agency (EPA) Superfund ...

The Analytical Potential of Comparative Educational Research: Review of Two Historical Studies

ERIC Educational Resources Information Center

Tippelt, Rudolf

2017-01-01

In this review, Rudolf Tippelt focuses on two central comparative educational publications that compare the English and German education systems under specific historical perspectives: (1) Lenhart V, "Die erste Schrift zur vergleichenden Erziehungswissenschaft"/"The First Treatise in Comparative Education." Fredericus Augustus…

Visual Motion Perception and Visual Information Processing

DTIC Science & Technology

1993-12-31

tradi- tionally called the "span of apprehension" (Kulpe, 1904; Durable Storage Wundt , 1899). However, a partial-report procedure demon- strates...Gehrig. P. (1992). On the time course Wundt . W. (1899). Zur Kritik tachistoskopischer Versuche [A crit- of perceptual information that results from a

Kontinuierliche Wanddickenbestimmung und Visualisierung des linken Herzventrikels

NASA Astrophysics Data System (ADS)

Dornheim, Lars; Hahn, Peter; Oeltze, Steffen; Preim, Bernhard; Tönnies, Klaus D.

Zur Bestimmung von Defekten in der Herztätigkeit kann die Veränderung der Wanddicke des linken Ventrikels in zeitlichen MRTAufnahmesequenzen gemessen werden. Derzeit werden für diese Bestimmung im allgemeinen nur die aufwändig manuell erstellte Segmentierungen der Endsystole und Enddiastole benutzt. Wir stellen ein bis auf die Startpunktinitialisierung automatisches Verfahren zur Bestimmung der Wanddicke des linken Ventrikels und ihrer Veränderung vor, das auf einer vollständigen Segmentierung der Herzwand in allen Zeitschritten durch ein dynamisches dreidimensionales Formmodell (Stabiles Feder-Masse-Modell) basiert. Dieses Modell nutzt bei der Segmentierung neben der Grauwertinformation eines Zeitschrittes auch die Segmentierungen der anderen Zeitschritte und ist so aufgebaut, dass die Wanddicken direkt gemessen und visualisiert werden können. Auf diese Weise werden die lokalen Wanddickenextrema über den gesamten Aufnahmezeitraum detektiert, auch wenn sie nicht in die Endsystole bzw. -diastole fallen. Das Verfahren wurde auf sechs 4D-Kardio-MRT-Datensätzen evaluiert und stellte sich als sehr robust bzgl. der einzig nötigen Interaktion heraus.

Modulare und durchgängige Produktmodelle als Erfolgsfaktor zur Bedienung einer Omni-Channel-Architektur - PLM 4.0

NASA Astrophysics Data System (ADS)

Golovatchev, Julius; Felsmann, Marcus

Mit der Transformation der Wertschöpfungsstrukturen von Utility 1.0 zu Utility 4.0 erfolgt offensichtlich auch eine Veränderung des Produkts. Vor dem Hintergrund disruptiver Technologien (IoT, Big Data, Cloud, Robotics etc.) und auch gesellschaftlicher Veränderungen entstehen ständig neue Geschäftsmodelle und Produkte, die über die reine Versorgungsdienstleistung (z. B. Strom) hinausgehen. Dabei muss der wertvolle Rohstoff Produktdaten für smarte Produkte durchgängiger und schneller nutzbar gemacht werden. Die modularen und durchgängigen Produktstrukturen leisten einen Beitrag zur Beherrschung von Komplexität und stellen somit einen wesentlichen Hebel für erfolgreiche Produktentwicklung und -management dar. In diesem Beitrag werden Ansätze beschrieben, wie es den vor der Herausforderung Utility 4.0 stehenden Unternehmen gelingen kann, Smart-Energy-Produkte so zu modellieren, dass sie die Interoperabilität der einzelnen Produktionsmodule sicherstellt und ein Ende-zu-Ende-Management ermöglicht.

Einstellung und Wissen von Lehramtsstudierenden zur Evolution - ein Vergleich zwischen Deutschland und der Türkei

NASA Astrophysics Data System (ADS)

Graf, Dittmar; Soran, Haluk

Es wird eine Untersuchung vorgestellt, in der Wissen und Überzeugungen von Lehramtsstudierenden aller Fächer zum Thema Evolution an zwei Universitäten in Deutschland und der Türkei erhoben worden sind. Die Befragung wurde in Dortmund und in Ankara durchgeführt. Es stellte sich heraus, dass ausgeprägte Defizite im Verständnis der Evolutionsmechanismen herrschen. Viele Studierende, insbesondere aus der Türkei, sind nicht von der Faktizität der Evolution überzeugt. Dies gilt sowohl für Studierende mit Fach Biologie als auch für Studierende mit anderen Fächern. Näher untersucht worden sind die Faktoren, die die Überzeugungen zur Evolution beeinflussen können, was ja in Anbetracht der hohen Ablehnungsrate der Evolution von besonderem Interesse ist. Das Vertrauen in die Wissenschaft spielt hierbei eine besondere Rolle: Wer der Wissenschaft vertraut, ist auch eher von der Evolution überzeugt, als diejenigen, die skeptisch gegenüber der Wissenschaft sind.

Theoretische Konzepte der Physik

NASA Astrophysics Data System (ADS)

Longair, Malcolm S.; Simon, B.; Simon, H.

"Dies ist kein Lehrbuch der theoretischen Physik, auch kein Kompendium der Physikgeschichte ... , vielmehr eine recht anspruchsvolle Sammlung historischer Miniaturen zur Vergangenheit der theoretischen Physik - ihrer "Sternstunden", wenn man so will. Frei vom Zwang, etwas Erschöpfendes vorlegen zu müssen, gelingt dem Autor etwas Seltenes: einen "lebendigen" Zugang zum Ideengebäude der modernen Physik freizulegen, ... zu zeigen, wie Physik in praxi entsteht... Als Vehikel seiner Absichten dienen dem Autor geschichtliche Fallstudien, insgesamt sieben an der Zahl. Aus ihnen extrahiert er das seiner Meinung nach Lehrhafte, dabei bestrebt, mathematische Anachronismen womöglich zu vermeiden... Als Student hätte ich mir diese gescheiten Essays zum Werden unserer heutigen physikalischen Weltsicht gewünscht. Sie sind originell, didaktisch klug und genieren sich auch nicht, von der Faszination zu sprechen, die ... von der Physik ausgeht. Unnötig darauf hinzuweisen, das sie ein gründliches "konventionelles" Studium weder ersetzen wollen noch können, sie vermögen aber, dazu zu ermuntern." #Astronomische Nachrichten (zur englischen Ausgabe)#1

Zur Rolle von Plansprachen im terminologiewissenschaftlichen Werk von Eugen Wuster (The Role of Planned Languages in Eugen Wuster's Work on Terminology Science).

ERIC Educational Resources Information Center

Blanke, Detlev

1998-01-01

Discusses the relationship between planned languages and specialized technical languages, with particular reference to Esperanto, and analyzes its significance for several aspects of Eugen Wuster's (the founder of terminology science) work. (Author/VWL)

[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.

Physik gestern und heute Spurensuche

NASA Astrophysics Data System (ADS)

Engels, Wolfgang; Heering, Peter

2005-01-01

Im Jahre 1927 erhielt Charles Thomson Rees Wilson für die von ihm entwickelte Methode zur Visualisierung der Spuren ionisierender Strahlung den Nobelpreis für Physik. Die nach ihm benannte Nebelkammer wurde in der ersten Hälfte des 20. Jahrhunderts zu einem Standardinstrument für Untersuchungen subatomarer Prozesse.

Lifelong Learning: One Focus, Different Systems. Studien zur Erwachsenenbildung, Band 19.

ERIC Educational Resources Information Center

Harney, Klaus, Ed.; Heikkinen, Anja, Ed.; Rahn, Sylvia, Ed.; Schemmann, Michael, Ed.

These 17 articles on different subjects of the broader theme "lifelong learning" represent the latest results of the discussions of the Vocational Education and Culture Research Network. An introduction (Klaus Harney et al.) provides summaries of the contents. The articles are "The Global and International Discourse of Lifelong…

Special Course on Subsonic/Transonic Aerodynamic Interference for Aircraft

DTIC Science & Technology

1983-07-01

SHOCKS H = .83. CL = .40. COW .0005. A = 6.0 Fig. 25 Iteration history for transonic airfoil b) REDESIGNED WING design (M = .77) with weak shock Fig. 27...Finished Wing (King Cobra). RAE TN Aero. 2383, 1950. 10. Holstein , H.: Messungen zur Laminarhaltung der Grenzchicht an elnem Flugel. Lilenthal-Bericht

Germany’s Chosen Path: Domestic Security Institutions in the Berlin Republic 1990-97.

DTIC Science & Technology

1997-12-01

wird vom Neorealismusparadigma unterstotzt, hier dargestel It durch Kenneth Waltz. Das liberate Paradigma unterstUtzt die Perspektive der "Kultur von Zur... Paradigma folgen. Urn diesen aktuellen Weg in Richtung Realismus zu andern, mul$ Deutschland bestimmte Institutionen verandern oder abschaffen. In der

Ueber das Mannheimer Woerterbuch zur Verbvalenz (About the Mannheim Dictionary of Verb Valence)

ERIC Educational Resources Information Center

Schumacher, Helmut

1976-01-01

Describes the purpose, structure and application of this monolingual verb lexicon, which indicates the morphosyntactic environments of the most common German verbs. Mention is made of the forthcoming valence lexicon. The book is for teachers and textbook writers. (Text is in German.) (IFS/WGA)

A Computational Study of the Modification of Raindrop Size Distributions in Subcloud Downdrafts.

DTIC Science & Technology

1981-08-01

Schumann (1939) and Findeisen (1939). It is characterized by a raindrop distribution consisting of many small droplets and a few large drops; all large...rain by means of sequential rain drop size distributions. Quart. J. Roy. Meteor. Soc., 88, 301-314. Findeisen , W., 1939: Zur Frage der

On the Buckling Force of Floating Ice Plates,

DTIC Science & Technology

1981-06-01

the derivations in Kappus phenomena is beyond the scope of the present report. (1939) or Kerr (1972), using Lagrange coordinates and Therefore, in the...eq 36 and w,(x, 0) in eq 24, we obtain LITERATURE CITED Pee(0) = L- YB2 (42) Kappus , R. (1939) Zur Elastizitatstheorie endlicher Verschie- 28 bungen

Degradable Implantate: Entwicklungsbeispiele

NASA Astrophysics Data System (ADS)

Ruffieux, Kurt; Wintermantel, Erich

Resorbierbare Implantate werden seit mehreren Jahrzehnten in der Implantologie eingesetzt. Bekannt wurden diese Biomaterialien mit dem Aufkommen von sich selbst auflösenden Nahtfäden auf der Basis von synthetisch hergestellten Polylactiden und Polyglycoliden in den 70er Jahren. In einem nächsten Schritt wurden Implantate wie Platten und Schrauben zur Gewebefixation aus den gleichen Biomaterialien hergestellt.

PubMed

Schützenberger, Anne; Hammer, Georg Philipp

2018-06-01

Sanuki T et al. Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia. Otolaryngol Head Neck Surg 2017; 157: 80–84 JAPANISCHE ÄRZTE FüR HALS-, NASEN- UND OHRENHEILKUNDE SOWIE KOPF- UND HALSCHIRURGIE BERICHTETEN üBER STIMMLICHE LANGZEITERGEBNISSE NACH DURCHFüHRUNG EINER THYROPLASTIK TYP 2 ZUR BEHANDLUNG DER SPASMODISCHEN DYSPHONIE VOM ADDUKTOR TYP.

Eine 200-μm-Kamera zur unvollständigen Himmelsdurchmusterung mit dem ISO-Satelliten.

NASA Astrophysics Data System (ADS)

Burgdorf, M.

The C200 camera designed for the wavelength range >160 μm is composed of the detector elements and their preamplifiers. The limiting sensitivity to be reached is estimated. In building the infrared satellite experiment ISOPHOT the detector arrays and selecting electronics are of key importance.

Zur Soziolinguistik in der Bundesrepublik Deutschland (Sociolinguistics in the Federal Republic of Germany)

ERIC Educational Resources Information Center

Jachnow, Helmut

1975-01-01

Traces the history of sociolinguistic studies in West Germany from the early nineteenth century with Humboldt and reports on the state and purposes of sociolinguistic studies in present-day Federal Republic of Germany. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden (Text is in German.) (TL)

Pragma- und textilinguistische Untersuchungsmethoden zur indirekten Rede im Englischen (Pragmatic and Text-Linguistic Research Methods on Indirect Discourse in English)

ERIC Educational Resources Information Center

Ziegesar, Detlef von

1976-01-01

Examines the mechanisms involved in changing from direct to indirect discourse, taking as a starting point research findings in linguistic pragmatics, which involve the practical application of speech symbol use between speaker and hearer. (Text is in German.) (IFS/WGA)

Investigations on Laminar Boundary-Layer Stability and Transition on Curved Boundaries

DTIC Science & Technology

1943-08-01

an konkaven Wanden. G’.ottineer Nachrichten . Neue Folgo, 2, Nr. 1. Ii. Tollmien, W.: The Production of Turbulence. T.M. No. 609, NACA, 1931. 12...Schlichting, H.: Zur Entstehung der Turbulenz bei der Plattenstromung. GBttinger Nachrichten , M.P.K., pp. 181-208, 19_, und Bd. l, 1935. 13, . Taylor, G. I

Impulse fur Bibliotheken (Impulses for Libraries). Publications of Essen University Library 19.

ERIC Educational Resources Information Center

Helal, Ahmed H., Ed.

This collection of 12 papers commemorates the retirement of Bernhard Adams. Adams had a 30-year career at the Bochum University Library (Germany) and advocated innovation and automation in libraries. The papers are: (1) "Gemeinsame Wegstrecken: Bernhard Adams zur Ehre" ("Common Milestones: In Honor of Bernhard Adams") (Harro…

Zur Wortbildung in wissenschaftlichen Texten (Word Formation in Scientific Texts)

ERIC Educational Resources Information Center

Rogalla, Hanna; Rogalla, Willy

1976-01-01

Discusses a German frequency list of 1,500 to 2,000 scientific words, which is being developed, and the importance of learning word-building principles. Substantive and adjective suffixes are listed according to frequency, followed by remarks on copulative compounds, with examples and frequency ranking, and, finally, prefixes. (Text is in German.)…

Wege zur Festigung der Fachlexik (Ways of Building a Technical Vocabulary)

ERIC Educational Resources Information Center

Kalmykowa, Elena

1974-01-01

Learning to read foreign technical texts requires (a) a minimum vocabulary and (b) effective drill. The following are suggested: translation, question-answer method, definition exercises, exercises to develop skill in the use of reference works, schematic presentations and tables, annotating and making reports and summaries. (Text is in German.)…

On the quantization of wave fields⋆

NASA Astrophysics Data System (ADS)

Rosenfeld, L.

2017-04-01

Originally published in German "Zur Quantelung der Wellenfelder" in Annalen der Physik 397, 113 (1930). Submitted for publication on March 18, 1930Translated by Donald Salisbury, Max-Planck-Institut für Wissenschaftsgeschichte, Berlin and Austin College, Sherman, TX, USA and Kurt Sundermeyer, Max-Planck-Institut für Wissenschaftsgeschichte, Berlin. DSalisbury@austincollege.edu

Qualitätsmanagement in molekularbiologischen Laboratorien

NASA Astrophysics Data System (ADS)

Schulze, Manuela

Jedes Laboratorium führt Untersuchungen nach bestem Wissen und Gewissen durch, und jeder Analytiker weiß von sich, dass er/sie gute Arbeit macht. Trotzdem können Analysen des gleichen Probenmaterials in verschiedenen Laboren zu unterschiedlichen Ergebnissen führen. Sofern es sich dabei nicht um Untersuchungen im Bereich der Nachweisgrenze und damit letztlich um statistisch bedingte Unterschiede oder Inhomogenitäten im Probenmaterial handelt, trägt dies nicht zur Vertrauenswürdigkeit von analytischen Untersuchungsergebnissen bei. Mit der zunehmenden Globalisierung der Märkte rückt die gegenseitige Anerkennung von analytischen Resultaten immer stärker in den Vordergrund. Die Vergleichbarkeit von Laborresultaten wird erleichtert, wenn sich die Laboratorien auf die gleichen Richtlinien zur Vorgehensweise und Handhabung ihrer Arbeiten verständigen. Im Bereich der Laboruntersuchungen von Lebensmitteln, Futtermitteln und Saatgut ist als derartige Rischt-Schnur die EN ISO/IEC 17025 [1] anerkannt. Diese Norm enthält alle Anforderungen, die Prüflaboratorien erfüllen müssen, wenn sie nachweisen wollen, dass sie ein Qualitätsmanagementsystem betreiben, technisch (meint: fachlich) kompetent und fähig sind, fachlich fundierte Ergebnisse zu erzielen.

Epigenetische Aspekte bei Karzinomen der Kopf-Hals-Region

PubMed Central

Schmezer, Peter; Plass, Christoph

2009-01-01

Zusammenfassung Plattenepithelkarzinome der Kopf-Hals-Region (HNSCC) zählen seit Jahren zu den weltweit häufigsten Krebsarten. Trotz vieler Bemühungen hat sich das 5-Jahres-Überleben bei Patienten mit HNSCC kaum verbessert. Um einen Fortschritt zu erzielen, ist es notwendig, die der Erkrankung zugrunde liegenden biologischen Prozesse besser zu verstehen. Neben den bekannten genetischen Veränderungen haben molekular-zytogenetische Untersuchungen bei HNSCC gezeigt, dass es weitere Veränderungen gibt, die mit Vermehrung und Verlust chromosomaler Bereiche einhergehen, für die jedoch die krankheitsverursachenden Gene bisher nicht identifiziert wurden. Darüberhinaus haben jüngste Forschungsergebnisse verdeutlicht, dass epigenetische Modifikationen wie die DNA Methylierung eine wichtige Rolle spielen. So konnte gezeigt werden, dass bei HNSCC eine Reihe von Genen (z.B. das Tumorsuppressorgen CDKN2A sowie DAPK1, MGMT, TIMP3, TCF21, und C/EBPα) hypermethylierte Bereiche in regulatorischen DNA Sequenzen aufweisen, wodurch ihre Expression verringert oder unterbunden wird. Die Hypermethylierung solcher Gene könnte als Biomarker zur Früherkennung von HNSCC genutzt werden und nicht zuletzt dadurch zur Verbesserung von Prävention und Therapieerfolg beitragen. PMID:18483718

Rosazea-Management: Update über allgemeine Maßnahmen und topische Therapieoptionen.

PubMed

Schaller, M; Schöfer, H; Homey, B; Hofmann, M; Gieler, U; Lehmann, P; Luger, T A; Ruzicka, T; Steinhoff, M

2016-12-01

Obwohl bislang für die Rosazea keine kurative Therapie besteht, können verschiedene Optionen zur Behandlung der Symptome und zur Vorbeugung von Exazerbationen empfohlen werden. Neben Selbsthilfemaßnahme wie der Vermeidung von Triggerfaktoren und einer geeigneten Hautpflege sollte das Rosazea-Management bei Patienten mit erythematöser und leichter bis schwerer papulopustulöser Rosazea die Anwendung topischer Präparate als First-Line-Therapie umfassen. Da Überlappungen der charakteristischen Rosazea-Symptome im klinischen Alltag die Regel sind, sollte die medikamentöse Therapie auf die individuellen Symptome zugeschnitten werden; auch eine Kombinationstherapie kann erforderlich sein. Zu den für die Behandlung der Hauptsymptome der Rosazea zugelassenen Wirkstoffen gehören Brimonidin gegen das Erythem sowie Ivermectin, Metronidazol oder Azelainsäure gegen entzündliche Läsionen. Ihre Wirksamkeit wurde in zahlreichen validen, gut kontrollierten Studien belegt. Darüber hinaus existieren verschiedene nicht zugelassene topische Behandlungsmöglichkeiten, deren Wirksamkeit und Sicherheit noch in größeren, kontrollierten Studien zu untersuchen ist. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Epidemiologie, Prävention und Früherkennung des Zervixkarzinoms

PubMed Central

Wentzensen, Nicolas

2016-01-01

Zusammenfassung Hintergrund Persistierende Infektionen mit humanen Papillomviren sind die notwendige Ursache des Zervixkarzinoms. Die Entwicklung von HPV-basierten Präventionsverfahren, der HPV Impfung und der HPV-Testung, führt derzeit zu umfangreichen Veränderungen von Zervixkarzinom-Vorsorgeprogrammen. Eine Dekade nach Einführung der HPV-Imfpung in vielen Ländern werden bereits Reduktionen von HPV-Infektionen und Krebsvorstufen in jungen Frauen beobachtet. Der Fokus liegt jetzt auf der Integration von neuen Testverfahren im Screening von Populationen mit zunehmenden Impfraten. Ergebnisse und Schlussfolgerung Ein erfolgreiches Zervixkarzinom-Vorsorgeprogramm besteht aus verschiedenen Komponenten, vom primären Screening über die Triage zur Kolposkopie mit Biopsie, um Frauen mit Kresbvorstufen zu identifizieren, die eine therapeutische Intervention benötigen. Im primären Screening wird eine kleine Gruppe von Frauen mit erhöhtem Risiko für eine Krebsvorstufe identifiziert, während die grosse Mehrheit kein erhöhtes Risiko hat. Je nach primärem Testverfahren werden in screen-positiven Frauen zusätzliche Triage-Tests durchgeführt, um zu entscheiden, wer zur Kolposkopie überwiesen werden sollte. Derzeit gibt es drei verschiedene Ansätze für das primäre Zervixkarzinomscreening: Die Zervix-Zytologie, die HPV-Testung, und die HPV-Zytologie Ko-Testung. Zahlreiche Triage-Tests für HPV-positive Frauen werden derzeit untersucht, darunter sind die Zytologie, HPV-Genotypisierung, p16/Ki-67 Zytologie, und diverse Methylierungstests. Die steigende Anzahl an Optionen für die Früherkennung des Zervixkarzinoms stellt eine Herausforderung für klinische Leitlinien dar. Die zunehmende Komplexität von Vorsorgeprogrammen kann zur Verunsicherung von Ärzten und von am Screening teilnehmenden Frauen führen. Die Präzisions-Prävention des Zervixkarzinoms ist eine neuer Ansatz, der umfangreiche Risikodaten basierend auf der individuellen Vorgeschichte und von Testergebnissen integriert und einheitliche, Risiko-basierte Managementempfehlungen gibt. PMID:28265177

Microplane Model for Fracture Analysis of Concrete Structures

DTIC Science & Technology

1983-05-01

Curves for Cot,- Proceadings, Intern. Sympositim cai Numevical crete io Tension," Mater ils ,tndI : Str ~tuiztres d.- Un R. /na~gr No I., an. o196.9...and 226. ivinsterwalder, K, , "Festigkeit und Verfor- mung van Bet an lniter- 7.oRsIannitgenl, Duo tsatho 8. Kr~ner, h. , Zur 2’lastischen Verformung

Learning, Adjustment and Stress Disorders: With Special Reference to Tsunami Affected Regions. Beitrage zur Padagogischen und Rehabilitationspsychologie. Volume 1

ERIC Educational Resources Information Center

Witruk, Evelin, Ed.; Riha, David, Ed.; Teichert, Alexandra, Ed.; Haase, Norman, Ed.; Stueck, Marcus, Ed.

2010-01-01

This book contains selected contributions from the international workshop Learning, "Adjustment and Stress Disorders--with special reference to Tsunami affected Regions" organised by Evelin Witruk and the team of Educational and Rehabilitative Psychology at the University of Leipzig in January 2006. The book contains new results and the…

An der Schwelle zur Zweisprachigkeit: Fremdsprachenunterricht fur Fortgeschrittene (On the Threshold of Bilingualism: Foreign Language Learning for Advanced Students).

ERIC Educational Resources Information Center

Kubler, Silvia, Ed.; Portmann, Paul R., Ed.

1994-01-01

This collection of articles on Bilingualism includes: "Fremdsprachenunterricht fur Fortgeschrittene: ein Uberblick" (Foreign Language Learning for Advanced Students: An Overview) (Paul R. Portmann); "Never Mind the Width, Feel the Quality: From Quantity to Quality in Language Teaching at Advanced Levels" (Mike Makosch); "Irren ist menschlich: Ein…

German-American Workshop on Adult Education with Target Groups = Deutsch-amerikanisches Doppelseminar zur Zielgruppenarbeit.

ERIC Educational Resources Information Center

Kerner, Claus, Ed.; Odenbrett, Glenn, Ed.

This collection includes eight papers (authored by Germans) on adult education programs in Cleveland, Ohio, and eight papers (authored by Americans) about adult education programs in the Federal Republic of Germany as well as German and English introductions to the collection. The following papers are included: "Neue Wege in der…

Kooperatives Lernen lernen? Zur Diskussion uber das Bildungswesen in Japan (Learning Cooperative Learning? On the Discussion of the Japanese Educational System).

ERIC Educational Resources Information Center

Schubert, Volker

1998-01-01

Suggests a reconsideration of the criticism of Japanese competition against the background of the Japanese educational system's highly developed learning culture. Considers some of the basic aspects of group-oriented communal learning in school, while also cautioning against a "monocausal" culturalism. (Author/CMK)

Das Smart Meter Gateway - Der kritische Erfolgsfaktor für die Digitalisierung der Energiewende

NASA Astrophysics Data System (ADS)

Abs, Paul-Vincent

Der kritische Erfolgsfaktor der Digitalisierung in der Energiewirtschaft liegt im bevorstehenden hohen Investitionsvolumen und der Beherrschung der neuen Technik. Ein Weg zur Kostenminimierung liegt im Zusammenschluss der einzelnen Akteure, um gemeinsame Skalenvorteile zu heben. Auch bieten neue Geschäftsmodelle die Möglichkeit, zusätzliche Erlöse zu generieren.

Über den Beitrag von Heinrich Bruns zur theoretischen geometrischen Optik - unter Berücksichtigung seines Briefwechsels mit Wissenschaftlern der Zeiss-Werke in Jena 1888 - 1893.

NASA Astrophysics Data System (ADS)

Ilgauds, H.-J.; Münzel, G.

Heinrich Bruns, director of the Leipzig University Observatory, was working on theoretical geometrical optics, and applied this to practical questions. His correspondence with opticians of the Zeiss Company in Jena gives evidence of their mutual regard and inspiration.

Tokamak und Stellarator - zwei Wege zur Fusionsenergie: Fusionsforschung

NASA Astrophysics Data System (ADS)

Milch, Isabella

2006-07-01

Im Laufe der Fusionsforschung haben sich zwei Bautypen für ein zukünftiges Kraftwerk als besonders aussichtsreich erwiesen: Tokamak und Stellarator. Mit dem geplanten Tokamak-Experimentalreaktor ITER steht die internationale Fusionsforschung vor der Demonstration eines Energie liefernden Plasmas. Parallel soll die in Greifswald entstehende Forschungsanlage Wendelstein 7-X die Kraftwerkstauglichkeit des alternativen Bauprinzips der Stellaratoren zeigen.

A Framework and Strategies for Determining Reference Conditions for Streams with Legacy Sediments on Military Installations

DTIC Science & Technology

2009-03-01

water where there is a sharp change in channel slope, such as a waterfall or lake, resulting from differential rates of erosion above and below the...Beitrage zur Lehre von der biologische Gewasserbeurteilung. International Review of Hydrobiology 2:126-52. ———. 1909. Oekologie der Saprobien. Uber

Reforms and Innovations in Estonian Education. Baltische Studien zur Erziehungs- und Sozialwissenschaft. Volume 16

ERIC Educational Resources Information Center

Mikk, Jaan, Ed.; Veisson, Marika, Ed.; Luik, Piret, Ed.

2008-01-01

This collection of papers provides a small overview of educational research in Estonia. The papers in the collection treat school reforms since the renewal of independence in 1991, new approaches to teacher training, the implementation of a child-centred approach in school, the achieving of educational aims and other actual topics in education.…

Die physikalischen Umweltwissenschaften und das Militär Zur Erforschung Grönlands im Kalten Krieg

NASA Astrophysics Data System (ADS)

Heymann, Matthias

Die modernen Umweltwissenschaften stehen heute im Mittelpunkt von Forschungsförderung und öffentlicher Aufmerksamkeit. Im Zuge des seit den 1970er Jahren erwachten Interesses am globalen Wandel der Umwelt und den damit verknüpften Problemen, ist ihre Bedeutung rasch gestiegen. Viele Wurzeln der modernen Umweltwissenschaften liegen jedoch im Kalten Krieg.

Poverty, Education and Gender: Pedagogic Transformations in the Schools for the Poor ("Armenschulwesen") in Hamburg, 1788-1871

ERIC Educational Resources Information Center

Mayer, Christine

2011-01-01

In the second half of the eighteenth century, an enlightened reformist spirit spread among Hamburg's bourgeois upper classes. This was exemplified by the activities of the "Gesellschaft zur Beforderung der Kunste und nutzlichen Gewerbe" ("Society for the Promotion of the Arts and Useful Trades") founded in 1765 as well as by a…

Wissensstrukturierung im Unterricht: Neuere Forschung zur Wissensreprasentation und ihre Anwendung in der Didaktik (Knowledge Structuring in Instruction: Recent Research on Knowledge Representation and Its Application in the Classroom).

ERIC Educational Resources Information Center

Einsiedler, Wolfgang

1996-01-01

Asks whether theories of knowledge representation provide a basis for the development of theories of knowledge structuring in instruction. Discusses codes of knowledge, surface versus deep structures, semantic networks, and multiple memory systems. Reviews research on teaching, external representation of cognitive structures, hierarchical…

"Columns and Columnists": Zur Verwendung des "personenlichen Journalismus" im Unterricht (Columns and Columnists: On the Use of "Personal Journalism" in Teaching)

ERIC Educational Resources Information Center

Redling, Julius

1977-01-01

Discusses American journalism--specifically the syndicated columns. To show their usefulness for English teaching, Art Buchwald's "Unqualifications" is described and the text interpreted. It is suggested that for humorous aspects and language deviations be stressed; for Grades 11-13 irony, American technology and education. (Text is in…

Merkel cell carcinoma: is this a true carcinoma?

PubMed

Jankowski, Marek; Kopinski, Piotr; Schwartz, Robert; Czajkowski, Rafal

2014-11-01

Recent years have brought an enhanced understanding of Merkel cell carcinoma (MCC) biology, especially with regard to the Merkel cell polyoma virus as a causative agent. Differences between Merkel cell polyomavirus-positive and Merkel cell polyomavirus-negative MCC in morphology; gene expression, miRNA profiles and prognosis have been reported. Origin of MCC is controversial. Presence of neurosecretory granules has suggested that these carcinomas originate from one of the neurocrest derivatives, most probably Merkel cells; the name Merkel cell carcinoma is now widely accepted. Expression of PGP 9.5, chromogranin A and several neuropeptides, initially regarded as specific markers for neural and neuroendocrine cells, has recently been shown in a subset of lymphomas. MCC commonly expresses terminal deoxynucleotidyl transferase and PAX5. Their co-expression under physiologic circumstances is restricted to pro/pre-B cells and pre-B cells. These findings lead to the hypothesis by zur Hausen et al. that MCC originates from early B cells. This review was intended to critically appraise zur Hausen's hypothesis and discuss the possibility that MCC is a heterogenous entity with distinct subtypes. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Atopic Eczema and Stress among Single Parents and Families: An Empirical Study of 96 Mothers.

PubMed

Gieler, Uwe; Schoof, Stefanie; Gieler, Tanja; Scheewe, Sibylle; Schut, Christina; Kupfer, Jörg

2017-01-04

This study investigated the extent to which single mothers of children with atopic eczema experience disease-related stress. A total of 96 mothers were divided into 4 groups: mothers living with a partner, who had or did not have a child with atopic eczema, and single mothers, who had or did not have a child with atopic eczema. The following questionnaires were used to assess psychological burden: Short Stress Questionnaire (Kurzer Fragebogen zur Erfassung von Belastung; KFB), Satisfaction with Life Questionnaire (Fragebogen zur Lebenszufriedenheit; FLZ), General Depression Scale (Allgemeine Depressions-Skala; ADS), and the Questionnaire for Parents of Children with Atopic Eczema (Fragebogen für Eltern von Neurodermitis kranken Kindern; FEN). Single mothers had higher levels of helplessness and aggression due to their child's scratching behaviour than did mothers living with a partner and a child with atopic eczema. Single mothers of children with atopic eczema had the highest scores regarding experienced stress in the family and the lowest scores concerning general life satisfaction. Special care should be provided for single mothers with higher stress, in order to teach them how to deal with the scratching behaviour of their children.

Spitznävi: unterschiedliche klinische, dermatoskopische und histopathologische Merkmale in der Kindheit.

PubMed

Dika, Emi; Neri, Iria; Fanti, Pier Alessandro; Barisani, Alessia; Ravaioli, Giulia Maria; Patrizi, Annalisa

2017-01-01

Die Charakterisierung der klinischen Merkmale und des biologischen Potenzials von Spitznävi hat in den letzten Jahrzehnten breites Interesse gefunden. Das Ziel dieser Arbeit ist die Beschreibung der klinischen und dermatoskopischen Merkmale von Spitznävi sowie des klinischen Ergebnisses nach chirurgischer Exzision von Spitznävi in drei pädiatrischen Altersgruppen. Restrospektive Studie zur Analyse von klinischen Merkmalen, videodermatoskopischen Bildern, histopathologischen Diagnosen und Behandlungsergebnissen. Der Grad der Pigmentierung wurde sowohl klinisch als auch histopathologisch beurteilt. Bei 71 Patienten wurden 72 spitzoide Neoplasien entfernt. Videodermatologische Bilder lagen für 41 Patienten vor. Das Muster der Pigmentierung korrelierte signifikant mit dem Alter der Patienten: Hyperpigmentierte Läsionen waren bei Vorschulkindern selten, bei Patienten von 7 bis 12 Jahren und ab 13 Jahren dagegen häufiger. Eine histopathologische Diagnose von atypischen Spitznävi wurde selten durchgeführt. Keiner der Patienten, bei denen ursprünglich ein atypischer Spitznävus diagnostiziert worden war, entwickelte ein Lokalrezidiv oder Metastasen während der anschließenden Nachbeobachtung. Pigmentierte Spitznävi traten im Alter ab 13 Jahren häufiger auf. Die Studie bestätigt andere Berichte über die Altersverteilung von Pigmentierungsmustern und hebt die geringe Anzahl atypischer Spitznävi bei pädiatrischen Patienten hervor sowie das Ausbleiben von Rezidiven bei der langfristigen Nachbeobachtung. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Proverb comprehension reconsidered--'theory of mind' and the pragmatic use of language in schizophrenia.

PubMed

Brüne, Martin; Bodenstein, Luise

2005-06-15

For decades, impaired proverb comprehension has been regarded as typical of schizophrenic thought disorder. Testing patients' proverb understanding has widely been abandoned, however, due to poor reliability and validity of the assessment procedures. Since the underlying cognitive deficit of impaired proverb interpretation remained obscure, this study sought to determine the relation of proverb understanding with other cognitive domains, particularly 'theory of mind' or 'mindreading', in schizophrenia. 31 patients diagnosed with schizophrenia were assessed using a novel German Proverb Test [Barth, A., Küfferle, B., 2001. Die Entwicklung eines Sprichworttests zur Erfassung konkretistischer Denkstörungen bei schizophrenen Patienten. Nervenarzt 72, 853-858.], a 'theory of mind' test battery, a variety of executive functioning tests and verbal intelligence. Psychopathology was measured using the PANSS [Kay, S.R., Opler, L.A., Lindenmayer, J.P., 1989. The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. Br. J. Psychiatry 158 (suppl. 7), 59-67.]. Patients' task performance was compared to a group of healthy control persons. 'Theory of mind', executive functioning and intelligence were strongly correlated with patients' ability to interpret proverbs correctly. In a regression analysis 'theory of mind' performance predicted, conservatively estimated, about 39% of the variance of proverb comprehension in the patient group. The ability to interpret such metaphorical speech that is typical of many proverbs crucially depends on schizophrenic patients' ability to infer mental states. Future studies may further address differences between schizophrenia subtypes or the relation to specific symptom clusters.

Zur Frage der Textauswahl in einem Lesekurs fuer die Sozialwissenschaften (On the Question of the Choice of Textbooks in a Course in the Social Sciences)

ERIC Educational Resources Information Center

Apelt, Hans-Peter

1974-01-01

Passages from three selected samples of textbooks are used to show what requirements are made of textbooks in the social sciences. Some hints are given to the teacher for converting reading suggestions into instructional material. Short texts from Karl Marx are also suggested. (Text is in German.) (IFS/WGA)

Artificial Turbulence for Imaging and Wave Propagation. Volume 3432

DTIC Science & Technology

1998-07-01

zunehmenden Maße Möglichkeiten gesucht, lokale Unscharfen in dem Objektbild eines Fernrohres oder einer Kamera , welche beispielsweise durch...Verwendung von Kameras oder Fernrohren zur Beobachtung von Objekten innerhalb der Erdatmosphäre oder durch diese hindurch treten lokale Unscharfen in dem...Trägerschicht aufgebracht sind. Die Einrichtung wird in den Strahlengang des betreffenden Beobachtungsgerätes, beispielsweise einer Kamera oder eines

Bildung und bildungstheoretische Ueberlegungen zur Grundung der Republik (Education and the Republic--Educational Theorists Reflections on the Foundation of the Republic).

ERIC Educational Resources Information Center

Hellekamps, Stephanie

1996-01-01

Draws on Wilhelm von Humboldt's typology of the active human being to debate the questions whether and how individuals can produce their social and political world. Discusses, with reference to Marie Condorcet and Immanuel Kant, procedures of the public that are necessary prerequisites for actions aimed at forming the world. (DSK)

Wolfgang Pauli

NASA Astrophysics Data System (ADS)

Enz, Charles P.

2000-11-01

Wolfgang Pauli gehört zu den bedeutendsten Physikern des 20. Jahrhunderts. Erst das von ihm entdeckte Ausschließungsprinzip erklärt den Aufbau des Periodensystems der Elemente. Darüber hinaus legte er den Grundstein für die Quantenfeldtheorie. Privat zeigte sich Pauli als bissiger und humorvoller Mensc gleichermaßen, und sein Hang zur Psychoanalyse lässt ihn überdies als interessante Persönlichkeit erscheinen.

Wirkstoffe, Medikamente und Mathematische Bildverarbeitung

NASA Astrophysics Data System (ADS)

Bauer, Günter J.; Lorenz, Dirk A.; Maaß, Peter; Preckel, Hartwig; Trede, Dennis

Die Entwicklung neuer Medikamente ist langwierig und teuer. Der erste Schritt ist hierbei die Suche nach neuen Wirkstoffkandidaten, die für die Behandlung bislang schwer therapierbarer Krankheiten geeignet sind. Hierfür stehen der Pharma- und Biotechnologieindustrie riesige Substanzbibliotheken zur Verfügung. In diesen Bibliotheken werden die unterschiedlichsten Substanzen gesammelt, die entweder synthetisch hergestellt oder aus Pilzen, Bakterienkulturen und anderen Lebewesen gewonnen werden können.

Briefkasten oder Brieftaube? Zur Auswahl der Lexik in amerikanischen Deutschlehrwerken fuer die Grundstufe. ("Mailbox" or "Carrier Pigeon"? Selecting Vocabulary for American College-Level Elementary German Textbooks).

ERIC Educational Resources Information Center

Bolton, Sibylle

A comparison of four college-level elementary German textbooks reveals significant differences in the numbers of vocabulary entries in each textbook. Further comparison of three of the textbooks with the basic German vocabulary lists provided in "Kontaktschwelle Deutsch als Fremdsprache" and in "Das Zertificat Deutsch als Fremdsprache" reveal in…

Zur Afuwertung der Kultur- und Landeskunde. Ein Literaturbericht (Toward an Evaluation of Culture Studies and Other Area Studies. A Survey of the Literature)

ERIC Educational Resources Information Center

Hartig, Paul

1975-01-01

Eight recent monographs and collections on area and culture study in foreign language teaching are discussed and compared. The focus is on the various authors' definitions of the topic (culture, civilization, realia, etc.). Mentioned also is the function of area study in the course. (Text is in German.) (IFS/WGA)

Bewehrte Betonbauteile unter Betriebsbedingungen: Forschungsbericht

NASA Astrophysics Data System (ADS)

Eligehausen, Rolf; Kordina, Karl; Schießl, Peter

2000-09-01

Vorwort. Teil I: Rißbreiten (Gert König) 1 Ein mechanisches Modell zur Erhöhung der Vorhersagegenauigkeit über die Rißbreiten unter Betriebsbedingungen (Gert König und Michael Fischer). 1.1 Einleitung und Zielsetzung. 1.2 Versuchsprogramm. 1.3 Meßtechnik. 1.4 Belastung und Versuchsdurchführung. 1.5 Literatur. 2 Rißbreiten und Verformungszunahme vorgespannter Bauteile unter wiederholter Last - und Zwangbeanspruchung (Gert König und Michael Fischer). 2.1 Einleitung und Zielsetzung. 2.2 Versuchsprogramm. 2.3 Auswertung. 2.4 Ausblick. 2.5 Literatur. 3 Rißverhalten von Beton bei plötzlicher Abkühlung (Viktor Mechtcherine und Harald S. Müller). 3.1 Einleitung. 3.2 Experimentelle Untersuchungen. 3.3 Formulierung eines Stoffgesetzes für thermisch beanspruchten Beton. 3.4 Riß entwicklung in einer Betonplatte unter Temperaturschock. 3.5 Zusammenfassung. 3.6 Literatur. 4 Stahlfaserbeton unter Betriebsbedingungen bei Dauerbeanspruchung (Bo Soon Kang, Bernd Schnütgen und Friedhelm Stangenberg). 4.1 Einleitung. 4.2 Wirkung von Stahlfasern im Beton. 4.3 Versuchsprogramm. 4.4 Untersuchungen zum Verbundverhalten. 4.5 Untersuchungen zum Verhalten unter Biegebeanspruchung. 4.6 Theoretische Untersuchungen. 4.7 Literatur. 5 Experimentelle Untersuchungen an Stahlbeton-Zugkörpern unter wiederholter Belastung zur Ermittlung des versteifenden Einflusses der Mitwirkung des Betons zwischen den Rissen (Petra Seibel und Gerhard Mehlhorn). 5.1 Einleitung. 5.2 Ansatz zur Bestimmung der Mitwirkung des Betons zwischen den Rissen nach Eurocode 2, Model Code 90 und Günther. 5.3 Experimentelle Untersuchungen. 5.4 Ergebnisse. 5.5 Zusammenfassung. 5.6 Literatur. 6 Riß- und Verformungsverhalten von vorgefertigten Spannbetonträgern unter Betriebsbedingungen bei besonderer Berücksichtigung des Betonalters (Monika Maske, Heinz Meichsner und Lothar Schubert). 6.1 Einleitung. 6.2 Beschreibung der Fertigteilträger. 6.3 Belastungsversuche. 6.4 Ergebnisse. 6.5 Zusammenfassung. 6.6 Literatur. Teil II: Verbundfragen (Rolf Eligehausen). 1 Ein mechanisches Modell zur Beschreibung des Verbundverhaltens zwischen Stahl und Beton (Gert König, Nguyen V. Tue und Wolfgang Kurz). 1.1 Einleitung. 1.2 Beschreibung der Kraftübertragung zwischen Stahl und Beton. 1.3 Vorstellung des Modells. 1.4 Materialgesetze für die Berechnung der Verformung des Fachwerks. 1.5 Vergleich zwischen Versuch und Modell. 1.6 Zusammenfassung und Ausblick. 1.7 Literatur. 2 Verbund unter nicht ruhender Beanspruchung (Rainer Koch und György L. Balázs). 2.1 Übersicht über die durchgeführten Versuche. 2.2 Versuchkörper und Materialien. 2.3 Versuchseinrichtungen. 2.4 Versuche und Ergebnisse. 2.5 Zusammenfassung und Ausblick. 2.6 Literatur. 3 Trag- und Verformungsverhalten von Stahlbetontragwerken unter Betriebsbelastung (Thomas M. Sippel und Rolf Eligehausen). 3.1 Einleitung. 3.2 Allgemeines. 3.3 Rechenmodell und Materialmodelle. 3.4 Vergleich zwischen Versuchen und Rechnung. 3.5 Parameterstudien. 3.6 Vereinfachtes Rechenmodell. 3.7 Zusammenfassung. 3.8 Literatur. 4 Verbundverhalten von Spanngliedern mit nachträglichem Verbund unter Betriebsbedingungen (Josef Hegger, Norbert Will und Heiner Cordes). 4.1 Einführung. 4.2 Verbundverhalten von Spanngliedern. 4.3 Zeitabhängige Effekte des Verbunds. 4.4 Versuche unter statischer Langzeitbeanspruchung. 4.5 Versuche unter dynamischer Langzeitbeanspruchung. 4.6 Bemessungsvorschlag für Verbundkennwerte. 4.7 Zusammenfassung. 4.8 Literatur. 5 Spannungsumlagerungen in gemischt bewehrten Querschnitten (Josef Hegger, Heiner Cordes und Matthias Rudlof). 5.1 Problemstellung und Zielsetzung. 5.2 Spannungsumlagerungen bei gemischter Bewehrung. 5.3 Versuche an zentrischen Zugkörpern. 5.4 Versuchsergebnisse. 5.5 Ermittlung und Vergleich von Verbundkennwerten. 5.6 Zusammenfassung. 5.7 Literatur. Teil III: Bauteile (Karl Kordina). 1 Einfluß von Längsbeanspruchungen auf den Neigungswinkel der Schubrisse (Marek Los und Ulrich Quast). 1.1 Einleitung. 1.2 Ungerissener Zustand. 1.3 Gerissener Zustand. 1.4 FEM-Berechnungen. 1.5 Zusammenfassung. 1.6 Literatur. 2 Auswirkungen des unterschiedlichen Verformungsverhaltens bei Beund Entlastung auf die Beanspruchungen im Gebrauchszustand (Jochen Keysberg). 2.1 Einleitung und Zielsetzung. 2.2 Modelle für die Momenten-Verkrümmungs-Beziehung. 2.3 Programm zur nichtlinearen Berechnung. 2.4 Einfluß von Lastwechseln auf nichtlineare Berechnungen. 2.5 Zusammenfassung. 2.6 Literatur. 3 3D-Analyse von Balken-Stützen-Verbindungen aus normal- und hochfestem Beton unter zyklischer Beanspruchung (Josko Ozbolt, Yijun Li und Rolf Eligehausen). 3.1 Einleitung. 3.2 Materialmodell und FE-Diskretisierung. 3.3 Numerische Analyse. 3.4 Schlußfolgerungen. 3.5 Zusammenfassung. 3.6 Literatur. 4 Der Einfluß von freien Schwingungen infolge dynamischer Belastung auf die Deterioration eines Bauwerks (Manfred Specht und Michael Kramp). 4.1 Veranlassung des Forschungsvorhabens. 4.2 Forschungsziele. 4.3 Versuchsträger, Versuchsdurchführung und Versuchsergebnisse. 4.4 Auswertung. 4.5 Ergebnisse für die Systemidentifikation von Stahlbetonkonstruktionen. 4.6 Literatur. 5 Lokale Schwind- und Temperaturgradienten in bewehrten, oberflächennahen Zonen von Betonkonstruktionen (Josef Eibl und Stephan Kranz). 5.1 Problemstellung. 5.2 Temperatur- und Feuchtefeldberechnung. 5.3 Numerisches Berechnungsmodell zur Spannungsanalyse im Beton. 5.4 Durchgeführte Versuche. 5.5 Rechnerische Untersuchungen. 5.6 Zusammenfassung. 5.7 Literatur. 6 Wassereindringverhalten von Flüssigkeiten beim Biegeriß (Gert König und Christian Brunsch). 6.1 Problemstellung. 6.2 Experimentelle Untersuchungen. 6.3 Entwicklung eines Modells zur rechnerischen Abschätzung des zeitlichen Eindringens einer Wassermenge in Biegerisse von Stahlbetonbauteilen. 6.4 Zusammenfassung und Diskussion der Versuchsreihe. 6.5 Literatur. 7 Dauerhaftigkeitsprobleme von offenen Becken (György Iványi, Wilhelm Buschmeyer und Udo Paas). 7.1 Einleitung. 7.2 Bestandsaufnahme. 7.3 Felduntersuchungen. 7.4 Laboruntersuchungen. 7.5 Berechnungen. 7.6 Entwurfs- und Ausführungskriterien. 7.7 Literatur. Teil IV: Korrosion und Ermüdung (Peter Schießl). 1 Ermüdungskorrosion von Spannstahl (Herbert Kupfer und Hans H. Müller). 1.1 Forschungsziel. 1.2 Korrosionsversuche an Spannstählen. 1.3 Methoden zur Erkennung von Anrissen. 2 Korrosionsermüdung von Stahl in Betonbauteilen (J. W. Weber, Peter Schießl und Jörg Moersch). 2.1 Allgemeines. 2.2 Wesentliche Einflüsse bei der Schwingungsrißkorrosion. 2.3 Ziel der Untersuchungen. 2.4 Prüfkörper und Betone. 2.5 Chloridbeaufschlagung. 2.6 Ergebnisse. 2.7 Zusammenfassung. 2.8 Literatur. 3 Untersuchungen zum Rißkorrosionsverhalten von Spannstählen unter Betriebsbedingungen (Jörg Moersch und Peter Schießl). 3.1 Einführung und Ziel. 3.2 Untersuchungsprogramm. 3.3 Ergebnisse. 3.4 Zusammenfassung der Ergebnisse. 3.5 Literatur. 4 Schwingfestigkeit von Stahlbeton bei Beanspruchung mit Meerwasser (Ulf Nürnberger und Willibald Beul). 4.1 Einführung. 4.2 Mechanismus. 4.3 Schwingfestigkeitsuntersuchungen. 4.4 Folgerungen. 4.5 Literatur. 5 Wasserstoffinduzierte Spannungsrißkorrosion von zugschwellbeanspruchten Spannstählen (Ulf Nürnberger und Willibald Beul). 5.1 Einführung. 5.2 Untersuchungen. 5.3 Folgerung. 5.4 Literatur. 6 Selbstheilung und Bewehrungskorrosion bei von schwach sauren Wässern durchströmten Trennrissen in bewehrtem Beton (Wieland Ramm und Michaela Biscoping). 6.1 Übersicht. 6.2 Einleitung. 6.3 Versuchsprogramm. 6.4 Versuchsergebnisse. 6.5 Zusammenfassung. 6.6 Literatur. 7 Untersuchungen zur Reibermüdung bei teilweise vorgespannten Bauteilen (Heiner Cordes, Josef Hegger und Jens U. Neuser). 7.1 Einleitung. 7.2 Stand der Forschung. 7.3 Versuchsaufbau und Versuchsdurchführung. 7.4 Versuchsergebnisse. 7.5 Zusammenfassung und Ausblick. 7.6 Literatur. Teil V: Junger Beton (Ferdinand S. Rostásy). 1 Ermittlung und Berechnung des Nullspannungstemperaturgradienten im jungen Beton (Rupert Springenschmid und Jean-Louis Bostvironnois). 1.1 Einleitung. 1.2 Der Nullspannungstemperaturgradient. 1.3 Ergebnisse und Schußfolgerungen. 1.4 Literatur. 2 Experimentelle Ermittlung der Verformungskennwerte von jungem Beton und der Zwangspannungen in situ (Markus Plannerer und Rupert Springenschmid). 2.1 Einleitung. 2.2 Versuche zur Ermittlung der Verformungskennwerte und der Zwangspannungen. 2.3 Laborergebnisse. 2.4 In-situ-Ergebnisse. 2.5 Zusammenfassung. 2.6 Literatur. 3 Werkstoffeigenschaften jungen Betons--Experimente und Modellierung (Ferdinand S. Rostásy und Alex-W. Gutsch). 3.1 Einleitung. 3.2 Versuche und Modellbildung. 3.3 Zusammenfassung. 3.4 Literatur.

Ein Kredit für Weihnachtsbaumkugeln

NASA Astrophysics Data System (ADS)

Tutsch, Sina

Eine Mathematikerin aus dem DFG-Forschungszentrum Matheon arbeitet an Methoden zur dreidimensionalen Visualisierung. Sie hat die Geschäftsidee, Weihnachtsbaumkugeln mit bewegten Hologrammen herzustellen, die sich individuell gestalten lassen, und plant eine Existenzgründung. Aus einem öffentlichen Förderprogramm erhält sie ein günstiges Darlehen in Höhe von 50 000 Euro. Für die Startphase ihres Unternehmens benötigt sie jedoch den vierfachen Betrag.

Acta Mechanica Sinica (Selected Articles),

DTIC Science & Technology

1985-12-05

done by an external force. In the 1930’s, Trefftz and Kappus [8 ] also applied this principle to derive the elastic buckling equation and stability...theorie der stabilitat des elastischen gleichgewichts, Zeit. fur Angew. Math. u Mech. B13 (1933), L... 160. 120 [8] Kappus , R., Zur elastizitats...strain relations and boundary condiiomns for the prebeckling fundamental path solution. As Kappus had done in 1939, a new variation 6* can be imposed m

Middle-Class Consensus, Social Capital and the Mechanics of Economic Development

DTIC Science & Technology

2005-01-01

Michael, Social Capital and Regional Mobility, Nr. 4/2002. "* Schdfer, Wolf, EU-Erweiterung: Anmerkungen zum Balassa - Samuelson -Effekt, Nr. 3/2002...variations, while the argument of both the present paper and most of the previous literature on inequality and growth refers to long-run growth effects of...Diskussionsbeitriige zur Finanzwissenschaft " Josten, Stefan, Crime, Inequality, and Economic Growth. A Classical Argument for Distributional Equality

Europeanization of the Hospital Markets - Opportunities and Risks for German Hospitals (Europaeisierung des Krankenhausmarkets - Chancen und Risiken fuer deutsche Krankenhaeuser)

DTIC Science & Technology

2004-07-06

Information Services Institut (3M HIS Institut) hat u.a. mit der Entwicklung eines Werkzeugs zur Pflege und Weiterentwicklung des deutschen DRG-Systems ftir... Pflege (Krankenhauspflege) a. die Kosten wachsen schneller als allgerneine Inflation b. praktisch stabile Krankenversicherungsentnahme c. es existieren 9...Krankenkassen d. die Pflege ist von der Krankenversicherung voll (theoretisch) vergUltet e. Missverhlitnis zwischen Versicherungsentnuhrne und

Video: einige Bemerkungen zum medien-spezifischen Ort und zur didaktischen Basis (Video: Some Notes on Its Place among Teaching Media and on Its Theoretical Basis in FL Teaching)

ERIC Educational Resources Information Center

Bauer, Hans-Ludwig

1976-01-01

Reports on the introduction of video recorders at various branches of the Goethe Institute. The characteristics of video are compared with those of films, tapes and printed matter. Video's advantage is that through it authentic, unprepared material can be presented, and it provides strong motivation. (Text is in German.) (IFS/WGA)

Vapor Pressure of N,N’-Diisopropylcarbodiimide (DICDI)

DTIC Science & Technology

2016-02-01

S) Brozena, Ann. (ECBC); Williams, Barry R. (Leidos, Inc.); and Tevault, David E. (JRAD, Inc.) 5d. PROJECT NUMBER CB Defense Technology Base...historical data are compared to the new correlation. 2. EXPERIMENTAL DETAILS The DICDI used in the present work was obtained from Sigma -Aldrich...26, 1960. 7. Bayer Corporation, Carbodiimides. U.K. Patent GB685,970, January 14, 1953 . 8. Seefelder, M.; Neubauer, G. Verfahren zur

Biokompatible Metalle

NASA Astrophysics Data System (ADS)

Ha, Suk-Woo; Wintermantel, Erich

Metalle als Implantatwerkstoffe werden in der Medizin für zwei Hauptanwendungen eingesetzt: für Prothesen des totalen Gelenkersatzes wie beispielsweise Hüft-, Knie- und Schulterprothesen und für Fixationselemente zur Stabilisierung von Frakturen. Beispiele hierfür sind Osteosyntheseplatten, Marknägel, Schrauben, Drähte und Stents. Eine der ersten Anwendungen von Metallen im menschlichen Körper war die Fixation von Fragmenten eines gebrochenen Humerus (Oberarmknochen) mit einem Metalldraht durch zwei französische Physiker im Jahr 1775 [1]. Ausführliche Untersuchungen zur Verträglichkeit von Metallen im menschlichen Körper wurden bereits im frühen 19. Jahrhundert durchgeführt. Von den untersuchten Werkstoffen verursachten die edlen Metalle wie Gold, Silber und Platin aufgrund ihrer Korrosionsbeständigkeit und Körperverträglichkeit die geringsten Reizungen im menschlichen Körper. Die klinische Anwendung der Edelmetalle war jedoch wegen der geringen mechanischen Eigenschaften beschränkt. Andere Metalle wie Messing, Kupfer oder Eisen wiesen vergleichsweise höhere Festigkeitswerte auf, sie waren jedoch aufgrund der geringen Korrosionsbeständigkeit und Biokompatibilität nicht für den klinischen Einsatz geeignet. Ein weiteres Problem stellte die Gefahr der Infektion durch unsterile Instrumente und Implantate dar. Gegen Ende des 19. Jahrhunderts hielt die antiseptische Operationsmethode Einzug in die Kliniken, die z. B. erfolgreiche Operationen mit Silberdraht ermöglichte.

Ganzheitliche Digitalisierungsansätze im Stadtwerk: Von der Strategie bis zur Umsetzung

NASA Astrophysics Data System (ADS)

Dudenhausen, Roman; Hahn, Heike

Digitalisierung muss im Stadtwerk dazu führen, Kundenerwartungen, die heutzutage schon vielfach durch digitales Know-how und Erfahrungen geprägt sind, in einzigartiger Weise zu entsprechen - in Form digitaler Kundenkontaktpunkte, automatisierter Prozesse oder plattformbasierter Geschäftsmodelle. Eine große Rolle spielen dabei unternehmensweit nutzbare Informationen, die eine 360-Grad-Sicht auf den Kunden ermöglichen. Nur in dieser Kombination werden sich nachhaltig Wettbewerbsvorteile generieren lassen. Manch ein Kunde wird die Lust, einen Prozess zu Ende zu gehen, schon vor dem Abschluss verlieren, wenn er nicht unmittelbar und ohne die digitale Welt zu verlassen zum Ziel kommt. Eine nur "halb digitale Kundenerfahrung" wird weder zu Neugeschäft noch zur positiven emotionalen Bindung zwischen Kunden und Stadtwerk führen. Nicht zu unterschätzen sind zudem Erwartungen hinsichtlich zukünftiger Geschäftsmodelle, aus denen sich disruptive Bedrohungen für die herkömmlichen Strom- und Gasangebote ergeben werden. Erste innovative Ansätze finden sich bereits im Markt, die erahnen lassen, dass zurzeit viel diskutierte Technologien wie die Blockchain nicht mehr nur hypothetischer Natur sind. Die Auseinandersetzung mit der Digitalisierung erfolgt dabei sinnvollerweise in einem unternehmensweit abgestimmten Rahmen, der eine zielgerichtete und ganzheitliche Vorgehensweise ermöglicht.

Zinc Detoxification Is Required for Full Virulence and Modification of the Host Leaf Ionome by Xylella fastidiosa.

PubMed

Navarrete, Fernando; De La Fuente, Leonardo

2015-04-01

Zinc (Zn) is an essential element for all forms of life because it is a structural or catalytic cofactor of many proteins, but it can have toxic effects at high concentrations; thus, microorganisms must tightly regulate its levels. Here, we evaluated the role of Zn homeostasis proteins in the virulence of the xylem-limited bacterium Xylella fastidiosa, causal agent of Pierce's disease of grapevine, among other diseases. Two mutants of X. fastidiosa 'Temecula' affected in genes which regulate Zn homeostasis (zur) and Zn detoxification (czcD) were constructed. Both knockouts showed increased sensitivity to Zn at physiologically relevant concentrations and increased intracellular accumulation of this metal compared with the wild type. Increased Zn sensitivity was correlated with decreased growth in grapevine xylem sap, reduced twitching motility, and downregulation of exopolysaccharide biosynthetic genes. Tobacco plants inoculated with either knockout mutant showed reduced foliar symptoms and a much reduced (czcD) or absent (zur) modification of the leaf ionome (i.e., the mineral nutrient and trace element composition), as well as reduced bacterial populations. The results show that detoxification of Zn is crucial for the virulence of X. fastidiosa and verifies our previous findings that modification of the host leaf ionome correlates with bacterial virulence.

Hydraulische Optimierung des Reaktionsraumes um einen Infiltrationsbrunnen zur unterirdischen Enteisenung. Feldversuche und numerische Simulation zur Planung der optimalen Verfahrensergiebigkeit (Teil 1/2) Hydraulic optimization of the reaction zone around an injection well during subsurface iron removal

NASA Astrophysics Data System (ADS)

Ahrns, Johannes; Bartak, Rico; Grischek, Thomas; Pörschke, Richard

2017-11-01

In subsurface iron removal (SIR), oxygen-enriched water is injected into an aquifer to create a reaction zone. Aside from the hydraulic properties of the aquifer, groundwater quality often varies with depth so that in vertical wells the dissolved oxygen distribution (reaction zone) may not correspond to the dissolved iron concentration which may result in a lower efficiency coefficient. Therefore, measures to hydraulically optimize the formation of the reaction zone through a non-conventional injection were investigated. A high-resolution groundwater flow model was calibrated based on tracer and pump tests and used to plan the optimized injection for a SIR-pilot well with two screen segments. An optimized injection appears to be possible through the inactivation of well screen sections using packers. A doubling of the efficiency coefficient in comparison to a conventional injection was predicted when a packer, which remains evacuated inside the well while pumping, was used to seal 4/5 of the upper well screen length during injection. This scenario was used to plan the operating regime for a SIR field test, which is presented in Part 2.

Analyse der pharmazeutischen Versorgungssituation von Patienten mit Psoriasis-Arthritis auf Basis von Routinedaten der Gesetzlichen Krankenversicherung.

PubMed

Sondermann, Wiebke; Ventzke, Julia; Matusiewicz, David; Körber, Andreas

2018-03-01

Die Psoriasis-Arthritis (PsA) gehört zu den chronisch entzündlichen Gelenkerkrankungen. Trotz zahlreicher versorgungswissenschaftlicher Studien in Deutschland liegen zur pharmazeutischen Versorgungssituation von PsA-Patienten bisher kaum aktuelle Ergebnisse vor. Mit Hilfe einer systematischen Literaturrecherche sowie anhand von Routinedaten der Allgemeinen Ortskrankenkasse (AOK) Rheinland/Hamburg wird ein aktueller Überblick über die pharmazeutische Versorgung von PsA-Patienten in Deutschland gegeben. Selektiert wurden Versicherte aus dem ambulanten und stationären Bereich, die im 1. und 2. Quartal des Jahres 2014 die gesicherte Abrechnungsdiagnose Psoriasis-Arthritis L40.5+ aufwiesen. Anschließend wurden auf Basis dieser "vorab definierten" Kohorte die Arzneimitteldaten für 5 Jahre (01.01.2010-31.12.2014) abgerufen. Es konnten insgesamt n  =  3205 Versicherte (45 % männlich, 55 % weiblich) der AOK Rheinland/Hamburg mit einer gesicherten PsA-Diagnose selektiert werden. Das Durchschnittsalter betrug 58,9 Jahre. 53,7 % der PsA-Patienten wurden mit systemischen PsA-relevanten Arzneimitteln versorgt. Nichtsteroidale Antirheumatika (NSAR) wurden am häufigsten verordnet, gefolgt von systemischen Glucocorticoiden. Von den selektierten PsA-Patienten, die eine Systemtherapie erhielten, wurden 72,1 % mittels einer Disease-modifying-antirheumatic-Drug (DMARD)-Monotherapie behandelt, gefolgt von der Kombinationstherapie aus DMARDs und Biologika (20,9 %). Die pharmakologische Therapie der PsA muss eine Gewährleistung zwischen adäquater Versorgung der PsA mit Verhinderung der Krankheitsprogression und ökonomischer Verantwortung darstellen. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Neue Laser und Strahlquellen - alte und neue Risiken?

PubMed

Paasch, Uwe; Schwandt, Antje; Seeber, Nikolaus; Kautz, Gerd; Grunewald, Sonja; Haedersdal, Merete

2017-05-01

Die Entwicklungen im Bereich dermatologischer Laser, hochenergetischer Blitzlampen, LED und neuer Energie- und Strahlquellen der letzten Jahre haben gezeigt, dass mit neuen Wellenlängen, Konzepten und Kombinationen zusätzliche, zum Teil über den ästhetischen Bereich hinaus gehende therapeutische Optionen für den Dermatologen erschlossen werden konnten. Wurden bisher zum Beispiel mit fraktionalen Lasern Falten behandelt, sind eben diese Systeme heute in Kombination mit Medikamenten wichtige Werkzeuge bei der Behandlung von Narben, bei Feldkanzerisierung und epithelialen Tumoren. Die Anforderungen an den die Indikation stellenden und vorzugsweise therapierenden Arzt steigen mit der immer komplexer werdenden Technik und den zunehmenden Komorbiditäten und Komedikationen einer älter werdenden Patientenklientel. Parallel etabliert wurden, zunächst für einige wenige Indikationen, Geräte für die Heimanwendung, die sich durch geringe Leistung und spezielle Sicherheitsvorkehrungen zur Vermeidung von Unfällen, Risiken und Nebenwirkungen auszeichnen. Trotz der reduzierten Effizienz solcher Selbstbehandlungsmaßnahmen steigt die Wahrscheinlichkeit einer Fehlanwendung, da die Grundvoraussetzung für eine korrekte Therapie, nämlich die exakte Diagnose und Indikationsstellung, nicht vorausgesetzt werden kann. Bei einer Haarentfernung können so Pigmenttumoren, bei einer Faltentherapie neoplastische Hautveränderungen adressiert und zu erwartende, unvorhergesehene und neue Nebenwirkungen und Komplikationen induziert werden. In diesem Szenario ist es wichtig, alle potenziellen Anwender dieser neuen Technologien vor deren Einsatz so zu qualifizieren, dass den Therapierten maximale Therapiesicherheit bei höchster Effizienz unter dem Leitbild diagnosis certa - ullae therapiae fundamentum garantiert wird. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

European Research Program on Viscous Flows

DTIC Science & Technology

1980-11-01

hochviskoser Flassigkeiten. To be published in Acta Mechanica (1980) 8.36b K.O. Felsch Ein Beitrag zur Berechnung der Str ~ mung in einer Tesla- M...R. Schilling Berechnung der ausgebillten Str ~ mung in gekrummten Kanalen R. Simon mit rechteckigem Quersclnitt. Recent developments in theoretical an...package. co 12 REFERENCES No. Author Title, etc 1.4a S.G. Sundkvist V~rmek&llors inverkan pd str ~mning och temperatur i ventiler- ade lokaler (Numerisk

Determination of Parameters for Development of a Physiologically Based Model for the Toxicokinetics of C(+)P(+)-Soman

DTIC Science & Technology

1993-06-01

In conducting research utilizing recombinant DNA technology , the investigator(s) adhered to current guidelines promulgated by the National...zur Rtickstandanalyse), saponin (BDH, Poole, UK), aluminium sulfate.16 H2 0 (BDH Analar, Ž 98%), sodium bicarbonate (Lamens en Indemans, ’s...isopropanol). The mixture was extracted with 3 ml ethyl acetate. Gas chromatographic analysis of the soman stereoisomers in the ethyl acetate phase was

Kamera-basierte Erkennung von Geschwindigkeitsbeschränkungen auf deutschen Straen

NASA Astrophysics Data System (ADS)

Nienhüser, Dennis; Ziegenmeyer, Marco; Gumpp, Thomas; Scholl, Kay-Ulrich; Zöllner, J. Marius; Dillmann, Rüdiger

An Fahrerassistenzsysteme im industriellen Einsatz werden hohe Anforderungen bezüglich Zuverlässigkeit und Robustheit gestellt. In dieser Arbeit wird die Kombination robuster Verfahren wie der Hough-Transformation und Support-Vektor-Maschinen zu einem Gesamtsystem zur Erkennung von Geschwindigkeitsbeschränkungen beschrieben. Es setzt eine Farbvideokamera als Sensorik ein. Die Evaluation auf Testdaten bestätigt durch die ermittelte hohe Korrektklassifikationsrate bei gleichzeitig geringer Zahl Fehlalarme die Zuverlässigkeit des Systems.

Das CARNOTsche Paradigma und seine erkenntnistheoretischen Implikationen

NASA Astrophysics Data System (ADS)

Schöpf, Hans-Georg

Der vorliegende historisch-kritische Essay führt die Eigentümlichkeiten der klassischen phänomenologischen Thermodynamik auf das von CARNOT geschaffene Paradigma zurück und greift einige damit zusammenhängende Fragen auf.Translated AbstractCARNOT's Paradigm and its Epistemological ImplicationsThe present historic-critical essay traces the pecularities of classical phenomenological thermodynamics back to the paradigm, created by CARNOT, and takes up some questions to which this paradigm gives rise.

PubMed

Hey, Christiane

2018-04-01

Bock JM et al. Evaluation of the natural history of patients who aspirate. Laryngoscope 2017; 127: S1–S10 DIE KLINISCHE PROGRESSION DER ASPIRATION BIS ZU EVENTUELLEN PULMONALEN STöRUNGEN IST NICHT VOLLSTäNDIG VERSTANDEN. EMPFEHLUNGEN ZUR ERNäHRUNGSUMSTELLUNG, SCHWERE VON PENETRATION UND ASPIRATION GEMäß PAS SOWIE DIE ÄTIOLOGIE DER DYSPHAGIE BEEINFLUSSEN MöGLICHERWEISE DIE ZEITSPANNE BIS ZUM AUFTRETEN DES ERSTEN PULMONALEN EREIGNISSES SOWIE DAS GESAMTüBERLEBEN VON PATIENTEN MIT VFS-DOKUMENTIERTER, ASYMPTOMATISCHER PENETRATION UND ASPIRATION.

Untersuchungen zur Regeneration des Hinterendes bei Anaitides mucosa (Polychaeta, Phyllodocidae)

NASA Astrophysics Data System (ADS)

Röhrkasten, A.

1983-06-01

Caudal regeneration was investigated in decerebrate Anaitides mucosa and in brain-intact individuals. Both groups show an identical capacity to regenerate lost caudal segments. Furthermore there is no difference in males and females. Low temperature (5 °C) inhibits the regeneration of caudal segments, but it is necessary for normal oogenesis. Under conditions of high temperature (15 °C), caudal regeneration is very extensive. At the same time degeneration of most oocytes occurs.

Networking as a Seismograph for Social Development. A Contribution to the Function Expansion of Networks Using the Example of Health Promotion of the Socially Disadvantaged (Netzwerkbildung als Seismograph gesellschaftlicher Entwicklungen: Ein Beitrag zur Funktionserweiterung von Netzwerken am Beispiel der Gesundheitsfoerderung von sozial Benachteiligten)

DTIC Science & Technology

2008-03-01

Miftelzu- wachs profitieren mochten. Je st5rker eine Landesvereinigung Modellprojekte akqui- rieren muss, urn die eigene Funktionsf5higkeit...Denn 5hnlich wie die Krankenkas- sen stehen andere Institutionen und Bereiche wie Sozialversicherungstrager, die Arzteschaft, Institutionen des Sports

The Concept of Comprehensive Security: A Distinctive Feature of a Shared Security Culture in Europe

DTIC Science & Technology

2007-12-01

Sicherheitsbegriff, ed. Bundesakademie für Sicherheitspolitik (Hamburg: Mittler, 2001), 18. 92. Emil Kirchner and James Sperling , “The New Security Threats in...im 21. Jahrhundert - Keine allein militärische Aufgabe. Rede von Heidi Wegener, MdB, am 23.03.2006 im Marshall Center. www.marshallcenter.org/site...Wenger (Zürich: Forschungsstelle für Sicherheitspolitik, 2005), 11 217. Kurt R. Spillmann, " Von der bewaffneten Neutralität zur kooperativen

Literaturunterricht als Erziehung zum "rationalen Handeln." Zur Theorie und Operationalisierung einer literaturdidaktischen Kategorie (The Teaching of Literature as "Education for Rational Behavior." On the Theory and Implementation of a Category in Teaching Literature)

ERIC Educational Resources Information Center

Bach, Gerhard

1975-01-01

Using Richard Wright's novel "Black Boy" as a model to work on, the author illustrates a 4-dimensional approach to the teaching of foreign literature: (1) scientific definition of the goals, (2) making a teaching plan, (3) defining methods, and (4) actual use on a teaching model. (Text is in German.) (IFS/WGA)

Die nuklearen Anlagen von Hanford (1943-1987) Eine Fallstudie über die Schnittstellen von Physik, Biologie und die US-amerikanische Gesellschaft zur Zeit des Kalten Krieges

NASA Astrophysics Data System (ADS)

Macuglia, Daniele

Die Geschichte des Kalten Krieges eröffnet viele Möglichkeiten, sich näher mit den Schnittstellen von Physik und Biologie während des 20. Jahrhunderts zu befassen. Nicht nur das Unglück in Tschernobyl aus dem Jahr 1986, auch das Beispiel der nuklearen Anlagen in Hanford in den Vereinigten Staaten zeigt die biologischen Folgen von nuklearer Physik.

Mikrospritzgießen

NASA Astrophysics Data System (ADS)

Ebert, Karl-Herbert; Ammer, Daniel; Hoffstetter, Marc; Wintermantel, Erich

Bei der Betrachtung von aktuellen Produktentwicklungen lässt sich durch alle Branchen hinweg ein deutlicher Trend zur Miniaturisierung und Funktionsintegration auf kleinstem Raum erkennen. Der Einsatz technischer Kunststoffe, die überwiegend im Thermoplast-Spritzgießverfahren verarbeitet werden, leistet dabei einen wichtigen Beitrag um diese Produktentwicklungen in marktfähige Artikel umsetzen zu können. Hierbei sind im Vergleich zum Standardspritzgießen einige Besonderheiten hinsichtlich des Formenbaus, der Anlagen- sowie Prozesstechnik und der Qualitätssicherung zu beachten.

Zur Funktion von Weiterbildung fur Frauen in den neuen Landern im Kontext des Transformationsprozesses (On the Function of Further Education for Women in the New Laender in the Context of the Process of Transformation).

ERIC Educational Resources Information Center

Schiersmann, Christiane; Ambos, Ingrid

1996-01-01

Focuses on motives leading women in the new German Laender to participate in further education and on gender-related barriers to further education. Shows that women accept the need for further education, hoping to improve their job situation but knowing that their efforts will have a limited effect on employment chances. (DSK)

Bewertung von Fahrzeuggeräuschen

NASA Astrophysics Data System (ADS)

Genuit, Klaus; Schulte-Fortkamp, Brigitte; Fiebig, André; Haverkamp, Michael

Bei der Wahrnehmung und Beurteilung eines Automobils sind unzählige Merkmale und Eigenschaften von Bedeutung. Dabei können Merkmale objektiv-technisch beschrieben werden, wie Angaben zur Motorisierung, Höchstgeschwindigkeit, Drehmoment, zulässige Zuladung, Verbrauch usw. Daneben sind weitere Eigenschaften von Bedeutung, die sich einer einfachen objektiv-technischen Beschreibung entziehen. Hier sind Begriffe zu nennen, wie Sicherheit, allgemeine Qualitätsanmutung, Design, Ergonomie, Komfort, Haptik, Fahrdynamik, Zuverlässigkeit, die deutlich schwieriger objektiv erfassbar und beschreibbar sind (Abb. 4.1).

Behavioral Issues in the Use of Interactive Systems

DTIC Science & Technology

1976-12-14

communication. American Psychologist, 1971, 26, 949-961. Codd , E. F . Seven steps to rendezvous with the casual user. IBM Research Report, RI 1333. 1974. Conrad...Approved for public releasel distribution unlimited. F LL(I j i’ This ~Research wavs spotdi pr yteEnierons~ao _ 1Repr o seionrin who Zur ichati emte...natural language ( Codd , 1974). Behavioral work has shown that non-programmers could learn to use a laboratory query language in about 3 hours (Thomas

[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.

Prä- und perioperative Aspekte der Versorgung dermatochirurgischer Patienten.

PubMed

Müller, Cornelia S L; Hubner, Wakiko; Thieme-Ruffing, Sigrid; Pföhler, Claudia; Vogt, Thomas; Volk, Thomas; Gärtner, Barbara C; Bialas, Patric

2017-02-01

Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf wenige Ausnahmen fast alle Eingriffe traditionell in Lokal- bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri- und postoperative Überwachung obliegt dabei dem dermatochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern. Hierzu gehören neben Hygieneaspekten, Kenntnissen in der Überwachung der Patienten sowie dem Aspekt der surgical site infections auch Fragen zur postoperativen Schmerztherapie sowie detailliertes pharmakologisches Wissen über die zur Anwendung kommenden Lokalanästhetika und das Handling der damit assoziierten toxischen und allergischen Reaktionen. Eine interdisziplinäre Zusammenarbeit und Verantwortung für den Patienten ist notwendig und erfordert die Erarbeitung und Umsetzung qualitätsorientierter und evidenzbasierter Handlungsanweisungen, die im dermatochirurgischen OP-Setting meist weit über das eigentliche Fach hinausgehen. Ziel dieses Weiterbildungsartikels soll die komprimierte Darstellung der genannten fachübergreifenden Standpunkte bezüglich der wichtigsten perioperativen Aspekte sein. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Efficiency of selection methods for increased ratio of pupal-larval to adult-larval weight gains in Tribolium.

PubMed

Campo, J L; Cobos, P

1994-01-12

Four lines of Tribolium castaneum were selected in each of three replicates for increased ratio of (pupal-larval) to (adult-larval) weight gains, using selection for increased (pupal-larval) weight gain (PL), selection for decreased (adult-larval) weight gain (AL), direct selection for the ratio (R) and linear selection index of larval, pupal and adult weights (I), respectively, for four generations. Linear index was calculated with economic weights of m(2) -m(3) , m(3) -m(1) and m(1) -m(2) , respectively, with m(1) , m(2) and m(3) being the means for larval, pupal and adult weights. Selection to increase the ratio is considered to be a method to maximize the mean response in (adult-larval) weight while controlling the response in (pupal-adult) weight, and as a form of antagonistic selection to increase the weight gain during a given age period relative to the gain at another age period. Larval, pupal and adult weights were measured at 14, 21 and 28 days after adult emergence, respectively. The selected proportion was 20 % in all lines. The response observed for the ratio differed significantly among lines (p < 0.01), with the I and AL lines having the greatest responses. Line R was less effective in improving the objective of selection, while line PL appeared to be inappropriate. The observed responses for the numerator and denominator weight gains were positive in line PL, and negative in the AL, R and I lines. All lines apart from line PL decreased the (adult-larval) weight, holding (pupal-adult) weight constant. Larval weight showed the greatest influence on the response for the objective of selection. The results for this greater than 1 ratio are compared with results of others for smaller than 1 ratios, in which indirect selection for increased numerator is the more efficient alternative to the selection index. ZUSAMMENFASSUNG: Effizienz Selektionsverfahren zur Verbesserung des Quotienten der Gewichtsentwicklung zwischen Puppe/Larve und Käfer/Larve bei Tribolium. In den jeweils drei Versuchsserien zur Erhöhung des Quotienten (Gewicht von Puppe-Larve/Gewicht von Käfer-Larve) wurden vier Versuchsreihen von Tribolium castaneum untersucht: die Versuchsreihe PL wurde gewählt um die Differenz (Puppengewicht-Larvengewicht) zu erhöhen, die Versuchsreihe AL wurde gewählt um die Differenz (Käfergewicht-Larvengewicht) zu reduzieren, die Versuchsreihe R wurde direkt für den Koeffizienten gewählt und die Auswahl der Versuchsreihe I erfolgte über einen linearen Index, errechnet aus dem Gewicht von Larven, Puppen und Käfern über vier Generationen. Der lineare Index wurde berechnet aus den Gewichten von (m(2) -m(3) ), (m(3) -m(1) ) bzw. (m(1) -m(2) ), wobei m(1) , m(2) und m(3) die Mittelwerte für das Gewicht von Larven, Puppen bzw. Käfern sind. Die Auswahl zur Erhöhung des Quotienten ist eine Methode zur Maximierung des Durchschnittsgewichtsverhältnisses Käfer/Larve, sowie eine antagonische Auswahlform zur Erhöhung der Gewichtszunahme während einer bestimmten Wachstumsperiode im Vergleich zur Gewichtszunahme während einer anderen Wachstumsperiode. Das Selektionsverhältnis belief sich auf 20%. Die beim Quotienten beobachtete Antwort wies bedeutende Unterschiede zwischen Versuchsreihen auf (p < 0.01), wobei die höchsten Antworten bei den Versuchsreihen I und AL beobachtet wurden. Versuchsreihe R war am wenigsten effektiv, während Versuchsreihe PL nicht geeignet schien, das Auswahlziel zu verbessern. Die bei Nenner und Zähler beobachteten Antworten waren positiv bei der Versuchsreihe PL und negativ bei den anderen drei Versuchsreihen. Die Ergebnisse für diesen Quotient größer als 1 wurden mit denen anderer Versuche für Quotienten kleiner als 1 verglichen, bei denen die Auswahl zur Erhöhung des Zählers die effizienteste Alternative zum Auswahlindex ist. RESUMEN: Eficiencia de métodos de selección para incrementar el cociente entre la ganancia en peso de pupa-peso de larva y la ganancia en peso de adulto-peso de larva en Tribolium Cuatro líneas de Tribolium castaneum fueron seleccionadas en cada una de tres repeticiones para incrementar el cociente (peso de pupa-peso de larva)/(peso de adulto-peso de larva); la línea PL fue seleccionada para aumentar la diferencia (peso de pupa-pesp de larva), la línea AL fue seleccionada para disminuir la diferencia (peso de adulto-peso de larva), fa línea R fue seleccionada directamente para el cociente, y la línea I fue seleccionada por medio de un índice lineal basado en los pesos de larva, pupa y adulto, durante cuatro generaciones. El índice lineal se calculó con pesos económicos de (m(2) -m(3) ), (m(3) -m(1) ), y (m(1) -m(2) ) respectivamentee, siendo m(1) , m(2) , y m(3) los valores medios para el peso de larva, pupa y adulto. La selección para aumentar el cociente indicado es un método para maximizar la respuesta en (peso de adulto-peso de larva) controlando al tiempo la respuesta en (peso de pupa-peso de adulto), y es una forma de selección antagónica para aumentar la ganancia de peso durante un periodo de edad en relación con la ganancia en peso durante otro periodo. La proporción de selección due el 20 %. La respuesta observada en el cociente difería significativamente entre lineas (p < 0.01), teniendo las líneas I y AL las mayores respuestas. La línea R fue menos efectiva, mientras que la línea PL parecía inapropiada para mejorar el objetiyo de selección. Las respuestas observadas en el denominador y en el numerador fueron positivas en la línea PL, y negativas en las otras tres líneas. Los resultados para este cociente mayor que 1 se comparan con los de otros experimentos para cocientes menores que 1, en los que la selección para incrementar el numerador es la alternativa más eficiente al índice de selección. 1994 Blackwell Verlag GmbH.

Implications of the Khrgian-Mazin Distribution Function for Water Clouds and Distribution Consistencies With Aerosols and Rain

DTIC Science & Technology

1991-12-06

Preprints 14th Radar Meteorology Conf. Tucson, Amer. Meteor. Soc. 413-418. Findeisen , W. (1932) Measurement of the size and number of cloud drops for the...study of coagulation in non-homogeneous clouds. Gerl. Beitr. z Geophys. 35:295-340. Findeisen , W. (1938) Die kolloid-meteorologischen vorgtnge bei...der nieder-schlagsbildung. Meteor. Z. 55:12 1-135. Findeisen , W. (1939) Zur Frage der Regentropfenbildung in reinen Wasserwolken. Meteor. Z. 56:365-368

Tissue Engineering in der Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie

NASA Astrophysics Data System (ADS)

Bücheler, Markus; Bootz, Friedrich

Tissue Engineering ist eine Schlüsseltechnologie für den Gewebeersatz der Zukunft. Am Beispiel der Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie werden klinisch etablierte Gewebeersatzmethoden und aktuelle Entwicklungen des Tissue Engineering gegenübergestellt. Die Besonderheiten der zu ersetzenden Gewebe im Kopf- und Halsbereich erfordert vielfältige Ersatzverfahren. Im klinischen Alltag werden heute vor allem autogene Transplantate und Implantate für den Gewebeersatz verwendet [1]. In vitro hergestellte Gewebe werden abgesehen von Einzelanwendungen zur Zeit noch nicht am Patienten eingesetzt.

Funkmesstechnik

NASA Astrophysics Data System (ADS)

Plaßmann, Wilfried

Ein Hauptgebiet der Funkmesstechnik ist durch den Begriff RADAR (radio detection and ranging gekennzeichnet. Bei diesem Verfahren werden impulsförmige elektromagnetische Wellen von einer Antenne ausgesendet und an Körpern oder Stoffverteilungen (Wolken) reflektiert. Die Sendeantenne wird auf Empfang umgeschaltet, und anhand des Echos sind Rückschlüsse auf die Lage und die Beschaffenheit der Körper oder der Stoffverteilungen möglich. Angewendet wird die Radartechnik bei der Kontrolle und der Sicherung des Land-, Wasser- und Flugverkehrs, in der Meteorologie zur Wetterprognose, in der Astrologie und im militärischen Bereich.

[Critical mass, explosive participation at the Max-Planck Institute about research of the living conditions of the scientific-technical world in Starnberg].

PubMed

Sonntag, Philipp

2014-01-01

Reviewers of the Max-Planck-Institut zur Erforschung der Lebensbedingungen der wissenschaftlich-technischen Welt (MPIL) did focus upon an abundance of vague reports of evaluative commissions, of benchmarking, of scientific modes. Thus it remained rather neglected, what staff actually had researched. An example: Progression and end of project AKR (Work-Consumption-Assessment) does display all kinds of related emotions at MPIL, and the sensitive guidance by Carl Friedrich von Weizsäcker.

Abtasttheorem

NASA Astrophysics Data System (ADS)

Plaßmann, Wilfried

Das Abtasttheorem von Shannon ist von grundlegender Bedeutung für die Nachrichtentechnik, besonders aber für den Fall, dass ein Analogsignal in ein digital codiertes Signal überführt werden soll. Es legt fest, wie oft ein analoges Signal abgetastet werden muss, um es, digital codiert, wieder ″fehlerfrei″ in ein analoges Signal zurückwandeln zu können. Außerdem ist bezüglich der im Analogsignal enthaltenen Frequenzen eine bestimmte Bedingung zu erfüllen. Die Ableitung ist hier in verkürzter Form dargestellt.

Mathematisches Bewusstsein

NASA Astrophysics Data System (ADS)

Kaenders, Rainer; Kvasz, Ladislav

Wenn jemand sagt, dass ein Bus um 9 Uhr abfährt - weiß man es dann? Angenommen, man ist darüber unterrichtet, dass die Busse unter der Woche immer zur vollen Stunde abfahren - von 7 Uhr morgens bis 7 Uhr abends, weiß man es dann mit dem Wissen um diese allgemeine Regel besser, dass der Bus um 9 Uhr abfährt? Macht es einen Unterschied, ob man den Fahrplan erstellt, den Bus lenkt oder nur mitfährt, um sich dieser Tatsache bewusst zu sein?

Nichtkontinuierliche (zeitdiskrete) Signale

NASA Astrophysics Data System (ADS)

Plaßmann, Wilfried

Zeitdiskrete Signale werden häufig aus zeitkontinuierlichen Signalen durch Abtastung erzeugt. Dass beide Signale gleichwertig sind, zeigt das Abtasttheorem (Kap. 116) von Shannon, sofern die Bedingung nach (116.2), f_{ab}≈(2{,}2 {\\ldots} 4)\\cdot fg) eingehalten wird. Digitale Signale haben Vorteile: Einfache Speicherung, Weiterverarbeitung in Rechnern, wenig störanfällige Übertragung. Für die Bearbeitung dieser Signale dienen die im Kapitel dargestellten Hilfsmittel: Diskrete Fouriertransformation; Schnelle Fouriertransformation; z-Transformation: Darstellung, Sätze zur z-Transformation, Korrespondenzen zu Zeitfunktionen, Beispiele.

On the Situation in the Near East: Fleet Activities in the Indian Ocean: Summary from July 1980 to August 1982 (Zur Lage im Mittleren Osten: Flottenaktivataeten in Indischen Ozean: Ueberblick vom Juli 1980 bis August 1982).

DTIC Science & Technology

1983-05-16

KRIVAK and KOTLIN Classes, but now and then1Q KASHIN-Class destroyers were also employed. With the end of the Iranian-American hostage crisis in late...Beira and Port Louis. The cruiser and one KOTLIN destroyer entered Aden In May 1981, and then An late July the cruiser with one KRIVAK frigate redeployed

Development of a Gene Therapy Trial for Metastatic Prostate Cancer

DTIC Science & Technology

2008-01-01

Evidence that replication of the antitumor adenovirus ONYX -015 is not controlled by the p53 and p14(ARF) tumor suppressor genes. J Virol 2002; 76...12483–12490. 27 Rothmann T, Hengstermann A, Whitaker NJ, Scheffner M, zur Hausen H. Replication of ONYX -015, a potential anticancer adenovirus, is...export, rather than p53 inactivation, determines ONYX -015 tumor selectivity. Cancer Cell 2004; 6: 611–623. 29 O’Shea CC, Soria C, Bagus B, McCormick F

Introduction of a Diagnosis Related Groups’ Case Flat Rate System: Hopes and Fears (einfuerhrng eines drg-fallpauschalensystems - hoffnungen und aengste)

DTIC Science & Technology

2000-06-01

Anwendung und Pflege des neuen Systems dienen soil, wenn die entscheidenden Vorgaben bereits durch die Deckelung gegeben sind. Oder denkt man an den...Software und die da- mit verbundenen Lizenzgebuhren, sondern auch in der Folge um die Schulung der Mitarbeiter sowie die Pflege und Weiterentwicklung...sung an die medizinische Entwicklung" sowie von "Verfahren zur laufen- den Pflege des VergOtungssystems" gesprochen. Es mossen jedoch klare

Von Donuts und Zucker: Mit Neutronen biologische Makromoleküle erforschen

NASA Astrophysics Data System (ADS)

May, Roland P.

2003-05-01

Für die Erforschung von Biomolekülen bieten Neutronen einzigartige Eigenschaften. Vor allem ihre unterschiedliche Wechselwirkung mit dem natürlichen Wasserstoff und seinem schweren Isotop Deuterium ermöglicht tiefe Einblicke in Struktur, Funktion und Dynamik von Proteinen, Nukleinsäuren und Biomembranen. Bei vielen Fragestellungen zur Strukturaufklärung gibt es kaum oder keine Alternative zum Neutron. Das Institut Laue-Langevin trägt Bahnbrechendes zum Erfolg der Neutronen-Methoden in der Biologie bei.

Grundlagen der Nachrichtenübertragung

NASA Astrophysics Data System (ADS)

Plaßmann, Wilfried

Die Nachrichtentechnik hat die Aufgabe, Nachrichten auszutauschen. Nachrichten sind z. B. Fragen, Beobachtungen und Befehle. Unter dem Begriff Nachrichtenübertragung wird hier die elektrische Nachrichtenübertragung verstanden, denn zur Übermittlung von Nachrichten werden Spannungen und Ströme sowie elektrische und magnetische Felder eingesetzt. Die Übertragung beginnt mit der Nachrichtenquelle, die die Nachrichten aussendet, und endet mit der Nachrichtensenke, die sie empfängt. Zwischen beiden liegt das elektrische Nachrichtenübertragungssystem, dessen Funktionseinheiten dargestellt sind und erläutert werden.

Zur Biosynthese von Phenylalanin und Tyrosin

NASA Astrophysics Data System (ADS)

Lingens, F.; Keller, E.

1983-03-01

With the discovery of arogenic acid two new pathways for the biosynthesis of phenylalanine and tyrosine have been revealed. The occurrence of two, three, or four pathways for the biosynthesis of phenylalanine and tyrosine in microorganisms and plants may be a useful tool for taxonomic classifications. Investigations on enterobacteriaceae, pseudomonads, flavobacteria, streptomycetes, archaebacteria, and on Sphaerotilus, Trichococcus and Leptothrix species from bulking sludge are described. The possible role of arogenate in the evolution of the pathways for tyrosine and phenylalanine biosynthesis is discussed.

Ueber Bild und Rolle zum Sprachhandeln. Ueberlegungen und praktische Beispiele zur Arbeit mit Rollenspiel und Bildergeschichte im Deutschunterricht mit auslaendischen Studenten (On Picture and Role in Language-in-Action. Considerations and Practical Examples of Role-Playing and Picture Stories in Teaching German to Foreign Learners).

ERIC Educational Resources Information Center

Loeffler, Renate

1979-01-01

Describes work at an American college with students who are receiving an introduction to colloquial German. Role-playing and picture stories prove useful in learning, in both productive and receptive aspects. Describing a picture on three levels--factual, psychological and contemplative--is shown to be very useful. (IFS/WGA)

Models in Insurance: Paradigms, Puzzles, Communications and Revolutions.

DTIC Science & Technology

1980-06-01

80.7] G. Buoro, G. Pavesi and G. Zucchiatti, "Osservazioni sul Sistema di Calcolo del Margine di Solvabiliti," 71-80. [80.8] J. Calcanis and A...Vegas, "Un Ensayo sobre la Concepci6n Sistema aplicada a la Empresa de Seguros," 443-462. [80.41] K. H. Wolff, "Zur numerischen Berechnung der... Teoria della Credibilit&," Giornale dell’ Istituto degli Attuari, 27, 219-231 (1964). (D51 N. De Pril, "The Efficiency of a Bonus-Malus System," AB, 10

Vergleich von rekombinanten Vaccinia- und DNA-Vektoren zur Tumorimmuntherapie im C57BL/6-Mausmodell

NASA Astrophysics Data System (ADS)

Johnen, Heiko

2002-10-01

In der vorliegenden Arbeit wurden Tumorimpfstoffe auf der Basis des Plasmid-Vektors pCI, modified vaccinia virus Ankara (MVA) und MVA-infizierten dendritischen Zellen entwickelt und durch Sequenzierung, Western blotting und durchflußzytometrische Analyse überprüft. Die in vivo Wirksamkeit der Vakzinen wurde in verschiedenen Tumormodellen in C57BL/6 Mäusen verglichen. Die auf dem eukaryotischen Expressionsvektor pCI basierende DNA-Vakzinierung induzierte einen sehr wirksamen, antigenspezifischen und langfristigen Schutz vor Muzin, CEA oder beta-Galactosidase exprimierenden Tumoren. Eine MVA-Vakzinierung bietet in den in dieser Arbeit durchgeführten Tumormodellen keinen signifikanten Schutz vor Muzin oder beta-Galactosidase exprimierenden Tumoren. Sowohl humane, als auch murine in vitro generierte dendritische Zellen lassen sich mit MVA – im Vergleich zu anderen viralen Vektoren – sehr gut infizieren. Die Expressionsrate der eingefügten Gene ist aber gering im Vergleich zur Expression in permissiven Wirtszellen des Virus (embryonale Hühnerfibroblasten). Es konnte gezeigt werden, daß eine MVA-Infektion dendritischer Zellen ähnliche Auswirkungen auf den Reifezustand humaner und muriner dendritischer Zellen hat, wie eine Infektion mit replikationskompetenten Vakzinia-Stämmen, und außerdem die Hochregulation von CD40 während der terminalen Reifung von murinen dendritischen Zellen inhibiert wird. Die während der langfristigen in vitro Kultur auf CEF-Zellen entstandenen Deletionen im MVA Genom führten zu einer starken Attenuierung und dem Verlust einiger Gene, die immunmodulatorische Proteine kodieren, jedoch nicht zu einer Verminderung des zytopathischen Effekts in dendritischen Zellen. Die geringe Expressionsrate und die beobachtete Inhibition der Expression kostimulatorischer Moleküle auf dendritischen Zellen kann für eine wenig effektive Induktion einer Immunantwort in MVA vakzinierten Tieren durch cross priming oder die direkte Infektion antigenpräsentierender Zellen verantwortlich sein. Durch die Modifikation einer Methode zur intrazellulären IFN-gamma Färbung konnten in vakzinierten Mäusen tumorantigenspezifische CTL sensitiv und quantitativ detektiert werden. Die so bestimmte CTL-Frequenz, nicht jedoch die humorale Antwort, korrelierte mit der in vivo Wirksamkeit der verschiedenen Vakzinen: DNA vakzinierte Tiere entwickeln starke tumorantigenspezifische CTL-Antworten, wohingegen in MVA-vakzinierten Tieren überwiegend gegen virale Epitope gerichtete CD4 und CD8-T-Zellen detektiert wurden. Die Wirksamkeit der pCI-DNA-Vakzine spricht für die Weiterentwicklung in weiteren präklinischen Mausmodellen, beispielsweise unter Verwendung von MUC1 oder HLA-A2 transgenen Mäusen. Die Methoden zur Detektion Tumorantigen-spezifischer CTL in 96-Loch-Mikrotiterplatten können dabei zur systematischen Suche nach im Menschen immundominanten T-Zell-Epitopen im Muzin-Molekül genutzt werden. Der durchgeführte Vergleich der auf den Vektoren pCI und MVA basierenden Vakzinen und die Analyse neuerer Publikationen führen zu dem Ergebniss, daß vor allem DNA-Vakzinen in Zukunft eine wichtige Rolle bei der Entwicklung von aktiven Tumorimpfstoffen spielen werden. Rekombinante MVA-Viren, eventuell in Kombination mit DNA- oder anderen Vektoren, haben sich dagegen in zahlreichen Studien als wirksame Impfstoffe zur Kontrolle von durch Pathogene hervorgerufenen Infektionserkrankungen erwiesen. In this study, tumor vaccines based on the plasmid pCI, the attenuated vaccinia virus strain modified vaccinia virus Ankara (MVA) and MVA-infected dendritic cells were constructed and characterized by sequencing, Western blot and flow cytometric analysis. The efficiency to induce tumor immunity in vivo was compared in several C57BL/6 mouse tumor models. Naked DNA Vaccination based on the eukaryotic expression vector pCI did induce very effective, antigen-specific and long-term protection against tumor cell lines expressing mucin, CEA or beta-Gal whereas MVA vaccination did not elicit protective immunity against Mucin or beta-Gal expressing tumors. MVA does infect human or murine in vitro generated dendritic cells very efficiently compared to other viral vectors, however expression levels of the inserted antigens in dendritic cells are significantly lower than in permissive host cells (chicken embryo fibroblasts). It could be shown that the effect of MVA infection on the maturation status of dendritic cells is similar to the effects described for dendritic cells infected with replication competent vaccinia strains. In addition it was shown that the upregulation of the important costimulatory molecule CD40 through LPS stimulation is strongly inhibited in MVA infected cells. During passage in tissue culture, MVA has accumulated a number of large deletions, including a number of immunomodulatory molecules and resulting in a strong attenuation. However the strong cytopathic effect on dendritic cells is maintained. The low level of expression and the effect on dendritic cell maturation may be responsible for the failure of MVA to induce tumor immunity through either cross presentation or direct infection of antigen presenting cells. To detect and quantify tumor-antigen-specific CTL a method based on intracellular IFN-gamma staining was modified and it could be shown that the cellular – but not the humoral – response does correlate with in vivo protection: DNA but not MVA vaccines do induce high levels of tumorantigen-specific CTL whereas MVA-vaccines do induce strong and long lasting CD4 and CD8-T-cell responses against vaccinia antigens. The excellent protection induced by pCI-DNA-vaccination in different tumor models does encourage us to further investigate the elicitation of tumor immunity in MUC1 or HLA-A2 transgenic mice. In mice transgenic for human MHC-I, the IFN-gamma staining protocol could be used to systematically screen for mucin T-cell epitopes that are relevant in humans.

[Hepatitis E - More than a Rare Travel-Associated Infectious Disease!

PubMed

Wedemeyer, Heiner

2017-06-01

Übertragungswege  In Deutschland infizieren sich jedes Jahr wahrscheinlich mehr als 300 000 Menschen mit dem Hepatitis-E-Virus (HEV). Die Hepatitis E ist in Mitteleuropa in der Regel eine durch den zoonotischen HEV-Genotyp-3-verursachte autochthone, d. h. lokal erworbene Infektionskrankheit. Der Verzehr von nicht ausreichend erhitztem Schweine- oder Wildfleisch ist ein Hauptrisikofaktor für HEV-Infektionen, Übertragungen des Virus durch Bluttransfusionen sind aber auch möglich. Diagnostik  Bei Immunkompetenten kann die Diagnose einer akuten Hepatitis E mit dem Nachweis von anti-HEV-IgM gestellt werden. Serologische Tests können bei Immunsupprimierten aber falsch-negativ sein, weshalb in diesen Fällen eine HEV-Infektion nur durch den direkten Nachweis des Erregers mittels PCR im Blut oder Stuhl erfolgen sollte. Natürlicher Verlauf  Eine akute Hepatitis E kann bei Patienten mit anderen chronischen Lebererkrankungen zu einem Leberversagen führen. Chronische Verläufe, definiert durch eine Virämie von mind. 3 Monaten, sind bei Organtransplantierten mit immunsuppressiver Medikation beschrieben, können aber auch bei anderen Immundefizienzen auftreten. Eine chronische Hepatitis E kann innerhalb von Monaten zu einer fortgeschrittenen Leberfibrose oder zur Zirrhose führen. Extrahepatische Manifestationen  Extrahepatische Manifestationen können während und nach einer HEV-Infektion auftreten. Insbesondere Guillain-Barré-Syndrome und die neuralgische Schulteramyotrophie sind mit einer Hepatitis E assoziiert worden. Therapie  Ribavirin hat eine antivirale Wirksamkeit gegen HEV. Bei chronischer Hepatitis E sollte die Behandlung für 3 – 6 Monate durchgeführt werden. Therapieversagen und Rückfälle nach Beendigung einer Behandlung sind möglich. Ein Impfstoff gegen HEV ist bisher nur in China zugelassen.

[Gerog Fresenius and the species Aspergillus fumigatus].

PubMed

Schmidt, A

1998-01-01

The species Aspergillus fumigatus was first extensively described by G. Fresenius. J. B. Georg W. Fresenius was born in Frankfurt/Main, Germany, in 1808 and also died there in 1866. He studied medicine and finished his doctorate thesis (MD) in 1829. Afterwards he started his career as a physician and surgeon in Frankfurt/Main in the same year. In 1831 Fresenius became a university lecturer for botany at the "Senckenbergisches medicinisches Institut"; this institute specialized in botany. In this year Fresenius also became the director of the botanical gardens of Frankfurt/Main. Apart from his collaboration in the institute for agriculture he actively participated in the microscopical association of Frankfurt as well as the "Senckenbergische medicinische Gesellschaft". Almost over the whole period, Fresenius also worked as a physician taking care of miserable people. The outstanding publications of Fresenius are "Die Flora von Frankfurt" (Flora of Frankfurt) and "Beiträge zur Mykologie" (Contributions to Mycology). The monograph "Beiträge zur Mykologie" was published by Fresenius as a dedication for the centennial celebrations of the Senckenberg foundation ("Senckenbergische Stiftung"). It contains 132 pages and 13 excellent lithographic figures (Camera lucida). The third part of this monograph also contains the description of the species A. fumigatus. Fresenius was an engaged physician as well as an outstanding researcher and expert in natural sciences who described numerous new fungal species some of which are still accepted nowadays in accordance with the "International Code of Botanical Nomenclature".

Hydrological Dynamics In High Mountain Catchment Areas of Central Norway

NASA Astrophysics Data System (ADS)

Löffler, Jörg; Rößler, Ole

Large-scaled landscape structure is regarded as a mosaic of ecotopes where process dynamics of water and energy fluxes are analysed due to its effects on ecosystem functioning. The investigations have been carried out in the continental most Vågå/Oppland high mountains in central Norway since 1994 (LÖFFLER &WUNDRAM 1999, 2000, 2001). Additionally, comparable investigations started in 2000 dealing with the oceanic high mountain landscapes on same latitudes (LÖFFLER et al. 2001). The theoretical and methodological framework of the project is given by the Landscape-Ecological Complex Analysis (MOSIMANN 1984, 1985) and its variations due to technical and principle methodical challenges in this high mountain landscape (KÖHLER et al. 1994, LÖFFLER 1998). The aim of the project is to characterize high mountain ecosystem structure, functioning and dynamics within small catchment areas, that are chosen in two different altitudinal belts each in the eastern continental and the western oceanic region of central Norway. In the frame of this research project hydrological and meteorological measurements on ground water, percolation and soil moisture dynamics as well as on evaporation, air humidity and air-, surface- and soil-temperatures have been conducted. On the basis of large-scaled landscape-ecological mappings (LÖFFLER 1997) one basic meteorological station and several major data logger run stations have been installed in representative sites of each two catchment areas in the low and mid alpine belts of the investigation regions ( JUNGet al. 1997, LÖFFLER &WUNDRAM 1997). Moreover, spatial differentiations of groundwater level, soil moisture and temperature profiles have been investigated by means of hand held measurements at different times of the day, during different climatic situations and different seasons. Daily and annual air-, surface- and soil-temperature dynamics are demonstrated by means of thermoisopleth-diagrams for different types of ecotopes of the different altitudinal belts. The local differences of temperature dynamics are illustrated in a map as an example of the low alpine altitudinal belt showing a 4-dimensional characterization (in space and time) of high mountain ecosystem functioning. Hydrological aspects derived from those results are presented showing the large- scaled hydrological dynamics of high mountain catchment basins in central Norway. The results of the process analysis of hydrological dynamics in the central Norwegian high mountains are discussed within the frame of investigations on altitudinal changes of mountain ecosystem structure and functioning (LÖFFLER &WUNDRAM [in print]). The poster illustrates the theoretical and methodological conception, methods and techniques, examples from complex data material as well as general outcomes of the project (RÖßLER [in prep.]. JUNG, G., J. LÖFFLER &D. WUNDRAM (1997): Untersuchungen zur Struktur, Funktion und Dynamik mittelnorwegischer Hochgebirgsökosysteme. Forschungsansatz. Oldenburger Geoökologisches Kolloquium 3: 4-36. Oldenburg. KÖHLER, B., J. LÖFFLER &D. WUNDRAM (1994): Probleme der kleinräumigen Geoökovarianz im mittelnorwegischen Gebirge. Norsk geogr. Tidsskr. 48: 99- 111. LÖFFLER, J. (1997): Großmaßstäbige geoökologische Kartierungen in den Höhenstufen des mittelnorwegischen Gebirges. NORDEN 12: 205-228. Bremen. LÖFFLER, J. (1998): Geoökologische Untersuchungen zur Struktur mittelnorwegischer Hochgebirgsökosysteme. Oldenburger Geoökologische Studien 1. Oldenburg. LÖFFLER, J., O.-D. FINCH, J. NAUJOK &R. PAPE (2001): Möglichkeiten der Integration zoologischer Aspekte in die landschaftsökologische Untersuchung von Hochgebirgen. Methodendiskussion am Beispiel ökologischer Prozesssysteme und Biozönosen. Naturschutz u. Landschaftsplanung 33 (11): 351-357. LÖFFLER, J. &D. WUNDRAM (1997): Klimatische Phänomene in mittelnorwegischen Hochgebirgslandschaften und ihre ökosystemare Bedeutung. Oldenburger Geoökologisches Kolloquium 3: 37-86. Oldenburg. LÖFFLER, J. &D. WUNDRAM (1999): Kleinräumige Klimavarianz im mittelnorwegischen Hochgebirgsraum Vågå/Oppland. NORDEN 13: 267 -276. Bremen. LÖFFLER, J. &D. WUNDRAM (2000) : Temperature Dynamics of Ecotopes in small Catchment Areas. In: C. BEIERKUHNLEIN et al. (Hrsg.): Zukunft mitteleuropäischer Kulturlandschaft. Analyse - Planung - Management. Tagungsband mit Kurzfassungen der Beiträge zur 1. Jahrestagung der IALE- Region Deutschland: 76, Nürtingen. LÖFFLER, J. &D. WUNDRAM (2001): Räumliche und zeitliche Differenzierung des Temperaturhaushalts von Hochgebirgsökosystemen. NORDEN 14: 85 -102. Bremen. LÖFFLER, J. &D. WUNDRAM (in print): Geoökologische Untersuchungen zur Prozessdynamik mittelnorwegischer Hochgebirgsökosysteme. Oldenburger Geoökologische Studien 2. Oldenburg. MOSIMANN, T. (1984): Landschaftsökologische Komplexanalyse. Wiesbaden. MOSIMANN, T. (1985): Untersuchungen zur Funktion subarktischer und alpiner Geoökosysteme (Finnmark [Norwegen] und Schweizer Alpen). Physiogeographica 7. Basel. RÖßLER, O. (in prep.): Modelling the Water Balance of Central Norwegian High Mountain Ecosystems. University of Oldenburg.

Versuche zur Gewinnung von katalytischen Antikörpern zur Hydrolyse von Arylcarbamaten und Arylharnstoffen. (English Title: Attempts to produce catalytic antibodies for hydrolysis of arylcarbamates and arylureas)

NASA Astrophysics Data System (ADS)

Werner, Deljana

2002-05-01

Im Rahmen dieser Arbeit gelang es, katalytische Antikörper zur Hydrolyse von Benzylphenylcarbamaten sowie zahlreiche monoklonale Antikörper gegen Haptene herzustellen. Es wurden verschiedene Hapten-Protein-Konjugate unter Verwendung unterschiedlicher Kopplungsmethoden hergestellt und charakterisiert. Zur Generierung der hydrolytisch aktiven Antikörper wurden Inzuchtmäuse mit KLH-Konjugaten von 4 Übergangszustandsanaloga (ÜZA) immunisiert. Mit Hilfe der Hybridomtechnik wurden verschiedene monoklonale Antikörper gegen diese ÜZA gewonnen. Dabei wurden sowohl verschiedene Immunisierungsschemata als auch verschiedene Inzuchtmausstämme und Fusionstechniken verwendet. Insgesamt wurden 32 monoklonale Antikörper gegen die verwendeten ÜZA selektiert. Diese Antikörper wurden in groen Mengen hergestellt und gereinigt. Zum Nachweis der Antikörper-vermittelten Katalyse wurden verschiedene Methoden entwickelt und eingesetzt, darunter immunologische Nachweismethoden mit Anti-Substrat- und Anti-Produkt-Antikörpern und eine photometrische Methode mit Dimethylaminozimtaldehyd. Der Nachweis der hydrolytischen Aktivität gelang mit Hilfe eines Enzymsensors, basierend auf immobilisierter Tyrosinase. Die Antikörper N1-BC1-D11, N1-FA7-C4, N1-FA7-D12 und R3-LG2-F9 hydrolysierten die Benzylphenylcarbamate POCc18, POCc19 und Substanz 27. Der Nachweis der hydrolytischen Aktivität dieser Antikörper gelang auch mit Hilfe der HPLC. Der katalytische Antikörper N1-BC1-D11 wurde kinetisch und thermodynamisch untersucht. Es wurde eine Michaelis-Menten-Kinetik mit Km von 210 µM, vmax von 3 mM/min und kcat von 222 min-1 beobachtet. Diese Werte korrelieren mit den Werten der wenigen bekannten Diphenylcarbamat-spaltenden Abzyme. Die Beschleunigungsrate des Antikörpers N1-BC1-D11 betrug 10. Das ÜZA Hei3 hemmte die hydrolytische Aktivität. Dies beweist, dass die Hydrolyse in der Antigenbindungsstelle stattfindet. Weiter wurde zwischen der Antikörperkonzentration und der Umsatzgeschwindigkeit eine lineare Abhängigkeit festgestellt. Die thermodynamische Gleichtgewichtsdissoziationskonstante KD des Abzyms von 2,6 nM zeugt von einer sehr guten Affinität zum ÜZA. Hydrolytisch aktiv waren nur Antikörper, die gegen das Übergangszustandsanalogon Hei3 hergestellt worden waren. Es wird vermutet, dass die Hydrolyse der Benzylphenylcarbamate über einen Additions-Eliminierungsmechanismus unter Ausbildung eines tetraedrischen Übergangszustandes verläuft, dessen analoge Verbindung Hei3 ist. Im Rahmen der Generierung von Nachweisantikörpern zur Detektion der Substratabnahme bei der Hydrolyse wurden Anti-Diuron-Antikörper hergestellt. Einer der Antikörper (B91-CG5) ist spezifisch für das Herbizid Diuron und hat einen IC50-Wert von 0,19 µg/l und eine untere Nachweisgrenze von 0,04 µg/l. Ein anderer Antikörper (B91-KF5) reagiert kreuz mit einer Palette ähnlicher Herbizide. Mit diesen Antikörpern wurde ein empfindlicher Labortest, der ein Monitoring von Diuron auf Grundlage des durch die Trinkwasserverordnung festgeschriebenen Wertes für Pflanzenschutzmittel von 0,1 µg/l erlaubt, aufgebaut. Der Effekt der Anti-Diuron-Antikörper auf die Diuron-inhibierte Photosynthese wurde in vitro und in vivo untersucht. Es wurde nachgewiesen, dass sowohl in isolierten Thylakoiden, als auch in intakten Algen eine Vorinkubation der Anti-Diuron-Antikörper mit Diuron zur Inaktivierung seiner Photosynthese-hemmenden Wirkung führt. Wurde der Elektronentransport in den isolierten Thylakoiden oder in Algen durch Diuron unterbrochen, so führte die Zugabe der Anti-Diuron-Antikörper zur Reaktivierung der Elektronenübertragung. Attempts to produce catalytic antibodies for hydrolysis of arylcarbamates and arylureas: The aim of the investigations was to produce antibodies which are able to cleave herbicides resistant to naturally occuring enzymes. Structurally similar carbamate and urea derivatives were chosen for the experiments. Phosphonate derivatives were synthesized that mimick possible transition state analogues in structure and charge. Mice were immunized with 4 different derivatives after conjugating them to carrier proteins. 32 hybridomas were established that produce monoclonal antibodies binding to these derivatives. The possible cleavage of substrates was determined by immunoassays with monoclonal antibodies against the substrate and the products and with a photometric method based on dimethylaminocinammonaldehyde. The measuring of cleavage products was succeeded by an amperometric method. The enzyme sensor was based on immobilized tyrosinase which oxidizes p-chlorophenol and phenol. The antibodies N1-BC1-D11, N1-FA7-C4, N1-FA7-D12 und R3-LG2-F9 hydrolysed the benzylphenylcarbamates POCc18, POCc19 und Substance 27. The hydrolytic activity of these antibodies was also succeeded with HPLC. The catalytic antibody N1-BC1-D11 was investigated kinetically and thermodynamically. A Michaelis-Menten-Kinetic was observed (at pH 8.0 exhibited a Km 210 µM, a vmax 3 mM/min and a kcat 222 min-1). These values are in the range of the values obtained for the antibody-catalysed hydrolysis of diphenylcarbamates. The rate enhancement of N1-BC1 was 10. The reaction was completely inhibited by stoichiometric quantities of the transition state analogue Hei3. This is consistent with the affinity of the abzyme to Hei3 of 2.6 nM, determined by BIAcore assay. Only antibodies generated against Hei3 showed hydrolytic activity. The hydrolysis of benzylphenylcarbamates presumably occurs via an addition-elimination-Mechanism involving a tetrahedral intermediate. In summary, this work presents the first example of antibody-catalysed hydrolysis of benzylphenylcarbamates. Monoclonal anti-diuron antibodies were generated that bind to the herbicide diuron with an extremely low equilibrium dissociation constant. A sensitive immunoassay with a low detection limit of 0.2 nM for diuron was established. This is the most sensitive immunological method for detection of diuron known so far. These antibodies were also used in vitro and in vivo to prevent diuron-dependent inhibition of photosynthesis or to restore photosynthesis after inhibition. In isolated thylakoids prepared from spinach leaves (Spinacia oleracea L.) the diuron-inhibited Hill reaction was reconstituted immediately following the addition of the monoclonal antibodies. In an in vivo approach the photosynthetic oxygen evolution of the cell wall deficient mutant (cw 15) of the green alga Chlamydomonas reinhardtii Dangeard was monitored. The antibodies prevented the diuron-dependent inhibition of photosynthesis and restored photosynthesis after inhibition. Transgenic plants that synthesize and accumulate these antibodies or antibody fragments and are therefore diuron-resistant can be created.

Republication of: On the general relativity theory

NASA Astrophysics Data System (ADS)

Weyl, H.

2009-07-01

This English translation of the paper by H. Weyl, "Zur allgemeinen Relativitätstheorie", Physikalische Zeitschrift 24, 230-232 (1923), in which he formulated the geometrical foundations of a model of an expanding Universe, has been selected by the Editors of General Relativity and Gravitation for publication in the Golden Oldies series of the journal. The paper is accompanied by an editorial note written by Juergen Ehlers and by Weyl's brief biography compiled by Andrzej Krasiński from internet sources, with corrections provided by Weyl's son and grandson.

Netz ohne doppelten Boden: Internet-Sicherheit

NASA Astrophysics Data System (ADS)

Fichtner, Johann

2002-07-01

Die Sicherheitslücken des heutigen Internets haben zwei Ursachen: sein ursprüngliches Design für rein militärische Zwecke sowie die gefährliche Sorglosigkeit der Entwickler und Betreiber von Internet-Komponenten. Dabei kann ein kleiner Kreis von Experten Angriffe auf die eigentlichen Netzknoten ausführen. Typische Hacker-Angriffe kommen von Endsystemen des Internets und richten sich auch gegen Endsysteme wie Firmen-Intranets oder einzelne PCs. Dagegen gibt es eine Reihe von Schutzmöglichkeiten. Es ist jedoch keine einfache Lösung zur Erhöhung der Internet-Sicherheit in Sicht.

Von den Flitterwochen zur distanzierten Partnerschaft. Deutsche Manager in internationalen M&A

NASA Astrophysics Data System (ADS)

Fuchs, Martina; Schalljo, Martin

2017-04-01

Cross-border mergers and acquisitions (M&A) require considerable intercultural openness on the part of the managers involved. A recent wave of takeovers by private equity investors and foreign investors from emerging economies has challenged German executives. In cases of friendly takeovers, as described in this study, managers at first appear to extend a cosmopolitan welcome to the new owners. However, further analysis of structural hermeneutics reveals latent normative professional ethics of managers which lead to practices of distancing, in particular from young investors from China, India, and Russia.

Allgemeine Sprachfaehigkeit und Fremdsprachenerwerb. Zur Struktur von Leistungsdimensionen und linguistischer Kompetenz des Fremdsprachenlerners (General Language Ability and Foreign Language Acquisition. On the Structure of Performance Dimensions and the Linguistic Competence of the Foreign Language Learner). Diskussions beitraege aus dem Institute fuer Bildungsforschung, No. 1.

ERIC Educational Resources Information Center

Sang, Fritz; Vollmer, Helmut J.

This study investigates the theoretical plausibility and empirical validity of the assumption that all performance in a foreign language can be traced back to a single factor, the general language ability factor. The theoretical background of this hypothesis is reviewed in detail. The concept of a unitary linguistic competence, interpreted as an…

Schaltungsunterlagen

NASA Astrophysics Data System (ADS)

Döring, Peter

Beim Zeichnen von Schaltplänen werden alle zugehörigen Maschinen, Geräte, Schaltteile und Leitungen nicht maßstabsgetreu und der tatsächlichen Ausführung ähnlich gezeichnet, sondern durch genormte graphische Symbole dargestellt. Die Ausführungen in diesem Kapitel sollen dazu eine Hilfestellung geben. Behandelt werden folgende Themen: Wichtige VDE-Bestimmungen; Diagrammdarstellungen; Schaltzeichen nach DIN; Kennzeichnung von elektrischen Betriebsmitteln; Schaltungsunterlagen der Energietechnik; Schaltungsunterlagen der Elektronik; Schaltzeichen für Binäre Elemente; Entwurf von Schaltungen: Einzelplatinen, Gedruckte Schaltungen; Projektierung. Zahlreiche Tabellen und Abbildungen dienen zur Erläuterung.

Urbanisierung und Ökologische Stadtentwicklung. Zur Integration urbaner Biodiversität und Ökosystemleistungen in Deutschland und China

NASA Astrophysics Data System (ADS)

Kümper-Schlake, Lennart

2016-06-01

Urbanisation processes increase land-use conflicts and ecosystem destruction globally. Especially in China, a country with an outstanding urbanization rate, city governments are challenged by environmental and health problems. Urban green spaces - subsequently defined as urban biodiversity and ecosystem services - can minimize numerous environmental risks and at the same time contribute to the citizens' well-being and quality of life. In this highly relevant field of nature conservation, geographical perspectives are required - in science, politics, policy, planning and practice.

Kundenfokus: Startpunkt für die digitale Transformation bei Stadtwerken

NASA Astrophysics Data System (ADS)

Fett, Perry; Küller, Philipp

Big Data, Internet der Dinge, Mobile Computing und soziale Medien - die modernen Informationstechnologien durchdringen den Alltag der meisten Menschen und lösen hierdurch eine digitale Transformation aus. Im Unternehmenskontext manifestiert sich die Digitalisierung durch eine neue Qualität der wissensbasierten Entscheidungsunterstützung und der Automatisierung bzw. Autonomisierung der Geschäftsprozesse. Für Stadtwerke gilt es nun, die Chancen der Digitalisierung zu ihren Gunsten zu nutzen. Ein Startpunkt könnte hierbei sein, wie Stadtwerke zukünftig mit ihren Kunden interagieren. Ausgelöst durch die Liberalisierung der Märkte rückt der Kunde heute stärker in den Mittelpunkt - die Energiewirtschaft steht nun vor der Herausforderung, dem Wettbewerb einen Schritt voraus zu sein und dem Kunden ein absolut positives Kundenerlebnis (Customer Experience) sowohl als Maßnahme zur Kundenbindung als auch zum Kundenaufbau zu bieten. Das vorliegende Kapitel zeigt hierfür die Erfolgskriterien für die gelungene Etablierung des Kundenfokus im eigenen Unternehmen auf. Mit dem Customer-Focus-Cycle-Modell von Fujitsu, angelehnt an den Deming-Kreislauf, wird ein allgemeingültiger Ansatz für ein mögliches Vorgehen beim Aufbau des Kundenfokus vorgestellt. Die sechs Phasen werden dabei anhand praktischer Beispiele erläutert und geben zudem Hinweise zu Methoden und Tools. Aus dem vorgestellten "Werkzeugkasten" wird ferner die Customer-Journey-Methode im Detail erläutert. Weiter soll das präsentierte Reifegradmodell Unternehmen dabei unterstützen, den eigenen Status quo festzustellen und die persönlichen Ziele auf dem Weg zur kundenzentrierten Organisation festzulegen.

Kompressionstherapie bei Patienten mit Ulcus cruris venosum.

PubMed

Dissemond, Joachim; Assenheimer, Bernd; Bültemann, Anke; Gerber, Veronika; Gretener, Silvia; Kohler-von Siebenthal, Elisabeth; Koller, Sonja; Kröger, Knut; Kurz, Peter; Läuchli, Severin; Münter, Christian; Panfil, Eva-Maria; Probst, Sebastian; Protz, Kerstin; Riepe, Gunnar; Strohal, Robert; Traber, Jürg; Partsch, Hugo

2016-11-01

Wund-D.A.CH. ist der Dachverband deutschsprachiger Fachgesellschaften, die sich mit den Thematiken der Wundbehandlung beschäftigen. Experten verschiedener Fachgesellschaften aus Deutschland, Österreich und der Schweiz haben nun einen aktuellen Konsens der Kompressionstherapie für Patienten mit Ulcus cruris venosum erstellt. In Europa ist das Ulcus cruris venosum eine der häufigsten Ursachen für chronische Wunden. Neben der konservativen und interventionellen Wund- und Venentherapie, ist die Kompressionstherapie die Basis der Behandlungsstrategien. Die Kompressionstherapie kann heute mit sehr unterschiedlichen Materialien und Systemen durchgeführt werden. Während in der Entstauungsphase insbesondere Verbände mit Kurzzugbinden oder Mehrkomponentensysteme zur Anwendung kommen, sind es anschließend überwiegend Ulkus-Strumpfsysteme. Eine weitere, bislang wenig verbreitete Alternative sind adaptive Kompressionsbandagen. Insbesondere für die Rezidivprophylaxe werden medizinische Kompressionsstrümpfe empfohlen. Durch die Vielzahl der heute zur Verfügung stehenden Behandlungsoptionen, kann für nahezu alle Patienten ein Konzept entwickelt werden, dass sich an den individuellen Bedürfnissen und Fähigkeiten orientiert und daher auch akzeptiert und durchgeführt wird. Die Kompressionstherapie ist für die Behandlung von Patienten mit Ulcus cruris venosum essentiell. In den letzten Jahren sind viele verschiedene Therapieoptionen verfügbar, die in den deutschsprachigen Ländern unterschiedlich angewendet oder durchgeführt werden. Daher soll dieser Expertenkonsens dazu beitragen, konkrete Empfehlungen für die praktische Durchführung der Kompressionstherapie von Patienten mit Ulcus cruris venosum darzustellen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Titanisierung von Implantatoberflächen

NASA Astrophysics Data System (ADS)

Zimmermann, Hanngörg; Heinlein, Markus; Guldner, Norbert W.

Titan gilt seit Jahrzehnten als einer der wichtigsten Implantatwerkstoffe in der Medizin. Neben den guten mechanischen Eigenschaften (Leichtigkeit, hohe Festigkeit etc.), besitzen Titanimplantate vor allem eine hervorragende Körperverträglichkeit, so dass die Implantate optimal in den humanen Organismus integriert werden [1]. Ist jedoch aufgrund der Anforderungen an das Implantat eine hohe Flexibilität und/ oder Elastizität gefragt, so scheidet der Werkstoff Titan aufgrund seiner spröden und unflexiblen Materialeigenschaften aus. Die Folge ist der Einsatz von Implantatmaterialien, sowohl künstlichen als auch biologischen Ursprungs, welche nicht selten eine unzureichende Biokompatibilität aufweisen und somit zu Fremdköper- und immunologischen Reaktionen und Einkapselung des Implantates führen können. Die Erhöhung der Körperverträglichkeit, eine Adaption an das biologische Umfeld und eine hohe Biokompatibilität sind demzufolge die wichtigsten Eigenschaften bei der bedarfsgerechten Herstellung von Implantaten und Implantatoberflächen. Zur Gestaltung von innovativen, biokompatiblen Oberflächen stehen unterschiedliche technische Lösungsansätze zur Verfügung. Zum einen besteht die Möglichkeit, geeignete Oberflächeneigenschaften aus dem Grundmaterial selbst zu optimieren. Dies geschieht unter anderem durch Modifikation der Werkstoffoberflächen in Form von Texturierungen und Oberflächenrauhigkeiten. Zum anderen können die Oberflächeneigenschaften unabhängig von denen des Trägermaterials gestaltet werden. Durch Funktionalisierung der Oberflächen mit geeigneten Beschichtungen oder der Zugabe von Medikamenten (Drug Eluting) werden die Kunststoffimplantate dahingehend verändert, dass eine Steigerung der Körperakzeptanz erreicht wird. Die Titanbeschichtung von Implantatoberflächen kombiniert die positiven Materialeigenschaften von Titan und Polymer.

Molekulare Diagnostik von Hautinfektionen am Paraffinmaterial - Übersicht und interdisziplinärer Konsensus.

PubMed

Sunderkötter, Cord; Becker, Karsten; Kutzner, Heinz; Meyer, Thomas; Blödorn-Schlicht, Norbert; Reischl, Udo; Nenoff, Pietro; Geißdörfer, Walter; Gräser, Yvonne; Herrmann, Mathias; Kühn, Joachim; Bogdan, Christian

2018-02-01

Nukleinsäure-Amplifikations-Techniken (NAT), wie die PCR, sind hochsensitiv sowie selektiv und stellen in der mikrobiologischen Diagnostik wertvolle Ergänzungen zur kulturellen Anzucht und Serologie dar. Sie bergen aber gerade bei formalinfixiertem und in Paraffin eingebettetem Gewebe ein Risiko für sowohl falsch negative als auch falsch positive Resultate, welches nicht immer richtig eingeschätzt wird. Daher haben Vertreter der Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM) und der Deutschen Dermatologischen Gesellschaft (DDG) einen Konsensus in Form einer Übersichtsarbeit erarbeitet, wann eine NAT am Paraffinschnitt angezeigt und sinnvoll ist und welche Punkte dabei in der Präanalytik und Befundinterpretation beachtet werden müssen. Da bei Verdacht auf eine Infektion grundsätzlich Nativgewebe genutzt werden soll, ist die PCR am Paraffinschnitt ein Sonderfall, wenn beispielsweise bei erst nachträglichaufgekommenem Verdacht auf eine Infektion kein Nativmaterial zur Verfügung steht und nicht mehr gewonnen werden kann. Mögliche Indikationen sind der histologisch erhobene Verdacht auf eine Leishmaniose, eine Infektion durch Bartonellen oder Rickettsien, oder ein Ecthyma contagiosum. Nicht sinnvoll ist oder kritisch gesehen wird eine NAT am Paraffinschnitt zum Beispiel bei Infektionen mit Mykobakterien oder RNA-Viren. Die Konstellation für eine NAT aus Paraffingewebe sollte jeweils benannt werden, die erforderliche Prä-Analytik, die jeweiligen Grenzen des Verfahrens und die diagnostischen Alternativen bekannt sein. Der PCR-Befund sollte entsprechend kommentiert werden, um Fehleinschätzungen zu vermeiden. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Eine selbstkonsistente Carleman Linearisierung zur Analyse von Oszillatoren

NASA Astrophysics Data System (ADS)

Weber, Harry; Mathis, Wolfgang

2017-09-01

Die Analyse nichtlinearer dynamischer Schaltungen ist bis heute eine herausfordernde Aufgabe, da nur selten analytische Lösungen angegeben werden können. Daher wurden eine Vielzahl von Methoden entwickelt, um eine qualitative oder quantitative Näherung für die Lösungen der Netzwerkgleichung zu erhalten. Oftmals wird beispielsweise eine Kleinsignalanalyse mit Hilfe einer Taylorreihe in einem Arbeitspunkt durchgeführt, die nach den Gliedern erster Ordnung abgebrochen wird. Allerdings ist diese Linearisierung nur in der Nähe des stabilen Arbeitspunktes für hyperbolische Systeme gültig. Besonders für die Analyse des dynamischen Verhaltens von Oszillatoren treten jedoch nicht-hyperbolische Systeme auf, sodass diese Methode nicht angewendet werden kann Mathis (2000). Carleman hat gezeigt, dass nichtlineare Differentialgleichungen mit polynomiellen Nichtlinearitäten in ein unendliches System von linearen Differentialgleichungen transformiert werden können Carleman (1932). Wird das unendlichdimensionale Gleichungssystem für numerische Zwecke abgebrochen, kann bei Oszillatoren der Übergang in eine stationäre Schwingung (Grenzzyklus) nicht wiedergegeben werden. In diesem Beitrag wird eine selbstkonsistente Carleman Linearisierung zur Untersuchung von Oszillatoren vorgestellt, die auch dann anwendbar ist, wenn die Nichtlinearitäten keinen Polynomen entsprechen. Anstelle einer linearen Näherung um einen Arbeitspunkt, erfolgt mit Hilfe der Carleman Linearisierung eine Approximation auf einem vorgegebenen Gebiet. Da es jedoch mit der selbstkonsistenten Technik nicht möglich ist, das stationäre Verhalten von Oszillatoren zu beschreiben, wird die Berechnung einer Poincaré-Abbildung durchgeführt. Mit dieser ist eine anschließende Analyse des Oszillators möglich.

Farewell to Diversity? New State Zones of Health Care Service in China’s Far West

PubMed Central

Klotzbücher, Sascha; Lässig, Peter; Jiangmei, Qin; Dongsheng, Rui; Weigelin-Schwiedrzik, Susanne

2014-01-01

Using James Scott’s (2009) theoretical framework of the interaction between the state and peripheral people, we argue that the welfare state should be regarded as a pull-factor in the context of the state’s endeavours to project its power to distant peoples in assigned state zones. Our discussion is based on interviews in Xinyuan County in the Western part of the Xinjiang Uyghur Autonomous Region, China. Presenting current policies and alternative policy options discussed at the local level for providing primary health care in rural China, we argue that decisions made in the implementation process did not respond to the special health needs of mobile pastoralists in the high plains, but were part of the central state logic of homogenising settlement efforts and health care. Der theoretische Ansatz von James Scott zu Expansion von staatlicher Ordnung auf periphere Randgebiete wird auf den Aufbau von Wohlfahrts- und Gesundheitspolitik des modernen Staates angewendet und weiterentwickelt. Anhand mehrjähriger Feldstudien zwischen 2005 und 2009 zur Gesundheitsversorgungsstruktur im Kreis Xinyuan der Autonomen Uighurischen Region Xinjiang in der Volksrepublik China werden zuerst die nationalen Restrukturierungsmaßnahmen vorgestellt und Lösungen für eine bessere Versorgung der halbnomadisierenden kasachischen Hirtenfamilien diskutiert. Lokal entwickelte und an die nomadischen Lebensformen angepasste mobile Lösungen zur Gesundheitsfürsorge konnten nicht implementiert werden. Die Anstrengungen der staatlichen Akteure sind als Versuch zu sehen, bisher marginalisierte Gruppen aus den peripheren Gebirgsregionen und über die Integration in eine staatliche Gesundheitsversorgung in den Tälern anzusiedeln. PMID:25729121

Deutsches "Nationales Krebshilfe-Monitoring" 2015-2019 - Studienprotokoll und erste Ergebnisse.

PubMed

Schneider, Sven; Görig, Tatiana; Schilling, Laura; Breitbart, Eckhard W; Greinert, Rüdiger; Diehl, Katharina

2017-09-01

Das Projekt "Nationales Krebshilfe-Monitoring zur Solariennutzung" (National Cancer Aid Monitoring of Tanning Bed Use, NCAM) ist eine deutsche Großstudie mit dem Ziel, die wichtigsten Risikofaktoren für Hautkrebs zu beobachten: natürliches Sonnenlicht und künstliche UV-Strahlung. NCAM ist eine bundesweite Querschnittstudie mit zunächst vier Runden der Datenerfassung (sogenannten Wellen) zwischen 2015 und 2018. Jedes Jahr wird eine bundesweit repräsentative Stichprobe aus 3.000 Personen im Alter von 14 bis 45 Jahren befragt. Die Querschnittsbefragung wird durch eine Kohorte von n = 450 aktuellen Solariennutzern ergänzt. Die erste Welle im Jahr 2015 ergab eine Gesamtprävalenz der Solariennutzung von 29,5 %. Elf Prozent aller Teilnehmer hatten in den vergangenen zwölf Monaten ein Solarium genutzt. Zu den Determinanten der aktuellen Solariennutzung gehörten jüngeres Alter, weibliches Geschlecht und Vollzeit-/Teilzeitbeschäftigung. Die hauptsächlichen Beweggründe, die für die Nutzung eines Solariums genannt wurden, waren Entspannung und Attraktivitätssteigerung. NCAM ist weltweit die erste Studie zur Überwachung der Risikofaktoren für Hautkrebs in jährlichen Intervallen anhand einer großen, landesweit repräsentativen Stichprobe. Erste Ergebnisse deuten darauf hin, dass Millionen Deutsche trotz Warnungen der WHO Solarien nutzen, und dass viele dieser Nutzer Jugendliche sind - trotz gesetzlicher Beschränkungen, die das Ziel haben, die Nutzung von Solarien durch Minderjährige zu verhindern. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Comparative genomics of bacterial zinc regulons: enhanced ion transport, pathogenesis, and rearrangement of ribosomal proteins.

PubMed

Panina, Ekaterina M; Mironov, Andrey A; Gelfand, Mikhail S

2003-08-19

Zinc is an important component of many proteins, but in large concentrations it is poisonous to the cell. Thus its transport is regulated by zinc repressors ZUR of proteobacteria and Gram-positive bacteria from the Bacillus group and AdcR of bacteria from the Streptococcus group. Comparative computational analysis allowed us to identify binding signals of ZUR repressors GAAATGTTATANTATAACATTTC for gamma-proteobacteria, GTAATGTAATAACATTAC for the Agrobacterium group, GATATGTTATAACATATC for the Rhododoccus group, TAAATCGTAATNATTACGATTTA for Gram-positive bacteria, and TTAACYRGTTAA of the streptococcal AdcR repressor. In addition to known transporters and their paralogs, zinc regulons were predicted to contain a candidate component of the ATP binding cassette, zinT (b1995 in Escherichia coli and yrpE in Bacillus subtilis). Candidate AdcR-binding sites were identified upstream of genes encoding pneumococcal histidine triad (PHT) proteins from a number of pathogenic streptococci. Protein functional analysis of this family suggests that PHT proteins are involved in the invasion process. Finally, repression by zinc was predicted for genes encoding a variety of paralogs of ribosomal proteins. The original copies of all these proteins contain zinc-ribbon motifs and thus likely bind zinc, whereas these motifs are destroyed in zinc-regulated paralogs. We suggest that the induction of these paralogs in conditions of zinc starvation leads to their incorporation in a fraction of ribosomes instead of the original ribosomal proteins; the latter are then degraded with subsequent release of some zinc for the utilization by other proteins. Thus we predict a mechanism for maintaining zinc availability for essential enzymes.

Gesammelte Werke / Collected Works

NASA Astrophysics Data System (ADS)

Schwarzschild, Karl; Voigt, Hans-Heinrich

Der bekannte Astronom Karl Schwarzschild (1873-1916) gilt als der Begründer der Astrophysik und als hervorragender Forscher mit einer erstaunlichen Bandbreite seiner Interessen. Arbeiten zur Himmelsmechanik, Elektrodynamik und Relativitätstheorie weisen ihn als vorzüglichen Mathematiker und Physiker auf der Höhe seiner Zeit aus. Untersuchungen zur Photographischen Photometrie, Optik und Spektroskopie zeigen den versierten Beobachter, der sein Meßinstrumentarium beherrscht, und schließlich arbeitete Schwarzschild als Astrophysiker an Sternatmosphären, Kometen, Struktur und Dynamik von Sternsystemen. Die in seinem kurzen Leben entstandene Fülle an wissenschaftlichen Arbeiten ist in drei Bänden der Gesamtausgabe gesammelt, ergänzt durch biographisches Material, Annotationen von Fachleuten und einen Essay des Nobelpreisträgers S. Chandrasekhar. The well-known astronomer Karl Schwarzschild (1873-1916) is regarded as the founder of astrophysics and as an exceptionally talented researcher whose interests spanned a remarkably broad spectrum. His work on celestial mechanics, electrodynamics, and relativity theory demonstrates his great abilities as a mathematician and physicist who significantly influenced the science of his times. His investigations of photographic photometry, optics, and spectroscopy display his strengths as an observer who knew his instruments. But above all Schwarzschild pursued questions of astrophysics, addressing in particular stellar atmospheres, comets, and the structure and dynamics of stellar systems. The host of scientific works that he authored in his short life is now collected in the form of this three-volume complete works; it is supplemented by biographical material, notes from some of todays experts, and an essay by the Nobel Laureate S. Chandrasekhar.

Grundlegende Steuerungsverfahren im heterogenen Logistiknetz mit Kanban

NASA Astrophysics Data System (ADS)

Dickmann, Eva; Dickmann, Philipp; Lödding, Hermann; Möller, Niklas; Rücker, Thomas; Schneider, Herfried M.; Zäh, Michael F.

In vielen Unternehmen werden heterogene (verschiedene) Steuerungen in einem abgestimmten Konzept kombiniert. Je nach Anwendungsfall und Rahmenbedingungen werden Kombinationen allgemein bekannter Steuerungen oder Steuerungsvarianten gemischt eingesetzt, um eine optimale Steuerung für unterschiedliche Fälle zu erreichen. Hierbei stehen neben den bekannten und weit verbreiteten Methoden, wie Material Requirements Planning (MRP) oder Kanban, auch weniger bekannte oder neue Methoden zur Auswahl, wie die Produktionssteuerung mit dezentraler, bestandsorientierter Fertigungsregelung (DBF). Kanban ist ein simples und effizientes Steuerungskonzept, das in der klassischen Form für spezifische einfache Anwendungsfälle umsetzbar ist. Hochentwickelte Steuerungsalgorithmen können helfen, komplexe Abläufe optimal abzubilden. Mit einer grundlegenden Vereinfachung der Abläufe kann allerdings in vielen Fällen ein wesentlich stärkerer und umfassender Verbesserungseffekt erzielt werden. Die wesentliche Fragestellung sollte folglich lauten: Warum ist der Ablauf nicht mit einer einfachen Steuerung wie Kanban abzubilden? Um die Vorteile des Konzepts auch in untypischen Bereichen anwenden zu können, sind jedoch verschiedene Varianten oder Kanban-ähnliche Steuerungsmethoden entstanden. Darüber hinaus sind in der Praxis hybride Steuerungen im Einsatz, welche so kombiniert werden, dass die Zusammensetzung anspruchsvolle Eigenschaftsbilder noch exakt abbildet. In der Praxis basieren die Steuerungsentscheidungen nur zu einem kleinen Teil auf den eigentlichen Steuerungsalgorithmen, wie sie uns das MRP-System zur Verfügung stellt. Moderne Steuerungswelten" schließen alle relevanten Informationsquellen in eine heterogene Entscheidungsmatrix mit ein. Letztlich zählt nicht, ob die Entscheidung auf den Informationen aus dem MRP-System oder auf Softfacts basierend getroffen wurde, sondern nur, ob die Entscheidung erfolgreich war.

Mittelwert- und Arbeitstaktsynchrone Simulation von Dieselmotoren

NASA Astrophysics Data System (ADS)

Zahn, Sebastian

Getrieben durch die immer restriktiveren Anforderungen an das Emissions- und Verbrauchsverhalten moderner Verbrennungsmotoren steigt die Komplexität von Motormanagementsystemen mit jeder Modellgeneration an. Damit geht nicht nur eine Zunahme des Softwareumfangs von Steuergeräten sondern zugleich ein deutlicher Anstieg des Applikations-, Vermessungs- und Testaufwandes einher. Zur Effizienzsteigerung des Software- und Funktionsentwicklungsprozesses haben sich daher in der Automobilindustrie sowie in Forschungsinstituten verschiedene modell- und simulationsbasierte Methoden wie die Model-in-the-Loop (MiL) Simulation, die Software-in-the-Loop (SiL) Simulation, das Rapid Control Prototyping (RCP) sowie die Hardware-in-the-Loop (HiL) Simulation etabliert.

Visualisierung analoger Schaltungen durch 3-D Animation von transienten SPICE-Simulationen

NASA Astrophysics Data System (ADS)

Becker, J.; Manoli, Y.

2007-06-01

Für das Zeichnen analoger Schaltpläne wird oft versucht, die Potentialverteilung in der entsprechenden Schaltung auszunutzen, um eine Platzierung der Bauteile nach abfallendem Potential vorzunehmen. Mit Hilfe von Computerunterstützung gelingt es, eine verallgemeinerte dreidimensionale Platzierungsstrategie anzuwenden, die allein auf Grund der Potentialwerte einer Schaltung die automatische Generierung einer technisch exakten Potentialdarstellung erlaubt. Somit ist es möglich, die Ergebnisse von transienten SPICE-Simulationen in jedem Zeitschritt darzustellen und eine Animation des zeitlichen Verhaltens zu erzeugen. Die Umsetzung dieser Methode zur Einbettung in eine webbasierte Lern - und Arbeitsplattform wird im Folgenden erläutert.

Transition of the Combustion of Condensed Systems into an Explosion

DTIC Science & Technology

1975-02-06

tubes iwholly L 1 ed,’ with exrlnsives. Figure Cb de ,-cts the tube which w-.as used ty Gi’pson ar’J !Ma’L"ek for the study of the transition of ccrtUS...continuous optical recording c_’ the trocess of the tlii-sitiOTI CT’ crmsr.ion into aCetonatio.. it is schematically’ de -cicted on rg c The tube...r thlis zur-ose Zverev designed a special electronic amelifier. hIs amplifIer had a sc.*w resnonse, which made it rossible to use the ciezoelectric

Konzeption, Entwicklung und Evaluierung eines Messsystems zur sortenreinen Klassifikation von fluoreszenzcodierten Kunststoffen im Rahmen des Kunststoff-Recyclings(Conception, development and evaluation of a measuring system for the classification of fluorescence coded plastics within the framework of plastic recycling)

DTIC Science & Technology

2016-06-13

REPORT DOCUMENTATION PAGE 1 Form Approved OMB No. 0704-0 188 Public reporting burden for this collection of information is estimated to average 1...PRI CE CODE 19, SECURITY CLASSI FI CATI ON 20. LIM ITATION OF ABSTRACT OF ABSTRACT UNCLASSIFIED UL Standard Form 298 (Rev. 2-89) Prescribed by...Trennung komplexer Kunststoffmixturen in Form von typi- schem Kunststoffmahlgut ("Flakes") und insbesondere dunkler bzw. schwarzer Kunst- stoffe beseitigt

Willkommen, Mr. Chance: Methodologische Betrachtungen zur Gute empirischer Forschung in der Padagogik, diskutiert vor allem an der neueren Untersuchung uber Gewalt von Heitmeyer u.a. (1995) = Welcome, Mr. Chance: Methodological Considerations Concerning the Quality of Empirical Research in Educational Science Based on a Recent Study on Violence Published by Heitmeyer et al. (1995).

ERIC Educational Resources Information Center

Wellenreuther, Martin

1997-01-01

Argues that the usefulness of strictly quantitative research is still questioned in educational studies, primarily due to deficiencies in methodological training. Uses a critique of a recent study by Heitmeyer et al. (1995) to illustrate the requirements of "good" empirical research. Considers the problems of hypothesis testing in field research.…

Aufbau des humanoiden Roboters BART III

NASA Astrophysics Data System (ADS)

Resetov, Dimitri; Pietsch, Björn; Gerth, Wilfried

Der vorliegende Beitrag präsentiert den humanoiden Roboter BART III, der am Institut für Regelungstechnik als eine robuste und erweiterbare Plattform für weiterführende Grundlagenforschung zur zweibeinigen Fortbewegung entwickelt wurde. Im Gegensatz zu den bisher am IRT genutzten Robotern BARt-UH und LISA besitzt der neue Roboter einen beweglichen Oberkörper mit einem Bauchgelenk und Armen. BART III besitzt insgesamt 19 aktive Freiheitsgrade, 12 davon im Unterkörper. Ein weiteres Merkmal des Roboters ist die im gesamten Körper verteilte Ansteuerelektronik, die neben der lokalen Motorregelung diverse sicherheitsrelevante Funktionen übernimmt.

Contributions to the History of Astronomy, Vol. 5 (German Title: Beiträge zur Astronomiegeschichte, Band 5)

NASA Astrophysics Data System (ADS)

Dick, Wolfgang R.; Hamel, Jürgen

This book contains articles on 16th century horoscopes, on Athanasius Kircher's ``Organum Mathematicum'', on Gottfried Kirch's idea of an astronomical society, on a stellar photometer dating from 1786, on Bessel's review of Gauss' ``Theoria Motus'', on letters by F.X. von Zach, on the discovery of the minor planet Eros, as well as on the astronomers Christoph Scheiner, Johann Philipp von Wurzelbau, Georg Koch and Felix Linke. Short contributions and book reviews conclude this volume. Most papers are written in German. Main papers have English abstracts.

Sternbilder und ihre Mythen

NASA Astrophysics Data System (ADS)

Fasching, Gerhard

Die Sternbilder und die damit verbundenen Mythen helfen, sich am Sternenhimmel zurechtzufinden und vermitteln die Vielfalt der Bilder der Mythologie und der Sternsagen. Sternkarten und alte Kupferstiche aus dem Bestand der Österreichischen Nationalbibliothek zeigen, wie man sich in früheren Jahrhunderten den Sternenhimmel vorgestellt hat. Ausführliche Sachverzeichnisse mit über 3000 Suchbegriffen erleichtern den Zugang zu Stern- und Sternbildnamen und zur Mythologie. Die dritte, erweiterte Auflage gibt für die kommenden Jahrzehnte darüber Auskunft, wo und wann die Planeten aber auch Sternhaufen, Gasnebel und Galaxien am Himmel mühelos aufgefunden werden können.

Herausforderungen durch die deutsche Wiedervereinigung

NASA Astrophysics Data System (ADS)

Stäglin, Reiner

Die Wiedervereinigung stellte auch die Statistik vor große Aufgaben. Die als Organ der staatlichen Planung staatsnah orientierte Statistik der DDR musste auf das zur Neutralität und wissenschaftlichen Unabhängigkeit verpflichtete System der Bundesrepublik umgestellt werden. Ebenso verlangten die Universitäten eine Neuorientierung. Die Deutsche Statistische Gesellschaft hat sich vor allem dreier Aufgaben mit großem Engagement, aber auch mit Bedachtsamkeit angenommen: Aufnahme und Integration der Statistiker aus den neuen Bundesländern in die Gesellschaft, Begleitung der Neuausrichtung des Faches Statistik an deren Hochschulen und Sicherung sowie Nutzung von Datenbeständen der ehemaligen DDR.

Grundlagen und Grundbegriffe der Messtechnik

NASA Astrophysics Data System (ADS)

Plaßmann, Wilfried

Es ist eine wesentliche Aufgabe der Messtechnik, technische Vorgänge quantitativ zu erfassen und anhand der gemessenen Größen Funktionsabläufe zu steuern. Als Beispiel sei ein Kraftwerk zur Energieerzeugung genannt, bei dem nur über die Messung von Temperaturen, Leistungen, Drücken und anderen Größen Aussagen über den momentanen Zustand möglich sind und bei Abweichungen vom Sollwert geeignete Eingriffe in das System erfolgen können. Damit eine eindeutige Kommunikation möglich wird, sind die in der Messtechnik verwendeten Begriffe, Messverfahren und Maßeinheiten in entsprechenden Normen oder Vorschriften festgelegt.

Automatisierung des Verfahrens nach Beyer & Schweiger (1969) zur Bestimmung von Durchlässigkeit und Porosität aus Kornverteilungskurven

NASA Astrophysics Data System (ADS)

Houben, Georg J.; Blümel, Martin

2017-11-01

Porosity is a fundamental parameter in hydrogeology. The empirical method of Beyer and Schweiger (1969) allows the calculation of hydraulic conductivity and both the total and effective porosity from granulometric data. However, due to its graphical nature with type curves, it is tedious to apply and prone to reading errors. In this work, the type curves were digitized and emulated by mathematical functions. The latter were implemented into a spreadsheet and a visual basic program, allowing the fast automated application of the method for any number of samples.

Imagineering the astronomical revolution - Essay review

NASA Astrophysics Data System (ADS)

Jardine, Nicholas.

2006-11-01

Concerning following Books: (I) Transmitting knowledge - words, images, and instruments in early modern Europe. Kusukawa and Maclean (eds.), OUP, Oxford, 2006; (II) Widmung, Welterklärung und Wissenschaftslegitimierung: Titelbilder und ihre Funktionen in der wissenschaftlichen Revolution. Remmert, Harrassowitz, Wiesbaden, 2005; (III) The power of images in early modern science. Lefevre, Renn and Schoepflin (eds.), Birkhäuser, Basel, 2003; (IV) Immagini per conoscere - dal Rinascimento alla rivoluzione scientifica. Meroi and Pogliano (eds.), Olschki, Florenz, 2001; (V) Erkenntnis Erfindung Konstruktion - Studien zur Bildgeschichte von Naturwissenschaften und Technik vom 16. bis zum 19. Jahrhundert. Holländer (ed.), Mann, Berlin, 2000.

Transcriptional regulation by Ferric Uptake Regulator (Fur) in pathogenic bacteria.

PubMed

Troxell, Bryan; Hassan, Hosni M

2013-01-01

In the ancient anaerobic environment, ferrous iron (Fe(2+)) was one of the first metal cofactors. Oxygenation of the ancient world challenged bacteria to acquire the insoluble ferric iron (Fe(3+)) and later to defend against reactive oxygen species (ROS) generated by the Fenton chemistry. To acquire Fe(3+), bacteria produce low-molecular weight compounds, known as siderophores, which have extremely high affinity for Fe(3+). However, during infection the host restricts iron from pathogens by producing iron- and siderophore-chelating proteins, by exporting iron from intracellular pathogen-containing compartments, and by limiting absorption of dietary iron. Ferric Uptake Regulator (Fur) is a transcription factor which utilizes Fe(2+) as a corepressor and represses siderophore synthesis in pathogens. Fur, directly or indirectly, controls expression of enzymes that protect against ROS damage. Thus, the challenges of iron homeostasis and defense against ROS are addressed via Fur. Although the role of Fur as a repressor is well-documented, emerging evidence demonstrates that Fur can function as an activator. Fur activation can occur through three distinct mechanisms (1) indirectly via small RNAs, (2) binding at cis regulatory elements that enhance recruitment of the RNA polymerase holoenzyme (RNAP), and (3) functioning as an antirepressor by removing or blocking DNA binding of a repressor of transcription. In addition, Fur homologs control defense against peroxide stress (PerR) and control uptake of other metals such as zinc (Zur) and manganese (Mur) in pathogenic bacteria. Fur family members are important for virulence within bacterial pathogens since mutants of fur, perR, or zur exhibit reduced virulence within numerous animal and plant models of infection. This review focuses on the breadth of Fur regulation in pathogenic bacteria.

Transcriptional regulation by Ferric Uptake Regulator (Fur) in pathogenic bacteria

PubMed Central

Troxell, Bryan; Hassan, Hosni M.

2013-01-01

In the ancient anaerobic environment, ferrous iron (Fe2+) was one of the first metal cofactors. Oxygenation of the ancient world challenged bacteria to acquire the insoluble ferric iron (Fe3+) and later to defend against reactive oxygen species (ROS) generated by the Fenton chemistry. To acquire Fe3+, bacteria produce low-molecular weight compounds, known as siderophores, which have extremely high affinity for Fe3+. However, during infection the host restricts iron from pathogens by producing iron- and siderophore-chelating proteins, by exporting iron from intracellular pathogen-containing compartments, and by limiting absorption of dietary iron. Ferric Uptake Regulator (Fur) is a transcription factor which utilizes Fe2+ as a corepressor and represses siderophore synthesis in pathogens. Fur, directly or indirectly, controls expression of enzymes that protect against ROS damage. Thus, the challenges of iron homeostasis and defense against ROS are addressed via Fur. Although the role of Fur as a repressor is well-documented, emerging evidence demonstrates that Fur can function as an activator. Fur activation can occur through three distinct mechanisms (1) indirectly via small RNAs, (2) binding at cis regulatory elements that enhance recruitment of the RNA polymerase holoenzyme (RNAP), and (3) functioning as an antirepressor by removing or blocking DNA binding of a repressor of transcription. In addition, Fur homologs control defense against peroxide stress (PerR) and control uptake of other metals such as zinc (Zur) and manganese (Mur) in pathogenic bacteria. Fur family members are important for virulence within bacterial pathogens since mutants of fur, perR, or zur exhibit reduced virulence within numerous animal and plant models of infection. This review focuses on the breadth of Fur regulation in pathogenic bacteria. PMID:24106689

Umgang mit Antithrombotika bei Operationen an der Haut vor und nach Publikation der entsprechenden S3-Leitlinie.

PubMed

Gaskins, Matthew; Dittmann, Martin; Eisert, Lisa; Werner, Ricardo Niklas; Dressler, Corinna; Löser, Christoph; Nast, Alexander

2018-03-01

Laut einer Befragung im Jahre 2012 war der Umgang mit Antithrombotika bei dermatochirurgischen Eingriffen in Deutschland sehr heterogen. 2014 wurde erstmals eine evidenzbasierte Leitlinie zu diesem Thema veröffentlicht. Es wurde eine anonyme Befragung derselben Stichprobe zum Umgang mit Antithrombotika sowie zu Kenntnissen der Leitlinie durchgeführt. Die Ergebnisse wurden als relative Häufigkeiten berichtet und denen aus 2012 gegenübergestellt. 208 Antwortbögen wurden ausgewertet (Rücklaufquote: 36,6 %). Die große Mehrheit der Dermatologen erklärte, kleinere Eingriffe unter Fortführung der Therapie mit Phenprocoumon, niedrig dosierter Acetylsalicylsäure (≤ 100 mg) und Clopidogrel sowie mit direkten oralen Antikoagulanzien durchzuführen. Bei größeren Eingriffen war der Umgang hingegen weiterhin heterogen, insbesondere unter niedergelassenen Dermatologen. Der Anteil der Dermatologen, die Phenprocoumon, Acetylsalicylsäure und Clopidogrel leitlinienkonform verwendeten, hat sich insgesamt vergrößert. Führten 2012 beispielsweise 53,8 % der Klinikärzte bzw. 36,3 % der niedergelassenen Dermatologen eine große Exzision unter Fortführung der Therapie mit niedrig dosierter Acetylsalicylsäure durch, taten dies 2017 90,2 % bzw. 57,8 % (Phenprocoumon: 33,8 % bzw. 11,9 % auf 63,9 % bzw. 29,9 %; Clopidogrel: 36,9 % bzw. 23,2 % auf 63,9 % bzw. 30,6 %). Unter den Klinikärzten war ein hoher Anteil mit der Leitlinie vertraut und fand diese hilfreich. Eine Zunahme des leitlinienkonformen Verhaltens war bei allen Eingriffen zu verzeichnen. Bei größeren Eingriffen zeigte sich trotz deutlicher Verbesserung die Notwendigkeit verstärkter Anstrengungen zur Leitlinienumsetzung bzw. zur Identifizierung von Implementierungsbarrieren. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Big Biology: Supersizing Science During the Emergence of the 21st Century

PubMed Central

Vermeulen, Niki

2017-01-01

Ist Biologie das jüngste Mitglied in der Familie von Big Science? Die vermehrte Zusammenarbeit in der biologischen Forschung wurde in der Folge des Human Genome Project zwar zum Gegenstand hitziger Diskussionen, aber Debatten und Reflexionen blieben meist im Polemischen verhaftet und zeigten eine begrenzte Wertschätzung für die Vielfalt und Erklärungskraft des Konzepts von Big Science. Zur gleichen Zeit haben Wissenschafts- und Technikforscher/innen in ihren Beschreibungen des Wandels der Forschungslandschaft die Verwendung des Begriffs Big Science gemieden. Dieser interdisziplinäre Artikel kombiniert eine begriffliche Analyse des Konzepts von Big Science mit unterschiedlichen Daten und Ideen aus einer Multimethodenuntersuchung mehrerer großer Forschungsprojekte in der Biologie. Ziel ist es, ein empirisch fundiertes, nuanciertes und analytisch nützliches Verständnis von Big Biology zu entwickeln und die normativen Debatten mit ihren einfachen Dichotomien und rhetorischen Positionen hinter sich zu lassen. Zwar kann das Konzept von Big Science als eine Mode in der Wissenschaftspolitik gesehen werden – inzwischen vielleicht sogar als ein altmodisches Konzept –, doch lautet meine innovative Argumentation, dass dessen analytische Verwendung unsere Aufmerksamkeit auf die Ausweitung der Zusammenarbeit in den Biowissenschaften lenkt. Die Analyse von Big Biology zeigt Unterschiede zu Big Physics und anderen Formen von Big Science, namentlich in den Mustern der Forschungsorganisation, der verwendeten Technologien und der gesellschaftlichen Zusammenhänge, in denen sie tätig ist. So können Reflexionen über Big Science, Big Biology und ihre Beziehungen zur Wissensproduktion die jüngsten Behauptungen über grundlegende Veränderungen in der Life Science-Forschung in einen historischen Kontext stellen. PMID:27215209

An analytic solution for periodic thermally-driven flows over an infinite slope

NASA Astrophysics Data System (ADS)

Zardi, Dino; Serafin, Stefano

2013-04-01

The flow generated along an infinite slope in an unperturbed stably stratified atmosphere at rest by a time periodic surface temperature forcing is examined. Following Defant (1949), a set of equations is derived which extends Prandtl's (1942) theory to allow for nonstationary conditions. Uniform boundary conditions are conducive to an along-slope parallel flow, governed by a periodically reversing local imbalance between along-slope advection and slope-normal fluxes of momentum and heat. Solutions include both a transient part and a subsequent periodic regime. The former can only be expressed in an integral form, whereas the latter is a combination of exponential and sine or cosine functions of time and height normal to the slope. Key parameters are the quantity Nα = N sinα (where α is the slope angle, and N is the Brunt-Väisälä frequency of the unperturbed atmosphere) and the angular frequency of the driving surface temperature cycle, ?. Three different flow regimes may occur, namely subcritical (Nα < ?), critical (Nα = ?) and supercritical (Nα > ?). The properties of the solutions in each regime are examined and discussed. The relationship between the present solutions and the earlier time-dependent slope flow model by Defant (1949) is also discussed. References Defant, F., 1949: Zur Theorie der Hangwinde, nebst Bemerkungen zur Theorie der Berg- und Talwinde. [A theory of slope winds, along with remarks on the theory of mountain winds and valley winds]. Arch. Meteor. Geophys. Bioclimatol., Ser. A, 1, 421-450 (Theoretical and Applied Climatology). [English translation: Whiteman, C.D., and E. Dreiseitl, 1984: Alpine meteorology: Translations of classic contributions by A. Wagner, E. Ekhart and F. Defant. PNL-5141 / ASCOT-84-3. Pacific Northwest Laboratory, Richland, Washington, 121 pp]. Prandtl, L., 1942: Strömungslehre [Flow Studies]. Vieweg und Sohn, Braunschweig, 382 pp.

Alternative Antriebe für Automobile: Hybridsysteme, Brennstoffzellen, alternative Energieträger

NASA Astrophysics Data System (ADS)

Stan, Cornel

Über die Realisierungsmöglichkeiten zukünftiger Antriebskonzepte - von Hybridsystemen Elektro-/Verbrennungsmotor über Brennstoffzellen bis zu alternativen Energieträgern wie Wasserstoff oder Alkohol - werden fundierte Kriterien der Qualität eines Antriebs entscheiden. Leistungsdichte, Drehmomentverlauf, Beschleunigungscharakteristik, spezifischer Energieverbrauch sowie Emission chemischer Stoffe und Geräusche sind dafür wichtige Merkmale zur Qualitätsbeurteilung. Die Verfügbarkeit und die Speicherfähigkeit vorgesehener Energieträger, die technische Komplexität, Kosten, Sicherheit, Infrastruktur und Service werden die Randbedingungen für die Einführung realisierbarer Konzepte alternativer Antriebe für Automobile stellen.

Empirische Verfahren zur Ableitung verschiedener Porositätsarten aus Durchlässigkeitsbeiwert und Ungleichkörnigkeitszahl - ein Überblick

NASA Astrophysics Data System (ADS)

Fuchs, Sven; Ziesche, Michael; Nillert, Peter

2017-06-01

This paper comprises a review of the 13 studies that have been proposed for the derivation of porosity, effective porosity and/or specific yield from grain size distributions (Lejbenson 1947; Istomina 1957; Beyer 1964; Hennig 1966; Golf 1966; Marotz 1968; Beyer und Schweiger 1969; Seiler 1973; Bureau of Reclamation 1984; Helmbold 1988; Beims und Luckner 1999; Balke et al. 2000; Helmbold 2002). Experimental design, limitations and application boundaries are discussed and methods are compared against each other. The quality of the predictive methods strongly depends on the experimental design and the sample type.

Personen- und Güterverkehr

NASA Astrophysics Data System (ADS)

Flämig, Heike; Gertz, Carsten; Mühlhausen, Thorsten

Im Jahr 2010 war in Deutschland der Verkehrssektor für fast 20 % der energiebedingten Treibhausgase verantwortlich. Das Klima hat sich bereits so weit verändert, dass zur Sicherung der Funktion der Verkehrssysteme auch Anpassungsmaßnahmen notwendig sind. Diese Maßnahmen müssen durch verkehrsreduzierende bzw. -beeinflussende Maßnahmen ergänzt werden. Ausgehend von den Emissionen im Verkehrssektor und möglichen Minderungen schlägt das Kapitel den Bogen zu Optionen der Anpassung an den Klimawandel, die ausführlich und konkret dargestellt werden. Besonders betrachtet werden die mannigfaltigen Gefahren der Rückkopplung sowie die vielfältigen Wechselwirungen mit anderen Themengebieten und Sektoren.

Analyse der Literatur zu Klimawirkungen in Deutschland: ein Gesamtbild mit Lücken

NASA Astrophysics Data System (ADS)

Fleischhauer, Mark; Greiving, Stefan; Lindner, Christian; Lückenkötter, Johannes; Schauser, Inke

Dieses Kapitel präsentiert Ergebnisse einer umfassenden Literaturauswertung zu relevanten Klimawirkungen für Deutschland, die im Rahmen des Projekts "Netzwerk Vulnerabilität" vorgenommen wurde. Es zeigt auf, dass ein aggregiertes Gesamtbild der Klimawirkungen für Deutschland als Grundlage für Folgenabschätzungen und Anpassungsplanungen noch nicht gezeichnet werden kann, da eine große Bandbreite an Ansätzen zur Bewertung von Vulnerabilitäten oder Klimawandelfolgen existiert und die gegenwärtig vorhandenen Klimawirkungs- und Vulnerabilitätsstudien von großer Heterogenität gekennzeichnet sind. Als erster Schritt wird deshalb eine Zusammenschau bereits vorhandener Ansätze geliefert.

[Leben im Eismeer - Tauchuntersuchungen zur Biologie arktischer Meerespflanzen und Meerestiere

PubMed

Lippert; Karsten; Wiencke

2000-01-01

Die Maske wird nochmals auf Dichtigkeit überprüft, der Knoten der Sicherungsleine mit zwei halben Schlägen fixiert, dann rutscht die Taucherin von der Eiskante in das kalte Wasser. Eine halbe Stunde vergeht, bevor ihr Kopf wieder aus dem Eisloch auftaucht und sie ein großes Sammelnetz nach oben reicht, gefüllt mit verschiedenen Arten von Makroalgen. Obwohl noch große Flächen des Kongsfjordes im arktischen Spitzbergen zugefroren sind und das Festland von einer dicken Schneedecke bedeckt ist, hat unter Wasser in den Algenwäldern bereits der Sommer und damit die Saison der Meeresbiologen begonnen.

Kommunikation mit Mitarbeitern

NASA Astrophysics Data System (ADS)

Spychala, Anne; Fleischmann, Jürgen

Kommunikation ist der Austausch von Nachrichten und Informationen zwischen Mitarbeitern eines Unternehmens (O'Hair et al. 1997). Dieser Austausch kann persönlich, aber z.B. auch per Telefon, E-Mail oder durch Computersysteme erfolgen. In diesem Kapitel betrachten wir die persönliche Kommunikation zwischen Vorgesetzten und Mitarbeitern. Zur persönlichen Kommunikation mit Mitarbeitern zählen sowohl formelle Gespräche mit Mitarbeitern als auch eher informelle Gespräche zwischen Tür und Angel. Die Gespräche können dabei mit einzelnen Mitarbeitern (z.B. jährliches Mitarbeitergespräch) oder mit Gruppen von Mitarbeitern (z.B. regelmäßige Projekt- oder Teambesprechungen) stattfinden.

Zur chemie der marsoberfläche

USGS Publications Warehouse

Keil, Klaus; Clark, Benton C.; Baird, A.K.; Toulmin, Priestley; Rose, Harry J.

1978-01-01

Analyses of 13 samples of Martian surface materials with the Viking X-ray fluorescence spectrometers show SiO2 similar to that of terrestrial mafic rocks, whereas Fe2O3, Cl, and S are higher and Al2O3, K2O, Rb, Sr, Y, and Zr are lower. Low totals suggest presence of CO2, H2O, and Na2O. Duricrust fragments are higher in S than fines, but samples from both landing sites are surprisingly similar. We suggest that Martian surface materials are aeolian deposits of complex mixtures of weathering products of maficultramafic rocks, possibly consisting of iron-rich clays, sulfates, iron oxides, carbonates, and chlorides.

Segmentierung von Aortenaneurysmen in CTA-Bildern mit dem statistischen Verfahren der Active Appearance Models

NASA Astrophysics Data System (ADS)

Greiner, Katharina; Egger, Jan; Großkopf, Stefan; Kaftan, Jens N.; Dörner, Ralf; Freisleben, Bernd

In diesem Beitrag werden Active Appearance Models (AAMs) zur Segmentierung der äußeren Kontur von Aortenaneurysmen eingesetzt. Diese Aufgabe ist wegen des geringen Kontrastes zum umliegenden Gewebe und des Aufbaus der teils thrombotisierten oder kalzifizierten Gefäßwände im Bereich eines Aneurysmas so komplex, dass sie aufgrund der Vielgestalt der Kontur in CT-Angiographie-Bildern die Verwendung eines statistischen Modells für Form und eingeschlossene Textur rechtfertigt. Für die Evaluation des Verfahrens wurden verschiedene statistische Modelle aus Schichten von neun CTA-Datensätzen trainiert und die Segmentierung anhand von Leave-One-Out-Tests überprüft.

Integriertes Informationsmanagement am KIT Was bleibt? Was kommt?

NASA Astrophysics Data System (ADS)

Labitzke, Sebastian; Nussbaumer, Martin; Hartenstein, Hannes; Juling, Wilfried

Der Beitrag beschreibt wesentliche seit dem Jahr 2005 an der Universität Karlsruhe bzw. am Karlsruher Institut für Technologie erzielte Ergebnisse in Bezug auf technische und organisatorische Integration für das Informationsmanagement. Insbesondere stehen die Portaldienste und das Identitätsmanagement im Fokus der technischen Innovation. Daneben werden zwei organisatorische Innovationen vorgestellt, die sich dediziert Fragestellungen zur IT-Governance und IT-Compliance widmen. Abschließend werden erzielte Schlüsselerfahrungen diskutiert, die im Zuge des Aufbaus eines integrierten Informationsmanagements gemacht wurden. Ausblickend wollen wir einen Bezug zu den allgegenwärtigen Problemstellungen und verbundenen Herausforderungen derartiger Vorhaben aufzeigen - Herausforderungen, die waren, sind und bleiben werden.

Organisationsaspekte in der Umsetzung

NASA Astrophysics Data System (ADS)

Balck, Henning; Bungard, Walter; Hofmann, Karsten; Ganz, Walter; Schwenker, Burkhard; Hanßen, Dirk; Meindl, Rudolf; Schloske, Alexander; Thieme, Paul; Teufel, Peter

Strukturbrüche sind eine der Hauptursachen für die Schwierigkeiten vieler Unternehmen, ihre Organisationsform zu modernisieren und vor allem turbulenten Marktbedingungen anzupassen. Klassische Beispiele für Strukturbrüche finden sich in der Spaltung von Aufbau- und Ablauforganisation, der Spaltung von Produktion und Dienstleistung oder der Spaltung von Planung und Ausführung. Ein wirkungsvoller Ansatz zur Überwindung solcher Spaltungen ist eine Art Versöhnungsmuster: die Polare Organisation. Wesentliche Elemente dieser Organisationsform sind ihr Netzwerkcharakter, kooperatives Zusammenwirken, eine hohe Kommunikationsintensität und eine polare Koppelung der kommunizierenden Partner oder - in abstrahierter Form - die organisierte Balance erfolgskritischer Gegensätze, wie Kosten und Qualität.

Innenstädte im ländlichen Raum - Wirksame Maßnahmen zur Revitalisierung zentraler Einzelhandelslagen im ruralen Umfeld

NASA Astrophysics Data System (ADS)

Hilpert, Markus; Völkening, Niklas; Beck, Christin

2018-06-01

In contrast to the retail sector in metropolises and medium-sized towns, its counterpart in rural regions is far less examined and described in scientific geographic literature. As many rural communities face similar challenges (e. g. growing vacancy rates, insufficient accessibility and unresolved succession in businesses), this article expounds fundamental mechanisms for strengthening or at least stabilizing their attractiveness as environments for living and for economy. Next to "hard" facts, as for example accessibility and parking spaces, less tangible themes like quality of stay, multicontextuality or service as well as comprehensive concepts like city marketing or place branding take on greater significance.

Neuausrichtung und Konsolidierung

NASA Astrophysics Data System (ADS)

Grohmann, Heinz

Mit der Wahl von Wolfgang Wetzel zum Vorsitzenden der Deutschen Statistischen Gesellschaft im Jahre 1972 begann eine 32jährige Ära, in der die praktische und die theoretische Statistik in einem ausgewogenen Verhältnis gepflegt wurden. Ein regelmäßiger vierjähriger Wechsel im Vorsitz stärkte die Gemeinschaft und die praktische wie die wissenschaftliche Arbeit gleichermaßen. Die jährlichen Hauptversammlungen behandelten gesellschaftlich aktuelle wie zukunftsorientierte Themen, und die Ausschüsse sowie weitere Veranstaltungen gaben Gelegenheit zur Förderung und Pflege einer Vielzahl von Arbeitsgebieten der Statistik. Darüber wird nicht nur in diesem Kapitel, sondern auch in den Teilen II und III des Bandes berichtet.

Zur Biologie des marinen Heterotardigraden Tetrakentron synaptae

NASA Astrophysics Data System (ADS)

Kristensen, R. M.

1980-06-01

The life cycle of Tetrakentron synaptae Cuénot, 1892, a tardigrade closely associated with the sea cucumber Leptosynapta galliennei Herapath, was investigated in the littoral zone at Roscoff (France). Eggs and juveniles were found only in June and July, adults only from May to October. There are vagile males and stationary dwarf males. The dorsoventrally flattened body, an enlarged slimy epicuticle in females and dwarf males, the full set of claws also in juveniles, and the anus, which is in a dorsocaudal position, are indicative for an epizoic, sessile life. There is strong evidence that T. synaptae punctures the cells of L. galliennei and sucks out their content, which is indicative of parasitism.

On the contribution of Heinrich Bruns to theoretical geometrical optics. With consideration of his correspondence with scientists of the Zeiss Company in Jena 1888-1893. (German Title: Über den Beitrag von Heinrich Bruns zur theoretischen geometrischen Optik Unter Berücksichtigung seines Briefwechsels mit Wissenschaftlern der Zeiss-Werke in Jena 1888-1893)

NASA Astrophysics Data System (ADS)

Ilgauds, Hans-Joachim; Münzel, Gisela

This paper describes the works of Heinrich Bruns, director of the Leipzig University Observatory, on theoretical geometrical optics, which followed an outstanding tradition in Leipzig. Bruns and his pupils did not stop at theoretical considerations, but applied their findings to practical questions. Bruns' correspondence with opticians of the Zeiss Company in Jena, so far known only fragmentarily, gives impressive evidence of their friendly relationship characterized by mutual regard and stimulation.

Mikrobielle Kurzzeitteste zur Bestimmung der mutagenen Potenz chemischer Substanzen

NASA Astrophysics Data System (ADS)

Gericke, Dietmar

1983-04-01

During the last 20 years it became much more interesting to test new chemicals as fast as possible for their carcinogenic potency. Therefore new test models were developed. Mutagenicity seems to be one sign for carcinogenicity. Therefore test systems using microorganisms were studied which are influenced by mutagenic substances. These systems are described, first of all the Ames-Test, using revertants of Salmonella typhimurium, secondly the Escherichia coli system deficient of DNA-polymerase A (DNA-Pol A-). The yeast Saccharomyces cerevisiae was introduced some years ago and finally the Neurospora crassa system serves as an additional test to define exactly the localisation of mutations. The tests and their problems are discussed.

Thermally driven up-slope flows: state of the art and open questions

NASA Astrophysics Data System (ADS)

Zardi, D.

2015-12-01

Thermally driven flows over simple slopes are a relevant research topic, not only per se, but also as a source of key concepts for understanding and modelling many other flows over more complex topographies. However, compared to down-slope, up-slope flows have received much less attention in the literature. Indeed, to investigate katabatic winds many extensive and well equipped field measurements were performed in recent years under various research projects, and a series of high-resolution numerical simulations were run. On the contrary, few field experiments have provided detailed datasets documenting the development of anabatic flows, and the analysis of numerical investigations still relies on Schumann's (1990) pioneering LES simulations. Also, analytic solutions - such as Prandtl's (1942) constant-K profiles - reproduce fairly well katabatic flows, but are definitely inadequate to accurately reproduce field data for up-slope flows (Defant 1949). In particular, some open questions still claim for further investigations, such as the conditions of instability of slope-parallel flow vs. vertical motions, and the related possible occurrence of flow separation, and the similarity analysis of slope-normal velocity profiles of temperature anomaly, wind intensity and turbulence related quantities. Here a review of the state of the art on the subject is proposed, along with some insights into possible future developments. ReferencesDefant, F., 1949: Zur Theorie der Hangwinde, nebst Bemerkungen zur Theorie der Berg- und Talwinde. [A theory of slope winds, along with remarks on the theory of mountain winds and valley winds]. Arch. Meteor. Geophys. Bioclimatol., Ser. A, 1, 421-450 (Theoretical and Applied Climatology). [English translation: Whiteman, C.D., and E. Dreiseitl, 1984: Alpine meteorology: Translations of classic contributions by A. Wagner, E. Ekhart and F. Defant. PNL-5141 / ASCOT-84-3. Pacific Northwest Laboratory, Richland, Washington, 121 pp]. Prandtl, L., 1942: Strömungslehre [Flow Studies]. Vieweg und Sohn, Braunschweig, 382 pp. Schumann, U., 1990: Large-eddy simulation of the up-slope boundary layer. Quart. J. Roy. Meteor. Soc., 116, 637-670.

Generating a Metal-responsive Transcriptional Regulator to Test What Confers Metal Sensing in Cells*

PubMed Central

Osman, Deenah; Piergentili, Cecilia; Chen, Junjun; Chakrabarti, Buddhapriya; Foster, Andrew W.; Lurie-Luke, Elena; Huggins, Thomas G.; Robinson, Nigel J.

2015-01-01

FrmR from Salmonella enterica serovar typhimurium (a CsoR/RcnR-like transcriptional de-repressor) is shown to repress the frmRA operator-promoter, and repression is alleviated by formaldehyde but not manganese, iron, cobalt, nickel, copper, or Zn(II) within cells. In contrast, repression by a mutant FrmRE64H (which gains an RcnR metal ligand) is alleviated by cobalt and Zn(II). Unexpectedly, FrmR was found to already bind Co(II), Zn(II), and Cu(I), and moreover metals, as well as formaldehyde, trigger an allosteric response that weakens DNA affinity. However, the sensory metal sites of the cells' endogenous metal sensors (RcnR, ZntR, Zur, and CueR) are all tighter than FrmR for their cognate metals. Furthermore, the endogenous metal sensors are shown to out-compete FrmR. The metal-sensing FrmRE64H mutant has tighter metal affinities than FrmR by approximately 1 order of magnitude. Gain of cobalt sensing by FrmRE64H remains enigmatic because the cobalt affinity of FrmRE64H is substantially weaker than that of the endogenous cobalt sensor. Cobalt sensing requires glutathione, which may assist cobalt access, conferring a kinetic advantage. For Zn(II), the metal affinity of FrmRE64H approaches the metal affinities of cognate Zn(II) sensors. Counter-intuitively, the allosteric coupling free energy for Zn(II) is smaller in metal-sensing FrmRE64H compared with nonsensing FrmR. By determining the copies of FrmR and FrmRE64H tetramers per cell, then estimating promoter occupancy as a function of intracellular Zn(II) concentration, we show how a modest tightening of Zn(II) affinity, plus weakened DNA affinity of the apoprotein, conspires to make the relative properties of FrmRE64H (compared with ZntR and Zur) sufficient to sense Zn(II) inside cells. PMID:26109070

A review of MRI findings in schizophrenia

PubMed Central

Shenton, Martha E.; Dickey, Chandlee C.; Frumin, Melissa; McCarley, Robert W.

2009-01-01

After more than 100 years of research, the neuropathology of schizophrenia remains unknown and this is despite the fact that both Kraepelin (1919/1971: Kraepelin,E., 1919/1971. Dementia praecox. Churchill Livingston Inc., New York) and Bleuler (1911/1950: Bleuler, E., 1911/1950. Dementia praecox or the group of schizophrenias. International Universities Press, New York), who first described ‘dementia praecox’ and the ‘ schizophrenias’, were convinced that schizophrenia would ultimately be linked to an organic brain disorder. Alzheimer (1897: Alzheimer, A., 1897. Beitrage zur pathologischen anatomie der hirnrinde und zur anatomischen grundlage einiger psychosen. Monatsschrift fur Psychiarie und Neurologie. 2, 82–120) was the first to investigate the neuropathology of schizophrenia, though he went on to study more tractable brain diseases. The results of subsequent neuropathological studies were disappointing because of conflicting findings. Research interest thus waned and did not flourish again until 1976, following the pivotal computer assisted tomography (CT) finding of lateral ventricular enlargement in schizophrenia by Johnstone and colleagues. Since that time significant progress has been made in brain imaging, particularly with the advent of magnetic resonance imaging (MRI), beginning with the first MRI study of schizophrenia by Smith and coworkers in 1984 (Smith, R.C., Calderon, M., Ravichandran, G.K., et al. (1984). Nuclear magnetic resonance in schizophrenia: A preliminary study. Psychiatry Res. 12, 137–147). MR in vivo imaging of the brain now confirms brain abnormalities in schizophrenia. The 193 peer reviewed MRI studies reported in the current review span the period from 1988 to August, 2000. This 12 year period has witnessed a burgeoning of MRI studies and has led to more definitive findings of brain abnormalities in schizophrenia than any other time period in the history of schizophrenia research. Such progress in defining the neuropathology of schizophrenia is largely due to advances in in vivo MRI techniques. These advances have now led to the identification of a number of brain abnormalities in schizophrenia. Some of these abnormalities confirm earlier post-mortem findings, and most are small and subtle, rather than large, thus necessitating more advanced and accurate measurement tools. These findings include ventricular enlargement (80% of studies reviewed) and third ventricle enlargement (73% of studies reviewed). There is also preferential involvement of medial temporal lobe structures (74% of studies reviewed), which include the amygdala, hippocampus, and parahippocampal gyrus, and neocortical temporal lobe regions (superior temporal gyrus) (100% of studies reviewed). When gray and white matter of superior temporal gyrus was combined, 67% of studies reported abnormalities. There was also moderate evidence for frontal lobe abnormalities (59% of studies reviewed), particularly prefrontal gray matter and orbitofrontal regions. Similarly, there was moderate evidence for parietal lobe abnormalities (60% of studies reviewed), particularly of the inferior parietal lobule which includes both supramarginal and angular gyri. Additionally, there was strong to moderate evidence for subcortical abnormalities (i.e. cavum septi pellucidi—92% of studies reviewed, basal ganglia—68% of studies reviewed, corpus callosum—63% of studies reviewed, and thalamus—42% of studies reviewed), but more equivocal evidence for cerebellar abnormalities (31% of studies reviewed). The timing of such abnormalities has not yet been determined, although many are evident when a patient first becomes symptomatic. There is, however, also evidence that a subset of brain abnormalities may change over the course of the illness. The most parsimonious explanation is that some brain abnormalities are neurodevelopmental in origin but unfold later in development, thus setting the stage for the development of the symptoms of schizophrenia. Or there may be additional factors, such as stress or neurotoxicity, that occur during adolescence or early adulthood and are necessary for the development of schizophrenia, and may be associated with neurodegenerative changes. Importantly, as several different brain regions are involved in the neuropathology of schizophrenia, new models need to be developed and tested that explain neural circuitry abnormalities effecting brain regions not necessarily structurally proximal to each other but nonetheless functionally interrelated. Future studies will likely benefit from: (1) studying more homogeneous patient groups so that the relationship between MRI findings and clinical symptoms become more meaningful; (2) studying at risk populations such as family members of patients diagnosed with schizophrenia and subjects diagnosed with schizotypal personality disorder in order to define which abnormalities are specific to schizophrenia spectrum disorders, which are the result of epiphenomena such as medication effects and chronic institutionalization, and which are needed for the development of frank psychosis; (3) examining shape differences not detectable from measuring volume alone; (4) applying newer methods such as diffusion tensor imaging to investigate abnormalities in brain connectivity and white matter fiber tracts; and, (5) using methods that analyze brain function (fMRI) and structure simultaneously. PMID:11343862

Turbulenzübergang in der Rohrströmung: Die Lösung eines alten Rätsels

NASA Astrophysics Data System (ADS)

Eckhardt, Bruno; Hof, Björn; Faisst, Holger

2006-09-01

Die Strömung von Flüssigkeiten und Gasen durch eine Röhre kann zwei Zustände annehmen. Einer ist laminar, also gleichmäßig geordnet, einer ist zeitlich-räumlich verwirbelt und turbulent. Mit dem Übergang zur Turbulenz nimmt der Strömungswiderstand drastisch zu. Vor etwa 120 Jahren beschrieb Osborne Reynolds bereits das Verhalten der Rohrströmung sehr genau. Er beobachtete, dass der Turbulenzübergang sehr empfindlich von äußeren Störungen abhängt, was bislang rätselhaft blieb. Dieses Rätsel konnte nun mit einer Kombination aus Computerstudien, Konzepten aus der nichtlinearen Dynamik und speziell entwickelten Experimenten gelöst werden.

Ultrastrukturelle Untersuchungen zur Morphologie und Genese der Spermien von Archaeogastropoda

NASA Astrophysics Data System (ADS)

Kohnert, R.; Storch, V.

1983-03-01

The sperm cells of Patella coerulea (Patellacea), Monodonta turbinata, and Gibbula tumida (Trochacea) were investigated by means of transmission electron microscopy. They belong to the primitive type (sensu Franzén) and have more features in common with primitive Bivalvia sperms than with Neritacea. Their head contains an apical acrosome and a roundish nucleus followed by 4 or 5 mitochondria and a centriolar apparatus which consists of two centrioles, one of which bears a flagellum. The sperm cells of Monodonta and Gibbula are very similar to each other and differ mainly in size; Patella exhibits more differences (very small acrosome, subacrosomal space, variable number of spherical mitochondria (origin of spermic dimorphism ?). The development of the sperm cells shows no peculiarities.

Einführung in die Technische Chemie

NASA Astrophysics Data System (ADS)

Behr, Arno; Agar, David W.; Jörissen, Jakob

Die "Technische Chemie" ist ein Lehrfach an Universitäten und Hochschulen. Nach dem die Studierenden der Chemie in den ersten Semestern ihres Studiums ausrei chen de theoretische Kenntnisse in Allgemeiner, Anorganischer, Organischer und Physikalischer Chemie erlangt haben, soll die Technische Chemie einen Blick auf die praktische Anwendung dieser Naturwissenschaft in unserer Wirtschaft lenken. Es gibt keine "biologische Industrie", "physikalische Industrie" oder "mathematische Industrie", wohl aber seit über 150 Jahren eine "chemische Industrie", die in dieser lan gen Zeit zahlreiche chemische Prozesse entwickelt und dazu vielfältige Methoden erarbeitet hat. Das Lehrfach Technische Chemie gibt einen Überblick über diese Pro zesse und Methoden und erleichtert dadurch den Schritt von der Universität zur be ruflichen Praxis.

Dürre, Waldbrände, gravitative Massenbewegungen und andere klimarelevante Naturgefahren

NASA Astrophysics Data System (ADS)

Glade, Thomas; Hoffmann, Peter; Thonicke, Kirsten

Klimarelevante Naturgefahren sind auf vielfältige Faktoren zurückzuführen, deren Zusammenwirken in der Gesamtheit betrachtet werden muss. Die vorbereitenden, auslösenden und kontrollierenden Faktoren werden in unterschiedlichster Weise vom Klimawandel beeinflusst. Die Autoren beschreiben beobachtete Trends und Projektionen zu Dürre, Waldbränden, gravitativen Massenbewegungen (Muren, Fels- und Bergstürze, Hangrutschungen) und Schneelawinen sowie das Zusammenspiel der unterschiedlichen Ursachen. Sie diskutieren darüber hinaus, welche der Veränderungen in der Häufigkeit oder Stärke von Naturgefahren tatsächlich ausschließlich dem Klimawandel zuzuschreiben sein könnten und welche Anteile hierbei der direkte menschliche Einfluss hat und konstatieren, dass eine eindeutige Trennung häufig nicht vollzogen werden kann.

Nebenwirkungen von TNF-alpha-Inhibitoren am Hautorgan.

PubMed

Lindhaus, Claudia; Tittelbach, Jörg; Elsner, Peter

2017-03-01

TNF-alpha-Inhibitoren werden seit Anfang der 1990er Jahre erfolgreich zur Behandlung diverser immunvermittelter entzündlicher Erkrankungen eingesetzt. Inzwischen gibt es eine umfangreiche Datenlage bezüglich ihrer Sicherheit. Nebenwirkungen sind bezogen auf die Häufigkeit der Anwendung selten und meist nicht schwerwiegend. Zu den Nebenwirkungen am Hautorgan zählen lokale injektionsassoziierte Reaktionen, Infektionen, immunvermittelte Reaktionen sowie Neoplasien. Die häufigsten schwerwiegenden Nebenwirkungen sind infektiöser Natur. Mykobakterielle Infektionen, aber auch non-mykobakterielle Erreger, Viren und Pilze können potenziell letale, systemische Infektionen auslösen. Im Folgenden wird eine Übersicht über das gegenwärtige Wissen bezüglich der Nebenwirkungen von TNFα-Inhibitoren am Hautorgan gegeben. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Akne.

PubMed

Degitz, Klaus; Ochsendorf, Falk

2017-07-01

Akne ist eine chronische Erkrankung mit hoher Prävalenz unter Jugendlichen. Pathogenetische Hauptfaktoren (und ihre klinischen Korrelate) sind gesteigerte Talgproduktion (Seborrhoe), follikuläre Hyperkeratose (Komedonen) und perifollikuläre Entzündungsvorgänge (Papulopusteln). Die Krankheit wird von endogenen (Androgene, IGF-1, neuroendokrine Faktoren) und exogenen (Propionibacterium acnes, Diät, mechanische Irritation, Inhaltsstoffe medizinischer oder kosmetischer Externa) Einflüssen moduliert. Akne geht mit zum Teil hoher Morbidität einher und kann bereits bei leichter Ausprägung eine erhebliche Verschlechterung der Lebensqualität bewirken. Zu Therapie stehen wirksame topische und systemische Behandlungsverfahren zur Verfügung. Eine optimale Behandlung erfordert eine stadiengerechtes Management und kontinuierliche ärztliche Begleitung der Patienten über den erforderlichen Behandlungszeitraum. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Musikalische Akustik

NASA Astrophysics Data System (ADS)

Meyer, Jürgen

Im weitesten Sinne umfasst die musikalische Akustik alle Themenbereiche, in denen Akustik und Musik in irgendeiner Form miteinander verbunden sind oder zumindest gleichzeitig eine Rolle spielen (Meyer 2004a). Im Mittelpunkt steht dabei die Akustik der Musikinstrumente und Gesangsstimmen, die sich mit der physikalischen Funktionsweise einschließlich der Einflussmöglichkeiten des Spielers auf die Tongestaltung und mit der Schallabstrahlung einschließlich der Klangeigenarten und der Richtungsabhängigkeit befasst (Meyer 2004b, Fletcher u. Rossing 1991). Sobald dabei klangästhetische Gesichtspunkte mit ins Spiel kommen, ist eine Einbeziehung psychoakustischer Aspekte unumgänglich. Erst auf dieser Grundlage ist eine qualitative Bewertung von Instrumenten möglich, die es den Instrumentenbauern erlaubt, anhand objektiver Kriterien bautechnische Veränderungen zur Verbesserung ihrer Instrumente vorzunehmen.

PVD-Beschichtungstechnologie

NASA Astrophysics Data System (ADS)

Lake, Markus K.

Die PVD-Technologie umfasst eine Reihe von Beschichtungsverfahren zur Abscheidung von Metallen, Legierungen oder chemischen Verbindungen durch Zufuhr von thermischer Energie oder durch Teilchenbeschuss im Hochvakuum. PVDVerfahren gestatten u. a. die Beschichtung bei niedrigen Prozesstemperaturen, so dass thermisch sensible Substrate, z. B. wärmebehandelte Stähle oder ausgewählte Kunststoffe, beschichtet werden können. Insbesondere mit dem Magnetron Sputter Ion Plating-Verfahren (MSIP-Verfahren) und mit dem Arc Ion Plating-Verfahren (AIP-Verfahren) ist es möglich, thermisch vorbehandelte Werkstoffe zu beschichten, ohne den eingestellten Wärmebehandlungszustand (Härte, Spannungszustand) zu verändern. Ferner können endbearbeitete Bauteile mit der PVD-Technologie beschichtet werden, da die eingesetzten PVD-Verfahren die Ausgangsoberfläche konturgetreu abbilden, ohne dass eine Nachbearbeitung erforderlich wird.

Extrusion & Compoundierung

NASA Astrophysics Data System (ADS)

Collin, Heinz; Schulze, Verena

Unter Extrusion wird das kontinuierliche Fördern von formbaren Massen verstanden. Dies können Kunststoffe, Teigwaren in der Lebensmittelindustrie oder auch keramische Massen sein. In der chemischen Industrie werden ebenfalls hochviskose (schwerfließende) Stoffe oder Pasten dosiert, gefördert und extrudiert. Früher waren vorzugsweise Kolbenstrangpressen im Einsatz, bis sich ab 1950 in steigendem Maße die Schneckenmaschinen durchgesetzt haben. Der weltweite Siegeszug der Kunststoffe ist zu einem erheblichen Teil auf die stetige technologische Weiterentwicklung im Bereich der Extrusionstechnik zurückzuführen. Der Markt der weltweit produzierten Maschinen für die Kunststoffverarbeitung erreichte im Jahr 2006 einen Wert von 20 Milliarden Euro und somit zählt dieser Bereich mittlerweile zu einem der großen Industriezweige [1].

Zeitspiel ist keine Alternative - Warum der Wandel zur Pflicht wird

NASA Astrophysics Data System (ADS)

Dieper, Stephan

"Wege entstehen dadurch, dass man sie geht." (Franz Kafka) Die Welt der Digitalisierung ist voll von Wegen, die jemand gegangen ist, bevor dort ein Weg war. Manche dieser Wege stellten sich als Sackgasse heraus, manche als Abkürzung und aus anderen wurden ganze Wegenetze und Städte. Die Energiewelt wird durch den digitalen Wandel nicht verschont bleiben. Durch die intelligenten Messsysteme und die zugehörigen, neuen Strukturen werden energiefremden Wettbewerbern Chancen zum Markteintritt eröffnet. EVUs müssen sich darauf einstellen, dass der permanente Wandel nicht mehr enden wird. Doch auch den EVUs eröffnen sich Optionen. Um erfolgreich zu sein, müssen sie lernen loszugehen, ohne das genaue Ziel zu kennen.

Magnetotomography—a new method for analysing fuel cell performance and quality

NASA Astrophysics Data System (ADS)

Hauer, Karl-Heinz; Potthast, Roland; Wüster, Thorsten; Stolten, Detlef

Magnetotomography is a new method for the measurement and analysis of the current density distribution of fuel cells. The method is based on the measurement of the magnetic flux surrounding the fuel cell stack caused by the current inside the stack. As it is non-invasive, magnetotomography overcomes the shortcomings of traditional methods for the determination of current density in fuel cells [J. Stumper, S.A. Campell, D.P. Wilkinson, M.C. Johnson, M. Davis, In situ methods for the determination of current distributions in PEM fuel cells, Electrochem. Acta 43 (1998) 3773; S.J.C. Cleghorn, C.R. Derouin, M.S. Wilson, S. Gottesfeld, A printed circuit board approach to measuring current distribution in a fuel cell, J. Appl. Electrochem. 28 (1998) 663; Ch. Wieser, A. Helmbold, E. Gülzow, A new technique for two-dimensional current distribution measurements in electro-chemical cells, J. Appl. Electrochem. 30 (2000) 803; Grinzinger, Methoden zur Ortsaufgelösten Strommessung in Polymer Elektrolyt Brennstoffzellen, Diploma thesis, TU-München, 2003; Y.-G. Yoon, W.-Y. Lee, T.-H. Yang, G.-G. Park, C.-S. Kim, Current distribution in a single cell of PEMFC, J. Power Sources 118 (2003) 193-199; M.M. Mench, C.Y. Wang, An in situ method for determination of current distribution in PEM fuel cells applied to a direct methanol fuel cell, J. Electrochem. Soc. 150 (2003) A79-A85; S. Schönbauer, T. Kaz, H. Sander, E. Gülzow, Segmented bipolar plate for the determination of current distribution in polymer electrolyte fuel cells, in: Proceedings of the Second European PEMFC Forum, vol. 1, Lucerne/Switzerland, 2003, pp. 231-237; G. Bender, S.W. Mahlon, T.A. Zawodzinski, Further refinements in the segmented cell approach to diagnosing performance in polymer electrolyte fuel cells, J. Power Sources 123 (2003) 163-171]. After several years of research a complete prototype system is now available for research on single cells and stacks. This paper describes the basic system (fundamentals, hardware and software) as well as the state of development until December 2003. Initial findings on a full-size single cell will be presented together with an outlook on the planned next steps.

Grüne Infrastruktur -. Konzepte und Strategien zur Förderung eines Bewusstseins für den Wert von Stadtgrün

NASA Astrophysics Data System (ADS)

Menke, Peter

2016-06-01

Due to climate change, but also because of the demographic change and financial constraints in many municipalities, the future of cities is a currently much-discussed topic. Conflicts over land-use are inevitable: As densification is an essential principle in growing cities, the pressure on open (green) spaces rises. Climate Change and water-management as well as mobility-issues and air-quality confront municipalities with new challenges, in terms of open space planning and greenery in the city. It is necessary to save the existing green in these days of budget-shortage and other priorities in communities. Municipalities have to raise new strategies to strengthen the awareness of the value of green in public and in the local business.

New insights into the biography of Gottfried Kirch. (German Title: Neue Erkenntnisse zur Biographie von Gottfried Kirch)

NASA Astrophysics Data System (ADS)

Herbst, Klaus-Dieter

New biographical results of Gottfried Kirch, the most outstanding astronomer around 1700 in German lands, are outlined on the basis of newly found sources and the first-time inclusion of additional letters from his correspondence, which comprises 600 letters. Special attention is drwawn to his stay in Langgrün and Lobenstein in the Vogtland, in Leipzig, Coburg, Guben and Berlin. In addition, new details about his family are revealed, especially about the older children Gottlieb, Heilmann and Theodora, the offspring from his first marriage. A third section deals with the possibilities which are to be expected from a systematic evaluation of Kirch's correspondence. Only about 100 out of 600 letters have been used for historical publications until now.

Herausforderungen für künftige Lernumgebungen am Beispiel der Fakultät für Medizin

NASA Astrophysics Data System (ADS)

Gergintchev, Ivan; Graf, Stephan

Nach der weit reichenden Etablierung von eLearning in den letzten Jahren stehen nahezu alle deutschen Hochschulen vor der Aufgabe, wettbewerbsfähige hochschulübergreifende Mechanismen sowie entsprechende organisatorische Rahmenbedingungen zu schaffen. Vor allem die Umsetzung von EBologna und die Unterstützung kooperativer Bildungsangebote verstärken diese Notwendigkeit. Motiviert durch die Veränderungen im Bereich der Hochschullehre und die Herausforderungen für künftige Lernumgebungen schlagen wir eine Integrationslösung im Sinne eines Learning Gateway vor, die zur webgestützten Abwicklung von kooperativen Bildungsangeboten in heterogen Lernumgebungen eingesetzt werden kann. Ihre Praxisanwendung verdeutlichen wir anschließend im komplexen Szenario der Medizin an der TUM. Die Evaluierung der Umsetzung belegt den deutlichen Mehrwert des Ansatzes.

Tourismus

NASA Astrophysics Data System (ADS)

Matzarakis, Andreas; Lohmann, Martin

Für den Tourismus haben Klima und Wetter eine große Relevanz: als Treiber des Verhaltens wie auch als Angebotsfaktor. Wetter und Klima sind demnach sowohl Bestandteil des touristischen Angebotes als auch limitierende Faktoren des Tourismus und Steuergrößen für die touristische Nachfrage. Insofern liegt es nahe, dass dieser Sektor vom Klimawandel betroffen sein wird. Der Tourismus ist aber auch ein Faktor, der seinerseits erheblich auf das Klima und den Klimawandel zurückwirkt. Dabei ist der Klimawandel aber nur einer von vielen voneinander abhängig erscheinenden Einflussfaktoren, denen der Sektor "Tourismus" ausgesetzt ist. Das heißt, es handelt sich um ein komplexes Wirkungsgefüge. Das Kapitel widmet sich den Klimawandelfolgen im Tourismus und macht diese beispielhaft an den Regionen "Küsten" sowie "Mittel- und Hochgebirge" fest, um Anpassungsmöglichkeiten anzufügen.

Contributions to the History of Astronomy, Vol. 3. (German Title: Beiträge zur Astronomiegeschichte, Band 3)

NASA Astrophysics Data System (ADS)

Dick, Wolfgang R.; Hamel, Jürgen

The main papers of this issue deal with previously unknown details of the foundation of the astronomical observatories in Gotha and in Königsberg (with numerous original documents by F.W. Bessel), with the Mecklenburg ordnance survey (1853-1873, with previously unknown letters by C.F. Gauss), with the merits of the Leipzig astronomer G.A. Jahn, with the internationality of the Astronomische Gesellschaft, and with early, previously little noted works on the expansion of the Universe. The issue contains a description of the important collection of sundials in the Kassel museum, discussions about the Medieval ``Phantom Period'', about Goethe's description of the zodiacal light, as well as obituaries and book reviews. Most papers in German, one in English.

Magnetic order in the frustrated Ising-like chain compound Sr3NiIrO6

NASA Astrophysics Data System (ADS)

Lefrançois, E.; Chapon, L. C.; Simonet, V.; Lejay, P.; Khalyavin, D.; Rayaprol, S.; Sampathkumaran, E. V.; Ballou, R.; Adroja, D. T.

2014-07-01

We have studied the field and temperature dependencies of the magnetization of single crystals of Sr3NiIrO6. These measurements evidence the presence of an easy axis of anisotropy and two anomalies in the magnetic susceptibility. Neutron powder diffraction realized on a polycrystalline sample reveals the emergence of magnetic reflections below 75 K with magnetic propagation vector k ˜ (0, 0, 1), undetected in previous neutron studies [T. N. Nguyen and H.-C. zur Loye, J. Solid State Chem. 117, 300 (1995), 10.1006/jssc.1995.1277]. The nature of the magnetic ground state, and the presence of two anomalies common to this family of material, are discussed on the basis of the results obtained by neutron diffraction, magnetization measurements, and symmetry arguments.

Viele Tests - viele Fehler?

NASA Astrophysics Data System (ADS)

Tabelow, Karsten

Bildgebende Verfahren haben sich in den letzten Jahren einen festen Platz in der Medizin erobert und die medizinische Forschung und Diagnostik revolutioniert. Sie ermöglichen Ärzten und Forschern einen Einblick in lebendes Gewebe. Mit der fortschreitenden technischen Entwicklung liefern die Verfahren immer höhere Auflösungen, schärfere Bilder und mehr Details. Bildgebende Verfahren sind ohne Mathematik undenkbar, von der Bildrekonstruktion aus den gemessenen Signalen, bis hin zur Auswertung der Bildinformation. Für die Analyse der großen Menge an Bilddatenpunkten (Voxel, volume element, im Gegensatz zum zweidimensionalen Pixel, picture element) werden häufig insbesondere Methoden der mathematischen Statistik benötigt. Zufällige Fehler in der Messung äußern sich als Bildrauschen, die Bilder wirken unscharf und gestört. Dadurch werden diagnostische Entscheidungen erschwert.

Gesellschaft, Lebensgemeinschaft, Ökosystem - Über die Kongruenz von politischen und ökologischen Theorien der Entwicklung

NASA Astrophysics Data System (ADS)

Voigt, Annette

Im Jahr 1859 veröffentlichte Charles Darwin "On the Origin of Species“. Seine Evolutionstheorie ist das wohl spektakulärste Beispiel einer naturwissenschaftlichen Theorie großer gesellschaftlicher Relevanz. Ihre verschiedenen Facetten wurden in der Öffentlichkeit kontrovers diskutiert, unter anderem auch ihre Anwendung zur Erklärung von Zuständen und Prozessen menschlicher Gesellschaften. Zum Teil wurde die Seiensweise der Natur - scheinbar unabhängig von gesellschaftlichen Interessen - für die Erklärung und Legitimation gesellschaftlicher Zustände oder die Legitimation von politischen Ideologien herangezogen (Sozialdarwinismus). Denn Gesellschaft funktioniere ja so, wie Darwin die Natur erklärt habe: es herrsche z. B. Konkurrenzkampf, Auslese und Arbeitsteilung, Erfolg hätten diejenigen, die sich an die Bedingungen am Besten anpassten.

Effects of strains, strain crosses and environments on additive genetic and phenotypic variances in Drosophila melanogaster.

PubMed

Noor, R R; Barker, J S; Kinghorn, B P

1993-01-12

The stability of phenotypic, additive genetic and environmental variances of thorax length of Drosophila melanogaster in pure and synthetic strains was examined in two different environments. Two pure strains from different geographic locations (Melbourne and Townsville) were used, together with three synthetic populations formed from them. The existence of differences in thorax length between the Melbourne and Townsville populations, genotype by environment interaction, and heterosis in crosses between these populations indicate that they are genetically different. Thus geographic separation can cause differences in mean thorax length of flies from different populations. Both the difference in selection histories between the two localities and drift could lead to these differences. Up to the thirty fifth generation there was no evidence of any reduction in the difference between the Melbourne and Townsville populations, in either laboratory environment. The genetic differentiation of strains therefore may be maintained over many generations under new environmental conditions. The fluctuation over generations of heterosis of thorax length is possibly caused by the fluctuation of the rate of loss of favourable epistatic interaction in crossbred genotypes in combination with natural selection effects. V(p) was significantly higher in poor than in the good environment. This higher V(p) in the poor environment is most likly due to higher non additive genetic variance. V(p) was also significantly influenced by strain. In general, V(p) values of synthetic strains were higher than those of pure strains in both environments. Finally, the additive and environmental variances of thorax length were relatively stable across strains, generations and environments. ZUSAMMENFASSUNG: Wirkung von Herkünften, Kreuzungen und Umwelten auf additiv-genetische und phänotypische Varianzen in Drosophila melanogaster Die Stabilität phänotypischer, additiv-genetischer und umweltbedingter Varianzen der Thoraxlänge von Drosophila melanogaster in reinen und synthetischen Herkünften wurde in zwei verschiedenen Umwelten überprüft. Zwei reine Herkünfte von verschiedenen Gegenden (Melboune und Townsville) wurden zusammen mit drei zwischen ihnen gebildeten synthetischen Populationen untersucht. Unterschiede in Thoraxlänge zwischen Melbourne- und Townsvilleherkünften, Genotypumweltinteraktionen und Heterosis in Kreuzungen zwischen diesen Populationen zeigen, daß sie sich genetisch unterscheiden. Die geographische Trennung kann also Unterschiede in der mittleren Thoraxlänge zur Folge haben, wobei unterschiedliche Selektionsgeschichte in beiden Gegenden und Drift dies verursachen können. Bis zur 35. Generation gab es in keinem Labormilieu einen Hinweis auf eine Reduktion der Unterschiede zwischen den beiden Populationen. Die genetische Differenz der Herkünfte erhält sich daher auch unter neuen Umweltverhältnissen über viele Generationen. Die Schwankung in Heterosis für Thoraxlänge ist möglicherweise durch Schwankungen in der Verlustrate günstiger epistatischer Interaktionswirkungen in Kreuzungsgenotypen zusammen mit natürlichen Selektionswirkungen verursacht. V(p) war durch Umweltbedingungen signifikant beeinflußt und höher in schlechtem als in gutem Milieu. Der hohe Wert in schlechtem Milieu ist wahrscheinlich auf nicht-additiv-genetische Varianz zurückzuführen. V(p) wurde auch signifikant durch Herkunft beeinflußt und Werte in synthetischen Linien waren höher Linien in beiden Milieus. Additive und umweltbedingte Varianzen waren über Linie, Generationen und Umwelt relativ stabil. 1993 Blackwell Verlag GmbH.

IQM-Reifegradmodell für die Bewertung und Verbesserung des Information Lifecycle Management Prozesses

NASA Astrophysics Data System (ADS)

Baškarada, Saša; Gebauer, Marcus; Koronios, Andy; Gao, Jing

Heutige Organisationen produzieren und speichern mehr Informationen als je zuvor. Der resultierende Informationsüberfluss, zusammen mit einem Mangel an Qualitätssicherung für das Information Lifecycle Management, führt zu einem unsicheren Status der Informationsqualität in vielen Organisationen. Weiterhin hat sich herausgestellt, dass das Bewerten, Verbessern und Steuern der Informationsqualität ein offenkundig schwieriges Unterfangen ist. Dieses Kapitel stellt ein Modell zur Bewertung und Verbesserung der Information Quality Management Capability Maturity (IQM-Reifegrad) vor. Es wird ein Satz von Kriterien vorgestellt, der aus Literaturrecherche und Fallstudien abgeleitet wurde. Die Reifegradindikatoren werden validiert und in einem mehrstufigen Reifegradmodell durch eine Delphi-Studie gruppiert. Das abgeleitete IQM-Reifegradmodell hilft Organisationen ihre bestehenden Praktiken im IQM zu bewerten und potentielle Lücken und Verbesserungsstrategien zu ermitteln.

Zusammenarbeit aus Sicht eines outgesourcten Instandhalters

NASA Astrophysics Data System (ADS)

Grüßer, Stefan; Loeven, Heinz-Wilhelm

Dauerhafter Unternehmenserfolg ist nur mit einer fortschrittlichen Instandhaltung zu erzielen. Durch den enormen Kostendruck infolge der Globalisierung und die Innovationssprünge auf der technischen Seite wird auch die Frage nach der modernen Organisationsform für die Instandhaltung gestellt. Eine Möglichkeit der Kostenoptimierung ist das Outsourcing von Instandhaltungsleistungen. Hierbei ist es unerlässlich, dass sich die Mitarbeiter zum Dienstleister entwickeln. In diesem Beitrag wird die Entwicklung der InfraServ Knapsack von einer internen Instandhaltungsabteilung hin zu einem Industriellen Dienstleister beschrieben und Aspekte der Zusammenarbeit mit externen Kunden aus der Sicht des outgesourcten Instandhalters geschildert. Es werden die wichtigen Entwicklungsschritte zur Dienstleistungsorientierung der früheren Eigeninstandhaltung aufgezeigt. Dieser Beitrag ist nicht als "Königsweg“ zu verstehen, er soll vielmehr anhand der Erfahrungen einer outgesourcten Eigeninstandhaltung Anregungen für die Entwicklung der eigenen Instandhaltungsorganisation liefern.

Die Digitalisierung der Energiewirtschaft: Potenziale und Herausforderungen der IKT-Branche für Utility 4.0

NASA Astrophysics Data System (ADS)

Aichele, Christian; Schönberger, Marius

Energieunternehmen haben auf dem Weg zur digitalen Transformation noch viele Herausforderungen zu bewältigen. Ein besonderer Schwerpunkt liegt derzeit auf der Modernisierung der IT-Systeme. Ausgangspunkt hierzu ist, dass sich bei den Endkonsumenten Mobile Applikationen, Smartphones, Tablet-PCs oder Smart TVs einer immensen Beliebtheit erfreuen. Durch diese Technologien wird die physische und virtuelle Welt in immer weiter zunehmendem Maße miteinander verknüpft. Mobile Applikation können einen wahren Hype hervorrufen und Verhaltensweisen auch nachhaltig verändern (ein Beispiel hierfür ist Pokémon Go, eine App die ein virtuelles Spiel mit der realen Umgebung kombiniert und die erstmalig auch eingefleischte Zocker aus der Anonymität ihrer häuslichen Umgebung hervorlocken konnte und für analoge Bewegung im Freien sorgte).

NAFLA - Ein Simulationswerkzeug zur analytischen Abschätzung von Schadstofffahnenlängen

NASA Astrophysics Data System (ADS)

Kumar Yadav, Prabhas; Händel, Falk; Müller, Christian; Liedl, Rudolf; Dietrich, Peter

2013-03-01

Groundwater pollution with organic contaminants remains a world-wide problem. Before selection of any remediation technique, it is important to pre-assess contaminated sites with respect to their hazard. For this, several analytical and numerical approaches have been used and an initial assessment of contaminated sites the MS-Excel© tool "NAFLA" was developed. "NAFLA" allows a quick and straightforward calculation and comparison of some analytical approaches for the estimation of maximum plume length under steady-state conditions. These approaches differ from each other in source geometry, model domain orientation, and in the consideration of (bio)chemical reaction within the domain. In this communication, we provide details about the development of "NAFLA", its possible usage and information for users. The tool is especially designed for application in student education, by authorities and consultants.

G-spot augmentation with autologous fat transplantation.

PubMed

Herold, Christian; Motamedi, Melodi; Hartmann, Uwe; Allert, Sixtus

2015-01-01

Lipofilling for G-spot augmentation is appealing because long-term persistence of the fat is expected to be very good. We report the case of a 29-year-old patient who requested G-spot augmentation to enhance sexual sensation. Autologous fat (8 cc) that was harvested from the trochanteric area was injected. Although there are few published data acknowledging the presence of the G-spot, the patient was satisfied with the procedure and no side effects occurred. Nevertheless, evaluation with standard questionnaires, such as Fragebogen zur Lebenszufriedenheit (FLZ) and Kurzfragebogen für sexuelle Probleme (KFSP-F), did not indicate the positive effects on subjective well-being and sexual parameters of a surgical G-spot augmentation. Studies comprising a larger series of patients are required before substantiated recommendations regarding the benefits and risks of this procedure will be possible.

Reinraumtechnik für die Medizintechnik

NASA Astrophysics Data System (ADS)

Petek, Max; Jungbluth, Martin; Krampe, Erhard

Die Reinraumtechnik ist heute ein unverzichtbarer Bestandteil bei der Fertigung von Produkten der Life Sciences, den Bereichen Pharma, Lebensmittel, Kosmetik und Medizintechnik. In Anbetracht der langen Historie der Medizintechnik ist sie jedoch eine sehr junge Disziplin. Die Bedeutung von Keimen und die richtige Einschätzung ihrer Größe wurden zwar sehr früh bereits durch Paracelsus erkannt, jedoch wurden daraus noch keine speziellen oder kontinuierlich umgesetzten Hygienevorschriften abgeleitet. Die erste bekannte technische Umsetzung von Hygieneempfehlungen geht auf den Franzosen François Nicolas Appert zurück, der eine aseptische Abfüllmethode für Lebensmittel entwickelte und diese 1810 veröffentlichte [1]. Die erste dokumentierte medizinische Umsetzung stellten Hygienevorschriften für Ärzte dar, die Ignaz Philipp Semmelweis nach 1847 in der Wiener Klinik für Geburtshilfe einführte [2].

Smart Meter Rollout: Intelligente Messsysteme als Schnittstelle zum Kunden im Smart Grid und Smart Market

NASA Astrophysics Data System (ADS)

Vortanz, Karsten; Zayer, Peter

Das Gesetz zur Digitalisierung der Energiewende ist verabschiedet. Ab 2017 sind moderne Messeinrichtungen (mME) und intelligente Messsysteme (iMSys) zu verbauen und zu betreiben. Der "deutsche Weg" für die Einführung von Smart Metern sieht einen stufenweisen Rollout sowie ein Höchstmaß an Informations- und Datensicherheit vor. Dabei spielen iMSys und mME eine wichtige Rolle bei der Neugestaltung der intelligenten Netze (Smart Grids) und des neuen Marktmodells (Smart Market). Dieser Beitrag beschäftigt sich mit den neuen Gesetzen, den Marktrollen und ihren Aufgaben, Datenschutz und Datensicherheit, dem iMSys als sichere Lösung, dem sicheren Betrieb von Smart Meter Gateways, Smart Grid - Smart Market, dem Zusammenspiel zwischen reguliertem Bereich und Markt, den Einsatzbereichen der iMSys sowie den Auswirkungen auf Prozesse und Systeme und gibt Handlungsempfehlungen.

Intelligente Messsysteme - Mehrwert für unterschiedliche Stufen der Wertschöpfung

NASA Astrophysics Data System (ADS)

Deppe, Benjamin

Die Veränderung der Energiewirtschaft schreitet kontinuierlich voran - und wird mit Gesetz zur Digitalisierung der Energiewende nicht abgeschlossen sein. Vielmehr steigen die Innovationsgeschwindigkeit und die Erwartungshaltung der Kunden. Dieses Kapitel beschreibt, wie intelligente Messsysteme die Basis für neue Möglichkeiten schaffen und wie sich diese Veränderungen auf die Wertschöpfung auswirken. Der Fokus liegt dabei auf dem Wandel der einzelnen Wertschöpfungsstufen im Verlauf der Liberalisierung des Messwesens und dem seit dem 02.09.2016 verbindlichen Messstellenbetriebsgesetzes. Der Beitrag zeigt auf, wie sich bisher getrennte Wertschöpfungsstufen nunmehr direkt berühren und miteinander interagieren. Deutlich wird dadurch, wie Informationen zu Mehrwert führen können - aber auch, welche Fragen noch zu beantworten sind und welche Hürden es zu überwinden gilt.

Statistik in Naturwissenschaft und Technik

NASA Astrophysics Data System (ADS)

Wilrich, Peter-Theodor

Mit dem Aufschwung von Naturwissenschaft und Technik zu Beginn des 19. Jahrhunderts entstand die mathematische Statistik, angeregt aus der Geodäsie (wie die Methode der kleinsten Quadrate) und der Anthropologie (wie die statistische Analyse mehrdimensionaler Beobachtungen und ihrer stochastischen Abhängigkeiten). Im Gegensatz zu den Wirtschafts- und Sozialwissenschaften, in denen Daten vorwiegend aus Beobachtungsstudien gewonnen werden, stehen in den Naturwissenschaften Experimente im Vordergrund. Daher gehört die statistische Versuchsplanung zu den insbesondere in Naturwissenschaft und Technik angewendeten statistischen Methoden, aber auch die Extremwertstatistik und Lebensdaueranalysen sowie die Methoden der räumlichen Statistik (insbesondere in der Umweltforschung). Im 20. Jahrhundert wurden Stichprobenpläne und Regelkarten (Kontrollkarten) zur Prozessregelung als Hilfsmittel der statistischen Qualitätssicherung entwickelt. Diese Methodenbündel, mit denen sich der Ausschuss Statistik in Naturwissenschaft und Technik immer wieder befasst, werden im Folgenden vorgestellt.

Individuelle Templates für Rekonstruktionen des linken Herzventrikels

NASA Astrophysics Data System (ADS)

Feder, Stefan; Falk, Volkmar; Gutberiet, Matthias; Bartz, Dirk

Bei krankhaften Vergrößerungen des linken Herzventrikels kann eine chirurgische Ventrikelrekonstruktion zur Verbesserung der Herzleistung beitragen. Die dabei erstellte Ventrikelgeometrie ist von entscheidender Bedeutung. Diese Studie befasst sich mit der computerbasierten Planung von individuellen Schablonen (Templates) für Ventrikelrekonstruktionen. Ziel ist es aus Cardio-CT-Daten, präoperativ, patientenindividuelle 3D-Modelle für Ventrikeltemplates zu erstellen. Hierfür wird aus CT-Daten der linksventrikuläre Blutpool segmentiert und daraus das Ventrikeltemplate modelliert. Dies geschieht anhand von zwei Kriterien: dem physiologischen Ventrikelfüllungsvolumen und der hämodynamisch günstigen ellipsoiden Form. Es konnten 20 3D-Templatemodelle mit einem durchschnittlichen Volumen von 144 ml erstellt werden. Die ellipsoide Form konnte durch manuelle Modellierung erreicht werden. Der Nachweis verbesserter Operationsergebnisse muss in nachfolgenden klinischen Studien erbracht werden.

Experimentelles FMCW-Radar zur hochfrequenten Charakterisierung von Windenergieanlagen

NASA Astrophysics Data System (ADS)

Schubert, Karsten; Werner, Jens; Schwartau, Fabian

2017-09-01

During the increasing dissemination of renewable energy sources the potential and actual interference effects of wind turbine plants became obvious. Turbines reflect the signals of weather radar and other radar systems. In addition to the static radar echoes, in particular the Doppler echoes are to be mentioned as an undesirable impairment Keränen (2014). As a result, building permit is refused for numerous new wind turbines, as the potential interference can not be reliably predicted. As a contribution to the improvement of this predictability, measurements are planned which aim at the high-frequency characterisation of wind energy installations. In this paper, a cost-effective FMCW radar is presented, which is operated in the same frequency band (C-band) as the weather radars of the German weather service. Here, the focus is on the description of the hardware design including the considerations used for its dimensioning.

Implantate in der Augenheilkunde

NASA Astrophysics Data System (ADS)

Dresp, Joachim H.

Im Bereich der Augenheilkunde findet sich die weltweit am häufigsten ausgeführte chirurgische Massnahme, die operative Behandlung des Grauen Stars: die Katarakt. Bei der Katarakt handelt es sich um eine Eintrübung der natürlichen Augenlinse, die sich je nach Stadium der Erkrankung leicht opak, über milchig bis zu bräunlich präsentiert. Mit dieser Zunahme der Undurchlässigkeit für das sichtbare Licht geht eine Abnahme des Sehvermögens einher, die bis zur totalen Erblindung führen kann. Bedingt durch die sehr eingeschränkten chirurgischen Möglichkeiten in den Ländern der Dritten Welt ist die Katarakt die Erblindungsursache Nummer 1 in der Welt. Ganz im Gegensatz hierzu ist in den industrialisierten Ländern Europas, Amerikas und Asiens die Katarakt-OP die sicherste chirurgische Intervention. In der Augenheilkunde werden Implantate aller drei Aggregatszustände verwendet.

STF Optimierung von single-bit CT ΣΔ Modulatoren basierend auf skalierten Filterkoeffizienten

NASA Astrophysics Data System (ADS)

Widemann, C.; Zorn, C.; Brückner, T.; Ortmanns, M.; Mathis, W.

2012-09-01

Die vorliegende Arbeit beschäftigt sich mit dem Signalübertragungsverhalten von single-bit continuous-time (CT) ΣΔ Modulatoren. Dabei liegt der Fokus der Untersuchung auf dem Peaking der Signaltransferfunktion (STF). Dieser Effekt kann die Performance und die Stabilität des Gesamtsystems negativ beeinflussen, da bei auftretendem STF-Peaking Signale außerhalb des Signalbands verstärkt werden. In dieser Arbeit wird ein neuer Ansatz zur Reduktion des Peakings vorgestellt, der auf der Optimierung der Systemdynamik basiert. Dabei werden die Filterkoeffizienten des Modulators systematisch angepasst. Anhand eines Beispielsystems wird gezeigt, dass der Ansatz genutzt werden kann, um das Übertragungsverhalten des Modulators abhängig vom Ausgangssystem zu verändern. So kann entweder die Systemsperformance verbessert werden, ohne Peaking in der STF zu erzeugen, oder das STF-Peaking reduziert werden, ohne die Systemperformance stark zu beeinflussen.

Erste Erkenntnisse zur Prospektion und Charakterisierung des Aquifers der Aroser Dolomiten, Schweiz

NASA Astrophysics Data System (ADS)

Regli, Christian; Kleboth, Peter; Eichenberger, Urs; Schmassmann, Silvia; Nyfeler, Peter; Bolay, Stephan

2014-03-01

In urban areas of the Swiss Alps the use of geothermal energy from several hundred meters depth becomes increasingly important. For this mainly open systems have priority. This work presents the first insights in the prospection and characterisation of the so far unexplored, utilizable, and abundant Aquifer of the Arosa Dolomites. Besides the use of established methods and techniques, such as seismic measurements, an exploration drilling, borehole geophysical measurements, and pumping tests, the application of the KARSYS-approach for geological and conceptual hydrogeological 3D-modelling of the aquifer is illustrated. In addition, the development of a viewer for 3D-visualization of drillings is documented. The hydrogeological and metrological approaches allow a lithological facies differentiation of the Arosa Dolomites, and a differentiation of the fractured and karstified areas within the aquifer. The results represent the basis for advanced findings optimizing and risks minimising exploration and drilling planning, and for sustainable utilization planning.

Batch-Versuche zur Bestimmung der Sorption und Reaktionskinetik von fluoreszierenden Tracern

NASA Astrophysics Data System (ADS)

Vaitl, Tobias; Wohnlich, Stefan

2018-06-01

For many tracer experiments, prior determination of interaction between solid medium and used tracers is of major interest in order to achieve efficient, economic and successful field experiments. In the present study, three different types of batch experiments were performed with three fluorescent dyes (Na-Fluorescein, Amidorhodamin G and Tinopal CBS-X) and three different rock types (sandstone, claystone and limestone), to determine distribution coefficients and reaction kinetics. All three rock types were analysed for organic carbon content, specific surface area and mineralogical composition to identify the main sorption mechanisms. For all tracers, different sorption properties were found depending on the type of rock. The strongest sorption was observed for Tinopal CBS-X in contact with claystone. Only Na-Fluorescein showed sorption (albeit limited) in contact with the sandstones. The investigated limestones indicated a high sorption for the tracer Tinopal CBS-X. Regarding reaction kinetics, in most cases, thermodynamic equilibrium conditions were reached after two weeks.

Spritzgießen

NASA Astrophysics Data System (ADS)

Bürkle, Erwin; Ammer, Daniel; Würtele, Martin

Kunststoffe zu spritzgießen ist eine der fortschrittlichsten Verarbeitungstechnologien. Durch Spritzgießen, ein Verfahren der Urformtechnik werden Formteile in der Regel mit komplexer Geometrie vollautomatisch hergestellt. Ausgehend vom Verfahrensablauf werden Thermoplaste, Duroplaste oder Kautschuk in einer Spritzgießmaschine aus dem Feststoffzustand heraus aufgeschmolzen, in einen formgebenden Hohlraum (Werkzeug) eingespritzt, dort verdichtet, abgekühlt oder zur Reaktion gebracht und dann als Formteil aus dem Werkzeug ausgeworfen. Etwa 60 % aller Kunststoffverarbeitungsmaschinen sind Spritzgießmaschinen (Abb. 26.1). Auf ihnen werden Formteile mit sehr niedrigen Massen im mg-Bereich bis hin zu großen Massen in zwei - z. T. sogar auch dreistelligen kg-Bereich hergestellt. Der Prozess des Spritzgießens nutzt in idealer Weise das besondere physikalische Verhalten der Kunststoffe. In einem verhältnismäßig einfachen Prozess werden durch Erwärmen des Kunststoffes und der nachfolgenden Formgebung im Schmelzezustand mit abschließender Abkühlung in einem formgebenden Werkzeug direkt gebrauchsfertige Formteile hergestellt [1, 31].

Classification of municipal occupations.

PubMed

Ilmarinen, J; Suurnäkki, T; Nygård, C H; Landau, K

1991-01-01

Eighty-eight job titles were analyzed with the "ergonomic job analysis procedure" [Arbeitswissenschaftliche Erhebungsverfahren zur Tätigkeits-analyse abbreviated (AET) in German]. The objective was to classify the wide range of municipal jobs into homogeneous groups according to job demand and to provide better possibilities to study the relationships between work and health among the aging municipal working population. Altogether 216 items were classified. First, a hierarchical cluster analysis was made, and a dendrogram of the analyzed job titles was drawn. Second, a profile analysis was done in which the single items were grouped into 39 sum items, and a graphic profile was drawn. Finally, the stress factors were listed and drawn in ranking order. The cluster analysis formed 13 groups. Groups exposed to the highest stress factor level were kitchen supervisors, dentists, and physicians. More than 10 stress factors (greater than 50% of the maximum) were found in nursing, administration, installation, transport, and technical supervision.

Hermann Hankel's "On the general theory of motion of fluids". An essay including an English translation of the complete Preisschrift from 1861

NASA Astrophysics Data System (ADS)

Villone, Barbara; Rampf, Cornelius

2017-12-01

The present is a companion paper to "A contemporary look at Hermann Hankel's 1861 pioneering work on Lagrangian fluid dynamics" by Frisch, Grimberg and Villone [Eur. Phys. J. H 42, 537-556 (2017)]. Here we present the English translation of the 1861 prize manuscript from Göttingen University "Zur allgemeinen Theorie der Bewegung der Flüssigkeiten" (On the general theory of the motion of the fluids) of Hermann Hankel (1839-1873), which was originally submitted in Latin and then translated into German by the Author for publication. We also provide the English translation of two important reports on the manuscript, one written by Bernhard Riemann and the other by Wilhelm Eduard Weber during the assessment process for the prize. Finally, we give a short biography of Hermann Hankel with his complete bibliography.

Integrierter Ansatz zur Beurteilung eines Aufsuchungsantrages auf Schiefergas in Hessen

NASA Astrophysics Data System (ADS)

Fritsche, Johann-Gerhard; Brodsky, Jan; Heggemann, Heiner; Hoffmann, Michaela; Hottenrott, Martin; Kracht, Matthias; Reischmann, Thomas; Rosenberg, Fred; Schlösser-Kluger, Inga

2016-06-01

In the context of an application for a shale gas exploration license including hydraulic fracturing, the Geological Survey of Hessen (HLNUG) has grouped and ranked structural geological regions in terms of their shale gas potential and the function of overlying rocks as barriers. Tectonic and structural features as well as the type of reservoir have been examined. Rock units overlying the shale gas layers have been classified as hydrogeological units and divided into aquifers and hydraulic barriers. Possible effects on drinking water abstraction facilities, mineral springs and water for industrial use have also been estimated, followed by an analysis of competing requirements for land use. A potential for shale gas can only be identified in a region north of Kassel, covering about 16 % of the claim area. Approximately 65 % of this region is overlapped by protection areas for drinking water and mineral springs, nature reserves and many other areas of public interest.

Supply Chain Management (SCM) mit Kanban

NASA Astrophysics Data System (ADS)

Beer, Anja; Dickmann, Eva; Dickmann, Philipp; Gerth, Wolf-Michael; Graßy, Mario; Herron, Colin; Schmidt, Peter; Seidl, Florian; Wittmann, Claus-Eduard

Nach Schätzungen von Mercer Management Consulting und dem Fraunhofer Institut wird der Wertschöpfungsanteil in der Automobilindustrie von durchschnittlich 35 % im Jahr 2002 auf 23 % im Jahr 2015 sinken [Merc 04]. Der Trend, die Produktionstiefe oder allgemeiner, die Wertschöpfungstiefe, zu reduzieren, hat zur Folge, dass die Kaufteile den größeren Teil der Wertschöpfung einnehmen. Die Optimierungspotentiale und der Einfluss auf die Kosten wandern immer mehr zu den Lieferanten, vor allem bei größeren Unternehmen oder Konzernen. Lieferanten-Philosophien, die auf oberflächlichen Verbindungen zu Lieferanten aufbauen, um immer optimal und schnell den günstigsten Teilepreis zu erhalten, haben sich in vielen Sparten oder Produktbereichen, z. B. im Maschinenbau, im besten Fall als kurzfristig erfolgreich erwiesen. Kooperative und nachhaltige Strategien sind der erfolgversprechendere Weg, zumindest mittelbis langfristig. In der Realität wird sehr wenig in Supply Chain-Konzepte investiert und die Umsetzungen sind daher vielmals oberflächlich.

Veränderungsmanagement: Utility 4.0

NASA Astrophysics Data System (ADS)

Hofstetter, Norbert

Finden Sie das rechte Maß für Ihre energiewirtschaftlichen Veränderungsvorhaben in "Utility 4.0". Mal was Gutes für Ältere: "Alter Dachs schlägt jungen Hasen". Beim Veränderungsmanagement ist Erfahrung gefragt. Die Bausteine der Veränderung reichen von wie sie mit ihrer Veränderungsgeschichte überzeugen bis wie sie die emotionale Achterbahn der Gefühle auf der individuellen Veränderungskurve bewältigen und wie Veränderungsprojekte auf Gesamtunternehmensebene ablaufen bis zur Frage, wie sie Ihre Macht-/Fachpromotoren und Multiplikatoren in Stellung bringen. Möglicherweise haben Sie die Veränderung in Form eines Start-up-ähnlichen Organisational Slack schon in Ihrem Haus. Nur wissen Sie es noch nicht. Und last but not least: Beschäftigen sie sich mit dem Thema Komplexitätshandhabung. Seien Sie es sich selbst Wert. Seien sie aufmerksam zu sich und ihrer Gesundheit!

Black soils and/or sediments at the western border of the Nördlinger Ries (South Germany)

NASA Astrophysics Data System (ADS)

Mailänder, S.; Eberle, J.; Blümel, W. D.

2009-04-01

In the framework of a geoarchaeological research project by the Institute of Geography, University of Stuttgart, in the year 2006 the construction of a kerosene pipeline trench was monitored at the western border of the impact crater "Nördlinger Ries" in South Germany (MAILÄNDER ET AL. 2008). Thereby black horizons were recognized at several places. They occured predominantly in depressions and were covered by holocene colluvial sediments, but rested on different bedrocks which include mud- and sandstones as well as lime. The most of these horizons seemed to be rich in humic material and clay. By means of various studies, which involve sedimentological, pedological, archaeobotanical and -zoological analysis as well as 14C-(AMS)-datings, the periods and circumstances of the development of these black horizons are explored. The poster presents the itemised research methods and their first results. Particularly micromorphological analysis and mollusc classifications turned out to be very valuable to reconstruct the palaeoenvironmental conditions during their formation and subsequent modifications. First datings of bulk samples and charcoal pieces refer to the Atlantic period, but the measured ages distribute to a long time space from about cal BC 5200 to cal BC 4000. The outcomes of this investigation should facilitate a comparison with similar horizons which are recovered in several Central European sediment profiles, for example in the Amöneburger Becken near Marburg in Hessen (RITTWEGER 2000). Also their composition will be contrasted with samples from archaeological findings in the surrounding and the possibility of an anthropogenic influence on their development will be checked. References MAILÄNDER, S., W. D. BLÜMEL & J. EBERLE (2008): Paläoumweltbedingungen und anthropogene Landoberflächenveränderungen im Umfeld des frühkeltischen Fürstensitzes auf dem Ipf am Westrand des Nördlinger Rieses: Erste Geländebefunde und Auswertungen 2005/2006.- In: KRAUSSE, D. L. (Ed.) (2008): Frühe Zentralisierungs- und Urbanisierungsprozesse. Zur Genese und Entwicklung frühkeltischer Fürstensitze und ihres territorialen Umlandes. Kolloquium des DFG-Schwerpunktprogramms 1171 (Blaubeuren, 9.-11. Oktober 2006).- Forschungen und Berichte zur Vor- und Frühgeschichte in Baden-Württemberg 101.- Stuttgart: 281-298. RITTWEGER, H. (2000): The "Black Floodplain Soil" in the Amöneburger Becken, Germany: a lower Holocene marker horizon and indicator of an upper Atlantic to Subboreal dry period in Central Europe?.- Catena 41: 143-164.

Dioxin-ähnliche Wirkungen durch Grundwasser am Industriestandort Zeitz

NASA Astrophysics Data System (ADS)

Schirmer, Kristin; Bopp, Stephanie; Russold, Sandra; Popp, Peter

Kurzfassung Im Rahmen der Etablierung des Standortes Zeitz (Sachsen-Anhalt) als Referenztestfeld zur Implementierung des Natural-Attenuation-Ansatzes, haben wir Grundwasser auf seine Fähigkeit untersucht, eine Dioxin-ähnliche Wirkung hervorzurufen. Die Dioxin-ähnliche Wirkung ist die Arylhydrocarbon Rezeptor-vermittelte Induktion des Proteinkomplexes Cytochrom CYP1A, welches als 7-Ethoxyresorufin-O-Deethylase (EROD) Enzymaktivität in einer Fischleberzelllinie gemessen wurde. Von 32 Probennahmestellen wiesen sieben eine signifikante EROD-Induktion auf, welche zu einem geringen Teil auf Polyzyklische Aromatische Kohlenwasserstoffe zurückzuführen war. Ein weiterer Teil der EROD-Induktion konnte den Substanzen Benzofuran, Indan und Inden zugesprochen werden, welche hier erstmalig als EROD-Induktoren identifiziert wurden. Alle Probennahmestellen mit signifikanter EROD-Induktion lagen im Anstrom bzw. westlich des früheren Standortes der Benzolanlage in Zeitz, was einen signifikanten Einfluss von Benzol vor allem auf den Transport und das Lösungsverhalten EROD-induzierender Grundwasserkontaminanten vermuten lässt. Insgesamt zeigen diese Untersuchungen, wie eine Kombination von chemischer und biologischer Analytik zu einer deutlich verbesserten Aussagekraft führt und somit zu einer nachhaltigen Überwachung der Qualität von Grundwasser beitragen kann. As part of setting up the test field Zeitz (Saxony-Anhalt, Germany) as a reference site for the implementation of Natural Attenuation as a remediation option, we have investigated groundwater for its ability to cause a dioxin-like response. The dioxin-like response is the aryl hydrocarbon receptor-mediated induction of the protein complex cytochrome CYP1A, which was measured as 7-Ethoxyresorufin-O-deethylase (EROD) enzyme activity in a fish liver cell line. Out of 32 sampling locations, seven showed significant EROD induction, which could be explained, to a minor extent, by the presence of polycyclic aromatic hydrocarbons. Another small portion of the EROD induction was attributed to the low molecular weight compounds, Benzofuran, Indane and Indene, which were shown for the first time to act as EROD inducers. All sampling locations showing significant EROD induction were located upstream or to the west of the former benzene production site in Zeitz. This indicates that benzene is likely to affect the transport and dissolution of EROD-inducing groundwater contaminants. In sum, this study shows how a combination of chemical and biological analysis can greatly augment knowledge about site characteristics and thus contribute to a sustainable monitoring of groundwater quality.

The role of biophysical indicators in the reconstruction of long-term late-spring - summer temperatures for the region of Western Hungary and Eastern Austria

NASA Astrophysics Data System (ADS)

Kiss, Andrea; Wilson, Rob; Holawe, Franz; Strömmer, Elisabeth; Bariska, István.

2010-05-01

We present an almost 500-year May-July temperature reconstruction based on 24 biophysical series. 19 are vine-related series from Kőszeg, Szombathely and Sopron in Western Hungary (11 series, from 1580s onwards), Vienna, Klosterneuburg, Perchtoldsdorf (7 series; at present from 1520s onwards) in Eastern Austria and Bratislava in Western Slovakia (1 series, from 1770s onwards). At present, the first, largest group is the vine related indicators, where dates of blossoming (1 series), beginning of grape ripening (3 series), dates of full ripening (2 series), beginning of grapevine harvest (8 series), starting dates of pressing out the juice (1 series: at present 1520s onwards), starting dates of tax-collection (after the pressed juice: 1 series) and wine quality indices (3 series: from 1580s onwards) are also included. The second main group of 4 indicators applied in the analysis are grain-harvest related indicators from Western Hungary, such as dates for estimation of harvesting-shares which are strongly dependant on the beginning of grain harvesting (at present 2 series: from 1640s onwards) and dates of grain tax collection (2 series: from 1560s onwards). A third group, still in development, is mainly related to more natural vegetation, and is strongly dependent on the full ripening of oak acorns: the starting dates of woodland pasture (at present 1 series: from 1770s onwards). The above-mentioned historical series correlate well, over the 18th-19th century period, with Vienna May-July measured temperature (Böhm, et. al. 2009). The complicated nature of these historical data is described (e.g. with respect to the normality of the data distribution), and we present methods to transform and composite the data into a homogenous, homoscedastic time-series that can be used for proxy based calibration. Finally, a preliminary May-July temperature reconstruction is derived using modified dendrochronological methods. (see Leijonhufvud et al. 2009) The Kőszeg, Szombathely, Sopron and Bratislava series and all presented analyses were developed within the framework of the EU project 'Millenium'. The Austrian series are partly based on published series (Pribram 1938, Lauscher 1985, Strömmer 2003) although in some cases modified and extended for this study, as well as newly developed data. The present work is a continuation of the 'Analysis of late spring-summer temperatures for Western Hungary based on vine, grain tithes and harvest records', presented at the annual congress of EGU in 2009 (Kiss and Wilson 2009). References Böhm, R., Jones, P.D., Hiebl, J., Frank, D., Brunetti, M., Maugeri and M. 2009: The early instrumental warm-bias: a solution for long central European temperature series 1760-2007. Climatic Change, doi: 10.1007/s10584-009-9649-4. Kiss, A. and Wilson, R. 2009: Analysis of late spring-summer temperatures for Western Hungary based on vine, grain tithes and harvest records. Geophysical Research Abstracts Vol 11, EGU2009-10945-1. Lauscher, F. 1985: Beiträge zur Wetterchronik seit dem Mittelalter. In: Sitzungsberichte, Abtheilung II, Mathematische, Physikalische und Technische Wissenschaften, Band 194, Heft 1-3. pp. 93-131. Leijonhufvud, L., Wilson, R., Möberg, A., Söderberg, J., Retső, D. and Söderlind, U. 2009: Five centuries of Stockholm winter/spring temperatures reconstructed from documentary evidence and instrumental observations. Climatic Change, doi: 10.1007/s10584-009-9650-y. Pribram, A. F. 1938: Materialien zur Geschichte der Preise und Löhne in Österreich. Band. I. Carl Ueberreuters Verlag, Wien. pp. 364-370. Strömmer, E. 2003: Klima-Geschichte. Methoden der Rekonstruction und historische Perspektive. Ostösterreich 1700 bis 1830. Forschungen und Beiträge zur Wiener Stadtgescichte 39. Franz Deuticke, Wien. pp. 59-71.

Assessment of text documentation accompanying uncoded diagnoses in computerized health insurance claims in Japan.

PubMed

Tanihara, Shinichi

2015-01-01

Uncoded diagnoses in health insurance claims (HICs) may introduce bias into Japanese health statistics dependent on computerized HICs. This study's aim was to identify the causes and characteristics of uncoded diagnoses. Uncoded diagnoses from computerized HICs (outpatient, inpatient, and the diagnosis procedure-combination per-diem payment system [DPC/PDPS]) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010 were analyzed. The text documentation accompanying the uncoded diagnoses was used to classify diagnoses in accordance with the International Classification of Diseases-10 (ICD-10). The text documentation was also classified into four categories using the standard descriptions of diagnoses defined in the master files of the computerized HIC system: 1) standard descriptions of diagnoses, 2) standard descriptions with a modifier, 3) non-standard descriptions of diagnoses, and 4) unclassifiable text documentation. Using these classifications, the proportions of uncoded diagnoses by ICD-10 disease category were calculated. Of the uncoded diagnoses analyzed (n = 363 753), non-standard descriptions of diagnoses for outpatient, inpatient, and DPC/PDPS HICs comprised 12.1%, 14.6%, and 1.0% of uncoded diagnoses, respectively. The proportion of uncoded diagnoses with standard descriptions with a modifier for Diseases of the eye and adnexa was significantly higher than the overall proportion of uncoded diagnoses among every HIC type. The pattern of uncoded diagnoses differed by HIC type and disease category. Evaluating the proportion of uncoded diagnoses in all medical facilities and developing effective coding methods for diagnoses with modifiers, prefixes, and suffixes should reduce number of uncoded diagnoses in computerized HICs and improve the quality of HIC databases.

[A failed experiment - Carl Friedrich von Weizsäcker, Jürgen Habermas and the Max-Planck Society].

PubMed

Leendertz, Ariane

2014-01-01

From 1970 to 1980 Carl Friedrich von Weizsäcker headed the Max-Planck-lnstitut zur Erforschung der Lebensbedingungen der wissenschaftlich-technischen Welt (MPI for the study of the living conditions of the world of science and technology) in Starnberg, jointly with Jürgen Habermas since 1971. From the start, the Max Planck Society regarded the new institute as an experiment that might perhaps be aborted a few years later. This is exactly what happened. With the retirement of Weizsäcker, his section was closed and the whole institute was renamed. In 1981. Habermas resigned, and then the institute was closed. This paper focusses on some of the problem constellations within the institute that partly explain its development and eventual closure: its birth out of the idea of scientific policy advice, the debates within the Max Planck Society and the complex relationship between Weizsäcker and Jürgen Habermas.

Isotopenhydrologische Methoden (2H, 18O) zur Bestimmung der Grundwasserneubildung in Trockengebieten: Potenzial und Grenzen

NASA Astrophysics Data System (ADS)

Beyer, Matthias; Gaj, Marcel; Königer, Paul; Tulimeveva Hamutoko, Josefina; Wanke, Heike; Wallner, Markus; Himmelsbach, Thomas

2018-03-01

The estimation of groundwater recharge in water-limited environments is challenging due to climatic conditions, the occurrence of deep unsaturated zones, and specialized vegetation. We critically examined two methods based on stable isotopes of soil water: (i) the interpretation of natural isotope depth-profiles and subsequent approximation of recharge using empirical relationships and (ii) the use of deuterium-enriched water (2H2O) as tracer. Numerous depth-profiles were measured directly in the field in semiarid Namibia using a novel in-situ technique. Additionally, 2H2O was injected into the soil and its displacement over a complete rainy season monitored. Estimated recharge ranges between 0 and 29 mm/y for three rainy seasons experiencing seasonal rainfall of 660 mm (2013/14), 313 mm (2014/15) and 535 mm (2015/16). The results of this study fortify the suitability of water stable isotope-based approaches for recharge estimation and highlight enormous potential for future studies of water vapor transport and ecohydrological processes.

Contributions to the History of Astronomy, Vol. 8 (German Title: Beiträge zur Astronomiegeschichte, Band 8)

NASA Astrophysics Data System (ADS)

Dick, Wolfgang R.; Hamel, Jürgen

The contributions span a time interval of more than 450 years. There are biographical investigations on Georg Joachim Rheticus, C.W.A. von Wahl and K.F. Heym, investigation on a reprint of a chapter of the principal work of Nicolaus Copernicus, on Christoph Scheiner and the "camera obscura", and, with respect to the history of timekeeping, on the "big Nuremberg clock". 19th century topics are: a contribution on the honorary doctorate of Joseph Fraunhofer, and on the construction of a lunar globe by Wilhelmine Witte, while the report on Friedrich Wilhelm Bessel and the cholera pandemia in Königsberg in the year 1831 gives a view into everyday life of scientists. 20th century topics are: the contributions on Bruno Thüring in Vienna and his relations with national socialism, as well as on Arthur Beer, Albert Einstein and the Warburg library. The book concludes by short communications, obituaries and book reviews.

Natural history and the formation of the human being: Kant on active forces.

PubMed

Waldow, Anik

2016-08-01

In his 1785-review of the Ideen zur Philosophie der Geschichte der Menschheit, Kant objects to Herder's conception of nature as being imbued with active forces. This attack is usually evaluated against the background of Kant's critical project and his epistemological concern to caution against the "metaphysical excess" of attributing immanent properties to matter. In this paper I explore a slightly different reading by investigating Kant's pre-critical account of creation and generation. The aim of this is to show that Kant's struggle with the forces of matter has a long history and revolves around one central problem: that of how to distinguish between the non-purposive forces of nature and the intentional powers of the mind. Given this history, the epistemic stricture that Kant's critical project imposes on him no longer appears to be the primary reason for his attack on Herder. It merely aggravates a problem that Kant has been battling with since his earliest writings. Copyright © 2016 Elsevier Ltd. All rights reserved.

The transformation of regular circular motion into straight motion according to Nasir al din al-Tusi - a genious model for the conscious preservation of a defect of Ptolemy's lunar theory (German Title: Die Umwandlung gleichförmiger Kreisbewegung in geradlinige Bewegung nach Nasir al din al-Tusi - Ein geniales Modell zur bewußten Beibehaltung eines Mangels der Ptolemäischen Mondtheorie)

NASA Astrophysics Data System (ADS)

Hein, Olaf; Mader, Rolf

Nasir al din al-Tusi (1201-1274) was one of the most important universal scholars of Islam. As a convinced Aristotelian, he rejected Ptolemy's modifications of the Aristotelian dogma of uniform circular motion. He created a theory of lunar motion which is only based on uniform circular motion, and which results in the same representation of lunar motion as conceived by Ptolemy. He successfully attempted to consciously preserve, and not to correct, an error of Ptolemy's theory (the doubling of the earth-moon distance in the syzygies as compared to the quadratures). We explain the Tusi mechanism and point out its philosophical consequences (the unwanted dissolution of the difference between the extra- and intralunar world).

Sternbilder und ihre Mythen

NASA Astrophysics Data System (ADS)

Fasching, Gerhard

Die Sternbilder, die seit alters her die Menschen in ihren Bann gezogen haben, und die damit verbundenen Mythen werden in zweifacher Weise vorgestellt. Erstens ist es die Absicht, dem Leser zu helfen, sich am Sternenhimmel zurechtzufinden, und zweitens will es ihm die Vielfalt der Bilder vermitteln, die damit verbunden sind. Am Anfang des Buches stehen die prächtigen Erzählungen aus Ovids Metamorphosen. Dann ist vom Sternenhimmel im Jahreskreis die Rede, um den Leser anzuregen, diesen fast unendlichen Bilderreichtum sich selbst durch eigene Beobachtungen zu erschließen. Ein umfangreicher Abschnitt behandelt die einzelnen Sternbilder und das hierzu überlieferte Wissen. Sternkarten und alte Kupferstiche aus dem Bestand der Österreichischen Nationalbibliothek zeigen, wie man sich in früheren Jahrhunderten den Sternenhimmel vorgestellt hat. Sternsagen und Mythen werden erzählt und auch das ptolemäische und das kopernikanische Weltsystem werden einander gegenübergestellt. Ausführliche Sachverzeichnisse mit über 3000 Suchbegriffen erleichtern den Zugang zu Stern- und Sternbildnamen und zur Mythologie.

[Forced sterilisation based on the Law for the Prevention of Hereditarily Diseased Offspring. The role of the Heil- und Pflegeanstalt (State Hospital) Günzburg].

PubMed

Steger, F; Schmer, B; Strube, W; Becker, T

2012-03-01

From 1934 to 1945, 350,000-400,000 human beings were sterilised by force in the German Reich. Forced sterilisation was based on the Gesetz zur Verhütung erbkranken Nachwuchses (Law for the Prevention of Hereditarily Diseased Offspring). The Heil- und Pflegeanstalt (State Hospital) Günzburg was one of the institutions where compulsory sterilisation was practised. Data evaluation was based on patient documents and annual reports of the archives of today's district hospital at Günzburg. Patient records were analysed with respect to predefined criteria. The municipal archives of Günzburg provided further historical sources and data. Between 1934 and 1943, 366 patients were sterilised in the Heil- und Pflegeanstalt (State Hospital) Günzburg. Age, sex and diagnosis were found to be criteria relevant for selection of patients for sterilisation. The study was able to show the active involvement of the Heil- und Pflegeanstalt (State Hospital) Günzburg in the compulsory sterilisation programme.

Dynamische Motorvermessung mit verschiedenen Methoden und Modellen

NASA Astrophysics Data System (ADS)

Schreiber, Alexander

Die stark zunehmenden gesetzlichen und wirtschaftlichen Vorgaben zur Senkung von Kraftstoffverbrauch und Abgasemissionen stellen große Anforderungen an die weitere Entwicklung von Benzin- und Dieselmotoren. Hierbei sind grundlegende Fortschritte durch Konstruktion und auslegungsbedingte Maßnahmen im Bereich der Einspritzung, Gemischaufbereitung, Aufladung, Brennverfahren und Abgasnachbehandlung zu erreichen. Ein wesentlicher Teil dieser Verbesserungen wird jedoch durch eine Zunahme von Variabilitäten erreicht wie z.B. verstellbaren Vor-, Haupt- und Nacheinspritzungen, variablem Raildruck, variablen Nockenwellensteuerwinkeln, Ventilhüben, Drall-/Tumbleklappen sowie verstellbaren Abgasturbinen, Abgasrückführströmen und Abgasnachbehandlungssystemen. Dadurch steigt die Zahl der Stellglieder (Aktoren) stark an. Hinzu kommen zusätzliche Sensoren wie z.B. für Luftzahl, NOx, Brennraumdruck, Abgastemperatur und Abgasdruck. Deshalb nimmt der Umfang der Steuerungs-, Regelungs- und Diagnosefunktionen in der Motorelektronik (ECU) stark zu. Bild 7-1 zeigt als Beispiel den Signalfluss für die gesteuerten und geregelten Größen eines Dieselmotors in einer beispielhaften Prüfstandsumgebung.

Planungsmodelle und Planungsmethoden. Anhaltspunkte zur Strukturierung und Gestaltung von Planungsprozessen

NASA Astrophysics Data System (ADS)

Diller, Christian; Karic, Sarah; Oberding, Sarah

2017-06-01

The topic of this article ist the question, in which phases oft he political planning process planners apply their methodological set of tools. That for the results of a research-project are presented, which were gained by an examination of planning-cases in learned journals. Firstly it is argued, which model oft he planning-process is most suitable to reflect the regarded cases and how it is positioned to models oft he political process. Thereafter it is analyzed, which types of planning methods are applied in the several stages oft he planning process. The central findings: Although complex, many planning processes can be thouroughly pictured by a linear modell with predominantly simple feedback loops. Even in times of he communicative turn, concerning their set of tools, planners should pay attention to apply not only communicative methods but as well the classical analytical-rational methods. They are helpful especially for the understanding of the political process before and after the actual planning phase.

Ein Entscheidungsmodell zur Weitergabe persönlicher Daten im Internet

NASA Astrophysics Data System (ADS)

Treiblmaier, Horst

In den vergangenen zwei Jahrzehnten wandelte sich das Internet von einer Spielwiese für technikbegeisterte Computerspezialisten zu einem vielseitig einsetzbaren weltweiten Netzwerk für Privatpersonen und Unternehmen. Maßgeblichen Anteil daran besaß die rasante Entwicklung des World Wide Web (WWW), das, durch die Möglichkeit multimediale Inhalte zu vermitteln, für einen großen Teil der Bevölkerung industrialisierter Länder zu einem wesentlichen Bestandteil des täglichen Lebens wurde. Dass diese Entwicklung noch lange nicht abgeschlossen ist, zeigt die derzeitige Diskussion zum Thema Web 2.0 bzw. 3.0. Waren es in den letzten Jahren die hohen Umsatzzuwächse im E-Commerce und multimedial gestaltete Webseiten in Kombination mit aufwändigen Applikationen, die für ständig steigende Nutzerzahlen im World Wide Web sorgten, so wird dieser Innovationsschub nunmehr durch eine Vielzahl von Anwendungen fortgesetzt, die sich durch die zunehmende Vernetzung der Nutzer untereinander auszeichnen.

Methodenvergleich zur Bestimmung der hydraulischen Durchlässigkeit

NASA Astrophysics Data System (ADS)

Storz, Katharina; Steger, Hagen; Wagner, Valentin; Bayer, Peter; Blum, Philipp

2017-06-01

Knowing the hydraulic conductivity (K) is a precondition for understanding groundwater flow processes in the subsurface. Numerous laboratory and field methods for the determination of hydraulic conductivity exist, which can lead to significantly different results. In order to quantify the variability of these various methods, the hydraulic conductivity was examined for an industrial silica sand (Dorsilit) using four different methods: (1) grain-size analysis, (2) Kozeny-Carman approach, (3) permeameter tests and (4) flow rate experiments in large-scale tank experiments. Due to the large volume of the artificially built aquifer, the tank experiment results are assumed to be the most representative. Hydraulic conductivity values derived from permeameter tests show only minor deviation, while results of the empirically evaluated grain-size analysis are about one magnitude higher and show great variances. The latter was confirmed by the analysis of several methods for the determination of K-values found in the literature, thus we generally question the suitability of grain-size analyses and strongly recommend the use of permeameter tests.

Investitionen aus den BRIC-Staaten. Grund zur Sorge für Unternehmen, Beschäftigte und Kommunen?

NASA Astrophysics Data System (ADS)

Franz, Martin; Henn, Sebastian

2017-04-01

Investments from BRIC countries - Brazil, Russia, India and China - are playing an increasingly important role in Germany. However, both the public and the potentially affected labour force often adopt sceptical, and sometimes even hostile attitudes towards investors from these countries. This article shows that apart from a few exceptions investors from the BRIC countries are generally better than their reputation precedes. An important conclusion drawn in this paper is that investors should not be received with stereotypes. Rather, it is necessary to perform deeper investigations into their strategies and the specific investment goals in each case. This is all the more necessary to ensure that investments from BRIC countries do not conflict with the domestic firms' interests or of their personnel. In fact, they can assist to increase the competitiveness of German firms, and as such not only prove beneficial for the workforce but also for Germany as a business destination.

Numerische Szenariosimulationen zur Ausbreitung von hochmineralisiertem Wasser in oberflächennahen Süßwasseraquiferen

NASA Astrophysics Data System (ADS)

Wiegers, Carla Elisabeth; Schäfer, Dirk

2015-06-01

In areas where the geological subsurface is used for storage of gases or fracking, there is a risk of saline formation water entering protected aquifers. The impact of such potential leakage therefore needs to be evaluated at relevant sites to develop practical monitoring concepts. Three-dimensional numerical simulations and a sensitivity analysis are performed to determine the influence of aquifer parameters, ground water flow, aquifer morphology, leakage rate and NaCl-concentration of the intruding water on the propagation behaviour of saline water. Two example scenarios were simulated based on a realistic site-scale conceptual model, one with water from the lower Braunkohlensande, (NaCl = 7.61 g/l) the other with saline water from the Bunter sandstone formation (NaCl = 280.3 g/l). The simulations show that saltwater migrates along the bottom of the aquifer, and that groundwater flow can dominate the transport of chloride. In this case the spreading of denser water is not influenced by the aquifer's morphology.

Lateral groundwater inflows into alluvial aquifers of main alpine valleys

NASA Astrophysics Data System (ADS)

Burger, Ulrich

2015-04-01

In alpine regions the topography is mainly characterised by deep incised valleys, mountain slopes and ridges. Usually the main valleys contain aquifers in alluvial soft rock. Lateral these aquifers are confined by mountainous hard rock slopes covered by heterogeneous sediments with different thickness. The slopes can be incised by lateral valleys. Numerical models for the main alluvial aquifers ask for lateral hydrogeological boundaries. Usually no flow boundaries or Constant head Boundaries are used, even if the lateral inflows to the main aquifers are rarely known. In this example a data set for a detailed investigated and monitored area is studied to give an answer on the location and the quantification of these lateral subsurface inflows. The study area is a typical main alpine valley with a thick alluvial aquifer (appr. 120m thick), lateral confined by granite, covered at the base of the steep slopes by quaternary sediments (Burger at al. 2012). The study consists of several steps 1.) Analytical calculation of the inflows on the base of investigated and monitored 2d profiles along fault zones (Perello et al 2013) which pinch out in the main valley 2.) Analytical models along typical W-dipping slopes with monitored slope springs 3.) Evaluating temperature and electrical conductivity profiles measured in approx. 30 groundwater wells in the alluvial aquifers and along the slopes to locate main lateral subsurface inflows 4.) Output of a regional model used for the hydrogeological back analyses of the excavation of a tunnel (Baietto et al. 2014) 5.) Output of a local numerical model calibrated with a monitoring dataset and results of a pumping test of big scale (450l/s for 10days) Results of these analyses are shown to locate and quantify the lateral groundwater inflows in the main alluvial aquifer. References Baietto A., Burger U., Perello P. (2014): Hydrogeological modelling applications in tunnel excavations: examples from tunnel excavations in granitic rocks; congress of IAEG, Engineering Geology for Society and Territory, Torino Burger U., San Nicoló L. Bösel D. und Perello P. (2012): Hydrogeologische Modelle - Hilfsmittel für die Planung am Beispiel des Brenner Basistunnel, Beiträge zur Beiträge zur COGeo 2011, Salzburg COGEO Perello P., Baietto A., Burger U., Skuk S. (2013): Excavation of the Aica-Mules pilot tunnel for the Brenner base tunnel: information gained on water inflows in tunnels in granitic massifs, Rock Mechanics and Rock Engineering, DOI 10.1007/s00603-013-0480-x

Nursing diagnoses determined by first year students: a vignette study.

PubMed

Hakverdioğlu Yönt, Gülendam; Korhan, Esra Akın; Erdemir, Firdevs; Müller-Staub, Maria

2014-02-01

The study aimed to determine the ability of first year students in identifying nursing diagnoses. In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Patient case study vignettes are recommended for education. To foster students' knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. © 2013 NANDA International, Inc.

ICD-10 classification in Danish child and adolescent psychiatry--have diagnoses changed after the introduction of ICD-10?

PubMed

Møller, Lene Ruge; Sørensen, Merete Juul; Thomsen, Per Hove

2007-01-01

The aim was to test this in a nationwide register study of diagnoses used in child and adolescents psychiatry in Denmark. A larger number of different diagnoses were expected to be applied after the introduction of the 10th version of the International Classification of Diseases (ICD-10). Reflecting the time trend, we particularly expected an increase in the number of neuropsychiatric diagnoses. From the Danish Psychiatric Central Register data were drawn on clinical discharge diagnoses. All patients aged 0-15 years examined at psychiatric hospitals from 1995-2002 were included; 22,469 children and adolescents with a first contact were registered. The most frequent discharge diagnoses were pervasive development disorders (PDD; 11.9%), adjustment disorders (10.6%), conduct disorder (9.5%), emotional and anxiety disorders (7.6%), hyperkinetic disorders (7.3%), and specific developmental disorders (7.3%). We found a significant increase in the number of neuropsychiatric and affective diagnoses and a significant decrease in the number of adjustment, conduct and anxiety diagnoses during the study period. Of the 22,469 diagnoses, 45% were only partly specified according to ICD-10. Thirty-four per cent had diagnoses unspecified on the four-character level (Fxx.9) and 11% had Z-diagnoses. A larger number of different diagnoses and an increase in the use of neuropsychiatric diagnoses were seen after the introduction of ICD-10. Many diagnoses were only partly specified; consequently, a more detailed specification of the ICD-10 is still required.

Factors determining growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2.7)

NASA Astrophysics Data System (ADS)

Bissinger, Vera

2003-04-01

In this thesis, I investigated the factors influencing the growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2-3). In the focal study site, Lake 111 (pH 2.7; Lusatia, Germany), the chrysophyte, Ochromonas sp., dominates in the upper water strata and the chlorophyte, Chlamydomonas sp., in the deeper strata, forming a pronounced deep chlorophyll maximum (DCM). Inorganic carbon (IC) limitation influenced the phototrophic growth of Chlamydomonas sp. in the upper water strata. Conversely, in deeper strata, light limited its phototrophic growth. When compared with published data for algae from neutral lakes, Chlamydomonas sp. from Lake 111 exhibited a lower maximum growth rate, an enhanced compensation point and higher dark respiration rates, suggesting higher metabolic costs due to the extreme physico-chemical conditions. The photosynthetic performance of Chlamydomonas sp. decreased in high-light-adapted cells when IC limited. In addition, the minimal phosphorus (P) cell quota was suggestive of a higher P requirement under IC limitation. Subsequently, it was shown that Chlamydomonas sp. was a mixotroph, able to enhance its growth rate by taking up dissolved organic carbon (DOC) via osmotrophy. Therefore, it could survive in deeper water strata where DOC concentrations were higher and light limited. However, neither IC limitation, P availability nor in situ DOC concentrations (bottom-up control) could fully explain the vertical distribution of Chlamydomonas sp. in Lake 111. Conversely, when a novel approach was adopted, the grazing influence of the phagotrophic phototroph, Ochromonas sp., was found to exert top-down control on its prey (Chlamydomonas sp.) reducing prey abundance in the upper water strata. This, coupled with the fact that Chlamydomonas sp. uses DOC for growth, leads to a pronounced accumulation of Chlamydomonas sp. cells at depth; an apparent DCM. Therefore, grazing appears to be the main factor influencing the vertical distribution of algae observed in Lake 111. The knowledge gained from this thesis provides information essential for predicting the effect of strategies to neutralize the acidic mining lakes on the food-web. Die vorliegende Dissertation beschäftigt sich mit den Faktoren, die das Wachstum und die Vertikalverteilung von Planktonalgen in extrem sauren Tagebaurestseen (TBS; pH 2-3) beeinflussen. Im exemplarisch untersuchten TBS 111 (pH 2.7; Lausitzer Revier) dominiert die Goldalge Ochromonas sp. in oberen und die Grünalge Chlamydomonas sp. in tieferen Wasserschichten, wobei letztere ein ausgeprägtes Tiefenchlorophyll-Maximum (DCM) ausbildet. Es wurde ein deutlicher Einfluss von Limitation durch anorganischen Kohlenstoff (IC) auf das phototrophe Wachstum von Chlamydomonas sp. in oberen Wasserschichten nachgewiesen, die mit zunehmender Tiefe von Lichtlimitation abgelöst wird. Im Vergleich mit Arbeiten aus neutralen Seen zeigte Chlamydomonas sp. erniedrigte maximale Wachstumsraten, einen gesteigerten Kompensationspunkt und erhöhte Dunkelrespirationsraten, was auf gesteigerte metabolische Kosten unter den extremen physikalisch-chemischen Bedingungen hinweist. Die Photosyntheseleistungen von Chlamydomonas sp. waren in Starklicht-adaptierten Zellen durch IC-Limitation deutlich verringert. Außerdem ergaben die ermittelten minimalen Zellquoten für Phosphor (P) einen erhöhten P-Bedarf unter IC-Limitation. Anschließend konnte gezeigt werden, dass Chlamydomonas sp. ein mixotropher Organismus ist, der seine Wachstumsraten über die osmotrophe Aufnahme gelösten organischen Kohlenstoffs (DOC) erhöhen kann. Dadurch ist dieser Organismus fähig, in tieferen, Licht-limitierten Wasserschichten zu überleben, die einen höheren DOC-Gehalt aufweisen. Da die Vertikalverteilung der Algen im TBS 111 jedoch weder durch IC-Limitation, P-Verfügbarkeit noch die in situ DOC-Konzentrationen abschließend erklärt werden konnte (bottom-up Kontrolle), wurde eine neue Theorie zur Entstehung der Vertikalverteilung geprüft. Grazing der phagotrophen und phototrophen Alge Ochromonas sp. auf der phototrophen Alge Chlamydomonas sp. erwies sich als herausragender Faktor, der über top-down Kontrolle die Abundanz der Beute in höheren Wasserschichten beeinflussen kann. Gemeinsam mit der Tatsache, dass Chlamydomonas sp. DOC zur Wachstumssteigerung verwendet, führt dies zu einer Akkumulation von Chlamydomonas sp. in der Tiefe, ausgeprägt als DCM. Daher erscheint grazing als der Hauptfaktor, der die beobachtete Vertikalschichtung der Algen im TBS 111 hervorruft. Die erzielten Ergebnisse liefern grundlegende Informationen, um die Auswirkungen von Strategien zur Neutralisierung der TBS auf das Nahrungsnetz abschätzen zu können.

The proportion of uncoded diagnoses in computerized health insurance claims in Japan in May 2010 according to ICD-10 disease categories.

PubMed

Tanihara, Shinichi

2014-01-01

Uncoded diagnoses in computerized health insurance claims are excluded from statistical summaries of health-related risks and other factors. The effects of these uncoded diagnoses, coded according to ICD-10 disease categories, have not been investigated to date in Japan. I obtained all computerized health insurance claims (outpatient medical care, inpatient medical care, and diagnosis procedure-combination per-diem payment system [DPC/PDPS] claims) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010. These were classified according to the disease categories of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). I used accompanying text documentation related to the uncoded diagnoses to classify these diagnoses. Using these classifications, I calculated the proportion of uncoded diagnoses by ICD-10 category. The number of analyzed diagnoses was 3,804,246, with uncoded diagnoses accounting for 9.6% of the total. The proportion of uncoded diagnoses in claims for outpatient medical care, inpatient medical care, and DPC/PDPS were 9.3%, 10.9%, and 14.2%, respectively. Among the diagnoses, Congenital malformations, deformations, and chromosomal abnormalities had the highest proportion of uncoded diagnoses (19.3%), and Diseases of the respiratory system had the lowest proportion of uncoded diagnoses (4.7%). The proportion of uncoded diagnoses differed by the type of health insurance claim and disease category. These findings indicate that Japanese health statistics computed using computerized health insurance claims might be biased by the exclusion of uncoded diagnoses.

[Epidemiologic and therapeutic status study of patients with hepatitis C].

PubMed

Xu, Min; Shi, Hai-yan; Cai, Wei-ping

2011-04-01

To investigate the different infective mode, the time from be infectived to be diagnosed and the time from be diagnosed to be treated of patients with hepatitis C. The different infective mode, the time from be infectived to be diagnosed and the time from be diagnosed to be treated of 216 patients with hepatitis C from march 2004 to march 2009 were retrospectively analyzed. 72.22 percents patients suffered from post transfusion hepatitis C (PTHC) and 27.78 percents patients suffered from sporadic hepatitisC (SHC). 32.61 percents patients were diagnosed after be infectived 15-20 years later. 3.26 percents patients were diagnosed after be infectived more than 20 years later. 33.80 percents patients were treated after be diagnosed more than 5 years later. 17.13 percents patients were treated after be diagnosed 10-15 years later. Most patients were infectived with hepatitis C by transfusing blood or blood products. Most patients were diagnosed after be infectived more than 15 years later. Almost half of patients were treated after be diagnosed more than 5 years later, and a significant portion of percents patients were treated after be diagnosed more than 10 years later.

Head impact exposure sustained by football players on days of diagnosed concussion.

PubMed

Beckwith, Jonathan G; Greenwald, Richard M; Chu, Jeffrey J; Crisco, Joseph J; Rowson, Steven; Duma, Stefan M; Broglio, Steven P; McAllister, Thomas W; Guskiewicz, Kevin M; Mihalik, Jason P; Anderson, Scott; Schnebel, Brock; Brolinson, P Gunnar; Collins, Michael W

2013-04-01

This study compares the frequency and severity of head impacts sustained by football players on days with and without diagnosed concussion and to identify the sensitivity and specificity of single-impact severity measures to diagnosed injury. One thousand two hundred eight players from eight collegiate football teams and six high school football teams wore instrumented helmets to measure head impacts during all team sessions, of which 95 players were diagnosed with concussion. Eight players sustained two injuries and one sustained three, providing 105 injury cases. Measures of head kinematics (peak linear and rotational acceleration, Gadd severity index, head injury criteria (HIC15), and change in head velocity (Δv)) and the number of head impacts sustained by individual players were compared between days with and without diagnosed concussion. Receiver operating characteristic curves were generated to evaluate the sensitivity and specificity of each kinematic measure to diagnosed concussion using only those impacts that directly preceded diagnosis. Players sustained a higher frequency of impacts and impacts with more severe kinematic properties on days of diagnosed concussion than on days without diagnosed concussion. Forty-five injury cases were immediately diagnosed after head impact. For these cases, peak linear acceleration and HIC15 were most sensitive to immediately diagnosed concussion (area under the curve = 0.983). Peak rotational acceleration was less sensitive to diagnosed injury than all other kinematic measures (P = 0.01), which are derived from linear acceleration (peak linear, HIC15, Gadd severity index, and Δv). Players sustained more impacts and impacts of higher severity on days of diagnosed concussion than on days without diagnosed concussion. In addition, of historical measures of impact severity, those associated with peak linear acceleration are the best predictors of immediately diagnosed concussion.

Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion

PubMed Central

Beckwith, Jonathan G.; Greenwald, Richard M.; Chu, Jeffrey J.; Crisco, Joseph J.; Rowson, Steven; Duma, Stefan M.; Broglio, Steven P.; McAllister, Thomas W.; Guskiewicz, Kevin M.; Mihalik, Jason P.; Anderson, Scott; Schnebel, Brock; Brolinson, P. Gunnar; Collins, Michael W.

2012-01-01

Purpose This study compares the frequency and severity of head impacts sustained by football players on days with and without diagnosed concussion and to identify the sensitivity and specificity of single impact severity measures to diagnosed injury. Methods 1,208 players from eight collegiate and six high school football teams wore instrumented helmets to measure head impacts during all team sessions, of which 95 players were diagnosed with concussion. Eight players sustained two injuries and one three, providing 105 injury cases. Measures of head kinematics (peak linear and rotational acceleration, Gadd Severity Index (GSI), Head Injury Criteria (HIC15), change in head velocity (Δv)) and the number of head impacts sustained by individual players were compared between days with and without diagnosed concussion. Receiver operator characteristic curves were generated to evaluate the sensitivity and specificity of each kinematic measure to diagnosed concussion using only those impacts that directly preceded diagnosis. Results Players sustained a higher frequency of impacts and impacts with more severe kinematic properties on days of diagnosed concussion than on days without diagnosed concussion. Forty-five injury cases were immediately diagnosed following head impact. For these cases, peak linear acceleration and HIC15 were most sensitive to immediately diagnosed concussion (AUC = 0.983). Peak rotational acceleration was less sensitive to diagnosed injury than all other kinematic measures (p = 0.01) which are derived from linear acceleration (peak linear, HIC15, GSI, and Δv). Conclusions Players sustain more impacts and impacts of higher severity on days of diagnosed concussion than on days without diagnosed concussion. Additionally, of historical measures of impact severity, those associated with peak linear acceleration are the best predictors of immediately diagnosed concussion. PMID:23135363

Sickness absence due to otoaudiological diagnoses and risk of disability pension: a nationwide Swedish prospective cohort study.

PubMed

Friberg, Emilie; Jansson, Catarina; Mittendorfer-Rutz, Ellenor; Rosenhall, Ulf; Alexanderson, Kristina

2012-01-01

Hearing difficulties are a large public health problem. Knowledge is scarce regarding risk of disability pension among people who have been sickness absent due to these difficulties. A cohort including all 4,687,756 individuals living in Sweden in 2005, aged 20-64, and not on disability or old-age pension, was followed through 2009. Incidence rate ratios (RR) of disability pension with 95% confidence intervals (CI) were estimated using Cox proportional hazard models. In multivariable models, individuals who had a sick-leave spell due to otoaudiological diagnoses in 2005 had a 1.52-fold (95% CI: 1.43-1.62) increased risk of being granted a disability pension compared to individuals on sick leave due to other diagnoses. Hearing and tinnitus sick-leave diagnoses were associated with risk of disability pension: RR 3.38, 95% CI: 3.04-3.75, and 3.30, 95% CI: 2.95-3.68, respectively. No association was observed between sick leave due to vertigo diagnoses and disability pension whereas otological diagnoses and no sick leave were inversely associated with risk of disability pension compared to non-otoaudiological sick-leave diagnoses. Sick leave due to otoaudiological diagnoses was positively associated with risk of disability pension due to otoaudiological diagnoses and sick leave due to a tinnitus diagnosis was also associated with risk of disability pension due to mental diagnoses. The risk of disability pension among individuals with hearing or tinnitus sick-leave diagnoses was highest in the age group 35-44. Moreover, men had a slightly higher risk. This large cohort study suggests an increased risk of disability pension among those with sickness absence due to otoaudiological diagnoses, particularly hearing and tinnitus diagnoses, compared to those with sickness absence due to non-otoaudiological diagnoses.

Somatoform, factitious, and related diagnoses in the national hospital discharge survey: addressing the proposed DSM-5 revision.

PubMed

Hamilton, James C; Eger, Melike; Razzak, Saman; Feldman, Marc D; Hallmark, Natalie; Cheek, Stephen

2013-01-01

The DSM-5 working group on the somatoform (SFD) and factitious (FD) disorders has recommended substantial revisions of these categories. The recommendations are based, in part, on anecdotal evidence that the diagnoses are infrequently used. To assess the assignment rates for SFD, FD, and related diagnoses among general medical inpatients. The National Hospital Discharge Survey was queried for instances of SFD and FD, along with related diagnoses identifying medical cases in which psychological factors play a role. Diagnoses of major depression and generalized anxiety disorder were queried for comparison purposes. The target diagnoses were assigned far less frequently than published prevalence and recognition rates suggest. Nearly half of the assigned target diagnoses were generic diagnoses (esp. physiological malfunction due to psychological factors) other than SFD or FD. However, the apparent degree of underassignment of the target diagnoses was not dramatically greater than the underassignment observed for major depression and generalized anxiety disorder. The results provide empirical support for the impression that physicians do not assign SFD and FD diagnoses in recognized cases, but do not strongly support the assertion that these diagnoses are uniquely problematic. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Quality of HIV care in the United Kingdom: key indicators for the first 12 months from HIV diagnosis.

PubMed

Delpech, V; Brown, A E; Croxford, S; Chau, C; Polavarapu, V; Cooper, N; Rooney, G; Yin, Z

2013-10-01

Prompt HIV diagnosis and treatment are associated with increased longevity and reduced transmission. The aim of the study was to examine late diagnoses and to assess the quality of care following diagnosis. National surveillance and cohort data were used to examine late HIV diagnoses and to assess the quality of care received in the 12 months following HIV diagnosis. In 2011, 79% (4910/6219) of persons (15 years and over) diagnosed with HIV infection had CD4 counts reported within 3 months; of these, 49% were diagnosed late (CD4 count < 350 cells/μL). Adults aged 50 years and over were more likely to be diagnosed late (67%) compared with those aged 15-24 years (31%). Sixty-four per cent of heterosexual men were diagnosed late compared with 46% of women and 36% of men who have sex with men (MSM) (P < 0.01). The percentage of late diagnoses was highest among black African adults (66%) compared with other ethnicities; 96% of black African adults diagnosed late were born abroad. Overall, 88% and 97% of patients were linked to care within 1 and 3 months of diagnosis, respectively, with little variation by demographics and exposure category. The crude 1-year mortality rate was 31.6 per 1000 persons diagnosed in 2010. It was highest among adults diagnosed late (40.3/1000 versus 5.2/1000 for prompt diagnoses) and particularly among those aged 50 years and over. Excluding deaths, 85% of the 5833 diagnosed in 2010 were retained in care in 2011; 92% of the 2264 adults diagnosed late in 2010 received antiretroviral therapy by the end of 2011. The National Health Service provides high-quality care to persons newly diagnosed with HIV infection in the UK, with no evidence of health inequalities. Despite excellent care, half of adults are diagnosed late according to the threshold at which national guidelines recommend treatment should begin. Such patients have an 8-fold increased risk of 1-year mortality compared with those diagnosed promptly. Reducing late diagnosis of HIV infection remains a public health priority in the UK. © 2013 British HIV Association.

How Are Genetic Conditions Diagnosed?

MedlinePlus

... Consultation How are genetic conditions diagnosed? How are genetic conditions diagnosed? A doctor may suspect a diagnosis ... and advocacy resources. For more information about diagnosing genetic conditions: Genetics Home Reference provides information about genetic ...

Mikrosensor-gesteuerte Rückkopplungs- Bioaktuatoren auf Halbleiterbasis zur biophysikalischen Krebsbehandlung

NASA Astrophysics Data System (ADS)

Wolf, Bernhard; Kraus, Michael

Acidic microenvironmental conditions combined with large hypoxic areas are ubiquitous hallmarks of most solid tumors. They result from a poorly organized vascularization and a deviant energy metabolism. There is convincing evidence supporting the hypothesis that such physico-chemical conditions promote the microevolution of malignant cells, inhibit the cellular immune response, and favor tumor cell invasion. In agreement with published data, our cell biological analyses and computer simulations indicate that treatment schemes which restore a tumor microenvironment reflecting that one found in normal tissues might improve the efficiency of immunotherapies and classical methods for cancer treatment. We suggest that the tumor microenvironment could be effectively monitored and manipulated by means of silicon-based feedback bioactuators which are controlled by integrated microsensors. In principle, miniaturized bioactuators can be implanted directly at the sites of inoperable tumors and metastases where they function as a "pH clamp" and thereby can reconstitute normal physico-chemical conditions. Drug application could be precisely controlled by an integrated microprocessor. Our paper summarizes the current state of development of microsensor-based feedback bioactuators and outlines possible applications in biophysical cancer treatment.

Aktuelle Entwicklungen - Orthopädische Implantate

NASA Astrophysics Data System (ADS)

Riner, Marc A.

Die guten Resultate und langen Standzeiten von bis zu 15 und 20 Jahren von implantierten Hüftendoprothesen führen dazu, immer jüngere Patienten mit einem Hüftgelenkersatz zu behandeln. Die Versorgung von jungen aktiven Patienten mit einer Hüftendoprothese stellt jedoch eine besondere Herausforderung dar [1]. Trotz umfangreicher Materialentwicklungen, Designoptimierungen und Verbesserungen der Operationstechnik, haben sich die Standzeiten der Prothesen zwar wesentlich verbessert, ist jedoch bei jungen Patienten verglichen mit denen von älteren Patienten deutlich verkürzt [2, 3]. Zudem kann die Hüftprothesenverankerung durch Knochenresektion im Rahmen der Erstimplantation, Adaptionsvorgängen im Knochen (stress shielding) aufgrund unphysiologischer Krafteinleitung, abriebbedingte Osteolyse und während der Implantat- bzw. Knochenzemententfernung auftretende knöcherne Defekte zu unbefriedigende Reimplantationsbedingungen im Fall einer Revision führen [4]. Dies hat in jüngerer Zeit zur Entwicklung von verschiedenen Endoprothesensystemen mit einem möglichst geringen Knochenverlust und damit einhergehenden verbesserten Rückzugsmöglichkeit im Revisionsfall geführt. Bei den knochensparend verankerten Hüftprothesen werden allgemein zwei Typen, die Schenkelhalsprothese und der Oberflächenersatz, unterschieden.

The identity of Hyla leucotaenia Burmeister, 1861 (Anura: Hylidae).

PubMed

Pinheiro, Paulo D P; Faivovich, Julián; Langone, José A; Kwet, Axel

2014-11-13

The German naturalist Carl Hermann Conrad Burmeister (1807-1892) had a prolific scientific career, spanning multiple taxa from diverse insect groups and trilobites to temnospondyls, birds, and extant and fossil mammals (see Berg, 1895). His contributions to anuran taxonomy are concentrated in two books, "Erläuterungen zur Fauna Brasiliensis…" (Burmeister, 1856) and "Reise durch die La Plata-Staaten…" (Burmeister, 1861). The latter is an account of his travels in Argentina and Uruguay from 1857-1860 and includes descriptions of three new species of frogs: Leiuperus nebulosus, Cystignathus mystacinus, and Hyla leucotaenia. While the first two names currently designate valid species, with the combinations Pleurodema nebulosum and Leptodactylus mystacinus respectively, the last name has had a more complex taxonomic history. It involves confusions involving a homonym, its consideration as a junior synonym of Hypsiboas pulchellus (Duméril & Bibron, 1841)-a widely distributed species in eastern Argentina, southeastern Brazil, and Uruguay (Frost, 2014)-and its actual identity corresponding to another widespread species in the same geographic area, with which it has never before been associated: Scinax squalirostris (A. Lutz, 1925). All these issues are discussed in this paper.

Zuverlässigkeit digitaler Schaltungen unter Einfluss von intrinsischem Rauschen

NASA Astrophysics Data System (ADS)

Kleeberger, V. B.; Schlichtmann, U.

2011-08-01

Die kontinuierlich fortschreitende Miniaturisierung in integrierten Schaltungen führt zu einem Anstieg des intrinsischen Rauschens. Um den Einfluss von intrinsischem Rauschen auf die Zuverlässigkeit zukünftiger digitaler Schaltungen analysieren zu können, werden Methoden benötigt, die auf CAD-Verfahren wie Analogsimulation statt auf abschätzenden Berechnungen beruhen. Dieser Beitrag stellt eine neue Methode vor, die den Einfluss von intrinsischem Rauschen in digitalen Schaltungen für eine gegebene Prozesstechnologie analysieren kann. Die Amplituden von thermischen, 1/f und Schrotrauschen werden mit Hilfe eines SPICE Simulators bestimmt. Anschließend wird der Einfluss des Rauschens auf die Schaltungszuverlässigkeit durch Simulation analysiert. Zusätzlich zur Analyse werden Möglichkeiten aufgezeigt, wie die durch Rauschen hervorgerufenen Effekte im Schaltungsentwurf mit berücksichtigt werden können. Im Gegensatz zum Stand der Technik kann die vorgestellte Methode auf beliebige Logikimplementierungen und Prozesstechnologien angewendet werden. Zusätzlich wird gezeigt, dass bisherige Ansätze den Einfluss von Rauschen bis um das Vierfache überschätzen.

Reisen im freien Fall - Teil 2: Das Zwillingsparadoxon aus dem Blickwinkel der ART

NASA Astrophysics Data System (ADS)

Sonne, Bernd; Weiß, Reinhard

2013-07-01

Nachdem wir uns mit den Prinzipien der ART und einigen Beispielen vertraut gemacht haben, kommen wir nun zur Berechnung des Zwillingsparadoxons aus Sicht des reisenden Zwillings. Dabei spielt das Äquivalenzprinzip eine große Rolle. Deshalb wird die Bewegungssituation noch einmal erläutert, diesmal aus Sicht von Katrin. Sie befindet sich in ihrem System S'in Ruhe. In ihrem System läuft die Zeit t'ab. Nach dem Start fühlt Katrin jedoch eine Kraft, die sie als Gravitationskraft interpretieren kann. Sie merkt es daran, dass sie in den Sitz gedrückt wird. Nach einiger Zeit werden die Triebwerke abgeschaltet, und das Raumschiff fliegt mit konstanter Geschwindigkeit weiter, Phase 2. Anschließend wird der Schub der Triebwerke solange umgekehrt, bis das Raumschiff irgendwo mit der Geschwindigkeit null am Umkehrpunkt U landet, Phase 3 (Abb. 15.1). Die Erde, auf der sich Michael befindet, bewegt sich mit x'(t') aus Sicht von Katrin im freien Fall von ihr weg, s. das Experiment mit dem steigenden Fahrstuhl in Abschn. 13.2.1.

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

[Management of Pregnancy-Associated Venous Thromboembolism - Current Recommendations].

PubMed

Linnemann, Birgit

2017-06-01

Diagnostik in der Schwangerschaft  Studien belegen den hohen Stellenwert der Kompressionssonografie der Beinvenen plus Duplexsonografie der Beckenvenen in der Diagnostik der Becken- und Beinvenenthrombose auch bei Schwangeren. Perfusionsszintigrafie und CT-Angiografie der Pulmonalarterien sind bei vergleichbarer fötaler Strahlenbelastung gleich aussagekräftig. Aufgrund der mütterlichen Strahlenbelastung favorisieren aktuelle Leitlinien bei fehlender struktureller Lungenerkrankung die Perfusionsszintigrafie als primäre Bildgebung. Es gibt keinen Grund, einer Schwangeren mit Lungenembolieverdacht eine notwendige radiologische Diagnosesicherung vorzuenthalten. Antikoagulation in der Schwangerschaft  Heparine bleiben Antikoagulans der 1. Wahl bei der Behandlung der venöses Thromboembolien (VTE) in der Schwangerschaft. Neue orale Antikoagulantien (NOAK) sind aufgrund ihrer geringen Molekülgröße plazentagängig und daher in der Schwangerschaft kontraindiziert. Peripartales Vorgehen  Zur Minimierung des postpartalen Blutungsrisikos vor der Geburt ist in den letzten Wochen vor der Geburt eine Aufteilung der NMH-Injektion auf 2 Tagesdosen sinnvoll. Bei der Entbindung ist eine interdisziplinäre Abstimmung wichtig. Postpartal kann eine NMH-Therapie fortgesetzt oder Warfarin eingesetzt werden (Kein Phenprocoumon, da es in die Muttermilch übergeht).

Grundwasserökosysteme im Recht? - Eine kritische Betrachtung zur rechtlichen Stellung von Grundwasserökosystemen

NASA Astrophysics Data System (ADS)

Hahn, Hans Jürgen; Schweer, Christian; Griebler, Christian

2018-05-01

Groundwater is the largest and oldest continental biome. However, in the German and EU legislation, groundwater is still considered an abiotic resource rather than an ecosystem. On the other hand, the German Water Act (WHG, Wasserhaushaltsgesetz) mentions groundwaters along with other water bodies that carry the status of ecosystems. Its ecosystem status is also referred to in the preamble of the European Groundwater Directive (EC-GWD). The implementation of groundwater protection measures should be geared to the ecosystemic approach for surface waters contained in the European Water Framework Directive (EC-WFD) and to the German National Biodiversity Strategy (BMU 2007). Addition of the terms "good ecological status" and "groundwater ecosystems" into the German and EU environmental water laws is recommended. Groundwater habitats and species should be subject to impact assessment and included into the FFH directive and German nature conservation laws. There is no technical or legal argument for the discrimination of groundwater ecosystems and species in environmental legislation. The authors argue for the legal equality of ground and surface water, and propose the adaption of the existing legislation according to ecological requirements.

[Neither Pedants nor Amateurs? Psychological Journals in Germany in the last three Decades of the 18th Century].

PubMed

Gantet, Claire

Neither pedants nor amateurs? Psychological journals in Germany in the last three decades of the 18th century The Magazin zur Erfahrungsseelenkunde introduced a new tone in the evolving field of psychology. For the first time, attention was paid not to the abstract relationships between body and soul, but to suffering individuals from the «common folk». The collection and systematic publication of accounts of readers should eventually allow the formulation of an empirical «science of the soul». The readers would eventually send accounts of personal and experienced «cases». By 1800, this conception of the science of psychology was called into question by educated philosophers who, in journals opened only to specialists, endeavored to develop a more professional psychology. They nevertheless failed in formulating general criteria of scientificity. The main argument of this article is that the distinction between amateurs and scientists was not an outcome of the inner evolution of the field of psychology, but that it developed through practices of communication in which periodicals play a major role.

Zur Biologie des Planktons des Königshafens (Nordsylter Wattenmeer)

NASA Astrophysics Data System (ADS)

Martens, P.

1982-06-01

From May 1979 on, the following parameters were measured at a station in the inlet of Königshafen near List (Island of Sylt): temperature, salinity, mesozooplankton (>76 µm), chlorophyll-a, seston dry weight, oxygen and phytoplankton-nutrients (NH4-N, NO2-N, NO3-N, PO4-P, SiO3-Si). A multiple regression analysis showed the interrelationships between the parameters measured. Tidal influences on zooplankton and seston dry weight could be observed. At low tide, the amount of zooplankton (not counting the harpacticoid copepods) declines and the number of harpacticoid copepods rises as does the seston dry weight too. The chlorophyll-a content is a function of the phytoplankton-nutrients. An increase in chlorophyll-a leads to a decrease in nitrogen and silicate concentrations. Phosphate, due possibly to a sewage inlet into the Königshafen, is not a limiting factor. The availability of nutrients is influenced by temperature, salinity and the tidal cycle. The amount of oxygen is dependent on water temperature and seston dry weight. High water temperatures and a high seston content lead to a decrease in oxygen concentrations.

GIS-MODFLOW: Ein kleines OpenSource-Werkzeug zur Anbindung von GIS-Daten an MODFLOW

NASA Astrophysics Data System (ADS)

Gossel, Wolfgang

2013-06-01

The numerical model MODFLOW (Harbaugh 2005) is an efficient and up-to-date tool for groundwater flow modelling. On the other hand, Geo-Information-Systems (GIS) provide useful tools for data preparation and visualization that can also be incorporated in numerical groundwater modelling. An interface between both would therefore be useful for many hydrogeological investigations. To date, several integrated stand-alone tools have been developed that rely on MODFLOW, MODPATH and transport modelling tools. Simultaneously, several open source-GIS codes were developed to improve functionality and ease of use. These GIS tools can be used as pre- and post-processors of the numerical model MODFLOW via a suitable interface. Here we present GIS-MODFLOW as an open-source tool that provides a new universal interface by using the ESRI ASCII GRID data format that can be converted into MODFLOW input data. This tool can also treat MODFLOW results. Such a combination of MODFLOW and open-source GIS opens new possibilities to render groundwater flow modelling, and simulation results, available to larger circles of hydrogeologists.

[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.

[Patterns of dysfunctional parenting styles and psychological disturbances in offspring].

PubMed

Kumnig, Martin; Höfer, Stefan; Huber, Alexandra; Messner, Carmen; Renn, Daniela; Mestel, Robert; Klingelhöfer, Jürgen; Kopp, Martin; Doering, Stephan; Schüßler, Gerhard; Rumpold, Gerhard

2013-01-01

Dysfunctional parenting styles represent a risk factor for the development of psychological disturbances. The present study investigated the differential validity of the German language Fragebogen zur Erfassung dysfunktionaler Erziehungsstile (FDEB; Measurement of Parental Styles, MOPS) and determined whether different forms of psychological disorders are associated with specific patterns of parenting styles. 145 inpatients, 108 outpatients and a control group of 633 representative individuals from the general population were investigated by adapting the FDEB. A comparison of dysfunctional parenting styles showed different distress levels within the diagnostic groups: Patients suffering from depression reported high levels of maternal indifference and over protectiveness together with an abusive rearing behavior on the part of both parents. Patients with anxiety disorders reported having overprotective mothers. Bulimic patients as well as those with personality disorders significantly exhibited stress in almost all areas. However, anorexic patients did not differ significantly from the control group, which appeared to be the least affected of all. The FDEB showed a satisfactory differential validity. There was evidence that specific patterns of dysfunctional parenting styles were associated with different diagnostic groups.

Newly Diagnosed Hepatitis C in the US Commercially Insured Population Before and After the 2012 Implementation of Expanded Screening Guidelines.

PubMed

Pyenson, Bruce S; Dieguez, Gabriela; Ferro, Christine; Mavinkurve, Maushumi; Gonzalez, Yuri Sanchez

2018-02-01

In the United States in 2014, more than 3 million individuals were estimated to have chronic hepatitis C virus (HCV) infection, including many undiagnosed individuals. In 2012, the Centers for Disease Control and Prevention expanded its HCV testing recommendations to target all adults born between 1945 and 1965, in addition to at-risk individuals, which has led to an increase in newly diagnosed patients. Few studies have explored the medical cost or clinical status of patients who are newly diagnosed with HCV. To compare the demographics, comorbidities, and medical costs of patients who are newly diagnosed and those who were previously diagnosed with HCV infection. We conducted a retrospective study using 2013 claims data from the Truven Health MarketScan Commercial database to compare patients newly diagnosed with HCV infection in 2013 and patients who were diagnosed before 2013. The patients were divided into 2 cohorts based on the time of diagnosis before and after 2013. All patients were classified by disease stage and by comorbidities, and were required to have continuous health plan enrollment between January 2010 and December 2013. The full-year costs were tabulated for every patient, regardless of the date of diagnosis. Of the 9193 patients with an HCV diagnosis in 2013 in the database, approximately 26% (N = 2428) were newly diagnosed in 2013, of whom 12% (N = 299) had advanced-stage HCV. The average age of the newly diagnosed patients was 49.5 years versus 54.1 years for previously diagnosed patients. Patients who were previously diagnosed had a higher prevalence of HIV, diabetes, and more severe cancers than patients who were newly diagnosed with HCV. Patients who were newly diagnosed with HCV had a higher prevalence of acute liver failure and drug-induced psychosis. The average annual per-patient per-month (PPPM) medical costs for both groups was approximately $2200 in 2013. The annual medical cost for a patient who was newly diagnosed increased sharply in the year before diagnosis, from approximately $588 PPPM for the 3 years before the diagnosis to approximately $854 PPPM in the year before diagnosis. In 2013, the healthcare costs of patients who were newly diagnosed with HCV were similar in their first year of diagnosis to the costs of patients who had been diagnosed previously, although patients who were previously diagnosed had more advanced-stage disease. Patients who were newly diagnosed had 3-fold the healthcare costs in their first year of diagnosis versus the costs in the 3 years before their diagnosis.

Assessment of the Relationship between Diagnoses of ASD and Caregiver Symptom Endorsement in Adults Diagnosed with Intellectual Disability

ERIC Educational Resources Information Center

Matson, Johnny L.; Hess, Julie A.; Mahan, Sara; Fodstad, Jill C.; Neal, Daniene

2013-01-01

Individuals diagnosed with an intellectual disability (ID) share overlapping traits with those diagnosed with both ID and an Autism Spectrum Disorder (ASD). Therefore, the purpose of this study was to determine if caregivers' reports of symptoms of ASD are of value (i.e., when comparing them to clinical diagnoses of ASD) and to determine which…

Telecytology: Is it possible with smartphone images?

PubMed

Sahin, Davut; Hacisalihoglu, Uguray Payam; Kirimlioglu, Saime Hale

2018-01-01

This study aimed to discuss smartphone usage in telecytology and determine intraobserver concordance between microscopic cytopathological diagnoses and diagnoses derived via static smartphone images. The study was conducted with 172 cytologic material. A pathologist captured static images of the cytology slides from the ocular lens of a microscope using a smartphone. The images were transferred via WhatsApp® to a cytopathologist working in another center who made all the microscopic cytopathological diagnoses 5-27 months ago. The cytopathologist diagnosed images on a smartphone without knowledge of their previous microscopic diagnoses. The Kappa agreement between microscopic cytopathological diagnoses and smartphone image diagnoses was determined. The average image capturing, transfer, and remote cytopathological diagnostic time for one case was 6.20 minutes. The percentage of cases whose microscopic and smartphone image diagnoses were concordant was 84.30%, and the percentage of those whose diagnoses were discordant was 15.69%. The highest Kappa agreement was observed in endoscopic ultrasound-guided fine needle aspiration (1.000), and the lowest agreement was observed in urine cytology (0.665). Patient management changed with smart phone image diagnoses at 11.04%. This study showed that easy, fast, and high-quality image capturing and transfer is possible from cytology slides using smartphones. The intraobserver Kappa agreement between the microscopic cytopathological diagnoses and remote smartphone image diagnoses was high. It was found that remote diagnosis due to difficulties in telecytology might change patient management. The developments in the smartphone camera technology and transfer software make them efficient telepathology and telecytology tools. © 2017 Wiley Periodicals, Inc.

Newly Diagnosed Hepatitis C in the US Commercially Insured Population Before and After the 2012 Implementation of Expanded Screening Guidelines

PubMed Central

Pyenson, Bruce S.; Dieguez, Gabriela; Ferro, Christine; Mavinkurve, Maushumi; Gonzalez, Yuri Sanchez

2018-01-01

Background In the United States in 2014, more than 3 million individuals were estimated to have chronic hepatitis C virus (HCV) infection, including many undiagnosed individuals. In 2012, the Centers for Disease Control and Prevention expanded its HCV testing recommendations to target all adults born between 1945 and 1965, in addition to at-risk individuals, which has led to an increase in newly diagnosed patients. Few studies have explored the medical cost or clinical status of patients who are newly diagnosed with HCV. Objective To compare the demographics, comorbidities, and medical costs of patients who are newly diagnosed and those who were previously diagnosed with HCV infection. Method We conducted a retrospective study using 2013 claims data from the Truven Health MarketScan Commercial database to compare patients newly diagnosed with HCV infection in 2013 and patients who were diagnosed before 2013. The patients were divided into 2 cohorts based on the time of diagnosis before and after 2013. All patients were classified by disease stage and by comorbidities, and were required to have continuous health plan enrollment between January 2010 and December 2013. The full-year costs were tabulated for every patient, regardless of the date of diagnosis. Results Of the 9193 patients with an HCV diagnosis in 2013 in the database, approximately 26% (N = 2428) were newly diagnosed in 2013, of whom 12% (N = 299) had advanced-stage HCV. The average age of the newly diagnosed patients was 49.5 years versus 54.1 years for previously diagnosed patients. Patients who were previously diagnosed had a higher prevalence of HIV, diabetes, and more severe cancers than patients who were newly diagnosed with HCV. Patients who were newly diagnosed with HCV had a higher prevalence of acute liver failure and drug-induced psychosis. The average annual per-patient per-month (PPPM) medical costs for both groups was approximately $2200 in 2013. The annual medical cost for a patient who was newly diagnosed increased sharply in the year before diagnosis, from approximately $588 PPPM for the 3 years before the diagnosis to approximately $854 PPPM in the year before diagnosis. Conclusion In 2013, the healthcare costs of patients who were newly diagnosed with HCV were similar in their first year of diagnosis to the costs of patients who had been diagnosed previously, although patients who were previously diagnosed had more advanced-stage disease. Patients who were newly diagnosed had 3-fold the healthcare costs in their first year of diagnosis versus the costs in the 3 years before their diagnosis. PMID:29692878

Multi Electrode Geoelectric on the Borehole Wall. Determination of Groundwater Velocity and Dispersion Parameters

NASA Astrophysics Data System (ADS)

Kessels, W.; Thorenz, C.; Rifai, H.

2002-05-01

A single well technique to determine groundwater flow and transport parameters is presented. Multi-electrode arrays are placed on a borehole wall by an inflatable packer or are installed behind the plastic casing. For measurements, a salt tracer is injected between the electrodes. This salt tracer cloud is afterwards moving in the natural groundwater flow field. The observation of this movement by geoelectric measurements is the basis for the determination of groundwater velocity and the dispersion parameters. The geoelectric observations are performed with n borehole electrodes and one earth connection. Thus, either n independent two point measurements or n*(n-1)/2 pole-to-pole measurements can be performed. The whole procedure consists of three phases: 1. Measurement of the basic conductivity without tracer. 2. Measurement during the injection. 3. Measurement after injection To test the method, measurements in a lab aquifer filled with sand are carried out. The results are discussed and the limitations of the method are shown. Here, the interpretation is restricted on two point geoelectric measurements and the transport equation for NaCl-tracered water. Due to the density contrast, the tracer shows a vertical movement which is not related to the natural velocity field. Numerical calculations with the finite-element-method simulator ROCKFLOW (Kolditz et al., 1999) reproduced this behaviour. The currently used interpretation code is based on an analytic solution of the transport equation. The parameters velocity and dispersion length are calculated by inversion. In the two scientific drillings CAT-LUD1 and CAT-LUD1A in the northern part of Germany multi-electrode installations behind the casing are tested in situ. A multi-electrode packer system is designed and build. References: Kessels, W., Zoth, G.(1997): Doppelmantel - Packers mit geoelektrischer Meßtechnik zur Bestimmung der Abstandsgeschwindigkeit des Grundwassers, Patentanmeldung Az:19855048.0 NLfB/GGA-Hannover. Kessels, W., Zoth, G. (1999): Doppelmantelpacker mit geoelektrischer Meßtechnik zur Bestimmung der Grundwasserströmung und hydraulischer Eigenschaften von Grundwasserleitern. -59. Jahrestagung der Deutschen Geophysikalischen Gesellschaft; 8.-12.März 1999, Braunschweig: 117. Kessels, W., Fulda, C., Binot, F., Dörhöfer, G., Fritz, J. (2001): Monitoring and Modeling in the Coastal Aquifer Test Field (CAT-Field) between Bremerhaven and Cuxhaven in the Northern Part of Germany. SWICA M3 Salt Water Intrusion and Coastal Aquifers Monitoring, Modeling and Management, 23. 25.April 2001; Essaouira, Morocco. Kolditz, O., Habbar, O., Kaiser, R., Rother, T. & Thorenz, C. (1999) ROCKFLOW - Theory and Users Manual. Release 3.4, Institute for Fluid Mechanics and Computer Application in Civil Engineering, University of Hannover

Deep soil compaction as a method of ground improvement and to stabilization of wastes and slopes with danger of liquefaction, determining the modulus of deformation and shear strength parameters of loose rock.

PubMed

Lersow, M

2001-01-01

For the stabilization of dumps with the construction of hidden dams and for building ground improvement, for instance for traffic lines over dumps, nearly all applied compaction methods have the aim to reduce the pore volume in the loose rock. With these methods, a homogenization of the compacted loose rock will be obtained too. The compaction methods of weight compaction by falling weight, compaction by vibration and compaction by blasting have been introduced, and their applications and efficiencies have been shown. For the estimation of the effective depth of the compaction and for a safe planning of the bearing layer, respectively, the necessary material parameters have to be determined for each deep compaction method. Proposals for the determination of these parameters have been made within this paper. In connection with the stabilization of flow-slide-prone dump slopes, as well as for the improvement of dump areas for the use as building ground, it is necessary to assess the deformation behavior and the bearing capacity. To assess the resulting building ground improvement, deformation indexes (assessment of the flow-prone layer) and strength indexes (assessment of the bearing capacity) have to be determined with soil mechanical tests. Förster and Lersow, [Patentschrift DE 197 17 988. Verfahren, auf der Grundlage last- und/oder weggesteuerter Plattendruckversuche auf der Bohrlochsohle, zur Ermittlung des Spannungs-Verformungs-Verhaltens und/oder von Deformationsmoduln und/oder von Festigkeitseigenschaften in verschiedenen Tiefen insbesondere von Lockergesteinen und von Deponiekörpern in situ; Förster W, Lersow M. Plattendruckversuch auf der Bohrlochsohle, Ermittlung des Spannungs-Verformungs-Verhaltens von Lockergestein und Deponiematerial Braunkohle--Surface Mining, 1998;50(4): 369-77; Lersow M. Verfahren zur Ermittlung von Scherfestigkeitsparametern von Lockergestein und Deponiematerial aus Plattendruckversuchen auf der Bohrlochsohle. Braunkohle--Surface Mining, 1995;51(1):39-47] improved a direct procedure, the so-called plate-loading test. With this improved procedure, it is possible to produce profiles of deformation parameters and shear-strength parameters of the loose rock. On this basis the settlement behavior and the bearing behavior of the ground can be described. The PDV-BS cone-penetration test and the pressiometer test are compared and the reliability of the soil mechanical indexes are assessed critically. The PDV-BS can be used as a calibration test for cone penetration tests as well as for the calibration of pressiometer tests. With the application of a PDV-BS and a pressiometer test in combination in a testing field, the anisotropy properties of the loose rock can be proved.

CT angiography in the setting of suspected acute mesenteric ischemia: prevalence of ischemic and alternative diagnoses.

PubMed

Henes, Frank Oliver; Pickhardt, Perry J; Herzyk, Andrzej; Lee, Scott J; Motosugi, Utaroh; Derlin, Thorsten; Lubner, Meghan G; Adam, Gerhard; Schön, Gerhard; Bannas, Peter

2017-04-01

The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI). We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA. Prevalence of diagnoses by age, sex, and admission status was compared using Cochran-Armitage and χ 2 tests. Prevalence was 18.8% (180/959) for AMI and 61.2% (587/959) for specific alternative diagnoses. In the remaining 20.0% (192/959), no clear clinical diagnosis was established. The most frequent alternative diagnoses were small-bowel obstruction (10.4%; 61/587), infectious colitis (8.7%; 51/587), pneumonia (6.5%; 38/587), cholecystitis (6.1%; 36/587), and diverticulitis (5.6%; 33/587). Prevalence of specific alternative diagnoses varied significantly according to both age (p < .013) and admissions status (p < 0.001). CTA had a sensitivity and specificity for diagnosing AMI of 89.4%/99.5% and for alternative diagnoses of 86.7%/96.9%, respectively. In the setting of suspected AMI, the prevalence of ischemic and alternative diagnoses varies significantly by age, sex, and admission status. CTA provides for rapid and non-invasive assessment of ischemic and alternative diagnoses with high diagnostic accuracy.

Determination of nursing diagnoses used by students in the first clinical practice.

PubMed

Türk, Gülengün; Tuğrul, Emel; Sahbaz, Muazzez

2013-10-01

This study was carried out descriptively with the purpose of determining nursing diagnoses that nursing freshmen students used in their first clinical practice. The sample of the study consisted of 61 nursing students. Data of the study were collected with the examination of 208 care plans that the students had prepared. Nursing diagnoses in the examined care plans were classified according to nursing diagnoses grouped under the domains of Taxonomy II NANDA-I. Students determined 31 different diagnoses in nine domains of NANDA-I. Total nursing diagnoses used in care plans were 635. It was determined that the nursing diagnoses that the students mostly used, according to classification of NANDA-I, were in the domains of safety/protection, activity/rest, comfort, elimination and exchange, and nutrition. © 2013 NANDA International.

Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

PubMed

Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

2018-05-01

Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

The convergence of personality disorder diagnoses across different methods among monolingual (Spanish-speaking only) Hispanic patients in substance use treatment.

PubMed

Samuel, Douglas B; Añez, Luis M; Paris, Manuel; Grilo, Carlos M

2014-04-01

Methods for diagnosing personality disorders (PDs) within clinical settings typically diverge from those used in treatment research. Treatment groups in research studies are routinely diagnosed using semistructured interviews or self-report questionnaires, yet these methods show poor agreement with clinical diagnoses recorded in medical charts or assigned by treating clinicians, reducing the potential for evidence-based practice. Furthermore, existing research has been limited by focusing on primarily White and English-speaking participants. Our study extended prior research by comparing 4 independent methods of PD diagnosis, including self-report questionnaire, semistructured interview, chart diagnoses, and ratings by treating clinicians, within a clinical series of 130 monolingual (Spanish only) Hispanic persons (69% male; M age 37.4), in treatment for substance use. The authors examined the convergence of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) PD diagnoses across these methods. PD diagnoses appeared infrequently within medical charts but were diagnosed at higher levels by independent treating clinicians, self-report questionnaires, and semistructured interviews. Nonetheless, diagnostic concordance between clinical diagnoses and the other methods were poor (κ < .20). Convergence of PD diagnoses across diagnostic methods for Spanish-speaking Hispanic persons are comparable to other groups allaying concerns about cross-cultural application of PD diagnoses. Additionally, the results of this study echo previous research in suggesting that clinicians' PD diagnoses overlap little with self-report questionnaires or semistructured diagnostic interviews and suggest that PDs are underdiagnosed using standard diagnostic approaches. Implications for the clinical application of empirically supported research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001-2014.

PubMed

Ramsey, Christine; Dziura, James; Justice, Amy C; Altalib, Hamada Hamid; Bathulapalli, Harini; Burg, Matthew; Decker, Suzanne; Driscoll, Mary; Goulet, Joseph; Haskell, Sally; Kulas, Joseph; Wang, Karen H; Mattocks, Kristen; Brandt, Cynthia

2017-02-01

To evaluate gender, age, and race/ethnicity as predictors of incident mental health diagnoses among Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans. We used US Veterans Health Administration (VHA) electronic health records from 2001 to 2014 to examine incidence rates and sociodemographic risk factors for mental health diagnoses among 888 142 veterans. Posttraumatic stress disorder (PTSD) was the most frequently diagnosed mental health condition across gender and age groups. Incidence rates for all mental health diagnoses were highest at ages 18 to 29 years and declined thereafter, with the exceptions of major depressive disorder (MDD) in both genders, and PTSD among women. Risk of incident bipolar disorder and MDD diagnoses were greater among women; risk of incident schizophrenia, and alcohol- and drug-use disorders diagnoses were greater in men. Compared with Whites, risk incident PTSD, MDD, and alcohol-use disorder diagnoses were lower at ages 18 to 29 years and higher at ages 45 to 64 years for both Hispanics and African Americans. Differentiating high-risk demographic and gender groups can lead to improved diagnosis and treatment of mental health diagnoses among veterans and other high-risk groups.

Nursing diagnosis in intensive care unit: the Turkey experience.

PubMed

Korhan, Esra Akn; Yönt, Gülendam Hakverdioğlu; Erdemir, Firdevs; Müller-Staub, Maria

2014-01-01

The purpose of this study was to determine intensive care unit nurses diagnostic abilities and diagnoses that they provide. A vignette study was performed. The vignette contained a patient's history, treatment, and signs/symptoms of 18 nursing diagnoses based on NANDA-I as the criterion standard. Turkish intensive care unit nurses (N = 45) stated nursing diagnoses described by patient data in the vignette. The resulting nursing diagnoses were grouped into Gordon's Functional Health Patterns, and descriptive analyses were performed. One-way analysis of variance was used to detect possible differences in diagnostic abilities based on nurses' education levels. Nurses identified 14 nursing diagnoses. Four of the predetermined psychosocial nursing diagnoses were not identified. The highest percentage of diagnoses was risk for impaired skin integrity (62.2%) and impaired oral mucous membrane (60.0%). The lowest number of diagnoses was impaired verbal communication (2.2%). A statistically significant difference was found between the educational level of nurses and their abilities to determine nursing diagnoses (P < .05). The findings are important for nursing education. They demonstrate the need to focus on patients as complete human beings, covering not only biological aspects but also cultural and social values, as well as emotional and spiritual care needs.

Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

PubMed

Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

2013-01-01

To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back pain (38% vs 46%). Results of this study have implications for the delivery of post-deployment health services to Iraq and Afghanistan War Veterans. Migraine and other headache diagnoses are common among Veterans, particularly women, and tend to occur in combination with other post-deployment health conditions for which patients are being treated. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Diagnoses during follow-up of patients presenting with fatigue in primary care.

PubMed

Nijrolder, Iris; van der Windt, Daniëlle; de Vries, Henk; van der Horst, Henriëtte

2009-11-10

Little is known about the distribution of diagnoses that account for fatigue in patients in primary care. We evaluated the diagnoses established within 1 year after presentation with fatigue in primary care that were possibly associated with the fatigue. We conducted a prospective observational cohort study with 1-year follow-up. We included adult patients who presented with a new episode of fatigue between June 2004 and January 2006. We extracted data on diagnoses during the follow-up period from the patients' medical records as well as data on pre-existing chronic diseases. Of the 571 patients for whom diagnostic data were available, 268 (46.9%) had received one or more diagnoses that could be associated with fatigue. The diagnoses were diverse and mostly included symptom diagnoses, with main categories being musculoskeletal (19.4%) and psychological problems (16.5%). Clear somatic pathology was diagnosed in 47 (8.2%) of the patients. Most diagnoses were not made during the consultation when fatigue was presented. Only a minority of patients were diagnosed with serious pathology. Half of the patients did not receive any diagnosis that could explain their fatigue. Nevertheless, because of the wide range of conditions and symptoms that may explain or co-occur with the fatigue, fatigue is a complex problem that deserves attention not only as a symptom of underlying specific disease.

Nursing diagnoses (NANDA-I) in hematology-oncology: a Delphi-study.

PubMed

Speksnijder, Herma T; Mank, Arno P; van Achterberg, Theo

2011-01-01

To identify NANDA-I diagnoses that are most relevant to hematology-oncology nursing in Europe. In a two-round, electronic, quantitative Delphi study, 28 experts from nine European countries assessed the relevance of NANDA-I diagnoses and health problems. This study identified 64 relevant diagnoses and three health problems. All experts listed 11 diagnoses: "imbalanced nutrition: less than body requirements,"diarrhea,"fatigue,"risk for bleeding,"risk for infection,"impaired oral mucous membrane,"risk for impaired skin integrity,"impaired skin integrity,"hyperthermia,"nausea,"acute pain," and the health problem "pruritis." The "NANDA-I classification 2009-2011" describes, in almost all disease- and treatment-related problems, nursing diagnoses as relevant to the adult patient with hematological malignancy. These diagnoses are therefore recommended. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

Two rare diagnoses during chronic lymphocytic leukaemia follow-up: Kaposi's sarcoma and Merkel cell carcinoma.

PubMed

Dogu, Mehmet H; Sari, Ismail; Hacioglu, Sibel; Degirmencioglu, Serkan; Şen, Nilay; Keskin, Ali

2016-02-01

Chronic lymphocytic leukaemia often has a clinical presentation characterised by increased neoplastic lymphocytes which are mostly mature looking due to B lymphocytes. Increased secondary cancer prevalence has been detected among patients with chronic lymphocytic leukaemia diagnosis. In this report, we present three chronic lymphocytic leukaemia patients who developed secondary rare cancers during their follow-up at our clinic. Case 1: A 54-year-old female patient was diagnosed with stage I chronic lymphocytic leukaemia in 2003 and was diagnosed with Merkel cell carcinoma in February 2013. Case 2: A 66-year-old male patient was diagnosed with stage II chronic lymphocytic leukaemia in 2009 and was diagnosed with Kaposi's sarcoma in March 2013. Case 3: A 77-year-old male patient was diagnosed with stage I chronic lymphocytic leukaemia in 2006 and was diagnosed with Kaposi's sarcoma in 2011. In conclusion, secondary cancers are observed in patients diagnosed with chronic lymphocytic leukaemia. Therefore, follow-up of chronic lymphocytic leukaemia requires additional attention in this context. © The Author(s) 2016.

A comprehensive iterative approach is highly effective in diagnosing individuals who are exome negative.

PubMed

Shashi, Vandana; Schoch, Kelly; Spillmann, Rebecca; Cope, Heidi; Tan, Queenie K-G; Walley, Nicole; Pena, Loren; McConkie-Rosell, Allyn; Jiang, Yong-Hui; Stong, Nicholas; Need, Anna C; Goldstein, David B

2018-06-15

Sixty to seventy-five percent of individuals with rare and undiagnosed phenotypes remain undiagnosed after exome sequencing (ES). With standard ES reanalysis resolving 10-15% of the ES negatives, further approaches are necessary to maximize diagnoses in these individuals. In 38 ES negative patients an individualized genomic-phenotypic approach was employed utilizing (1) phenotyping; (2) reanalyses of FASTQ files, with innovative bioinformatics; (3) targeted molecular testing; (4) genome sequencing (GS); and (5) conferring of clinical diagnoses when pathognomonic clinical findings occurred. Certain and highly likely diagnoses were made in 18/38 (47%) individuals, including identifying two new developmental disorders. The majority of diagnoses (>70%) were due to our bioinformatics, phenotyping, and targeted testing identifying variants that were undetected or not prioritized on prior ES. GS diagnosed 3/18 individuals with structural variants not amenable to ES. Additionally, tentative diagnoses were made in 3 (8%), and in 5 individuals (13%) candidate genes were identified. Overall, diagnoses/potential leads were identified in 26/38 (68%). Our comprehensive approach to ES negatives maximizes the ES and clinical data for both diagnoses and candidate gene identification, without GS in the majority. This iterative approach is cost-effective and is pertinent to the current conundrum of ES negatives.

Neural substrates related to auditory working memory comparisons in dyslexia: An fMRI study

PubMed Central

CONWAY, TIM; HEILMAN, KENNETH M.; GOPINATH, KAUNDINYA; PECK, KYUNG; BAUER, RUSSELL; BRIGGS, RICHARD W.; TORGESEN, JOSEPH K.; CROSSON, BRUCE

2010-01-01

Adult readers with developmental phonological dyslexia exhibit significant difficulty comparing pseudowords and pure tones in auditory working memory (AWM). This suggests deficient AWM skills for adults diagnosed with dyslexia. Despite behavioral differences, it is unknown whether neural substrates of AWM differ between adults diagnosed with dyslexia and normal readers. Prior neuroimaging of adults diagnosed with dyslexia and normal readers, and post-mortem findings of neural structural anomalies in adults diagnosed with dyslexia support the hypothesis of atypical neural activity in temporoparietal and inferior frontal regions during AWM tasks in adults diagnosed with dyslexia. We used fMRI during two binaural AWM tasks (pseudowords or pure tones comparisons) in adults diagnosed with dyslexia (n = 11) and normal readers (n = 11). For both AWM tasks, adults diagnosed with dyslexia exhibited greater activity in left posterior superior temporal (BA 22) and inferior parietal regions (BA 40) than normal readers. Comparing neural activity between groups and between stimuli contrasts (pseudowords vs. tones), adults diagnosed with dyslexia showed greater primary auditory cortex activity (BA 42; tones > pseudowords) than normal readers. Thus, greater activity in primary auditory, posterior superior temporal, and inferior parietal cortices during linguistic and non-linguistic AWM tasks for adults diagnosed with dyslexia compared to normal readers indicate differences in neural substrates of AWM comparison tasks. PMID:18577292

Does early paternal involvement predict offspring developmental diagnoses?

PubMed

Jackson, Dylan B; Newsome, Jamie; Beaver, Kevin M

2016-12-01

A long line of research has illustrated that fathers play an important role in the development of their children. Few studies, however, have examined the impact of paternal involvement at the earliest stages of life on developmental diagnoses in childhood. The present study extends this line of research by exploring the possibility that paternal involvement prenatally, postnatally, and at the time of birth may influence offspring risk for various diagnoses in childhood. A quasi-experimental, propensity score matching design was used to create treatment and control groups to assess the relationship between paternal involvement at each stage of development and developmental diagnoses. Approximately 6000 children, and a subsample of fathers, who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Activity, attention and learning, speech or language, and other diagnoses in early childhood, and overall number of diagnoses at 4years of age. We find no consistent evidence that low paternal involvement prenatally or postnatally increases the risk of various developmental diagnoses by age 4. However, children whose fathers were absent at the time of their birth were at significantly greater risk of incurring various developmental diagnoses, as well as a significantly greater number of developmental diagnoses. The findings expand our understanding of exactly how early paternal influence begins and the specific dimensions of early father behaviors that are related to the risk of various developmental diagnoses. Ultimately, these results have important implications concerning father involvement during the earliest stages of the life course. Copyright © 2016. Published by Elsevier Ireland Ltd.

Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001.

PubMed

Gallagher, Arlene M; Thomas, Janice M; Hamilton, William T; White, Peter D

2004-12-01

Little is known about whether the incidence of symptoms of fatigue presented in primary care, and the consequent diagnoses made, change over time. The UK General Practice Research Database was used to investigate the annual incidence of both fatigue symptoms and diagnoses recorded in UK primary care from 1990 to 2001. The overall incidence of all fatigue diagnoses decreased from 87 per 100 000 patients in 1990 to 49 in 2001, a reduction of 44%, while postviral fatigue syndromes decreased from 81% of all fatigue diagnoses in 1990 to 60% in 2001. Chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) together increased from 9% to 26% of all fatigue diagnoses. The incidence of fibromyalgia increased from less than 1 per 100 000 to 35 per 100 000. In contrast, there was no consistent change in the incidence of all recorded symptoms of fatigue, with an average of 1503 per 100 000, equivalent to 1.5% per year. CFS/ME and fibromyalgia were rarely diagnosed in children and were uncommon in the elderly. All symptoms and diagnoses were more common in females than in males. The overall incidence of fatigue diagnoses in general has fallen, but the incidence rates of the specific diagnoses of CFS/ME and fibromyalgia have risen, against a background of little change in symptom reporting. This is likely to reflect fashions in diagnostic labelling rather than true changes in incidence.

Research Diagnostic Criteria for Temporomandibular Disorders: Validity of Axis I Diagnoses

PubMed Central

Truelove, Edmond; Pan, Wei; Look, John O.; Mancl, Lloyd A.; Ohrbach, Richard K.; Velly, Ana; Huggins, Kimberly; Lenton, Patricia; Schiffman, Eric L.

2011-01-01

AIMS To estimate the criterion validity of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I TMD diagnoses. METHODS A combined total of 614 TMD community and clinic cases and 91 controls were examined at 3 study sites. RDC/TMD Axis I diagnoses were algorithmically derived from an examination performed by calibrated dental hygienists. Reference standards (Gold Standards) were established by means of consensus diagnoses rendered by 2 TMD experts using all available clinical data, including imaging studies. Validity of the RDC/TMD Axis I TMD diagnoses was estimated relative to reference-standard diagnoses (gold standard diagnoses). Target sensitivity and specificity were set a priori at ≥ 0.70 and ≥ 0.95, respectively. RESULTS Target sensitivity and specificity were not observed for any of the 8 RDC/TMD diagnoses. The highest validity was achieved for Group Ia myofascial pain (sensitivity 0.65, specificity 0.92) and Group Ib myofascial pain with limited opening (sensitivity 0.79, specificity 0.92). Target sensitivity and specificity were observed only when both Group I diagnoses were combined (0.87 and 0.98, respectively). For Group II (disc displacements) and Group III (arthralgia, arthritis, arthrosis) diagnoses, all estimates for sensitivity were below target (0.03 to 0.53), and specificity ranged from below to on target (0.86 to 0.99). CONCLUSION The RDC/TMD Axis I TMD diagnoses did not reach the targets set at sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Target validity was obtained only for myofascial pain without differentiation between normal and limited opening. Revision of the current Axis I TMD diagnostic algorithms is warranted to improve their validity. PMID:20213030

Bipolar Disorder in Nursing Homes: Impact on Antipsychotic Use, Diagnosis Patterns, and New Diagnoses in People with Dementia.

PubMed

Carnahan, Ryan M; Letuchy, Elena M

2018-01-01

Nursing home quality measures include the proportion of residents who receive antipsychotics. Residents with bipolar disorder are included even though antipsychotics are FDA-approved for this indication. We evaluated how including residents with bipolar disorder impacted the antipsychotic use quality measure for long-stay residents. We evaluated the agreement of minimum data set (MDS) bipolar disorder diagnoses with Medicare data, whether dementia was diagnosed before bipolar disorder, and how less-specific bipolar disorder diagnoses impacted findings. Cross-sectional study. Nursing homes in Iowa. 21,955 long-stay nursing home residents in the first quarter of 2014. We identified antipsychotic use and bipolar disorder using MDS data. We compared MDS bipolar disorder diagnoses with Chronic Conditions Warehouse (CCW) "ever" bipolar disorder indicators, and prior year claims. We compared CCW condition onset dates to identify bipolar disorder diagnosed after dementia. The mean (SD) proportion receiving antipsychotics was 19.6% (11.1%) with bipolar disorder and 18.3% (10.8%) without. The positive predictive value (PPV) of MDS bipolar disorder diagnoses was 80.2% versus CCW lifetime indicators, and 74.6% versus claims. PPV decreased by 27.1% when "bipolar disorder, unspecified" and "other bipolar disorders" diagnoses were excluded. Nearly three-quarters of residents with bipolar disorder had dementia. Over half of those with dementia had dementia first per CCW records. This proportion was lower among those with more specific bipolar disorder diagnoses or MDS bipolar disorder indicators. Bipolar disorder in nursing home residents is often first diagnosed after dementia using nonspecific diagnoses. This practice deserves further evaluation. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Gender Differences in the Prevalence of Fibromyalgia and in Concomitant Medical and Psychiatric Disorders: A National Veterans Health Administration Study.

PubMed

Arout, Caroline A; Sofuoglu, Mehmet; Bastian, Lori A; Rosenheck, Robert A

2018-04-02

Fibromyalgia is a poorly understood, chronically disabling pain syndrome. While research has focused on its clinical presentation and treatment, less is known about fibromyalgia's clinical epidemiology in real-world healthcare systems. Gender differences have been difficult to study because relatively few males are diagnosed with fibromyalgia. Veterans Health Administration (VHA) patients diagnosed with fibromyalgia nationwide in FY 2012 were compared to Veterans with other pain diagnoses on sociodemographic characteristics, medical and psychiatric diagnoses, health service use, and opioid and psychotropic prescription fills. Additional analyses compared characteristics of men and women diagnosed with fibromyalgia. Risk ratios and Cohen's d were used for bivariate comparisons, followed by logistic regression analyses to identify independent factors associated with a diagnosis of fibromyalgia in the VHA. Altogether, 77,087 of 2,216,621 Veterans with pain diagnoses (3.48%) were diagnosed with fibromyalgia. They were more likely to be female, younger than patients with other pain conditions, more likely to have multiple psychiatric comorbidities and other types of pain, and used more medical outpatient services. Women diagnosed with fibromyalgia were younger and more likely to have headaches, connective tissue diseases (CTD), and psychiatric comorbidities, while men had more comorbid medical conditions. In this large, predominantly older male sample of Veterans with pain diagnoses, those with fibromyalgia were far more likely to be women. Gender comparisons showed women with fibromyalgia were more likely to be diagnosed with psychiatric disorders and CTD, while males were more likely to be diagnosed with medical conditions. Fibromyalgia shows a striking, gender-dependent picture of multimorbidity, which should be considered in treatment.

Matrix Analysis of Traditional Chinese Medicine Differential Diagnoses in Gulf War Illness.

PubMed

Taylor-Swanson, Lisa; Chang, Joe; Schnyer, Rosa; Hsu, Kai-Yin; Schmitt, Beth Ann; Conboy, Lisa A

2018-03-08

To qualitatively categorize Traditional Chinese Medicine (TCM) differential diagnoses in a sample of veterans with Gulf War Illness (GWI) pre- and postacupuncture treatment. The authors randomized 104 veterans diagnosed with GWI to a 6-month acupuncture intervention that consisted of either weekly or biweekly individualized acupuncture treatments. TCM differential diagnoses were recorded at baseline and at 6 months. These TCM diagnoses were evaluated using Matrix Analysis to determine co-occurring patterns of excess, deficiency, and channel imbalances. These diagnoses were examined within and between participants to determine patterns of change and to assess stability of TCM diagnoses over time. Frequencies of diagnoses of excess, deficiency, and channel patterns were tabulated. Diagnoses of excess combined with deficiency decreased from 43% at baseline to 39% of the sample at 6 months. Excess+deficiency+channel imbalances decreased from 26% to 17%, while deficiency+channel imbalances decreased from 11% to 4% over the study duration. The authors observed a trend over time of decreased numbers of individuals presenting with all three types of differential diagnosis combinations. This may suggest that fewer people were diagnosed with concurrent excess, deficiency, and channel imbalances and perhaps a lessening in the complexity of their presentation. This is the first published article that organizes and defines TCM differential diagnoses using Matrix Analysis; currently, there are no TCM frameworks for GWI. These findings are preliminary given the sample size and the amount of missing data at 6 months. Characterization of the TCM clinical presentation of veterans suffering from GWI may help us better understand the potential role that East Asian medicine may play in managing veterans with GWI and the design of effective acupuncture treatments based on TCM. The development of a TCM manual for treating GWI is merited.

Detection of Pediatric Respiratory and Diarrheal Outbreaks from Sales of Over-the-counter Electrolyte Products

PubMed Central

Hogan, William R.; Tsui, Fu-Chiang; Ivanov, Oleg; Gesteland, Per H.; Grannis, Shaun; Overhage, J. Marc; Robinson, J. Michael; Wagner, Michael M.

2003-01-01

Objective: To determine whether sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal disease in children and, if so, how much earlier a signal relative to hospital diagnoses. Design: Retrospective analysis was conducted of sales of electrolyte products and hospital diagnoses for six urban regions in three states for the period 1998 through 2001. Measurements: Presence of signal was ascertained by measuring correlation between electrolyte sales and hospital diagnoses and the temporal relationship that maximized correlation. Earliness was the difference between the date that the exponentially weighted moving average (EWMA) method first detected an outbreak from sales and the date it first detected the outbreak from diagnoses. The coefficient of determination (r2) measured how much variance in earliness resulted from differences in sales' and diagnoses' signal strengths. Results: The correlation between electrolyte sales and hospital diagnoses was 0.90 (95% CI, 0.87–0.93) at a time offset of 1.7 weeks (95% CI, 0.50–2.9), meaning that sales preceded diagnoses by 1.7 weeks. EWMA with a nine-sigma threshold detected the 18 outbreaks on average 2.4 weeks (95% CI, 0.1–4.8 weeks) earlier from sales than from diagnoses. Twelve outbreaks were first detected from sales, four were first detected from diagnoses, and two were detected simultaneously. Only 26% of variance in earliness was explained by the relative strength of the sales and diagnoses signals (r2 = 0.26). Conclusion: Sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal diseases in children and usually are an earlier signal than hospital diagnoses. PMID:12925542

A French multicenter study of over 700 patients with 22q11 deletions diagnosed using FISH or aCGH.

PubMed

Poirsier, Céline; Besseau-Ayasse, Justine; Schluth-Bolard, Caroline; Toutain, Jérôme; Missirian, Chantal; Le Caignec, Cédric; Bazin, Anne; de Blois, Marie Christine; Kuentz, Paul; Catty, Marie; Choiset, Agnès; Plessis, Ghislaine; Basinko, Audrey; Letard, Pascaline; Flori, Elisabeth; Jimenez, Mélanie; Valduga, Mylène; Landais, Emilie; Lallaoui, Hakima; Cartault, François; Lespinasse, James; Martin-Coignard, Dominique; Callier, Patrick; Pebrel-Richard, Céline; Portnoi, Marie-France; Busa, Tiffany; Receveur, Aline; Amblard, Florence; Yardin, Catherine; Harbuz, Radu; Prieur, Fabienne; Le Meur, Nathalie; Pipiras, Eva; Kleinfinger, Pascale; Vialard, François; Doco-Fenzy, Martine

2016-06-01

Although 22q11.2 deletion syndrome (22q11.2DS) is the most recurrent human microdeletion syndrome associated with a highly variable phenotype, little is known about the condition's true incidence and the phenotype at diagnosis. We performed a multicenter, retrospective analysis of postnatally diagnosed patients recruited by members of the Association des Cytogénéticiens de Langue Française (the French-Speaking Cytogeneticists Association). Clinical and cytogenetic data on 749 cases diagnosed between 1995 and 2013 were collected by 31 French cytogenetics laboratories. The most frequent reasons for referral of postnatally diagnosed cases were a congenital heart defect (CHD, 48.6%), facial dysmorphism (49.7%) and developmental delay (40.7%). Since 2007 (the year in which array comparative genomic hybridization (aCGH) was introduced for the routine screening of patients with intellectual disability), almost all cases have been diagnosed using FISH (96.1%). Only 15 cases (all with an atypical phenotype) were diagnosed with aCGH; the deletion size ranged from 745 to 2904 kb. The deletion was inherited in 15.0% of cases and was of maternal origin in 85.5% of the latter. This is the largest yet documented cohort of patients with 22q11.2DS (the most commonly diagnosed microdeletion) from the same population. French cytogenetics laboratories diagnosed at least 108 affected patients (including fetuses) per year from among a national population of ∼66 million. As observed for prenatal diagnoses, CHDs were the most frequently detected malformation in postnatal diagnoses. The most common CHD in postnatal diagnoses was an isolated septal defect.

Low-Dose CT for Evaluation of Suspected Urolithiasis: Diagnostic Yield for Assessment of Alternative Diagnoses.

PubMed

Weinrich, Julius Matthias; Bannas, Peter; Regier, Marc; Keller, Sarah; Kluth, Luis; Adam, Gerhard; Henes, Frank Oliver

2018-03-01

The purpose of this study is to assess the diagnostic yield of low-dose (LD) CT for alternative diagnoses in patients with suspected urolithiasis. In this retrospective study, we included 776 consecutive patients who underwent unenhanced abdominal CT for evaluation of suspected urolithiasis. All examinations were performed with an LD CT protocol; images were reconstructed using iterative reconstruction. The leading LD CT diagnosis was recorded for each patient and compared with the final clinical diagnosis, which served as the reference standard. The mean (± SD) effective dose of CT was 1.9 ± 0.6 mSv. The frequency of urolithiasis was 82.5% (640/776). LD CT reached a sensitivity of 94.1% (602/640), a specificity of 100.0% (136/136), and an accuracy of 95.1% (738/776) for the detection of urolithiasis. In 93 of 136 patients (68.4%) without urolithiasis, alternative diagnoses were established as the final clinical diagnoses. Alternative diagnoses were most commonly located in the genitourinary (n = 53) and gastrointestinal (n = 18) tracts. LD CT correctly provided alternative diagnoses for 57 patients (61.3%) and was false-negative for five patients (5.4%). The most common clinical alternative diagnoses were urinary tract infections (n = 22). Seven diagnoses missed at LD CT were located outside the FOV. For 43 of all 776 patients (5.5%), neither LD CT nor clinical workup could establish a final diagnosis. The sensitivity, specificity, and accuracy of LD CT for the detection of alternative diagnoses were 91.9% (57/62), 95.6% (43/45), and 93.5% (100/107), respectively. LD CT enables the diagnosis of most alternative diagnoses in the setting of suspected urolithiasis. The most frequent alternative diagnoses missed by LD CT are urinary tract infections or diagnoses located outside the FOV of the abdominopelvic CT scan.

Prehospital triage of patients diagnosed with perforated peptic ulcer or peptic ulcer bleeding: an observational study of patients calling 1-1-2.

PubMed

Bonnesen, Kasper; Friesgaard, Kristian D; Boetker, Morten T; Nikolajsen, Lone

2018-04-05

Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB). In a three-year period in Central Denmark Region, all patients hospitalized within 24 h after a 1-1-2 emergency call and who subsequently received either a PPU or a PUB (hereinafter combined and referred to as PPU/PUB) or a First Hour Quintet (FHQ: respiratory failure, stroke, trauma, cardiac chest pain, and cardiac arrest) diagnosis were investigated. A modified Poisson regression was used to estimate the relative risk of receiving the highest and lowest prehospital response level. Also, a linear regression analysis was used to estimate the relative risk of 30-day mortality. Of 8658 evaluated patients, 263 were diagnosed with PPU/PUB. After adjusting for relevant confounding variables, patients diagnosed with PPU/PUB were less likely to receive ambulance transportation compared to patients diagnosed with stroke, RR = 1.41 (CI: 1.28-1.56); trauma, RR = 1.28 (CI: 1.15-1.42); cardiac chest pain, RR = 1.47 (CI: 1.33-1.62); and cardiac arrest, RR = 1.44 (CI: 1.31-1.42). Among patients diagnosed with PPU/PUB, 6.5% (CI: 3.3-9.7) did not receive ambulance transportation. The proportion of patients not receiving ambulance transportation was higher among patients diagnosed with PPU/PUB compared to patients diagnosed with an FHQ diagnosis. The 30-day mortality rate among patients diagnosed with PPU/PUB was 7.8% (CI: 4.2-11.1). This was lower than the 30-day mortality rate among patients diagnosed with respiratory failure (P = 0.010), stroke (P = 0.001), and cardiac arrest (P < 0.001), but comparable to the 30-day mortality among patients diagnosed with cardiac chest pain (P = 0.080) and trauma (P = 0.281). Among patients calling 1-1-2, fewer patients diagnosed with PPU/PUB received ambulance transportation than patients diagnosed with FHQ diagnoses, despite a high mortality among patients diagnosed with PPU/PUB.

Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records

ERIC Educational Resources Information Center

Coleman, Karen J.; Lutsky, Marta A.; Yau, Vincent; Qian, Yinge; Pomichowski, Magdalena E.; Crawford, Phillip M.; Lynch, Frances L.; Madden, Jeanne M.; Owen-Smith, Ashli; Pearson, John A.; Pearson, Kathryn A.; Rusinak, Donna; Quinn, Virginia P.; Croen, Lisa A.

2015-01-01

To identify factors associated with valid Autism Spectrum Disorder (ASD) diagnoses from electronic sources in large healthcare systems. We examined 1,272 charts from ASD diagnosed youth <18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. A total of 845 were classified with…

Disease identification based on ambulatory drugs dispensation and in-hospital ICD-10 diagnoses: a comparison.

PubMed

Halfon, Patricia; Eggli, Yves; Decollogny, Anne; Seker, Erol

2013-10-31

Pharmacy-based case mix measures are an alternative source of information to the relatively scarce outpatient diagnoses data. But most published tools use national drug nomenclatures and offer no head-to-head comparisons between drugs-related and diagnoses-based categories. The objective of the study was to test the accuracy of drugs-based morbidity groups derived from the World Health Organization Anatomical Therapeutic Chemical Classification of drugs by checking them against diagnoses-based groups. We compared drugs-based categories with their diagnoses-based analogues using anonymous data on 108,915 individuals insured with one of four companies. They were followed throughout 2005 and 2006 and hospitalized at least once during this period. The agreement between the two approaches was measured by weighted kappa coefficients. The reproducibility of the drugs-based morbidity measure over the 2 years was assessed for all enrollees. Eighty percent used a drug associated with at least one of the 60 morbidity categories derived from drugs dispensation. After accounting for inpatient under-coding, fifteen conditions agreed sufficiently with their diagnoses-based counterparts to be considered alternative strategies to diagnoses. In addition, they exhibited good reproducibility and allowed prevalence estimates in accordance with national estimates. For 22 conditions, drugs-based information identified accurately a subset of the population defined by diagnoses. Most categories provide insurers with health status information that could be exploited for healthcare expenditure prediction or ambulatory cost control, especially when ambulatory diagnoses are not available. However, due to insufficient concordance with their diagnoses-based analogues, their use for morbidity indicators is limited.

Service Use Preceding Opioid-Related Fatality.

PubMed

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Blanco, Carlos

2017-11-28

This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life. Most decedents (61.5%) had received clinical diagnoses of chronic noncancer pain conditions in the last year of life. As compared with decedents without chronic pain diagnoses, those with these diagnoses were significantly more likely to have filled prescriptions for opioids (49.0% versus 17.2%) and benzodiazepines (52.1% versus 26.6%) during the last 30 days of life, while diagnoses of opioid use disorder during this period were uncommon in both groups (4.2% versus 4.3%). The chronic pain group was also significantly more likely than the nonpain group to receive clinical diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life. Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.

Comparison of corneal degeneration and calcific band keratopathy from 2000 to 2013 in 69 horses.

PubMed

Berryhill, Emily H; Thomasy, Sara M; Kass, Philip H; Reilly, Christopher M; Good, Kathryn L; Hollingsworth, Steven R; Maggs, David J; Magdesian, K Gary; Pusterla, Nicola

2017-01-01

To compare signalment, presentation, treatment, and outcome in horses diagnosed with corneal degeneration (CD) or calcific band keratopathy (CBK) at a referral hospital. Sixty-nine horses (87 eyes) diagnosed with either CD or CBK. Medical records of horses diagnosed with CD or CBK at the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) between 2000 and 2013 were reviewed. Signalment, concurrent ophthalmic diagnoses, previous therapies, diagnostic tests, systemic diagnoses, treatment, follow-up, and outcomes were compared between horses diagnosed with CD or CBK. Age, breed, and gender were compared between the CD/CBK and UCD-VMTH populations. Thirty-three horses (42 eyes) and 36 horses (45 eyes) were diagnosed with CD and CBK, respectively. Horses with CD or CBK were significantly older (P < 0.001) than the UCD-VMTH population with a median age of 16 or 18 years, respectively. Appaloosas were significantly overrepresented in the CD/CBK population (33%) in comparison with the UCD-VMTH population (1.8%, P < 0.001). Equine recurrent uveitis was concurrently diagnosed in 67% and 84% of horses with CD or CBK, respectively. Pituitary pars intermedia dysfunction (PPID) was diagnosed significantly less often in horses with CD vs. CBK (P = 0.03). Chemical chelation with ethylenediaminetetraacetic acid was performed significantly less frequently in horses diagnosed with CD (7.1%) vs. CBK (31.1% of eyes) (P = 0.012). Despite some differences, equine CD and CBK are relatively similar conditions and may represent a continuum of disease severity. Horses with PPID should be monitored closely for corneal disease including CBK. © 2016 American College of Veterinary Ophthalmologists.

Once-monthly injection of paliperidone palmitate in patients with recently diagnosed and chronic schizophrenia: a post-hoc comparison of efficacy and safety.

PubMed

Si, Tianmei; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson; Feng, Yu

2017-12-01

The use of long-acting injectable antipsychotics in recently diagnosed schizophrenia remains less explored. We evaluated the efficacy and safety of paliperidone palmitate once-monthly (PP1M) treatment in adult patients with recently diagnosed vs. chronic schizophrenia. These post-hoc analyses included two multicenter studies. Study 1 (NCT01527305) enrolled recently diagnosed (≤5 years) and chronic (>5 years) patients; Study 2 (NCT01051531) enrolled recently diagnosed patients only. Recently diagnosed patients were further sub-grouped into ≤2 years or 2-5 years. The primary efficacy endpoint was the change from baseline in Positive and Negative Syndrome Scale (PANSS) total score. In Study 1, 41.5% patients had recent diagnosis (≤2 years: 56.8%; 2-5 years: 43.2%); 58.5% had chronic schizophrenia. In Study 2, 52.8% and 47.2% patients were grouped into ≤2 years and 2-5 years, respectively. PANSS total score showed significantly greater improvement in patients with recently diagnosed vs. chronic schizophrenia. Similar results were obtained for PANSS responder rate, improvements in PANSS, and CGI-S scores. PP1M was efficacious in both recently diagnosed and chronic schizophrenia, with the benefits being more pronounced in patients with recently diagnosed schizophrenia. This adds to growing evidence recommending long-acting antipsychotic interventions at early stages of schizophrenia.

Comparing the diagnostic properties of skin scraping, adhesive tape, and dermoscopy in diagnosing scabies.

PubMed

Abdel-Latif, Azmy A; Elshahed, Ahmad R; Salama, Omar A; Elsaie, Mohamed L

2018-06-01

Scabies is a contagious skin infestation that mainly presents with itching at night and skin burrows that are visible to the naked eye. Diagnosing scabies with dermoscopy is still a matter of controversy. The aim of our study was to compare the diagnostic properties of adhesive tape, skin scraping, and dermoscopy in diagnosing scabies. One hundred patients with clinical presumptive diagnoses of scabies underwent skin scraping, adhesive tape testing, and dermoscopic examination. Each diagnostic procedure was performed on three different areas. Comparing the diagnostic properties of the three methods, the adhesive tape test was the most sensitive method for diagnosing scabies. Sixteen cases (16.0%) were definitely diagnosed as scabies using the adhesive tape test detecting the presence of mites or their eggs. Only 10 cases (10.0%) were definitely diagnosed as scabies using the skin scraping test detecting mites or their eggs. Dermoscopic examination suggested a diagnosis of scabies in 22 cases (22.0%), of which only 10 were definitely diagnosed as scabies by detecting mites using the adhesive tape test, skin scraping, or both. The diagnosis of scabies can only be confirmed by seeing mites. The adhesive tape test and skin scraping procedure have high specificity in diagnosing scabies, but their low sensitivity cannot exclude the possibility of scabies. Dermoscopy-guided tape testing can be a helpful tool for better diagnosis of scabies.

Diagnoses-based cost groups in the Dutch risk-equalization model: the effects of including outpatient diagnoses.

PubMed

van Kleef, R C; van Vliet, R C J A; van Rooijen, E M

2014-03-01

The Dutch basic health-insurance scheme for curative care includes a risk equalization model (RE-model) to compensate competing health insurers for the predictable high costs of people in poor health. Since 2004, this RE-model includes the so-called Diagnoses-based Cost Groups (DCGs) as a risk adjuster. Until 2013, these DCGs have been mainly based on diagnoses from inpatient hospital treatment. This paper examines (1) to what extent the Dutch RE-model can be improved by extending the inpatient DCGs with diagnoses from outpatient hospital treatment and (2) how to treat outpatient diagnoses relative to their corresponding inpatient diagnoses. Based on individual-level administrative costs we estimate the Dutch RE-model with three different DCG modalities. Using individual-level survey information from a prior year we examine the outcomes of these modalities for different groups of people in poor health. We find that extending DCGs with outpatient diagnoses has hardly any effect on the R-squared of the RE-model, but reduces the undercompensation for people with a chronic condition by about 8%. With respect to incentives, it may be preferable to make no distinction between corresponding inpatient and outpatient diagnoses in the DCG-classification, although this will be at the expense of the predictive accuracy of the RE-model. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Diagnoses of Autism Spectrum Disorders in Germany: Time Trends in Administrative Prevalence and Diagnostic Stability

ERIC Educational Resources Information Center

Bachmann, Christian J.; Gerste, Bettina; Hoffmann, Falk

2018-01-01

For Germany, no data on trends in autism spectrum disorder diagnoses are available. The primary aim of this study was to establish the time trends in the administrative prevalence of autism spectrum disorder diagnoses. The second aim was to assess the stability of autism spectrum disorder diagnoses over time. We analysed administrative outpatient…

Research on Key Technology in Remote Education System of Spirit Diagnosing by Eye in TCM

ERIC Educational Resources Information Center

Guo, Feng; Li, Shaozi; Dai, Ying; Zhou, Changle; Lin, Ying

2011-01-01

Spirit diagnosing is an important theory in TCM (Traditional Chinese Medicine), by which a TCM doctor can diagnose a patient's body state. But this theory is complicated and difficult to master simply learned from books. To further the theory and skill of spirit diagnosing, in this paper, the authors propose a remote education system that can…

Debunking Occam's razor: Diagnosing multiple genetic diseases in families by whole-exome sequencing.

PubMed

Balci, T B; Hartley, T; Xi, Y; Dyment, D A; Beaulieu, C L; Bernier, F P; Dupuis, L; Horvath, G A; Mendoza-Londono, R; Prasad, C; Richer, J; Yang, X-R; Armour, C M; Bareke, E; Fernandez, B A; McMillan, H J; Lamont, R E; Majewski, J; Parboosingh, J S; Prasad, A N; Rupar, C A; Schwartzentruber, J; Smith, A C; Tétreault, M; Innes, A M; Boycott, K M

2017-09-01

Recent clinical whole exome sequencing (WES) cohorts have identified unanticipated multiple genetic diagnoses in single patients. However, the frequency of multiple genetic diagnoses in families is largely unknown. We set out to identify the rate of multiple genetic diagnoses in probands and their families referred for analysis in two national research programs in Canada. We retrospectively analyzed WES results for 802 undiagnosed probands referred over the past 5 years in either the FORGE or Care4Rare Canada WES initiatives. Of the 802 probands, 226 (28.2%) were diagnosed based on mutations in known disease genes. Eight (3.5%) had two or more genetic diagnoses explaining their clinical phenotype, a rate in keeping with the large published studies (average 4.3%; 1.4 - 7.2%). Seven of the 8 probands had family members with one or more of the molecularly diagnosed diseases. Consanguinity and multisystem disease appeared to increase the likelihood of multiple genetic diagnoses in a family. Our findings highlight the importance of comprehensive clinical phenotyping of family members to ultimately provide accurate genetic counseling. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An analysis of nursing diagnoses for patients undergoing procedures in a Brazilian interventional radiology suite.

PubMed

Viegas, Liza de Souza; Turrini, Ruth Natalia Teresa; da Silva Bastos Cerullo, Josinete Aparecida

2010-05-01

Innovations in minimally invasive surgery have led to more procedures being performed in the interventional radiology suite. It, therefore, is essential that nurses in radiology departments be competent to care for all types of patients. Use of nursing classification systems can improve care by providing standardized language for documentation. We conducted a project that involved 25 patients undergoing interventional radiology procedures between August and October 2006 in São Paulo, Brazil, to identify the most frequent North American Nursing Diagnosis Association (NANDA) nursing diagnoses used and then compared the NANDA diagnoses to Perioperative Nursing Data Set diagnoses. The most frequent nursing diagnoses in the participants were anxiety, chronic pain, inefficient tissue perfusion-peripheral, deficient knowledge, and risk for falls. These results are similar to diagnoses that have been reported in outpatient centers. The NANDA and Perioperative Nursing Data Set diagnoses were found to be similar. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Critical thinking and accuracy of nurses' diagnoses.

PubMed

Lunney, Margaret

2003-01-01

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

Identification of nursing management diagnoses.

PubMed

Morrison, R S

1997-02-01

Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.

Getting Diagnosed

MedlinePlus

... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis can ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in some ...

Association between Diagnosed ADHD and Selected Characteristics among Children Aged 4-17 Years: United States, 2011-2013. NCHS Data Brief. Number 201

ERIC Educational Resources Information Center

Pastor, Patricia N.; Reuben, Cynthia A.; Duran, Catherine R.; Hawkins, LaJeana D.

2015-01-01

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder diagnosed in U.S. children (1). While this disorder is most often diagnosed in children when they are in elementary school, it is increasingly being identified in preschool children (2-5). This report describes the prevalence of diagnosed ADHD among…

Using Plant Clinic Registers to Assess the Quality of Diagnoses and Advice Given to Farmers: A Case Study from Uganda

ERIC Educational Resources Information Center

Danielsen, Solveig; Boa, Eric; Mafabi, Moses; Mutebi, Emmanuel; Reeder, Robert; Kabeere, Flavia; Karyeija, Robert

2013-01-01

Purpose: This study developed a framework for quality assessment of diagnoses and advice given at plant clinics. Design/methodology/approach: Clinic registers from five plant clinics in Uganda (2006-2010) were used to develop quality assessment protocols for diagnoses and advice given by plant doctors. Assessment of quality of diagnoses was based…

Sickness absence due to musculoskeletal diagnoses and risk of diagnosis-specific disability pension: a nationwide Swedish prospective cohort study.

PubMed

Jansson, Catarina; Alexanderson, Kristina

2013-06-01

Musculoskeletal disorders constitute major public health problems. Few studies have, however, examined risk of disability pension among persons sickness absent due to musculoskeletal diagnoses. Thus, we constructed a prospective nationwide population-based cohort study based on Swedish registers, consisting of all 4,687,756 individuals living in Sweden December 31, 2004/2005, aged 20-64 years, who were not on disability or old-age pension. Those individuals who were sickness absent in 2005 due to musculoskeletal diagnoses were compared to those sickness absent due to non-musculoskeletal diagnoses and those with no sickness absence. Musculoskeletal diagnoses were categorized as follows: 1) artropathies/systemic connective tissue disorders, 2) dorsopathies, and 3) soft tissue disorders/osteopathies/chondropathies/other musculoskeletal disorders. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2009. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for socio-demographic factors and morbidity, sickness absence due to all categories of musculoskeletal diagnoses was associated with 12- to 18-fold increased risks of all-cause disability pension (adjusted model, category 2 diagnoses, IRR = 18.57, 95% CI = 18.18-18.97). Similar associations were observed among both women and men sickness absent due to all 3 musculoskeletal diagnostic categories. Moreover, increased risks of disability pension because of cancer, mental, circulatory and musculoskeletal diagnoses were observed among individuals sickness absent because of any musculoskeletal diagnostic category (disability pension due to musculoskeletal diagnoses, adjusted model, category 2 diagnoses, IRR = 50.66, 95% CI = 49.06-52.32). In conclusion, this nationwide cohort study reveals strongly increased risks of all-cause and diagnosis-specific disability pension among those sickness absent due to musculoskeletal diagnoses. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

How Do Health Care Providers Diagnose Osteogenesis Imperfecta?

MedlinePlus

... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose osteogenesis imperfecta (OI)? If OI is moderate or severe, health care providers usually diagnose it during prenatal ultrasound at ...

Diagnosing Lupus

MedlinePlus

... Lupus.org Sign Up for Our Newsletter Donate Diagnosing Lupus Learn about lab tests, lupus symptoms, and how ... doctor's appointment article Reducing time to diagnosis blog Diagnosing lupus Getting a lupus diagnosis is challenging. Here’s what ...

Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy

PubMed Central

Boyd, Patricia Anne; Loane, Maria; Garne, Ester; Khoshnood, Babak; Dolk, Helen

2011-01-01

This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000–2005 from 19 population-based registries in 11 European countries covering 2.5 million births were analysed. Cases included were livebirths diagnosed to 1 year of age, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly (TOPFA). In all, 465 cases of SCT were diagnosed between 2000 and 2005, a prevalence of 1.88 per 10,000 births (95% CI 1.71–2.06). Prevalence of XXX, XXY and XYY were 0.54 (95% CI 0.46–0.64), 1.04 (95% CI 0.92–1.17) and 0.30 (95% CI 0.24–0.38), respectively. In all, 415 (89%) were prenatally diagnosed and 151 (36%) of these resulted in TOPFA. There was wide country variation in prevalence (0.19–5.36 per 1000), proportion prenatally diagnosed (50–100%) and proportion of prenatally diagnosed resulting in TOPFA (13–67%). Prevalence of prenatally diagnosed cases was higher in countries with high prenatal detection rates of Down syndrome. The EUROCAT prevalence rate for SCTs diagnosed prenatally or up to 1 year of age represents 12% of the prevalence expected from cytogenetic studies of newborn babies, as the majority of cases are never diagnosed or are diagnosed later in life. There is a wide variation between European countries in prevalence, prenatal detection and TOPFA proportions, related to differences in screening policies as well as organizational and cultural factors. PMID:20736977

Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy.

PubMed

Boyd, Patricia Anne; Loane, Maria; Garne, Ester; Khoshnood, Babak; Dolk, Helen

2011-02-01

This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000-2005 from 19 population-based registries in 11 European countries covering 2.5 million births were analysed. Cases included were livebirths diagnosed to 1 year of age, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly (TOPFA). In all, 465 cases of SCT were diagnosed between 2000 and 2005, a prevalence of 1.88 per 10,000 births (95% CI 1.71-2.06). Prevalence of XXX, XXY and XYY were 0.54 (95% CI 0.46-0.64), 1.04 (95% CI 0.92-1.17) and 0.30 (95% CI 0.24-0.38), respectively. In all, 415 (89%) were prenatally diagnosed and 151 (36%) of these resulted in TOPFA. There was wide country variation in prevalence (0.19-5.36 per 1000), proportion prenatally diagnosed (50-100%) and proportion of prenatally diagnosed resulting in TOPFA (13-67%). Prevalence of prenatally diagnosed cases was higher in countries with high prenatal detection rates of Down syndrome. The EUROCAT prevalence rate for SCTs diagnosed prenatally or up to 1 year of age represents 12% of the prevalence expected from cytogenetic studies of newborn babies, as the majority of cases are never diagnosed or are diagnosed later in life. There is a wide variation between European countries in prevalence, prenatal detection and TOPFA proportions, related to differences in screening policies as well as organizational and cultural factors.

Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010

PubMed Central

Rock, Valerie; Zhang, Xuanping; Li, Yan; Elam-Evans, Laurie; Balluz, Lina

2013-01-01

Introduction Quitting smoking is a critical step toward diabetes control. It is not known whether smoking rates in adults with diabetes are similar to rates among adults who do not have the disease or whether people with diabetes have increased motivation to quit. We examined prevalence trends of current smoking and quit attempts among US adults with and without diagnosed diabetes from 2001 through 2010. Methods We used data from the 2001 through 2010 Behavioral Risk Factor Surveillance System, a state-based telephone survey of noninstitutionalized US adults, and conducted linear trend analysis and log linear regression. Results The adjusted prevalence of cigarette smoking among adults with diagnosed diabetes was 9% less than adults without diagnosed diabetes (adjusted prevalence ratio [APR], 0.91; 99% confidence interval [CI], 0.89−0.93). Declines in smoking prevalence were greater among adults without diabetes than adults with diagnosed diabetes (P < .001). Among smokers, the adjusted prevalence of quit attempts among adults with diagnosed diabetes was 13% higher than among adults without diagnosed diabetes (APR, 1.13; 99% CI, 1.11−1.15). Among adult smokers with diagnosed diabetes, quit attempts were stable over time for those aged 18 to 44 years and those with a high school education or less. Quit attempts were also stable for older smokers, non-Hispanic African Americans, and Hispanic smokers, regardless of diagnosed diabetes status. Conclusion A large proportion of smokers with diagnosed diabetes seemed to have quit smoking, but more research is needed to confirm success and how difficult it was to achieve. PMID:24050530

Effects of diagnosis on treatment recommendations in chronic insomnia--a report from the APA/NIMH DSM-IV field trial.

PubMed

Buysse, D J; Reynolds, C F; Kupfer, D J; Thorpy, M J; Bixler, E; Kales, A; Manfredi, R; Vgontzas, A; Stepanski, E; Roth, T; Hauri, P; Stapf, D

1997-07-01

The objective of this study was to determine whether sleep specialists and nonspecialists recommend different treatments for different insomnia diagnoses according to two different diagnostic classifications. Two hundred sixteen patients with chronic insomnia at five sites were each interviewed by two clinicians: one sleep specialist and one nonsleep specialist. All interviewers indicated diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV); sleep specialists also indicated diagnoses according to the International Classification for Sleep Disorders (ICSD). Interviewers then indicated how strongly they would recommend each item in a standard list of treatment and diagnostic interventions for each patient. We examined differences in treatment recommendations among the six most common DSM-IV diagnoses assigned by sleep specialists at different sites (n = 192), among the six most common ICSD diagnoses assigned by sleep specialists at different sites (n = 153), and among the six most common DSM-IV diagnoses assigned by nonspecialists at different sites (n = 186). In each analysis, specific treatment and polysomnography recommendations differed significantly for different diagnoses, using either DSM-IV or ICSD criteria. Conversely, different diagnoses were associated with different rank orderings of specific treatment and diagnostic recommendations. Sleep specialist and nonspecialist interviewers each distinguished treatment recommendations among different diagnoses, but in general, nonspecialists more strongly recommended medications and relaxation treatments. Significant site-related differences in treatment recommendations also emerged. Differences in treatment recommendations support the distinction between different DSM-IV and ICSD diagnoses, although they do not provide formal validation. Site-related differences suggest a lack of consensus in how these disorders are conceptualized and treated.

Nursing diagnosis taxonomy across the Atlantic Ocean: congruence between nurses' charting and the NANDA taxonomy.

PubMed

Thoroddsen, Asta; Thorsteinsson, Hrund Sch

2002-02-01

The purpose of this study was to analyse expressions or terms used by nurses in Iceland to describe patient problems. The classification of NANDA was used as reference. The research questions were: (a) Does NANDA terminology represent patient problems documented by Icelandic nurses? (b) If so, what kind of nursing diagnoses does it represent? (c) What kind of patient problems are not represented by NANDA terminology? (d) What are the most frequent nursing diagnoses used? A retrospective chart review was conducted in a 400 bed acute care hospital in Iceland. The sample was defined as nursing diagnosis statements in charts of patients hospitalized in two 6-month periods in two separate years. The data were analysed according to a predefined grading system based on the PES format or Problem -- (A)aetiology -- Signs and symptoms. A total of 1217 charts were used for the study, which yielded 2171 nursing diagnoses statements for analysis. Charts with at least one nursing diagnosis documented were 60.1% and the number of diagnoses per patient ranged from 0 to 10, with 65% of charts with three diagnoses or less. The number of diagnoses correlated with patients' length of stay, but not with increased age of the patients. The average number of statements per patient was 3.28. Almost 60% of the diagnoses were according to NANDA terminology, another 20% were stated as procedures, medical diagnoses or risks for complications. The 20 most frequently used nursing diagnoses accounted for 80% of all diagnoses documented. Discrepancy between nurses' documentation on emotional problems and availability of diagnosis in the NANDA taxonomy was evident. It can be concluded that the NANDA taxonomy seems to be culturally relevant for nurses in different cultures.

Nursing diagnoses related to psychiatric adult inpatient care.

PubMed

Frauenfelder, Fritz; van Achterberg, Theo; Müller Staub, Maria

2018-02-01

To detect the prevalence of NANDA-I diagnoses and possible relationships between those and patient characteristics such as gender, age, medical diagnoses and psychiatric specialty/setting. There is a lack on studies about psychiatric inpatient characteristics and possible relationships among these characteristics with nursing diagnoses. A quantitative-descriptive, cross-sectional, completed data sampling study was performed. The data were collected from the electronic patient record system. Frequencies for the social-demographic data, the prevalence of the NANDA-I diagnoses and the explanatory variables were calculated. In total, 410 nursing phenomena were found representing 85 different NANDA-I diagnoses in 312 patients. The NANDA-I diagnosis "Ineffective Coping" was the most frequently stated diagnosis followed by "Ineffective Health Maintenance," "Hopelessness" and "Risk for Other-Directed Violence". Men were more frequently affected by the diagnoses "Ineffective Coping," "Hopelessness," "Risk for Self-Directed Violence," "Defensive Coping" and "Risk for Suicide," whereas the diagnoses "Insomnia," "Chronic Confusion," "Chronic Low Self-Esteem" and "Anxiety" were more common in women. Patients under the age of 45 years were more frequently affected by "Chronic Low Self-Esteem" and "Anxiety" than older patients. "Ineffective Coping" was the most prevalent diagnosis by patients with mental disorders due to psychoactive substance use. Patients with schizophrenia were primarily affected by the diagnoses "Ineffective Coping," "Impaired Social Interaction" and "Chronic Low Self-Esteem." This study demonstrates the complexity and diversity of nursing care in inpatient psychiatric settings. Patients' gender, age and psychiatric diagnoses and settings are a key factor for specific nursing diagnosis. There are tendencies for relationships between certain nursing diagnosis and patient characteristics in psychiatric adult inpatients. This enhances the specific, extended knowledge for nursing care and its demands in this setting and therefore supports the daily nursing psychiatric care and its needs. © 2017 John Wiley & Sons Ltd.

"Testing-only" visits: an assessment of missed diagnoses in clients attending sexually transmitted disease clinics.

PubMed

Xu, Fujie; Stoner, Bradley P; Taylor, Stephanie N; Mena, Leandro; Martin, David H; Powell, Suzanne; Markowitz, Lauri E

2013-01-01

At sexually transmitted disease (STD) clinics, advances in testing technology coupled with increasing demands and diminishing resources have promoted the use of testing-only visits (clinic visits with testing for STDs but no full examination) to meet increasing demands for STD services. The aims of the present study were to estimate the prevalence of STD diagnoses that could become "missed diagnoses" if patients would use testing-only visits and to examine patient characteristics associated with these potential missed diagnoses. We conducted a self-administered survey of STD-related symptoms and sexual risk behaviors in patients seeking routine clinical care at 3 STD clinics. Medical charts were abstracted to estimate the prevalence of viral STDs, trichomoniasis, and other diagnoses from standard clinical services that could become missed diagnoses. Of 2582 patients included, the median age was 24 years and 50% were women. In women, overall, 3.2% were diagnosed as having a viral STD; 9.6%, trichomoniasis; and 41.0%, vulvovaginal candidiasis or symptomatic bacterial vaginosis. The prevalence of these potential missed diagnoses varied by patient characteristics, but in women who reported no symptoms, the prevalence of trichomoniasis was still 6.3%. In men, 19.3% received a diagnosis of urethritis but tested negative for both gonorrhea and chlamydia; this prevalence varied from 15.7% in those who reported no symptoms to 32.6% in those who reported malodor. A high proportion of STD clients received diagnoses from standard care visits that would be missed by testing-only visits. When patients, even those asymptomatic, use testing-only visits, missed diagnoses of STDs or related genital tract conditions can be substantial. The potential disadvantages of testing-only visits should be weighed against the advantages of such visits.

Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses incorrect?

PubMed

Liu, Danyang; Gan, Rongchang; Zhang, Weidi; Wang, Wei; Saiyin, Hexige; Zeng, Wenjiao; Liu, Guoyuan

2018-01-01

Emergency medicine is a 'high risk' specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses. Clinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ 2 test. Of the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (p<0.001). Aortic dissection and myocardial infarction were the most common cause of death (15 cases for each disease) and the most common missed class I diagnoses (80% and 66.7% for each), higher than the average 49.6% of all class I errors of the study patients. High major disparities between clinical diagnoses and postmortem examinations exist in emergency medical disputes cases; acute aortic dissection and myocardial infarction are the most frequently major missed diagnoses that ED clinicians should pay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Osteopathie bei gastroösophagealem Reflux mit Hiatushernie: Ein Fallbericht gemäß der CARE-Leitlinie].

PubMed

Rotter, Gabriele; Brinkhaus, Benno

2017-01-01

Hintergrund: Das Vorhandensein einer Hiatushernie kann das Auftreten einer gastroösophagealen Refluxerkrankung (GERD) als Komplikation bedingen. Konventionelle medizinische Therapiemaßnahmen können zu unerwünschten Ereignissen und Rezidiven führen. Bisher sind die Effekte von osteopathischen Behandlungen bei Hiatushernie und GERD nicht bekannt. Fallbericht: Eine 59-jährige Patientin mit endoskopisch diagnostizierter chronischer Gastritis, GERD und Hiatushernie beklagte einen persistierenden gastroösophagealen Reflux trotz konventionell-medizinischer konservativer Therapie. Die osteopathische Diagnostik ergab eine funktionelle Störung im Bereich des Magens und der Kardia mit einer Beteiligung zugehöriger Reflexzonen. Nach einer osteopathischen Behandlung als individuelle, befundorientierte Therapie ließen die Beschwerden erheblich nach. Die Hiatushernie war nach einer dieser Behandlung endoskopisch nicht mehr nachweisbar. Schlussfolgerungen: Dieser Fallbericht schildert die Symptomreduktion einer GERD nach osteopathischer Behandlung. In der endoskopischen Folgeuntersuchung fand sich die initial diagnostizierte Hiatushernie nicht mehr, diese Befund änderung könnte jedoch auf die unterschiedlichen Untersucher zurückgeführt werden. Prospektive kontrollierte klinische Studien sind notwendig, um den Stellenwert von osteopathischen Behandlungen bei GERD mit Hiatushernie zu untersuchen. © 2017 The Author(s). Published by S. Karger GmbH, Freiburg.

On the Making of Quantum Chemistry in Germany

NASA Astrophysics Data System (ADS)

Karachalios, Andreas

During the 1990s several historians of science have studied the emergence of quantum chemistry as an autonomous discipline in different national contexts (Nye, 1993; Simões, 1993; Simões, forthcoming; Gavroglu and Simões, 1994; Karachalios, 1997a). Beyond these disciplinary studies, a number of contributions to special aspects of this theme have appeared (Schweber, 1990; Gavroglu, 1995; Simões and Gavroglu, 1997, 1999a,b; Schwarz et al., 1999). In this literature the birth of quantum chemistry has generally been associated with two dates: the 1927 paper of Walter Heitler and Fritz London and the year 1931 in which Linus Pauling and John Clarke Slater independently explained the tetrahedral orientation of the four bonds of the carbon atom. To these dates we might also add a third: in 1928 London published a paper, 'Zur Quantentheorie der homöopolaren Valenzzahlen' (London, 1928), in which he gave a quantum mechanical explanation of the classical chemical notion of valency. There he showed a relationship between the valency numbers and the spectroscopical multiplicity, namely that valency=multiplicity-1. This relation established a bridge between physical and chemical facts. Taken together, these developments constitute important events for the international development of quantum chemistry.

Contributions to the History of Astronomy, Vol. 11. (German Title: Beiträge zur Astronomiegeschichte, Band 11)

NASA Astrophysics Data System (ADS)

Dick, Wolfgang R.; Duerbeck, H. W.; Hamel, Jürgen

2011-08-01

The contributions deal with astronomical concepts, historical observatories and biographical studies. Newly found copies of Copernicus' principal work are described, the development of the concepts "sphaera" and "orbis coelestis" from ancient times via Copernicus to Kepler is investigated. The concept of harmonical cosmology of Kepler and A. Kircher is analyzed in a major paper. A rediscovered letter by Kepler is interpreted. Other papers deal with the university observatory of Bützow (Mecklenburg-Western Pomerania), the observatories installed in Strasbourg in the 17th and early 19th centuries, and the Jesuit observatory which existed in Graz (Styria) in the 18th century, as well as the unrealized plans for an observing station of Vienna University Observatory in the 1940s. Einstein's thoughts about Friedmann's cosmological papers are presented. Biographical sketches on Philipp Feselius (1565-1610), Ferdinand Adolph Freiherr von Ende (1760-1816), Wilhelm Ebert (1871-1916) and Karl Julius Lohnert (1885-1944) are supplemented by an analysis of the social background of the important Astronomers of the 20th century. The claim that Jupiter's moons were described already 105 years before Galilei is contradicted in a discussion. The book concludes by short communications, obituaries and book reviews.

Schnellverfahren zur flammenlosen AAS-Bestimmung von Spurenelementen in geologischen Proben

NASA Astrophysics Data System (ADS)

Schrön, W.; Bombach, G.; Beuge, P.

This paper reports experience with direct quantitative trace element determinations in powdered geological samples by nameless atomic absorption spectroscopy. Two methods were explored. The first one is based on the production of a sample aerosol by laser radiation in a specifically designed sample chamber and the subsequent transport of the aerosol into a graphite tube, which has been preheated to a stable temperature. This technique is suited for a large range of concentration and is relatively free from matrix interferences. The technique was tested for the elements Ag, As, Bi, Cd, Co, Mn, Ni, Pb, Sb, Se, Sr and Tl. The described sample chamber can be also used in combination with other spcctroscopic techniques. The second method explored permits the quantitative determination of trace elements at very low concentrations. Essentially an accurately weighed amount of sample is placed on a graphite rod and introduced into a graphite furnace by inserting the rod through the sample injection port. Atomization takes place also under stable temperature conditions. Using this technique detection limits were found to be 10 -11 g for Ag, 2 × 10 -11 g for Cd and 10 -10 g for Sb in silicate materials.

Die Energiebranche am Beginn der digitalen Transformation: aus Versorgern werden Utilities 4.0

NASA Astrophysics Data System (ADS)

Doleski, Oliver D.

Die traditionelle Energieversorgung befindet sich in einer Zäsur. Das seit Jahrzehnten bewährte und stabile Geschäftsmodell einer zuverlässig planbaren, zentralen Energieerzeugung mit anschließender unidirektionaler Verteilung geriet spätestens seit der Energiewende des Jahres 2011 immer mehr unter Druck. Angesichts fortschreitender Digitalisierung und Dezentralisierung einerseits und gestiegener Erwartungshaltung der Kunden gegenüber "ihrem" Versorger andererseits sieht sich die Energiebranche heute einem epochalen Transformationsprozess gegenübergestellt. Bei diesem entwickeln sich aus den monopolistischen Versorgern des 19. und 20. Jahrhunderts (Utility 1.0), über die liberalisierten Energieversorgungsunternehmen (Utility 2.0) und Energiedienstleistungsunternehmen (Utility 3.0) heutiger Prägung, die digitalen Energiedienstleistungsunternehmen (Utility 4.0) von morgen. Oliver D. Doleski beschränkt sich in seinem Beitrag nicht auf die reine Beschreibung dieses Veränderungsprozesses an sich. Vielmehr werden darüber hinaus sowohl die mit dieser Entwicklung verbundenen übergeordneten Ziele als auch die wesentlichen Anforderungen an erfolgreiche Utilities 4.0 skizziert. Das Kapitel endet mit einem prägnanten Überblick profitabler Betätigungsfelder, die zur Sicherung der ökonomischen Zukunft von Energiekonzernen, Regionalversorgern und Stadtwerken beitragen können.

A multiwave range test for obstacle reconstructions with unknown physical properties

NASA Astrophysics Data System (ADS)

Potthast, Roland; Schulz, Jochen

2007-08-01

We develop a new multiwave version of the range test for shape reconstruction in inverse scattering theory. The range test [R. Potthast, et al., A `range test' for determining scatterers with unknown physical properties, Inverse Problems 19(3) (2003) 533-547] has originally been proposed to obtain knowledge about an unknown scatterer when the far field pattern for only one plane wave is given. Here, we extend the method to the case of multiple waves and show that the full shape of the unknown scatterer can be reconstructed. We further will clarify the relation between the range test methods, the potential method [A. Kirsch, R. Kress, On an integral equation of the first kind in inverse acoustic scattering, in: Inverse Problems (Oberwolfach, 1986), Internationale Schriftenreihe zur Numerischen Mathematik, vol. 77, Birkhauser, Basel, 1986, pp. 93-102] and the singular sources method [R. Potthast, Point sources and multipoles in inverse scattering theory, Habilitation Thesis, Gottingen, 1999]. In particular, we propose a new version of the Kirsch-Kress method using the range test and a new approach to the singular sources method based on the range test and potential method. Numerical examples of reconstructions for all four methods are provided.

A new hydrogeological model of charging shallow and deep aquifers in the Lake Neusiedl - Seewinkel region (Northern Burgenland, Austria)

NASA Astrophysics Data System (ADS)

Häusler, Hermann; Müllegger, Christian; Körner, Wilfried; Ottner, Franz; Prohaska, Thomas; Irrgeher, Johanna; Tchaikovsky, Anastassiya; Dober, Gregor; Gritzmann, Romana; Mykhaylyuk, Ivanna

2014-05-01

The hypothesis of ascending thermal groundwater in the Seewinkel was introduced by Tauber (1965), favoured by Schmid (1970), and followed up by Wurm (2000). The main idea of this hypothesis was up welling of saline waters from a deep aquifer along faults, which in the 1950s have been identified as such in seismic sections. An aquifer of marine deposits of Badenian to Sarmatian age was postulated as source, and hydrochemical composition of water should have changed during migration due to high contents of sodium carbonate and sulphate instead of potassium chloride in the shallow groundwater bodies of the Seewinkel. Häusler (2010) argued, however, that fault aquifers discharging saline waters nowhere have been identified in this region. Supposed that according to the ascendance hypothesis ion composition of up welling formation water could have undergone a change, the primary isotope signal of marine water should have not. In order to get a better insight to the groundwater cycle we compare results from geochemical analyses, clay mineralogical analyses, and leachates of source rocks of potential recharge areas with respective analyses of shallow and deep aquifers, and apply the method of stable hydroisotopes such as oxygen, deuterium, strontium and chloride for distinguishing origin of groundwaters. We evaluate the hypothesis of up welling connate waters, and eventually come up with a new conceptual hydrogeological model for the Neusiedl-Seewinkel region regarding composition, origin, flow direction and residence time of groundwater in shallow and deeper aquifers. The very low value of -12.26‰ for oxygen isotope ratio of thermal groundwater from the deepest aquifer drilled to a depth of about 1000 metres at Frauenkirchen in northern Seewinkel, which is not highly mineralised, excludes connate water as major source, which basically is characterized by high oxygen isotope ratio values. Taking into account that oxygen isotope ratio-values ranging from -12.0‰ to -10.5‰ in the catchment of Lake Neusiedl are characteristic for waters derived from the cooler period of the Pleistocene (Rank et al., 1982), we conclude that groundwater of the deepest aquifer of the Seewinkel is not of Badenian to Sarmatian age but only several tens of thousands of years old. The artesian wells of the Seewinkel region drilled down to several hundreds of metres yielded groundwater with oxygen isotope ratio-values ranging between -11.90‰ and -10.83‰, values fitting well to waters of Pleistocene age of that region. Since wells discharging the Leitha Mountains also revealed oxygen isotope ratio-values varying from -11.10‰ to -10.22‰, we conclude that the mountain chains surrounding Lake Neusiedl basically charged both shallow and deeper aquifers of the Seewinkel. From oxygen isotope ratios of these groundwater bodies we therefore conclude that first the majority of aquifers of the Lake Neusiedl region was charged from the surrounding mountain chains, and second that salinity of soils in the Seewinkel region cannot be derived from up welling connate water, as has been proofed for Lake Kelemenszék area south of Budapest (Simon et al., 2011). There is no doubt on the fact, however, that differing amounts of free carbon dioxide in several aquifers of the Seewinkel region originate from deep-seated post volcanic activity in this region. Häusler, H. (2010)(ed.): Geologische Karte der Republik Österreich 1:50.000, Erläuterungen zur Geologischen Karte 78 Rust.- 191 S., 65 Abb., 5 Tab., 2 Taf., (Geologische Bundesanstalt), Wien. Rank, D., Rajner, V., Staudner, F. and Papesch, W. (1982): Zur Altersdatierung der Grundwässer am Ostufer des Neusiedlersees.- BFB-Bericht, 43, 197-204, 2 Abb., (Biologisches Forschungsinstitut für Burgenland), Illmitz. Simon, S., Mádl-Szőnyi, J., Müller, I. and Pogácsás, G. (2011): Conceptual model for surface salinization in an overpressured and a superimposed gravity-flow field, Lake Kelemenszék area, Hungary.- Hydrogeology Journal, 19, 701-717. Tauber, A. F. (1965): Geologische Typologie und Genese der Mineralquellen und Mineralwässer im Neusiedlerseegebiet.- Wissenschaftliche Arbeiten aus dem Burgenland, 34, 259-304, 6 Tab., Eisenstadt. Wurm, M. (2000): Hydrogeochemische Methodik zur Klärung von Interaktionsprozessen von Formations-, Mineral-, Tiefengrund- und oberflächennahen Grundwässern im Einzugsgebiet des Neusiedlersees.- Unveröffentlichte Diplomarbeit, Institut für Geowissenschaften, Abteilung für Geologie und Lagerstättenlehre, Montanuniversität Leoben, 125 S., zahlr. Abb., Anhang (71 hydrochemische Analysen), Leoben.

How Are Obesity and Overweight Diagnosed?

MedlinePlus

... Share Facebook Twitter Pinterest Email Print How are obesity & overweight diagnosed? Using Body Mass Index The most ... and Blood Institute. (2012). How are overweight and obesity diagnosed? Retrieved August 8, 2012, from http://www. ...

Validation of nursing management diagnoses.

PubMed

Morrison, R S

1995-01-01

Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

An adverse event screening tool based on routinely collected hospital-acquired diagnoses.

PubMed

Brand, Caroline; Tropea, Joanne; Gorelik, Alexandra; Jolley, Damien; Scott, Ian; Sundararajan, Vijaya

2012-06-01

The aim was to develop an electronic adverse event (AE) screening tool applicable to acute care hospital episodes for patients admitted with chronic heart failure (CHF) and pneumonia. Consensus building using a modified Delphi method and descriptive analysis of hospital discharge data. Consultant physicians in general medicine (n = 38). In-hospital acquired (C-prefix) diagnoses associated with CHF and pneumonia admissions to 230 hospitals in Victoria, Australia, were extracted from the Victorian Admitted Episodes Data Set between July 2004 and June 2007. A 9-point rating scale was used to prioritize diagnoses acquired during hospitalization (routinely coded as a 'C-prefix' diagnosis to distinguish from diagnoses present on admission) for inclusion within an AE screening tool. Diagnoses rated a group median score between 7 and 9 by the physician panel were included. Selection of C-prefix diagnoses with a group median rating of 7-9 in a screening tool, and the level of physician agreement, as assessed using the Interpercentile Range Adjusted for Symmetry. Of 697 initial C-prefix diagnoses, there were high levels of agreement to include 113 (16.2%) in the AE screening tool. Using these selected diagnoses, a potential AE was flagged in 14% of all admissions for the two index conditions. Intra-rater reliability for each clinician ranged from kappa 0.482 to 1.0. A high level of physician agreement was obtained in selecting in-hospital diagnoses for inclusion in an AE screening tool based on routinely collected data. These results support further tool validation.

Inter-Observer Reliability of DSM-5 Substance Use Disorders*

PubMed Central

Denis, Cécile M.; Gelernter, Joel; Hart, Amy B.; Kranzler, Henry R.

2015-01-01

Aims Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence of the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Methods Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Results Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. Conclusions For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. PMID:26048641

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study.

PubMed

Paans, Wolter; Sermeus, Walter; Nieweg, Roos Mb; Krijnen, Wim P; van der Schans, Cees P

2012-08-01

This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses.Knowledge sources can support nurses in deriving diagnoses. A nurse's disposition toward critical thinking and reasoning skills is also thought to influence the accuracy of his or her nursing diagnoses. A randomised factorial design was used in 2008-2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, disposition, and reasoning skills on the accuracy of diagnoses: (1) a knowledge inventory, (2) the California Critical Thinking Disposition Inventory, and (3) the Health Science Reasoning Test. Nurses (n = 249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor. The use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse's age and the reasoning skills of `deduction' and `analysis'. Improving nurses' dispositions toward critical thinking and reasoning skills, and the use of a predefined record structure, improves accuracy of nursing diagnoses.

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

PubMed Central

2012-01-01

Background This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses. Knowledge sources can support nurses in deriving diagnoses. A nurse’s disposition toward critical thinking and reasoning skills is also thought to influence the accuracy of his or her nursing diagnoses. Method A randomised factorial design was used in 2008–2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, disposition, and reasoning skills on the accuracy of diagnoses: (1) a knowledge inventory, (2) the California Critical Thinking Disposition Inventory, and (3) the Health Science Reasoning Test. Nurses (n = 249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor. Results The use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse’s age and the reasoning skills of `deduction’ and `analysis’. Conclusions Improving nurses’ dispositions toward critical thinking and reasoning skills, and the use of a predefined record structure, improves accuracy of nursing diagnoses. PMID:22852577

Is length of stay in hospital a stable proxy for injury severity?

PubMed

Cryer, C; Gulliver, P; Langley, J D; Davie, G

2010-08-01

Is length of stay (LoS) in hospital a stable proxy for severity of injury when monitoring time trends in serious injury incidence? To investigate whether LoS metrics (mean, median and proportion exceeding several LoS thresholds) have changed over time for injury diagnoses with known severity. Time series investigation. New Zealand population admitted to hospital for injury and discharged during the period 1989 to 1998. Interpolated median and geometric mean lengths of stay, as well as the proportion of cases that have an LoS greater than or equal to 3, 4, 7 and 14 days in hospital. ICD-9-CM diagnoses that are approximately homogeneous in regard to severity of injury (ICD-HS diagnoses) were identified. Trends were investigated in the LoS statistics for: injury and non-injury diagnoses combined; all injury diagnoses; major body sites of injury; severity strata; and ICD-HS diagnoses. Almost without exception, there was a decline in the LoS statistics over time for all diagnoses, all injury diagnoses, each body site of injury investigated, severity strata, and the ICD-HS diagnoses. Reductions in median and geometric mean LoS over time, as well as reductions in the proportion exceeding selected LoS thresholds, were due to factors other than reductions in the incidence of serious injury; for example, changes in service delivery over time. An LoS threshold should not be used as a proxy for severity of injury if the goal is to monitor time trends in injury incidence.

Medical Surveillance Monthly Report (MSMR). Volume 15, Number 4, May 2008

DTIC Science & Technology

2008-05-01

diagnoses of sarcoidosis , active components, U.S. Armed Forces, 1999-2007 _______________ 15 Update: Deployment health assessments, U.S. Armed Forces...VOL. 15 / NO. 4 • MAY 2008 15 Incident Diagnoses of Sarcoidosis , Active Components, U.S. Armed Forces, 1999-2007 Figure 1. Annual numbers of...incident diagnoses of sarcoidosis by clinical setting, and proportions of incident cases diagnosed during hospitalization, active components, U.S. Armed

Diagnosing Autism Spectrum Disorder through Brain Functional Magnetic Resonance Imaging

DTIC Science & Technology

2016-03-01

Diagnosing Autism Spectrum Disorder through Brain Functional Magnetic Resonance Imaging THESIS MARCH 2016 Kyle A. Palko, Second Lieutenant, USAF AFIT...declared a work of the U.S. Government and is not subject to copyright protection in the United States. AFIT-ENC-MS-16-M-123 DIAGNOSING AUTISM SPECTRUM...PUBLIC RELEASE; DISTRIBUTION UNLIMITED. AFIT-ENC-MS-16-M-123 DIAGNOSING AUTISM SPECTRUM DISORDER THROUGH BRAIN FUNCTIONAL MAGNETIC RESONANCE IMAGING Kyle

A nationwide register study of the characteristics, incidence and validity of diagnosed Tourette syndrome and other tic disorders.

PubMed

Leivonen, Susanna; Voutilainen, Arja; Hinkka-Yli-Salomäki, Susanna; Timonen-Soivio, Laura; Chudal, Roshan; Gissler, Mika; Huttunen, Jukka; Sourander, Andre

2014-09-01

The aim of this study was to describe the characteristics and incidence rates of diagnosed tic disorders in the Finnish Hospital Discharge Register, including changing incidence rates between 1991 and 2010. We also aimed to validate the diagnoses of Tourette's syndrome recorded in the register. Children born between January 1, 1991 and December 31, 2010, who were diagnosed with tic disorders, were identified from the Finnish Hospital Discharge Register (n = 3003). We studied the validity of the Tourette's syndrome diagnoses by reviewing the medical charts of 88 children born since 1997 and carrying out telephone interviews with 55 of their guardians. The incidence rates of all diagnosed tic disorders increased during the study period. A comorbid diagnosis of hyperkinetic disorder diagnosis was recorded in 28.2% of the children with Tourette's syndrome, and the validity of the register-based Tourette's syndrome diagnosis was approximately 95%. This is the first nationwide study to demonstrate the increasing incidence of all register-based tic disorder diagnoses. The validity of the Tourette's syndrome diagnoses in the Finnish Hospital Discharge Register was good, and the data provided are suitable for use in further register-based studies of tic disorders. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study.

PubMed

Kallio, Jouko; Kauppila, Timo; Suominen, Lasse; Heikkinen, Anna Maria

2017-01-01

A playful competition was launched in a primary dental health care system to improve the recording of diagnoses into an electronic patient chart system and to study what diagnoses were used in primary dental care. This was a longitudinal follow-up study with public sector primary dental care practices in a Finnish city. A one-year-lasting playful competition between the dental care teams was launched and the monthly percentage of dentists' visits with recorded diagnosis before, during, and after the intervention was recorded. The assessed diagnoses were recorded with the International Classification of Diseases (ICD-10). Before the competition, the level of diagnosis recordings was practically zero. At the end of this intervention, about 25% of the visits had a recorded diagnosis. Two years after the competition, this percentage was 35% without any additional measures. The most frequent diagnoses were dental caries (K02, 38.6%), other diseases of hard tissues of teeth (K03, 14.8%), and diseases of pulp and periapical tissues (K04, 11.4%). Commitment to the idea that recording of diagnoses was beneficial improved the recording of dental diagnoses. However, the diagnoses obtained did not accurately reflect the reputed prevalence of oral diseases in the Finnish population.

Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis.

PubMed

Blumberg, Stephen J; Zablotsky, Benjamin; Avila, Rosa M; Colpe, Lisa J; Pringle, Beverly A; Kogan, Michael D

2016-10-01

Autism spectrum disorder diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey-the Survey of Pathways to Diagnosis and Services-to compare currently diagnosed (n = 1420) and previously diagnosed (n = 187) children aged 6-17 years based on retrospective parental reports of early concerns about their children's development, responses to those concerns by doctors and other healthcare providers, the type of provider who made the first autism spectrum disorder diagnosis, and the autism spectrum disorder subtype diagnoses received (if any). Propensity score matching was used to control for differences between the groups on children's current level of functioning and other current characteristics that may have been related to diagnosis loss. Approximately 13% of the children ever diagnosed with autism spectrum disorder were estimated to have lost the diagnosis, and parents of 74% of them believed it was changed due to new information. Previously diagnosed children were less likely to have parents with early concerns about verbal skills, nonverbal communication, learning, and unusual gestures or movements. They were also less likely to have been referred to and diagnosed by a specialist. Previously diagnosed children were less likely to have ever received a diagnosis of Asperger's disorder or autistic disorder. © The Author(s) 2015.

Diagnosis Lost: Differences between Children who Had and who Currently Have an Autism Spectrum Disorder Diagnosis

PubMed Central

Blumberg, Stephen J; Zablotsky, Benjamin; Avila, Rosa M; Colpe, Lisa J; Pringle, Beverly A; Kogan, Michael D

2016-01-01

Autism spectrum disorder (ASD) diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey—the Survey of Pathways to Diagnosis and Services—to compare currently diagnosed (n=1420) and previously diagnosed (n=187) children aged 6–17 years based on retrospective parental reports of early concerns about their children’s development, responses to those concerns by doctors and other health care providers, the type of provider who made the first ASD diagnosis, and the ASD subtype diagnoses received (if any). Propensity score matching was used to control for differences between the groups on children’s current level of functioning and other current characteristics that may have been related to diagnosis loss. Approximately 13% of the children ever diagnosed with ASD were estimated to have lost the diagnosis, and parents of 74% of them believe it was changed due to new information. Previously diagnosed children were less likely to have parents with early concerns about verbal skills, nonverbal communication, learning, and unusual gestures or movements. They were also less likely to have been referred to and diagnosed by a specialist. Previously diagnosed children were less likely to have ever received a diagnosis of Asperger’s disorder or autistic disorder. PMID:26489772

How Is Paget's Disease of Bone Diagnosed?

MedlinePlus

... of Bone Diagnosed? How Is Paget’s Disease of Bone Diagnosed? Symptoms of Paget’s Disease Many people with ... Last Reviewed 2015-05 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, ...

Diagnosing Diabetes and Learning about Prediabetes

MedlinePlus

... Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways to diagnose diabetes. Each ... or equal to 200 mg/dl What is Prediabetes? Before people develop type 2 diabetes, they almost ...

Large-scale hydrological modelling in the semi-arid north-east of Brazil

NASA Astrophysics Data System (ADS)

Güntner, Andreas

2002-07-01

Semi-arid areas are, due to their climatic setting, characterized by small water resources. An increasing water demand as a consequence of population growth and economic development as well as a decreasing water availability in the course of possible climate change may aggravate water scarcity in future, which often exists already for present-day conditions in these areas. Understanding the mechanisms and feedbacks of complex natural and human systems, together with the quantitative assessment of future changes in volume, timing and quality of water resources are a prerequisite for the development of sustainable measures of water management to enhance the adaptive capacity of these regions. For this task, dynamic integrated models, containing a hydrological model as one component, are indispensable tools. The main objective of this study is to develop a hydrological model for the quantification of water availability in view of environmental change over a large geographic domain of semi-arid environments. The study area is the Federal State of Ceará (150 000 km2) in the semi-arid north-east of Brazil. Mean annual precipitation in this area is 850 mm, falling in a rainy season with duration of about five months. Being mainly characterized by crystalline bedrock and shallow soils, surface water provides the largest part of the water supply. The area has recurrently been affected by droughts which caused serious economic losses and social impacts like migration from the rural regions. The hydrological model Wasa (Model of Water Availability in Semi-Arid Environments) developed in this study is a deterministic, spatially distributed model being composed of conceptual, process-based approaches. Water availability (river discharge, storage volumes in reservoirs, soil moisture) is determined with daily resolution. Sub-basins, grid cells or administrative units (municipalities) can be chosen as spatial target units. The administrative units enable the coupling of Wasa in the framework of an integrated model which contains modules that do not work on the basis of natural spatial units. The target units mentioned above are disaggregated in Wasa into smaller modelling units within a new multi-scale, hierarchical approach. The landscape units defined in this scheme capture in particular the effect of structured variability of terrain, soil and vegetation characteristics along toposequences on soil moisture and runoff generation. Lateral hydrological processes at the hillslope scale, as reinfiltration of surface runoff, being of particular importance in semi-arid environments, can thus be represented also within the large-scale model in a simplified form. Depending on the resolution of available data, small-scale variability is not represented explicitly with geographic reference in Wasa, but by the distribution of sub-scale units and by statistical transition frequencies for lateral fluxes between these units. Further model components of Wasa which respect specific features of semi-arid hydrology are: (1) A two-layer model for evapotranspiration comprises energy transfer at the soil surface (including soil evaporation), which is of importance in view of the mainly sparse vegetation cover. Additionally, vegetation parameters are differentiated in space and time in dependence on the occurrence of the rainy season. (2) The infiltration module represents in particular infiltration-excess surface runoff as the dominant runoff component. (3) For the aggregate description of the water balance of reservoirs that cannot be represented explicitly in the model, a storage approach respecting different reservoirs size classes and their interaction via the river network is applied. (4) A model for the quantification of water withdrawal by water use in different sectors is coupled to Wasa. (5) A cascade model for the temporal disaggregation of precipitation time series, adapted to the specific characteristics of tropical convective rainfall, is applied for the generating rainfall time series of higher temporal resolution. All model parameters of Wasa can be derived from physiographic information of the study area. Thus, model calibration is primarily not required. Model applications of Wasa for historical time series generally results in a good model performance when comparing the simulation results of river discharge and reservoir storage volumes with observed data for river basins of various sizes. The mean water balance as well as the high interannual and intra-annual variability is reasonably represented by the model. Limitations of the modelling concept are most markedly seen for sub-basins with a runoff component from deep groundwater bodies of which the dynamics cannot be satisfactorily represented without calibration. Further results of model applications are: (1) Lateral processes of redistribution of runoff and soil moisture at the hillslope scale, in particular reinfiltration of surface runoff, lead to markedly smaller discharge volumes at the basin scale than the simple sum of runoff of the individual sub-areas. Thus, these processes are to be captured also in large-scale models. The different relevance of these processes for different conditions is demonstrated by a larger percentage decrease of discharge volumes in dry as compared to wet years. (2) Precipitation characteristics have a major impact on the hydrological response of semi-arid environments. In particular, underestimated rainfall intensities in the rainfall input due to the rough temporal resolution of the model and due to interpolation effects and, consequently, underestimated runoff volumes have to be compensated in the model. A scaling factor in the infiltration module or the use of disaggregated hourly rainfall data show good results in this respect. The simulation results of Wasa are characterized by large uncertainties. These are, on the one hand, due to uncertainties of the model structure to adequately represent the relevant hydrological processes. On the other hand, they are due to uncertainties of input data and parameters particularly in view of the low data availability. Of major importance is: (1) The uncertainty of rainfall data with regard to their spatial and temporal pattern has, due to the strong non-linear hydrological response, a large impact on the simulation results. (2) The uncertainty of soil parameters is in general of larger importance on model uncertainty than uncertainty of vegetation or topographic parameters. (3) The effect of uncertainty of individual model components or parameters is usually different for years with rainfall volumes being above or below the average, because individual hydrological processes are of different relevance in both cases. Thus, the uncertainty of individual model components or parameters is of different importance for the uncertainty of scenario simulations with increasing or decreasing precipitation trends. (4) The most important factor of uncertainty for scenarios of water availability in the study area is the uncertainty in the results of global climate models on which the regional climate scenarios are based. Both a marked increase or a decrease in precipitation can be assumed for the given data. Results of model simulations for climate scenarios until the year 2050 show that a possible future change in precipitation volumes causes a larger percentage change in runoff volumes by a factor of two to three. In the case of a decreasing precipitation trend, the efficiency of new reservoirs for securing water availability tends to decrease in the study area because of the interaction of the large number of reservoirs in retaining the overall decreasing runoff volumes. Semiaride Gebiete sind auf Grund der klimatischen Bedingungen durch geringe Wasserressourcen gekennzeichnet. Ein zukünftig steigender Wasserbedarf in Folge von Bevölkerungswachstum und ökonomischer Entwicklung sowie eine geringere Wasserverfügbarkeit durch mögliche Klimaänderungen können dort zu einer Verschärfung der vielfach schon heute auftretenden Wasserknappheit führen. Das Verständnis der Mechanismen und Wechselwirkungen des komplexen Systems von Mensch und Umwelt sowie die quantitative Bestimmung zukünftiger Veränderungen in der Menge, der zeitlichen Verteilung und der Qualität von Wasserressourcen sind eine grundlegende Voraussetzung für die Entwicklung von nachhaltigen Maßnahmen des Wassermanagements mit dem Ziel einer höheren Anpassungsfähigkeit dieser Regionen gegenüber künftigen Änderungen. Hierzu sind dynamische integrierte Modelle unerlässlich, die als eine Komponente ein hydrologisches Modell beinhalten. Vorrangiges Ziel dieser Arbeit ist daher die Erstellung eines hydrologischen Modells zur großräumigen Bestimmung der Wasserverfügbarkeit unter sich ändernden Umweltbedingungen in semiariden Gebieten. Als Untersuchungsraum dient der im semiariden tropischen Nordosten Brasiliens gelegene Bundestaat Ceará (150 000 km2). Die mittleren Jahresniederschläge in diesem Gebiet liegen bei 850 mm innerhalb einer etwa fünfmonatigen Regenzeit. Mit vorwiegend kristallinem Grundgebirge und geringmächtigen Böden stellt Oberflächenwasser den größten Teil der Wasserversorgung bereit. Die Region war wiederholt von Dürren betroffen, die zu schweren ökonomischen Schäden und sozialen Folgen wie Migration aus den ländlichen Gebieten geführt haben. Das hier entwickelte hydrologische Modell Wasa (Model of Water Availability in Semi-Arid Environments) ist ein deterministisches, flächendifferenziertes Modell, das aus konzeptionellen, prozess-basierten Ansätzen aufgebaut ist. Die Wasserverfügbarkeit (Abfluss im Gewässernetz, Speicherung in Stauseen, Bodenfeuchte) wird mit täglicher Auflösung bestimmt. Als räumliche Zieleinheiten können Teileinzugsgebiete, Rasterzellen oder administrative Einheiten (Gemeinden) gewählt werden. Letztere ermöglichen die Kopplung des Modells im Rahmen der integrierten Modellierung mit Modulen, die nicht auf der Basis natürlicher Raumeinheiten arbeiten. Im Rahmen eines neuen skalenübergreifenden, hierarchischen Ansatzes werden in Wasa die genannten Zieleinheiten in kleinere räumliche Modellierungseinheiten unterteilt. Die ausgewiesenen Landschaftseinheiten erfassen insbesondere die strukturierte Variabilität von Gelände-, Boden- und Vegetationseigenschaften entlang von Toposequenzen in ihrem Einfluss auf Bodenfeuchte und Abflussbildung. Laterale hydrologische Prozesse auf kleiner Skala, wie die für semiaride Bedingungen bedeutsame Wiederversickerung von Oberflächenabfluss, können somit auch in der erforderlichen großskaligen Modellanwendung vereinfacht wiedergegeben werden. In Abhängigkeit von der Auflösung der verfügbaren Daten wird in Wasa die kleinskalige Variabilität nicht räumlich explizit sondern über die Verteilung von Flächenanteilen subskaliger Einheiten und über statistische Übergangshäufigkeiten für laterale Flüsse zwischen den Einheiten berücksichtigt. Weitere Modellkomponenten von Wasa, die spezifische Bedingungen semiarider Gebiete berücksichtigen, sind: (1) Ein Zwei-Schichten-Modell zur Bestimmung der Evapotranspiration berücksichtigt auch den Energieumsatz an der Bodenoberfläche (inklusive Bodenverdunstung), der in Anbetracht der meist lichten Vegetationsbedeckung von Bedeutung ist. Die Vegetationsparameter werden zudem flächen- und zeitdifferenziert in Abhängigkeit vom Auftreten der Regenzeit modifiziert. (2) Das Infiltrationsmodul bildet insbesondere Oberflächenabfluss durch Infiltrationsüberschuss als dominierender Abflusskomponente ab. (3) Zur aggregierten Beschreibung der Wasserbilanz von im Modell nicht einzeln erfassbaren Stauseen wird ein Speichermodell unter Berücksichtigung verschiedener Größenklassen und ihrer Interaktion über das Gewässernetz eingesetzt. (4) Ein Modell zur Bestimmung der Entnahme durch Wassernutzung in verschiedenen Sektoren ist an Wasa gekoppelt. (5) Ein Kaskadenmodell zur zeitlichen Disaggregierung von Niederschlagszeitreihen, das in dieser Arbeit speziell für tropische konvektive Niederschlagseigenschaften angepasst wird, wird zur Erzeugung höher aufgelöster Niederschlagsdaten verwendet. Alle Modellparameter von Wasa können von physiographischen Gebietsinformationen abgeleitet werden, sodass eine Modellkalibrierung primär nicht erforderlich ist. Die Modellanwendung von Wasa für historische Zeitreihen ergibt im Allgemeinen eine gute Übereinstimmung der Simulationsergebnisse für Abfluss und Stauseespeichervolumen mit Beobachtungsdaten in unterschiedlich großen Einzugsgebieten. Die mittlere Wasserbilanz sowie die hohe monatliche und jährliche Variabilität wird vom Modell angemessen wiedergegeben. Die Grenzen der Anwendbarkeit des Modell-konzepts zeigen sich am deutlichsten in Teilgebieten mit Abflusskomponenten aus tieferen Grundwasserleitern, deren Dynamik ohne Kalibrierung nicht zufriedenstellend abgebildet werden kann. Die Modellanwendungen zeigen weiterhin: (1) Laterale Prozesse der Umverteilung von Bodenfeuchte und Abfluss auf der Hangskala, vor allem die Wiederversickerung von Oberflächenabfluss, führen auf der Skala von Einzugsgebieten zu deutlich kleineren Abflussvolumen als die einfache Summe der Abflüsse der Teilflächen. Diese Prozesse sollten daher auch in großskaligen Modellen abgebildet werden. Die unterschiedliche Ausprägung dieser Prozesse für unterschiedliche Bedingungen zeigt sich an Hand einer prozentual größeren Verringerung der Abflussvolumen in trockenen im Vergleich zu feuchten Jahren. (2) Die Niederschlagseigenschaften haben einen sehr großen Einfluss auf die hydrologische Reaktion in semiariden Gebieten. Insbesondere die durch die grobe zeitliche Auflösung des Modells und durch Interpolationseffekte unterschätzten Niederschlagsintensitäten in den Eingangsdaten und die daraus folgende Unterschätzung von Abflussvolumen müssen im Modell kompensiert werden. Ein Skalierungsfaktor in der Infiltrationsroutine oder die Verwendung disaggregierter stündlicher Niederschlagsdaten zeigen hier gute Ergebnisse. Die Simulationsergebnisse mit Wasa sind insgesamt durch große Unsicherheiten gekennzeichnet. Diese sind einerseits in Unsicherheiten der Modellstruktur zur adäquaten Beschreibung der relevanten hydrologischen Prozesse begründet, andererseits in Daten- und Parametersunsicherheiten in Anbetracht der geringen Datenverfügbarkeit. Von besonderer Bedeutung ist: (1) Die Unsicherheit der Niederschlagsdaten in ihrem räumlichen Muster und ihrer zeitlichen Struktur hat wegen der stark nicht-linearen hydrologischen Reaktion einen großen Einfluss auf die Simulationsergebnisse. (2) Die Unsicherheit von Bodenparametern hat im Vergleich zu Vegetationsparametern und topographischen Parametern im Allgemeinen einen größeren Einfluss auf die Modellunsicherheit. (3) Der Effekt der Unsicherheit einzelner Modellkomponenten und -parameter ist für Jahre mit unter- oder überdurchschnittlichen Niederschlagsvolumen zumeist unterschiedlich, da einzelne hydrologische Prozesse dann jeweils unterschiedlich relevant sind. Die Unsicherheit einzelner Modellkomponenten- und parameter hat somit eine unterschiedliche Bedeutung für die Unsicherheit von Szenarienrechnungen mit steigenden oder fallenden Niederschlagstrends. (4) Der bedeutendste Unsicherheitsfaktor für Szenarien der Wasserverfügbarkeit für die Untersuchungsregion ist die Unsicherheit der den regionalen Klimaszenarien zu Grunde liegenden Ergebnisse globaler Klimamodelle. Eine deutliche Zunahme oder Abnahme der Niederschläge bis 2050 kann gemäß den hier vorliegenden Daten für das Untersuchungsgebiet gleichermaßen angenommen werden. Modellsimulationen für Klimaszenarien bis zum Jahr 2050 ergeben, dass eine mögliche zukünftige Veränderung der Niederschlagsmengen zu einer prozentual zwei- bis dreifach größeren Veränderung der Abflussvolumen führt. Im Falle eines Trends von abnehmenden Niederschlagsmengen besteht in der Untersuchungsregion die Tendenz, dass auf Grund der gegenseitigen Beeinflussung der großen Zahl von Stauseen beim Rückhalt der tendenziell abnehmenden Abflussvolumen die Effizienz von neugebauten Stauseen zur Sicherung der Wasserverfügbarkeit zunehmend geringer wird. --- Anmerkung: Der Autor ist Träger des von der Universitätsgesellschaft Potsdam e.V. vergebenen Wissenschaftspreises zur Förderung des wissenschaftlichen Nachwuchses für die beste Dissertation des Jahres 2002/2003 an der Universität Potsdam.

Deep learning aided decision support for pulmonary nodules diagnosing: a review.

PubMed

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

2018-04-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

[Increased revenues from secondary diagnoses : A comparison from dermatology, ophthalmology, and infectious diseases].

PubMed

Blaschke, V; Brauns, B; Khaladj, N; Schmidt, C; Emmert, S

2018-02-27

Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. However, it is vastly unknown if the revenues generated by the coders do indeed exceed their incurred costs. Coding data from the departments of dermatology, ophthalmology, and infectious diseases from Rostock University Hospital from 2007-2016 were analyzed for the effects of secondary diagnoses on the resulting DRG, i. e., hospital charges. Ophthalmological case were highly resistant to the addition of secondary diagnoses. In contrast, adding secondary diagnoses to cases from infectious diseases resulted in 15% higher revenues. Although dermatological and infectious cases share the same sensitivity to secondary diagnoses, higher revenues could only rarely be realized in dermatology, probably owing to a younger, less multimorbid patient population. Except for ophthalmology, trusting specialized coders with clinical coding generates additional revenues through the coding of secondary diagnoses which exceed the costs for employing these coders.

How Do Health Care Providers Diagnose Turner Syndrome?

MedlinePlus

... Email Print How do health care providers diagnose Turner syndrome? Health care providers use a combination of physical ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...

Ethical dilemma and moral distress: proposed new NANDA diagnoses.

PubMed

Kopala, Beverly; Burkhart, Lisa

2005-01-01

To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.

Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services.

PubMed

Chen, Huey Jen

2005-12-01

The stigma of mental illness is one of the factors that prevents Asian Americans/Pacific Islanders (APIs) from seeking formal mental health services. A somatic complaint is more acceptable in expressing psychiatric/emotional distress. Admission diagnoses in API emergency service users with secondary psychiatric diagnoses were identified from the 2001 National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). The sample consisted of 10,623 adult APIs. The study examined the differences in the six leading principal physical admission diagnoses between API emergency service users with psychiatric diagnoses and those without psychiatric diagnoses. Several of the study findings create concern (e.g., the higher percentage of APIs with psychiatric diagnosis who were discharged against medical advice, the high percentage admitted with medication intoxication). Further study is needed to provide guidance for clinical practice.

Course of Cytomegalovirus Retinitis in the Era of Highly Active Antiretroviral Therapy: Five-year Outcomes

PubMed Central

Jabs, Douglas A.; Ahuja, Alka; Van Natta, Mark; Lyon, Alice; Srivastava, Sunil; Gangaputra, Sapna

2010-01-01

Purpose To describe the five-year outcomes of patients with cytomegalovirus (CMV) retinitis and AIDS in the era of highly active antiretroviral therapy (HAART). Design Prospective, multicenter, observational study Participants 503 patients with AIDS and CMV retinitis Methods Follow-up every 3 months with medical history, ophthalmologic examination, laboratory testing, and retinal photographs. Participants were classified as having previously-diagnosed CMV retinitis and immune recovery (CD4+ T cells >100 cells/µL), previously-diagnosed retinitis and immune compromise, and newly-diagnosed CMV retinitis (diagnosis < 45 days prior to enrollment). Main outcome measures Mortality, retinitis progression (movement of the border of a CMV lesion ≥ ½ disc diameter or occurrence of a new lesion), retinal detachment, immune recovery uveitis (IRU), and visual loss (to worse than 20/40 and to 20/200 or worse), Results Overall mortality was 9.8 deaths/100 person-years (PY). Rates varied by group at enrollment from 3.0/100 PY for those with previously-diagnosed retinitis and immune recovery to 26.1/100 PY for those with newly-diagnosed retinitis. The rate of retinitis progression was 7.0/100 PY and varied from 1.4/100 PY for those with previously-diagnosed retinitis and immune recovery to 28.0/100 PY for those with newly-diagnosed retinitis. The rate of retinal detachment was 2.3/100 eye-years (EY) and varied from 1.2/100 EY for those with previously-diagnosed retinitis and immune recovery to 4.9/100 EY for those with newly-diagnosed retinitis. The rate of IRU was 1.7/100 PY and varied from 1.3/100 PY for those with previously-diagnosed retinitis and immune recovery at enrollment to 3.6/100 PY for those with newly-diagnosed retinitis who subsequently experienced immune recovery. The rates of visual loss to worse than 20/40 and to 20/200 or worse were 7.9/100 EY and 3.4/100 EY, respectively; they varied from 6.1/100 EY and 2.7/100 EY for those with previously-diagnosed retinitis and immune recovery to 11.8/100 EY and 5.1/100 EY for those with newly-diagnosed retinitis. Although the event rates tended to decline with time, in general, at no time did they reach zero. Conclusions Despite the availability of HAART, patients with AIDS and CMV retinitis remain at increased risk for mortality, retinitis progression, complications of the retinitis, and visual loss over a 5-year period. PMID:20673591

Trends in work disability with mental diagnoses among social workers in Finland and Sweden in 2005-2012.

PubMed

Rantonen, O; Alexanderson, K; Pentti, J; Kjeldgård, L; Hämäläinen, J; Mittendorfer-Rutz, E; Kivimäki, M; Vahtera, J; Salo, P

2017-12-01

Aims Social workers report high levels of stress and have an increased risk for hospitalisation with mental diagnoses. However, it is not known whether the risk of work disability with mental diagnoses is higher among social workers compared with other human service professionals. We analysed trends in work disability (sickness absence and disability pension) with mental diagnoses and return to work (RTW) in 2005-2012 among social workers in Finland and Sweden, comparing with such trends in preschool teachers, special education teachers and psychologists. Records of work disability (>14 days) with mental diagnoses (ICD-10 codes F00-F99) from nationwide health registers were linked to two prospective cohort projects: the Finnish Public Sector study, years 2005-2011 and the Insurance Medicine All Sweden database, years 2005-2012. The Finnish sample comprised 4849 employees and the Swedish 119 219 employees covering four occupations: social workers (Finland 1155/Sweden 23 704), preschool teachers (2419/74 785), special education teachers (832/14 004) and psychologists (443/6726). The reference occupations were comparable regarding educational level. Risk of work disability was analysed with negative binomial regression and RTW with Cox proportional hazards. Social workers in Finland and Sweden had a higher risk of work disability with mental diagnoses compared with preschool teachers and special education teachers (rate ratios (RR) 1.43-1.91), after adjustment for age and sex. In Sweden, but not in Finland, social workers also had higher work disability risk than psychologists (RR 1.52; 95% confidence interval 1.28-1.81). In Sweden, in the final model special education teachers had a 9% higher probability RTW than social workers. In Sweden, in the final model the risks for work disability with depression diagnoses and stress-related disorder diagnoses were similar to the risk with all mental diagnoses (RR 1.40-1.77), and the probability of RTW was 6% higher in preschool teachers after work disability with depression diagnoses and 9% higher in special education teachers after work disability with stress-related disorder diagnoses compared with social workers. Social workers appear to be at a greater risk of work disability with mental diagnoses compared with other human service professionals in Finland and Sweden. It remains to be studied whether the higher risk is due to selection of vulnerable employees to social work or the effect of work-related stress in social work. Further studies should focus on these mechanisms and the risk of work disability with mental diagnoses among human service professionals.

Inter-observer reliability of DSM-5 substance use disorders.

PubMed

Denis, Cécile M; Gelernter, Joel; Hart, Amy B; Kranzler, Henry R

2015-08-01

Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence concerning the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Diagnoses of Depression and Anxiety Versus Current Symptoms and Quality of Life in Multiple Sclerosis.

PubMed

Marrie, Ruth Ann; Patten, Scott B; Berrigan, Lindsay I; Tremlett, Helen; Wolfson, Christina; Warren, Sharon; Leung, Stella; Fiest, Kirsten M; McKay, Kyla A; Fisk, John D

2018-01-01

Studies assessing the prevalence of depression and anxiety in multiple sclerosis (MS) have used various ascertainment methods that capture different constructs. The relationships between these methods are incompletely understood. Psychiatric comorbidity is associated with lower health-related quality of life (HRQOL) in MS, but the effects of past diagnoses of depression and anxiety on HRQOL are largely unknown. We compared the prevalence of depression and anxiety in persons with MS using administrative data, self-reported physician diagnoses, and symptom-based measures and compared characteristics of persons classified as depressed or anxious by each method. We evaluated whether HRQOL was most affected by previous diagnoses of depression or anxiety or by current symptoms. We linked clinical and administrative data for 859 participants with MS. HRQOL was measured by the Health Utilities Index Mark 3. We classified participants as depressed or anxious using administrative data, self-reported physician diagnoses, and the Hospital Anxiety and Depression Scale. Multivariable linear regression examined whether diagnosed depression or anxiety affected HRQOL after accounting for current symptoms. Lifetime prevalence estimates for depression were approximately 30% regardless of methods used, but 35.8% with current depressive symptoms were not captured by either administrative data or self-reported diagnoses. Prevalence estimates of anxiety ranged from 11% to 19%, but 65.6% with current anxiety were not captured by either administrative data or self-reported diagnoses. Previous diagnoses did not decrease HRQOL after accounting for current symptoms. Depression and, to a greater extent, anxiety remain underdiagnosed and undertreated in MS; both substantially contribute to reduced HRQOL in MS.

Trauma, comorbidity, and mortality following diagnoses of severe stress and adjustment disorders: a nationwide cohort study.

PubMed

Gradus, Jaimie L; Antonsen, Sussie; Svensson, Elisabeth; Lash, Timothy L; Resick, Patricia A; Hansen, Jens Georg

2015-09-01

Longitudinal outcomes following stress or trauma diagnoses are receiving attention, yet population-based studies are few. The aims of the present cohort study were to examine the cumulative incidence of traumatic events and psychiatric diagnoses following diagnoses of severe stress and adjustment disorders categorized using International Classification of Diseases, Tenth Revision, codes and to examine associations of these diagnoses with all-cause mortality and suicide. Data came from a longitudinal cohort of all Danes who received a diagnosis of reaction to severe stress or adjustment disorders (International Classification of Diseases, Tenth Revision, code F43.x) between 1995 and 2011, and they were compared with data from a general-population cohort. Cumulative incidence curves were plotted to examine traumatic experiences and psychiatric diagnoses during the study period. A Cox proportional hazards regression model was used to examine the associations of the disorders with mortality and suicide. Participants with stress diagnoses had a higher incidence of traumatic events and psychiatric diagnoses than did the comparison group. Each disorder was associated with a higher rate of all-cause mortality than that seen in the comparison cohort, and strong associations with suicide were found after adjustment. This study provides a comprehensive assessment of the associations of stress disorders with a variety of outcomes, and we found that stress diagnoses may have long-lasting and potentially severe consequences. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Changes in sick-leave diagnoses over eleven years in a cohort of young adults initially sick-listed due to low back, neck, or shoulder diagnoses.

PubMed

Festin, Karin; Alexanderson, Kristina

2009-05-01

To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Eleven-year prospective cohort study. All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting > or = 28 days with low back, neck, or shoulder diagnoses. For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 22% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III Criteria: results from a Norwegian prospective study.

PubMed

Helgeland, Helene; Flagstad, Gro; Grøtta, Jon; Vandvik, Per Olav; Kristensen, Hanne; Markestad, Trond

2009-09-01

To determine the proportion of referred children with nonorganic abdominal pain who meet the criteria for 1 or more diagnoses of functional gastrointestinal disorders (FGID), explore the distribution of diagnoses according to the revised pediatric Rome III criteria (PRC-III), and to investigate reasons for failure to meet these criteria. We recruited children (4-15 years) consecutively referred by general practitioners to 4 general pediatric outpatient clinics for the evaluation of recurrent abdominal pain. FGID diagnoses were based on the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version, completed by parents. To exclude organic disease, all patients underwent medical investigations and were reevaluated at follow-up after 6 to 9 months. Of the 152 patients included, 142 (93%) had functional abdominal pain. Of these, 124 (87%) met the criteria for 1 or more diagnoses according to the PRC-III: 66% met the criteria for 1, 29% for 2, and 5% for 3 diagnoses. Irritable bowel syndrome was the most common diagnosis (43%) and overlapped with aerophagia in 16 children (38% of the children with overlapping diagnoses) and with abdominal migraine in 14 (33%). In the 18 patients (13%) not fulfilling the PRC-III for any FGID diagnosis, the main reason was insufficient pain frequency (83%). Of the referred children with functional abdominal pain, 87% met the PRC-III for specific diagnoses. This supports the use of these criteria as a diagnostic tool. The significant overlap between different FGIDs, however, makes it unclear whether some of the diagnoses represent distinct disorders or artificial categories.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death--a nationwide prospective cohort study.

PubMed

Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

2014-02-08

It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.

What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

PubMed

Patocka, Catherine; Turner, Joel; Wiseman, Jeffrey

2015-11-01

There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. We developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds. A purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered "must know" diagnoses, 61 (50%) "should know" diagnoses, and 7 (6%) "nice to know" diagnoses. We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

How Do Health Care Providers Diagnose Primary Ovarian Insufficiency (POI)?

MedlinePlus

... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose POI? The key signs of POI ... having periods for 4 months or longer, her health care provider may take these steps to diagnose the ...

High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.

PubMed

Wagner, Anjuli; Slyker, Jennifer; Langat, Agnes; Inwani, Irene; Adhiambo, Judith; Benki-Nugent, Sarah; Tapia, Ken; Njuguna, Irene; Wamalwa, Dalton; John-Stewart, Grace

2015-02-15

Despite expanded programs for prevention of mother-to-child HIV transmission (PMTCT), HIV-infected infants may not be diagnosed until they are ill. Comparing HIV prevalence and outcomes in infants diagnosed in PMTCT programs to those in hospital settings may improve pediatric HIV diagnosis strategies. HIV-exposed infants <12 months old were recruited from 9 PMTCT sites in public maternal child health (MCH) clinics or from an inpatient setting in Nairobi, Kenya and tested for HIV using HIV DNA assays. A subset of HIV-infected infants <4.5 months of age was enrolled in a research study and followed for 2 years. HIV prevalence, number needed to test, infant age at testing, and turnaround time for tests were compared between PMTCT programs and hospital sites. Among the enrolled cohort, baseline characteristics, survival, and timing of antiretroviral therapy (ART) initiation were compared between infants diagnosed in PMTCT programs versus hospital. Among 1,923 HIV-exposed infants, HIV prevalence was higher among infants tested in hospital than PMTCT early infant diagnosis (EID) sites (41% vs. 11%, p < 0.001); the number of HIV-exposed infants needed to test to diagnose one infection was 2.4 in the hospital vs. 9.1 in PMTCT. Receipt of HIV test results was faster among hospitalized infants (7 vs. 25 days, p < 0.001). Infants diagnosed in hospital were older at the time of testing than PMTCT diagnosed infants (5.0 vs. 1.6 months, respectively, p < 0.001). In the subset of 99 HIV-infected infants <4.5 months old followed longitudinally, hospital-diagnosed infants did not differ from PMTCT-diagnosed infants in time to ART initiation; however, hospital-diagnosed infants were >3 times as likely to die (HR = 3.1, 95% CI = 1.3-7.6). Among HIV-exposed infants, hospital-based testing was more likely to detect an HIV-infected infant than PMTCT testing. Because young symptomatic infants diagnosed with HIV during hospitalization have very high mortality, every effort should be made to diagnose HIV infections before symptom onset. Systems to expedite turnaround time at PMTCT EID sites and to routinize inpatient pediatric HIV testing are necessary to improve pediatric HIV outcomes.

Specialized computer system to diagnose critical lined equipment

NASA Astrophysics Data System (ADS)

Yemelyanov, V. A.; Yemelyanova, N. Y.; Morozova, O. A.; Nedelkin, A. A.

2018-05-01

The paper presents data on the problem of diagnosing the lining condition at the iron and steel works. The authors propose and describe the structure of the specialized computer system to diagnose critical lined equipment. The relative results of diagnosing lining condition by the basic system and the proposed specialized computer system are presented. To automate evaluation of lining condition and support in making decisions regarding the operation mode of the lined equipment, the specialized software has been developed.

High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

PubMed

Dunbar, R; Naidoo, P; Beyers, N; Langley, I

2017-09-01

Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

Psychosocial diagnoses occurring after patients present with fatigue.

PubMed

MacKean, Peter Reagh; Stewart, Moira; Maddocks, Heather L

2016-08-01

To discover the frequency of psychosocial and other diagnoses occurring at the end of a visit when patients present to their FPs with concerns about fatigue. Cross-sectional study of patient-FP encounters for fatigue. Ten FP practices in southwestern Ontario. A total of 259 encounters involving 167 patients presenting to their FPs between March 1, 2006, and June 30, 2010, with concerns about fatigue. The frequency of psychological and social diagnoses made at the end of visits, and whether diagnoses were made by FPs at the end of the visits versus whether the code for fatigue remained. The associations between patient age, sex, fatigue presenting with other symptoms, or the presence of previous chronic conditions and the outcomes was tested. Psychosocial diagnoses were made 23.9% of the time. Among psychosocial diagnoses made, depressive disorder and anxiety disorder or anxiety state were diagnosed more often in women (P = .048). Slightly less than 30% of the time, the cause of patients' fatigue remained undiagnosed at the end of the encounter. A diagnosis was made more often in men. Causes of fatigue frequently remain undiagnosed; however, when there is a diagnosis, psychosocial diagnoses are common. Therefore, it would be appropriate for FPs to screen for psychosocial issues when their patients present with fatigue, unless some other diagnosis is evident. Depression and anxiety could be considered particularly among female patients with fatigue. Copyright© the College of Family Physicians of Canada.

The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview.

PubMed

Nesvåg, Ragnar; Jönsson, Erik G; Bakken, Inger Johanne; Knudsen, Gun Peggy; Bjella, Thomas D; Reichborn-Kjennerud, Ted; Melle, Ingrid; Andreassen, Ole A

2017-03-14

Utilization of diagnostic information from national patient registries rests on the quality of the registered diagnoses. We aimed to investigate the agreement and consistency of diagnoses of psychotic and bipolar disorders in the Norwegian Patient Registry (NPR) compared to structured interview-based diagnoses given as part of a clinical research project. Diagnostic data from NPR were obtained for the period 01.01.2008-31.12.2013 for all patients who had been included in the Thematically Organized Psychosis (TOP) study between 18.10.2002 and 01.09.2014 with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of schizophrenia (n = 537), delusional disorder (n = 48), schizoaffective disorder (n = 118) or bipolar disorder (n = 408). Diagnostic agreement between the primary DSM-IV diagnosis in TOP and the International Classification of Diseases, 10th revision (ICD-10) diagnoses in NPR was evaluated using Cohen's unweighted nominal kappa (κ). Diagnostic consistency was calculated as the proportion of all registered severe mental disorder diagnoses in NPR that were equivalent to the primary diagnosis given in the TOP study. The proportion of patients registered with the equivalent ICD-10 diagnosis as the primary DSM-IV diagnosis given in TOP was 84.2% for the schizophrenia group, 68.8% for the delusional disorder group, 76.3% for the schizoaffective disorder group, and 78.4% for the bipolar disorder group. Diagnostic agreement was good for schizophrenia (κ = 0.74) and bipolar disorder (κ = 0.72), fair for schizoaffective disorder (κ = 0.63), and poor for delusional disorder (κ = 0.39). Among patients with DSM-IV schizophrenia, 4.7% were diagnosed with ICD-10 bipolar disorder, and among patients with DSM-IV bipolar disorder, 2.5% were diagnosed with ICD-10 schizophrenia. Diagnostic consistency was 84.9% for schizophrenia, 59.1% for delusional disorder, 65.9% for schizoaffective disorder, and 91.0% for bipolar disorder. When compared to research-based diagnoses, clinical diagnoses of schizophrenia and bipolar disorder in the NPR are accurate and consistent, with minimal diagnostic overlap between the two disorders.

Development and content validity testing of a comprehensive classification of diagnoses for pediatric nurse practitioners.

PubMed

Burns, C

1991-01-01

Pediatric nurse practitioners (PNPs) need an integrated, comprehensive classification that includes nursing, disease, and developmental diagnoses to effectively describe their practice. No such classification exists. Further, methodologic studies to help evaluate the content validity of any nursing taxonomy are unavailable. A conceptual framework was derived. Then 178 diagnoses from the North American Nursing Diagnosis Association (NANDA) 1986 list, selected diagnoses from the International Classification of Diseases, the Diagnostic and Statistical Manual, Third Revision, and others were selected. This framework identified and listed, with definitions, three domains of diagnoses: Developmental Problems, Diseases, and Daily Living Problems. The diagnoses were ranked using a 4-point scale (4 = highly related to 1 = not related) and were placed into the three domains. The rating scale was assigned by a panel of eight expert pediatric nurses. Diagnoses that were assigned to the Daily Living Problems domain were then sorted into the 11 Functional Health patterns described by Gordon (1987). Reliability was measured using proportions of agreement and Kappas. Content validity of the groups created was measured using indices of content validity and average congruency percentages. The experts used a new method to sort the diagnoses in a new way that decreased overlaps among the domains. The Developmental and Disease domains were judged reliable and valid. The Daily Living domain of nursing diagnoses showed marginally acceptable validity with acceptable reliability. Six Functional Health Patterns were judged reliable and valid, mixed results were determined for four categories, and the Coping/Stress Tolerance category was judged reliable but not valid using either test. There were considerable differences between the panel's, Gordon's (1987), and NANDA's clustering of NANDA diagnoses. This study defines the diagnostic practice of nurses from a holistic, patient-centered perspective. It is the first study to use quantitative methods to test a diagnostic classification system for nursing. The classification model could also be adapted for other nurse specialties.

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

PubMed

Tsujimura, Naoto; Takemoto, Hiroyoshi; Nakahara, Yujiro; Wakasugi, Masaki; Matsumoto, Takashi; Nishioka, Kiyonori; Takachi, Kou; Oshima, Satoshi; Yoshida, Kyotaro

2018-01-01

Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively. A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis. Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered. We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Medical audit of rectal biopsy diagnosis of inflammatory bowel disease.

PubMed

Frei, J V; Morson, B C

1982-03-01

The records of the rectal biopsy diagnoses of ulcerative colitis and Crohn's disease in the Department of Pathology, St Mark's Hospital, London, were reviewed. The biopsy diagnoses were compared to subsequent resection diagnoses on the same patients, and annual and seasonal variations in the frequency of these and related diagnoses were studied. The accuracy rate for the biopsy diagnosis of ulcerative colitis was about 70% and for Crohn's disease about 40% each time a biopsy was read. The low figure for the accuracy rate for Crohn's disease could be attributed to sampling error inherent in the diagnosis of a disease which is essentially patchy, showing discontinuous pathology. Also, many patients with Crohn's disease have a normal rectum which is biopsied to demonstrate the distinction from ulcerative colitis. In practical terms therefore a 40% accuracy rate in Crohn's disease is probably adequate. The rate of "false-positive" diagnoses was about 5%. There was a seasonal variation in the frequency of these two diagnoses, but no variation attributable to changes in observers, as pathology trainees in the Department change regularly. The frequency of diagnoses of non-specific inflammation and of normal colon did show such non-random variations.

Deep learning aided decision support for pulmonary nodules diagnosing: a review

PubMed Central

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping

2018-01-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing. PMID:29780633

PREDICTING CLINICALLY DIAGNOSED DYSENTERY INCIDENCE OBTAINED FROM MONTHLY CASE REPORTING BASED ON METEOROLOGICAL VARIABLES IN DALIAN, LIAONING PROVINCE, CHINA, 2005-2011 USING A DEVELOPED MODEL.

PubMed

An, Qingyu; Yao, Wei; Wu, Jun

2015-03-01

This study describes our development of a model to predict the incidence of clinically diagnosed dysentery in Dalian, Liaoning Province, China, using time series analysis. The model was developed using the seasonal autoregressive integrated moving average (SARIMA). Spearman correlation analysis was conducted to explore the relationship between meteorological variables and the incidence of clinically diagnosed dysentery. The meteorological variables which significantly correlated with the incidence of clinically diagnosed dysentery were then used as covariables in the model, which incorporated the monthly incidence of clinically diagnosed dysentery from 2005 to 2010 in Dalian. After model development, a simulation was conducted for the year 2011 and the results of this prediction were compared with the real observed values. The model performed best when the temperature data for the preceding month was used to predict clinically diagnosed dysentery during the following month. The developed model was effective and reliable in predicting the incidence of clinically diagnosed dysentery for most but not all months, and may be a useful tool for dysentery disease control and prevention, but further studies are needed to fine tune the model.

Unit Level Variations And Peer Influences In Mental Health Diagnoses In The U.S. Army

DTIC Science & Technology

2017-12-01

INFLUENCES IN MENTAL HEALTH DIAGNOSES IN THE U.S. ARMY by Zhi Wen Tan Kian Wee Evwin Lee December 2017 Thesis Advisor: Yu-Chu Shen Co-Advisor...DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE UNIT-LEVEL VARIATIONS AND PEER INFLUENCES IN MENTAL HEALTH DIAGNOSES IN THE U.S. ARMY 5... health care system, to examine how unit-level variations in incidents of mental health diagnoses affect the likelihood of an individual developing

Nursing diagnoses and interventions for post-acute-phase battered women.

PubMed

Carlson-Catalano, J

1998-01-01

To identify nursing diagnoses and interventions applicable for post-acute-phase battered women. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection. Fifty-three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.

A Characterization of t/s-Diagnosability and Sequential t-Diagnosability in Designs

DTIC Science & Technology

1990-10-01

41 151 161 171 181 r91 1101 REFERENCES K.-Y. Chwa and S. L. Hakimi, “On fault identification in diagnosable systems,” ZEEE Tmns. Comput...1975, pp. 167-170. S. L. Hakimi and A. T. Amin, “Characterization of the connection assignment problem of diagnosable systems,” ZEEE Trans. Comput...S. Karunanithi and A. D. Friedman, “Analysis of digital systems using a new measure of system diagnosis,” ZEEE Trans. Cornput., vol. C- A

Sexuality Among Middle-Aged and Older Adults With Diagnosed and Undiagnosed Diabetes

PubMed Central

Lindau, Stacy Tessler; Tang, Hui; Gomero, Ada; Vable, Anusha; Huang, Elbert S.; Drum, Melinda L.; Qato, Dima M.; Chin, Marshall H.

2010-01-01

OBJECTIVE To describe sexual activity, behavior, and problems among middle-age and older adults by diabetes status. RESEARCH DESIGN AND METHODS This was a substudy of 1,993 community-residing adults, aged 57–85 years, from a cross-sectional, nationally representative sample (N = 3,005). In-home interviews, observed medications, and A1C were used to stratify by diagnosed diabetes, undiagnosed diabetes, or no diabetes. Logistic regression was used to model associations between diabetes conditions and sexual characteristics, separately by gender. RESULTS The survey response rate was 75.5%. More than 60% of partnered individuals with diagnosed diabetes were sexually active. Women with diagnosed diabetes were less likely than men with diagnosed diabetes (adjusted odds ratio 0.28 [95% CI 0.16–0.49]) and other women (0.63 [0.45–0.87]) to be sexually active. Partnered sexual behaviors did not differ by gender or diabetes status. The prevalence of orgasm problems was similarly elevated among men with diagnosed and undiagnosed diabetes compared with that for other men, but erectile difficulties were elevated only among men with diagnosed diabetes (2.51 [1.53 to 4.14]). Women with undiagnosed diabetes were less likely to have discussed sex with a physician (11%) than women with diagnosed diabetes (19%) and men with undiagnosed (28%) or diagnosed (47%) diabetes. CONCLUSIONS Many middle-age and older adults with diabetes are sexually active and engage in sexual behaviors similarly to individuals without diabetes. Women with diabetes were more likely than men to cease all sexual activity. Older women with diabetes are as likely to have sexual problems but are significantly less likely than men to discuss them. PMID:20802158

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.

A retrospective observational study examining the characteristics and outcomes of tumours diagnosed within and without of the English NHS Bowel Cancer Screening Programme

PubMed Central

Morris, E J A; Whitehouse, L E; Farrell, T; Nickerson, C; Thomas, J D; Quirke, P; Rutter, M D; Rees, C; Finan, P J; Wilkinson, J R; Patnick, J

2012-01-01

Background: Colorectal cancer is common in England and, with long-term survival relatively poor, improving outcomes is a priority. A major initiative to reduce mortality from the disease has been the introduction of the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). Combining data from the BCSP with that in the National Cancer Data Repository (NCDR) allows all tumours diagnosed in England to be categorised according to their involvement with the BCSP. This study sought to quantify the characteristics of the tumours diagnosed within and outside the BCSP and investigate its impact on outcomes. Methods: Linkage of the NCDR and BCSP data allowed all tumours diagnosed between July 2006 and December 2008 to be categorised into four groups; screen-detected tumours, screening-interval tumours, tumours diagnosed in non-participating invitees and tumours diagnosed in those never invited to participate. The characteristics, management and outcome of tumours in each category were compared. Results: In all, 76 943 individuals were diagnosed with their first primary colorectal cancer during the study period. Of these 2213 (2.9%) were screen-detected, 623 (0.8%) were screening-interval cancers, 1760 (2.3%) were diagnosed in individuals in non-participating invitees and 72 437 (94.1%) were diagnosed in individuals not invited to participate in the programme due to its ongoing roll-out over the time period studied. Screen-detected tumours were identified at earlier Dukes' stages, were more likely to be managed with curative intent and had significantly better outcomes than tumours in other categories. Conclusion: Screen-detected cancers had a significantly better prognosis than other tumours and this would suggest that the BCSP should reduce mortality from colorectal cancer in England. PMID:22850549

Diagnosing co-occurring substance-related disorders: agreement between SCID, Hispanic clinicians, and Non-Hispanic clinicians.

PubMed

Torres, Luis R; Zayas, Luis H; Cabassa, Leopoldo J; Pérez, M Carmela

2007-11-01

Given the composition of the mental health and substance abuse workforce in the United States, Hispanic immigrants are often assigned to non-Hispanic, English-speaking clinicians. This produces challenges in communication and in understanding linguistic and cultural nuances and greatly impacts the accuracy of diagnoses and the delivery of appropriate services. With the inclusion of objective criteria in diagnostic categories, clinician-to-clinician agreement ought not to be impacted by the ethnicity of the client or the clinician. Both practice and research, however, suggest that this is not the case, particularly when diagnosing co-occurring mental health and substance abuse disorders. We explored the degree to which Hispanic and non-Hispanic clinicians agreed with each other and with the Structured Clinical Interview for DSM-IV-TR, Research Version (SCID) when diagnosing co-occurring substance-related disorders. Using a naturalistic design, 88 adult clients were videotaped in diagnostic intake interviews (utilizing the DSM-IV-TR) with Hispanic or non-Hispanic clinicians. Videotapes were then viewed and rated by clinicians who were ethnically cross-matched to those on tape. Clients were also administered the SCID. Data were collected from September 15, 2003, through February 7, 2005. Non-Hispanic clinicians diagnosed significantly more substance-related disorders than Hispanic clinicians, and both Hispanic and non-Hispanic clinicians significantly under-diagnosed substance-related diagnoses compared to the SCID. Clinicians had very low diagnostic reliability with each other and with the SCID. Implications for the assessment, diagnosis, and treatment of co-occurring substance-related disorders are discussed. Findings seem to concur with past research suggesting that clinicians may be influenced by factors other than the diagnostic criteria (e.g., cultural and social biases) when diagnosing, and that they may make erroneous attributions of pathology when diagnosing across cultures.

INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE.

PubMed

Işikay, Sedat; Hizli, Şamil; Çoşkun, Serkan; Yilmaz, Kutluhan

2015-12-01

Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. A total of 175 children with the diagnosis of celiac disease (study group) and 99 age- and sex-matched healthy children as controls (control group) were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3%) of newly diagnosed and in 2 (1.5%) of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0%) of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively). We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients, clinicians should be aware of this association and be alert about any neurological symptoms.

Visit complexity, diagnostic uncertainty, and antibiotic prescribing for acute cough in primary care: a retrospective study

PubMed Central

2013-01-01

Background Guidelines and performance measures recommend avoiding antibiotics for acute cough/acute bronchitis and presume visits are straightforward with simple diagnostic decision-making. We evaluated clinician-assigned diagnoses, diagnostic uncertainty, and antibiotic prescribing for acute cough visits in primary care. Methods We conducted a retrospective analysis of acute cough visits – cough lasting ≤21 days in adults 18–64 years old without chronic lung disease – in a primary care practice from March 2011 through June 2012. Results Of 56,301 visits, 962 (2%) were for acute cough. Clinicians diagnosed patients with 1, 2, or ≥ 3 cough-related diagnoses in 54%, 35%, and 11% of visits, respectively. The most common principal diagnoses were upper respiratory infection (46%), sinusitis (10%), acute bronchitis (9%), and pneumonia (8%). Clinicians prescribed antibiotics in 22% of all visits: 65% of visits with antibiotic-appropriate diagnoses and 4% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed diagnostic uncertainty in 16% of all visits: 43% of visits with antibiotic-appropriate diagnoses and 5% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed uncertainty more often when prescribing antibiotics than when not prescribing antibiotics (30% vs. 12%; p < 0.001). As the number of visit diagnoses increased from 1 to 2 to ≥ 3, clinicians were more likely to express diagnostic uncertainty (5%, 25%, 40%, respectively; p < 0.001) and prescribe antibiotics (16%, 25%, 41%, respectively; p < 0.001). Conclusions Acute cough may be more complex and have more diagnostic uncertainty than guidelines and performance measures presume. Efforts to reduce antibiotic prescribing for acute cough should address diagnostic complexity and uncertainty that clinicians face. PMID:23957228

Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria.

PubMed

Fishbain, D A; Goldberg, M; Meagher, B R; Steele, R; Rosomoff, H

1986-08-01

Two hundred and eighty-three chronic pain patients, consecutive admissions to the Comprehensive Pain Center of the University of Miami School of Medicine, received an extensive psychiatric evaluation based upon the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria and flowsheets. All patients received the following type of diagnoses: DSM-III axis I; DSM-III axis II, and personality type. The distribution of assigned diagnoses for the entire patient sample was reviewed and a statistical comparison between male and female patients was performed with regards to the prevalence of each diagnosis. Anxiety syndromes and depression of various diagnostic types were the most frequently assigned axis I diagnoses with over half the patient sample receiving each of these diagnoses. Males were significantly overrepresented in the axis I diagnoses of intermittent explosive disorders, adjustment disorders with work inhibitions, and alcohol abuse and other drug dependence, while females were significantly overrepresented in disorders of current depression of various diagnostic types and somatization disorders. 58.4% of the patients fulfilled criteria for axis II personality disorder diagnoses. The most frequently personality disorders found in the patient group were dependent (17.4%), passive aggressive (14.9%), and histrionic (11.7%). Males were significantly overrepresented in paranoid and narcissistic disorders while females were overrepresented in histrionic disorder. The most frequent personality types found in the patient group were compulsive (24.5%) and dependent (10.6%). All personality types were similarly distributed between the sexes. The results of the present study were compared to a previous study of DSM-III diagnoses in chronic pain patients and are discussed in terms of the prevalence of DSM-III diagnoses in the general population. Questions are raised as to the applicability of certain DSM-III diagnoses in the chronic pain population.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death – a nationwide prospective cohort study

PubMed Central

2014-01-01

Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data, including all 5 248 672 individuals living in Sweden in 2005, aged 20–64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. Results In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). Conclusion This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses. PMID:24507477

A model for diagnosing and explaining multiple disorders.

PubMed

Jamieson, P W

1991-08-01

The ability to diagnose multiple interacting disorders and explain them in a coherent causal framework has only partially been achieved in medical expert systems. This paper proposes a causal model for diagnosing and explaining multiple disorders whose key elements are: physician-directed hypotheses generation, object-oriented knowledge representation, and novel explanation heuristics. The heuristics modify and link the explanations to make the physician aware of diagnostic complexities. A computer program incorporating the model currently is in use for diagnosing peripheral nerve and muscle disorders. The program successfully diagnoses and explains interactions between diseases in terms of underlying pathophysiologic concepts. The model offers a new architecture for medical domains where reasoning from first principles is difficult but explanation of disease interactions is crucial for the system's operation.

Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

MedlinePlus

... Share Compartir Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily ... 2010, the age-adjusted percentage of adults aged 18 years or older with diagnosed diabetes performing daily ...

Medicaid Expenditures for Fee-for-Service Enrollees with Behavioral Diagnoses: Findings from a 50 State Claims Analysis.

PubMed

Ward, Martha C; Lally, Cathy; Druss, Benjamin G

2017-01-01

Medicaid is an important funder of care for individuals with behavioral (psychiatric and/or substance use) diagnoses, and expenditures will likely increase with expansion of services under the Affordable Care Act. This study provides national estimates of Medicaid expenditures using a comprehensive sample of fee-for-service Medicaid enrollees with behavioral diagnoses. Data for analysis came from 2003 to 2004 Medicaid Analytic eXtract (MAX) files for 50 states and the District of Columbia. Individuals with behavioral diagnoses had high rates of chronic medical comorbidities, and expenditures for medical (non-behavioral) diagnoses accounted for 74 % of their health care expenditures. Total Medicaid expenditure was approximately 15 billion dollars (equivalent to 18.91 billion in 2016 dollars) for individuals with any behavioral diagnosis. Medicaid fee-for-service beneficiaries with behavioral diagnoses have a high treated prevalence of individual medical comorbid conditions, and the majority of health care expenditures in these individuals are for medical, rather than behavioral health, services.

Systemic mycosis in three dogs from nonendemic regions.

PubMed

Pratt, Carmela L; Sellon, Rance K; Spencer, Erick S; Johnson, Ty W; Righter, Daniel J

2012-01-01

Three dogs were examined for clinical signs ultimately attributed to systemic fungal infections. One dog was evaluated for chronic, ulcerated dermal lesions and lymphadenomegaly; one dog was examined for acute onset of unilateral blepharospasm; and one dog had diarrhea and hematochezia. Two of the dogs were diagnosed with blastomycosis (one with disseminated disease and the other with the disease localized to the left eye). The third dog was diagnosed with disseminated histoplasmosis. None of the dogs originated from, or had traveled to, typical regions endemic for these fungal diseases. All diagnoses were established from histopathology and either polymerase chain reaction (PCR) or cytology and culture. The two dogs diagnosed with blastomycosis were treated with either itraconazole or ketoconazole with apparent resolution of the infections. The dog with ocular involvement had an enucleation prior to beginning therapy. The dog diagnosed with histoplasmosis was euthanized without treatment. In patients with characteristic clinical features, systemic fungal infections should still be considered as differential diagnoses regardless of their travel history.

Missed Diagnosis of Syrinx

PubMed Central

Oh, Chang Hyun; Kim, Chan Gyu; Lee, Jae-Hwan; Park, Hyeong-Chun; Park, Chong Oon

2012-01-01

Study Design Prospective, randomized, controlled human study. Purpose We checked the proportion of missed syrinx diagnoses among the examinees of the Korean military conscription. Overview of Literature A syrinx is a fluid-filled cavity within the spinal cord or brain stem and causes various neurological symptoms. A syrinx could easily be diagnosed by magnetic resonance image (MRI), but missed diagnoses seldom occur. Methods In this study, we reviewed 103 cases using cervical images, cervical MRI, or whole spine sagittal MRI, and syrinxes was observed in 18 of these cases. A review of medical certificates or interviews was conducted, and the proportion of syrinx diagnoses was calculated. Results The proportion of syrinx diagnoses was about 66.7% (12 cases among 18). Missed diagnoses were not the result of the length of the syrinx, but due to the type of image used for the initial diagnosis. Conclusions The missed diagnosis proportion of the syrinx is relatively high, therefore, a more careful imaging review is recommended. PMID:22439081

Positive predictive value of peptic ulcer diagnosis codes in the Danish National Patient Registry

PubMed Central

Viborg, Søren; Søgaard, Kirstine Kobberøe; Jepsen, Peter

2017-01-01

Background Diagnoses of peptic ulcer are registered in the Danish National Patient Registry (DNPR) for administrative as well as research purposes, but it is unknown whether the coding validity depends on the location of the ulcer. Objective To validate the International Classification of Diseases, 10th revision diagnosis codes of peptic ulcer in the DNPR by estimating positive predictive values (PPVs) for gastric and duodenal ulcer diagnoses. Methods We identified all patients registered with a hospital discharge diagnosis of peptic ulcer from Aarhus University Hospital, Denmark, in 1995–2006. Among them, we randomly selected 200 who had an outpatient gastroscopy at the time of ulcer diagnosis. We reviewed the findings from these gastroscopies to confirm the presence of peptic ulcer and its location. We calculated PPVs and corresponding 95% confidence intervals (CIs) of gastric and duodenal ulcer diagnoses, using descriptions from the gastroscopic examinations as standard reference. Results In total, 182 records (91%) were available for review. The overall PPV of peptic ulcer diagnoses in DNPR was 95.6% (95% CI 91.5–98.1), with PPVs of 90.3% (95% CI 82.4–95.5) for gastric ulcer diagnoses, and 94.4% (95% CI 87.4–98.2) for duodenal ulcer diagnoses. PPVs were constant over time. Conclusion The PPV of uncomplicated peptic ulcer diagnoses in the DNPR is high, and the location of the ulcers is registered correctly in most cases, indicating that the diagnoses are useful for research purposes. PMID:28503076

Positive predictive value of peptic ulcer diagnosis codes in the Danish National Patient Registry.

PubMed

Viborg, Søren; Søgaard, Kirstine Kobberøe; Jepsen, Peter

2017-01-01

Diagnoses of peptic ulcer are registered in the Danish National Patient Registry (DNPR) for administrative as well as research purposes, but it is unknown whether the coding validity depends on the location of the ulcer. To validate the International Classification of Diseases, 10 th revision diagnosis codes of peptic ulcer in the DNPR by estimating positive predictive values (PPVs) for gastric and duodenal ulcer diagnoses. We identified all patients registered with a hospital discharge diagnosis of peptic ulcer from Aarhus University Hospital, Denmark, in 1995-2006. Among them, we randomly selected 200 who had an outpatient gastroscopy at the time of ulcer diagnosis. We reviewed the findings from these gastroscopies to confirm the presence of peptic ulcer and its location. We calculated PPVs and corresponding 95% confidence intervals (CIs) of gastric and duodenal ulcer diagnoses, using descriptions from the gastroscopic examinations as standard reference. In total, 182 records (91%) were available for review. The overall PPV of peptic ulcer diagnoses in DNPR was 95.6% (95% CI 91.5-98.1), with PPVs of 90.3% (95% CI 82.4-95.5) for gastric ulcer diagnoses, and 94.4% (95% CI 87.4-98.2) for duodenal ulcer diagnoses. PPVs were constant over time. The PPV of uncomplicated peptic ulcer diagnoses in the DNPR is high, and the location of the ulcers is registered correctly in most cases, indicating that the diagnoses are useful for research purposes.

Very Early Processing Skills and Language Acquisition in Autism Spectrum Disorder

ERIC Educational Resources Information Center

Kushner, Nicole Blake

2017-01-01

With the increasing prevalence of autism diagnoses, large percentage of diagnosed individuals with comorbid language difficulties, and negative effects of these difficulties on language development and overall functioning, research on language acquisition in children diagnosed with autism spectrum disorder is essential. The current study used data…

77 FR 38844 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Development Conference: Diagnosing Gestational Diabetes Mellitus SUMMARY: The National Institutes of Health... Diabetes Mellitus.'' The conference will be open to the public. DATES: The conference will be held October... INFORMATION: Gestational diabetes mellitus (GDM) is a condition in which women without previously diagnosed...

Terahertz otoscope and potential for diagnosing otitis media

PubMed Central

Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

2016-01-01

We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. PMID:27446647

Rodin, Patton, Edison, Wilson, Einstein: Were They Really Learning Disabled?

ERIC Educational Resources Information Center

Adelman, Kimberly A.; Adelman, Howard S.

1987-01-01

The practice of posthumously diagnosing historical figures is discussed. Emphasis is on the unsatisfactory nature of evidence found for those diagnosed as learning-disabled or dyslexic and the possibility of other explanations for identified problems. Posthumous diagnoses of Auguste Rodin, George Patton, Thomas Edison, Woodrow Wilson, and Albert…

Diagnosing Behavior Problems: A Guide for Practitioners.

PubMed

Stelow, Elizabeth

2018-05-01

Clinicians play an important role in diagnosing problem behaviors as a precursor to treating them. This requires a protocol for gathering historical behavioral and health information, direct observation and examination of the animal, and a broad knowledge base of medical and behavioral differential diagnoses for those findings. Aggression and anxiety are the most commonly reported behavior problems in dogs. In cats, elimination problems and aggression are the most prevalent. Other important diagnoses for these species are cognitive dysfunction and abnormal repetitive behaviors. Copyright © 2017 Elsevier Inc. All rights reserved.

Endosonography and cytology in diagnosing and staging pancreatic body and tail carcinoma: Preliminary results of endosonographic guided puncture

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

Tio, T.L.; Sie, L.H.; Tytgat, G.N.J.

1993-01-01

Endosonography was performed in diagnosing and staging pancreatic body and tail carcinoma in two patients. In the first case endoscopy, abdominal ultrasound, and computed tomography were nondiagnostic in diagnosing the origin of submucosal gastric abnormalities. Endosonography diagnosed a pancreatic tail carcinoma with submucosal gastric involvement, and this was confirmed by endosonographic-guided cytology. Fundus varices due to segmented splenic vein involvement were found. Surgery was not recommended due to the advanced disease. In the second case pancreatic body carcinoma was diagnosed by ERCP and computed tomography. Transcutaneous ultrasonographic-guided cytological puncture confirmed the diagnosis. Endosonography revealed additional information of segmental portal hypertensionmore » with fundic varices due to splenic vein involvement. Autopsy confirmed the endosonographic diagnosis. 18 refs., 5 figs.« less

The Diagnostic Challenge Competition: Probabilistic Techniques for Fault Diagnosis in Electrical Power Systems

NASA Technical Reports Server (NTRS)

Ricks, Brian W.; Mengshoel, Ole J.

2009-01-01

Reliable systems health management is an important research area of NASA. A health management system that can accurately and quickly diagnose faults in various on-board systems of a vehicle will play a key role in the success of current and future NASA missions. We introduce in this paper the ProDiagnose algorithm, a diagnostic algorithm that uses a probabilistic approach, accomplished with Bayesian Network models compiled to Arithmetic Circuits, to diagnose these systems. We describe the ProDiagnose algorithm, how it works, and the probabilistic models involved. We show by experimentation on two Electrical Power Systems based on the ADAPT testbed, used in the Diagnostic Challenge Competition (DX 09), that ProDiagnose can produce results with over 96% accuracy and less than 1 second mean diagnostic time.

Behavioral Phenotype of Fragile X Syndrome in Adolescence and Adulthood

PubMed Central

Smith, Leann E.; Barker, Erin T.; Seltzer, Marsha Mailick; Abbeduto, Leonard; Greenberg, Jan S.

2012-01-01

The present study explored the behavioral profile of individuals with fragile X syndrome during adolescence and adulthood. Individuals with both fragile X syndrome and autism (n = 30) were compared with (a) individuals diagnosed with fragile X syndrome (but not autism; n = 106) and (b) individuals diagnosed with autism (but not fragile X syndrome; n = 135) on measures of autism symptoms, adaptive functioning, behavior problems, and psychological symptoms. Results indicated that individuals dually diagnosed with fragile X syndrome and autism displayed greater communication and social reciprocity impairments than individuals with fragile X syndrome only. Individuals in the dually diagnosed group also exhibited higher levels of repetitive and challenging behaviors than either comparison group, suggesting a unique profile of vulnerability for those diagnosed with both fragile X syndrome and autism. PMID:22264109

Improving Distributed Diagnosis Through Structural Model Decomposition

NASA Technical Reports Server (NTRS)

Bregon, Anibal; Daigle, Matthew John; Roychoudhury, Indranil; Biswas, Gautam; Koutsoukos, Xenofon; Pulido, Belarmino

2011-01-01

Complex engineering systems require efficient fault diagnosis methodologies, but centralized approaches do not scale well, and this motivates the development of distributed solutions. This work presents an event-based approach for distributed diagnosis of abrupt parametric faults in continuous systems, by using the structural model decomposition capabilities provided by Possible Conflicts. We develop a distributed diagnosis algorithm that uses residuals computed by extending Possible Conflicts to build local event-based diagnosers based on global diagnosability analysis. The proposed approach is applied to a multitank system, and results demonstrate an improvement in the design of local diagnosers. Since local diagnosers use only a subset of the residuals, and use subsystem models to compute residuals (instead of the global system model), the local diagnosers are more efficient than previously developed distributed approaches.

Identifying nursing interventions associated with the accuracy used nursing diagnoses for patients with liver cirrhosis 1

PubMed Central

Gimenes, Fernanda Raphael Escobar; Motta, Ana Paula Gobbo; da Silva, Patrícia Costa dos Santos; Gobbo, Ana Flora Fogaça; Atila, Elisabeth; de Carvalho, Emilia Campos

2017-01-01

ABSTRACT Objective: to identify the nursing interventions associated with the most accurate and frequently used NANDA International, Inc. (NANDA-I) nursing diagnoses for patients with liver cirrhosis. Method: this is a descriptive, quantitative, cross-sectional study. Results: a total of 12 nursing diagnoses were evaluated, seven of which showed high accuracy (IVC ≥ 0.8); 70 interventions were identified and 23 (32.86%) were common to more than one diagnosis. Conclusion: in general, nurses often perform nursing interventions suggested in the NIC for the seven highly accurate nursing diagnoses identified in this study to care patients with liver cirrhosis. Accurate and valid nursing diagnoses guide the selection of appropriate interventions that nurses can perform to enhance patient safety and thus improve patient health outcomes.

Accuracy in inference of nursing diagnoses in heart failure patients.

PubMed

Pereira, Juliana de Melo Vellozo; Cavalcanti, Ana Carla Dantas; Lopes, Marcos Venícios de Oliveira; da Silva, Valéria Gonçalves; de Souza, Rosana Oliveira; Gonçalves, Ludmila Cuzatis

2015-01-01

Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. the training allowed the exercise of clinical judgment and better accuracy of nurses.

Student nurses' perceived use of NANDA-I nursing diagnoses in the community setting.

PubMed

Ogunfowokan, Adesola A; Oluwatosin, Abimbola O; Olajubu, Aanuoluwapo O; Alao, Olujide A; Faremi, Adenike F

2013-02-01

Study explored knowledge and perception of student nurses on the use of NANDA-I nursing diagnoses in the community setting. Study adopted cross-sectional design. Convenient sampling method was used to select 290 nursing students. Data analysis was by descriptive and inferential statistics. A majority (81.3%) of the participants considered NANDA-I nursing diagnoses to be useful in the community. Significant association existed in the perception and level of education of the students (χ(2) = 8.257, d.f. = 1, p= .04). Knowledge and perception of the participants about the use of NANDA-I nursing diagnoses in the community is satisfactory. Use of NANDA-I nursing diagnoses should be encouraged among community health nurses. © 2012, The Authors. International Journal of Nursing Knowledge © 2012, NANDA International.

Parental happiness and strain among young adult parents diagnosed with Attention Deficit Hyperactivity Disorder.

PubMed

Kroeger, Rhiannon A

2018-03-01

This study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine whether young adult parents diagnosed with Attention Deficit Hyperactivity Disorder experience less parental happiness and/or more parental strain than their counterparts not diagnosed with Attention Deficit Hyperactivity Disorder. Results from logistic regression models indicated that young adult parents ever diagnosed with Attention Deficit Hyperactivity Disorder have significantly greater odds of feeling overwhelmed as parents and significantly lower odds of feeling close to their children or happy in their role as parents compared to those never diagnosed with Attention Deficit Hyperactivity Disorder. Potential implications of these results for scholars as well as health professionals treating adult Attention Deficit Hyperactivity Disorder patients with children are discussed.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

PubMed Central

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J.; Kessler, Ronald C.; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.

2012-01-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. PMID:21495110

Molecular diagnostic experience of whole-exome sequencing in adult patients.

PubMed

Posey, Jennifer E; Rosenfeld, Jill A; James, Regis A; Bainbridge, Matthew; Niu, Zhiyv; Wang, Xia; Dhar, Shweta; Wiszniewski, Wojciech; Akdemir, Zeynep H C; Gambin, Tomasz; Xia, Fan; Person, Richard E; Walkiewicz, Magdalena; Shaw, Chad A; Sutton, V Reid; Beaudet, Arthur L; Muzny, Donna; Eng, Christine M; Yang, Yaping; Gibbs, Richard A; Lupski, James R; Boerwinkle, Eric; Plon, Sharon E

2016-07-01

Whole-exome sequencing (WES) is increasingly used as a diagnostic tool in medicine, but prior reports focus on predominantly pediatric cohorts with neurologic or developmental disorders. We describe the diagnostic yield and characteristics of WES in adults. We performed a retrospective analysis of consecutive WES reports for adults from a diagnostic laboratory. Phenotype composition was determined using Human Phenotype Ontology terms. Molecular diagnoses were reported for 17.5% (85/486) of adults, which is lower than that for a primarily pediatric population (25.2%; P = 0.0003); the diagnostic rate was higher (23.9%) for those 18-30 years of age compared to patients older than 30 years (10.4%; P = 0.0001). Dual Mendelian diagnoses contributed to 7% of diagnoses, revealing blended phenotypes. Diagnoses were more frequent among individuals with abnormalities of the nervous system, skeletal system, head/neck, and growth. Diagnostic rate was independent of family history information, and de novo mutations contributed to 61.4% of autosomal dominant diagnoses. Early WES experience in adults demonstrates molecular diagnoses in a substantial proportion of patients, informing clinical management, recurrence risk, and recommendations for relatives. A positive family history was not predictive, consistent with molecular diagnoses often revealed by de novo events, informing the Mendelian basis of genetic disease in adults.Genet Med 18 7, 678-685.

Newly diagnosed thyrotoxicosis in hospitalized patients: clinical characteristics.

PubMed

Rotman-Pikielny, P; Borodin, O; Zissin, R; Ness-Abramof, R; Levy, Y

2008-11-01

Thyrotoxicosis is often diagnosed in an outpatient setting. The most common symptoms include irritability, heat intolerance, palpitations and weakness. Sometimes, however, thyrotoxicosis is first diagnosed in the hospital setting. The prevalent symptoms in hospitalized patients with newly diagnosed thyrotoxicosis have not been fully characterized. To determine the clinical characteristics of patients with thyrotoxicosis newly diagnosed during hospitalization. A retrospective computer-based search was undertaken to detect patients that were hospitalized in our medical centre during 1999-2006, and discharged with thyrotoxicosis or thyroiditis as the primary diagnosis. Fifty-eight patients (36F/22M; mean age 52.1 +/- 17.5 years) were identified. Weakness, weight loss and palpitations were the most common manifestations (50, 40 and 35%, respectively) and were predominantly present in patients with hyperthyroidism. Sore throat was present in 41% of patients with thyroiditis. Sinus tachycardia and atrial fibrillation occurred in 65.5 and 15.5% of the patients, more common in those with hyperthyroidism. The diagnoses on discharge were Graves' disease, subacute thyroiditis and multinodular goiter in 39.7, 34.5 and 8.9%, respectively. Weakness, weight loss and palpitations were the main symptoms in patients diagnosed with thyrotoxicosis during hospitalization. Thyrotoxicosis should be included in the differential diagnosis when patients are admitted to the hospital with those symptoms.

Implementation of Free Text Format Nursing Diagnoses at a University Hospital's Medical Department. Exploring Nurses' and Nursing Students' Experiences on Use and Usefulness. A Qualitative Study

PubMed Central

Frigstad, Sigrun Aasen; Nøst, Torunn Hatlen; André, Beate

2015-01-01

Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process. PMID:26075091

Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008

PubMed Central

Metzler, Thomas J.; Gima, Kristian S.; Bertenthal, Daniel; Maguen, Shira; Marmar, Charles R.

2009-01-01

Objectives. We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans. Methods. We determined the prevalence and predictors of mental health diagnoses among 289 328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data. Results. Of 289 328 Iraq and Afghanistan veterans, 106 726 (36.9%) received mental health diagnoses; 62 929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD. Conclusions. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness. PMID:19608954

Transperineal ultrasound compared to evacuation proctography for diagnosing enteroceles and intussusceptions.

PubMed

Weemhoff, M; Kluivers, K B; Govaert, B; Evers, J L H; Kessels, A G H; Baeten, C G

2013-03-01

This study concerns the level of agreement between transperineal ultrasound and evacuation proctography for diagnosing enteroceles and intussusceptions. In a prospective observational study, 50 consecutive women who were planned to have an evacuation proctography underwent transperineal ultrasound too. Sensitivity, specificity, positive (PPV) and negative predictive value, as well as the positive and negative likelihood ratio of transperineal ultrasound were assessed in comparison to evacuation proctography. To determine the interobserver agreement of transperineal ultrasound, the quadratic weighted kappa was calculated. Furthermore, receiver operating characteristic curves were generated to show the diagnostic capability of transperineal ultrasound. For diagnosing intussusceptions (PPV 1.00), a positive finding on transperineal ultrasound was predictive of an abnormal evacuation proctography. Sensitivity of transperineal ultrasound was poor for intussusceptions (0.25). For diagnosing enteroceles, the positive likelihood ratio was 2.10 and the negative likelihood ratio, 0.85. There are many false-positive findings of enteroceles on ultrasonography (PPV 0.29). The interobserver agreement of the two ultrasonographers assessed as the quadratic weighted kappa of diagnosing enteroceles was 0.44 and that of diagnosing intussusceptions was 0.23. An intussusception on ultrasound is predictive of an abnormal evacuation proctography. For diagnosing enteroceles, the diagnostic quality of transperineal ultrasound was limited compared to evacuation proctography.

Molecular Diagnostic Experience of Whole-Exome Sequencing in Adult Patients

PubMed Central

Posey, Jennifer E.; Rosenfeld, Jill A.; James, Regis A.; Bainbridge, Matthew; Niu, Zhiyv; Wang, Xia; Dhar, Shweta; Wiszniewski, Wojciech; Akdemir, Zeynep H.C.; Gambin, Tomasz; Xia, Fan; Person, Richard E.; Walkiewicz, Magdalena; Shaw, Chad A.; Sutton, V. Reid; Beaudet, Arthur L.; Muzny, Donna; Eng, Christine M.; Yang, Yaping; Gibbs, Richard A.; Lupski, James R.; Boerwinkle, Eric; Plon, Sharon E.

2015-01-01

Purpose Whole exome sequencing (WES) is increasingly used as a diagnostic tool in medicine, but prior reports focus on predominantly pediatric cohorts with neurologic or developmental disorders. We describe the diagnostic yield and characteristics of whole exome sequencing in adults. Methods We performed a retrospective analysis of consecutive WES reports for adults from a diagnostic laboratory. Phenotype composition was determined using Human Phenotype Ontology terms. Results Molecular diagnoses were reported for 17.5% (85/486) of adults, lower than a primarily pediatric population (25.2%; p=0.0003); the diagnostic rate was higher (23.9%) in those 18–30 years of age compared to patients over 30 years (10.4%; p=0.0001). Dual Mendelian diagnoses contributed to 7% of diagnoses, revealing blended phenotypes. Diagnoses were more frequent among individuals with abnormalities of the nervous system, skeletal system, head/neck, and growth. Diagnostic rate was independent of family history information, and de novo mutations contributed to 61.4% of autosomal dominant diagnoses. Conclusion Early WES experience in adults demonstrates molecular diagnoses in a substantial proportion of patients, informing clinical management, recurrence risk and recommendations for relatives. A positive family history was not predictive, consistent with molecular diagnoses often revealed by de novo events, informing the Mendelian basis of genetic disease in adults. PMID:26633545

Persistent smoking as a predictor of disability pension due to musculoskeletal diagnoses: a 23 year prospective study of Finnish twins.

PubMed

Ropponen, Annina; Korhonen, Tellervo; Svedberg, Pia; Koskenvuo, Markku; Silventoinen, Karri; Kaprio, Jaakko

2013-12-01

To investigate whether stability or changes in smoking predict disability pension (DP) due to low back diagnoses (LBD) and musculoskeletal diagnoses (MSD) after taking familial confounding into account using a co-twin design. Longitudinal smoking patterns and multiple covariates in a population-based cohort of 17,451 Finnish twins (6959 complete pairs) born before 1958 were surveyed through questionnaires in 1975 and 1981. The outcome data were collected from the national pension registers until the end of 2004. Cox proportional hazards regression models were used for statistical analyses. Disability pension due to low back diagnoses was granted to 408 individuals and disability pension due to musculoskeletal diagnoses to 1177 individuals during the follow-up of 23 years. Being a persistent smoker (current smoker both 1975 and 1981) predicted a significantly increased risk for disability pension (hazard ratio 1.69, 95% confidence interval 1.46, 1.97) compared to those individuals who had never smoked. The association remained when several confounding factors, including familial factors, were taken into account. Persistent smoking predicts early disability pension due to musculoskeletal diagnoses and low back diagnoses independently from numerous confounding factors, including familial effects shared by the co-twins. © 2013.

Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain

PubMed Central

Laslett, Mark; McDonald, Barry; Tropp, Hans; Aprill, Charles N; Öberg, Birgitta

2005-01-01

Background The tissue origin of low back pain (LBP) or referred lower extremity symptoms (LES) may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC) statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216) with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement (PCC) was estimated at 13%. "Exact" agreement between clinical and reference standard diagnoses was 32% and "clinical agreement" 51%. For six pathoanatomic categories (disc, facet joint, sacroiliac joint, hip joint, nerve root and spinal stenosis), PCC was 33% with actual agreement 56%. There was no overlap of 95% confidence intervals on any comparison. Diagnostic agreement on the six most common patho-anatomic categories produced a kappa of 0.31. Conclusion Clinical diagnoses agree with reference standards diagnoses more often than chance. Using available reference standards, most patients can have a tissue source of pain identified. PMID:15943873

Subsequent Breast Cancer Risk Following Diagnosis of Atypical Ductal Hyperplasia on Needle Biopsy

PubMed Central

Menes, Tehillah S; Kerlikowske, Karla; Lange, Jane; Jaffer, Shabnam; Rosenberg, Robert; Miglioretti, Diana L.

2017-01-01

Background Atypical ductal hyperplasia (ADH) is a known strong risk factor for breast cancer. Published risk estimates are based on cohorts that included women diagnosed prior to the widespread use of screening mammograms and do not differentiate between the methods used to diagnose ADH, which may be related to size of the ADH focus. These risks may overestimate the risk of women currently diagnosed with ADH. We sought to examine the risk of invasive cancer associated with ADH diagnosed on core needle biopsy versus excisional biopsy. Design Cohort study comparing ten-year cumulative risk of invasive breast cancer in women undergoing mammography with and without a diagnosis of ADH. Setting Five breast imaging registries that participate in the National Cancer Institute–funded Breast Cancer Surveillance Consortium (BCSC). Participants Women undergoing mammography in the BCSC. Exposure Diagnosis of ADH on core needle biopsy or excisional biopsy in women undergoing mammography. Main outcome Ten-year cumulative risk of invasive breast cancer risk. Results The sample included 955,331 women with 1,727 diagnoses of ADH. From 1996 to 2012, the proportion of ADH diagnosed by core needle biopsy increased from 21% to 77%. Ten years following a diagnosis of ADH, the cumulative risk of invasive breast cancer was 2.6 (95% CI 2.0, 3.4) times higher than risk in women with no ADH. ADH diagnosed via excisional biopsy was associated with an adjusted HR of 3.0 (95% CI 2.0, 4.5), and via core needle biopsy, with an HR of 2.2 (95% CI 1.5, 3.4). Ten years after an ADH diagnosis, an estimated 5.7% (95% CI 4.3, 10.1) of women were diagnosed with invasive cancer. Women with ADH diagnosed on excisional biopsy had a slightly higher risk (6.7 %; 95% CI 3.0, 12.8) compared to those with ADH diagnosed via core needle biopsy (5.0%; 95% CI 2.2, 8.9). Conclusions Current 10-year risks of invasive breast cancer after a diagnosis of ADH may be lower than previously reported. The risk associated with ADH is slightly lower for women diagnosed by needle core biopsy as compared to excisional biopsy. PMID:27607465

Diabetes and Prediabetes and Risk of Hospitalization: The Atherosclerosis Risk in Communities (ARIC) Study.

PubMed

Schneider, Andrea L C; Kalyani, Rita R; Golden, Sherita; Stearns, Sally C; Wruck, Lisa; Yeh, Hsin Chieh; Coresh, Josef; Selvin, Elizabeth

2016-05-01

To examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes. This study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with prediabetes, 4% with undiagnosed diabetes, 9% with diagnosed diabetes) with follow-up in 1990-2011 for hospitalizations. Participants were categorized by diabetes/HbA1c status: without diagnosed diabetes, HbA1c <5.7% (reference); prediabetes, 5.7 to <6.5%; undiagnosed diabetes, ≥6.5%; and diagnosed diabetes, <7.0 and ≥7.0%. Demographic adjusted rates per 1,000 person-years of all-cause hospitalizations were higher with increasing diabetes/HbA1c category (Ptrend < 0.001). Persons with diagnosed diabetes and HbA1c ≥7.0% had the highest rates of hospitalization (3.1 times higher than those without a history of diagnosed diabetes, HbA1c <5.7%, and 1.5 times higher than those with diagnosed diabetes, HbA1c <7.0%, P < 0.001 for both comparisons). Persons with undiagnosed diabetes had 1.6 times higher rates of hospitalization and those with prediabetes had 1.3 times higher rates of hospitalization than those without diabetes and HbA1c <5.7% (P < 0.001 for both comparisons). Rates of hospitalization by diabetes/HbA1c category were different by race (Pinteraction = 0.011) and by sex (Pinteraction = 0.020). There were significantly excess rates of hospitalizations due to cardiovascular, endocrine, respiratory, gastrointestinal, iatrogenic/injury, neoplasm, genitourinary, neurologic, and infection causes among those with diagnosed diabetes compared with those without a history of diagnosed diabetes (all P < 0.05). Persons with diagnosed diabetes, undiagnosed diabetes, and prediabetes are at a significantly elevated risk of hospitalization compared with those without diabetes. Substantial excess rates of hospitalizations in persons with diagnosed diabetes were for endocrine, infection, and iatrogenic/injury causes, which may be preventable with improved diabetes care. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

High Accuracy of Common HIV-Related Oral Disease Diagnoses by Non-Oral Health Specialists in the AIDS Clinical Trial Group.

PubMed

Shiboski, Caroline H; Chen, Huichao; Secours, Rode; Lee, Anthony; Webster-Cyriaque, Jennifer; Ghannoum, Mahmoud; Evans, Scott; Bernard, Daphné; Reznik, David; Dittmer, Dirk P; Hosey, Lara; Sévère, Patrice; Aberg, Judith A

2015-01-01

Many studies include oral HIV-related endpoints that may be diagnosed by non-oral-health specialists (non-OHS) like nurses or physicians. Our objective was to assess the accuracy of clinical diagnoses of HIV-related oral lesions made by non-OHS compared to diagnoses made by OHS. A5254, a cross-sectional study conducted by the Oral HIV/AIDS Research Alliance within the AIDS Clinical Trial Group, enrolled HIV-1-infected adults participants from six clinical trial units (CTU) in the US (San Francisco, New York, Chapel Hill, Cleveland, Atlanta) and Haiti. CTU examiners (non-OHS) received standardized training on how to perform an oral examination and make clinical diagnoses of specific oral disease endpoints. Diagnoses by calibrated non-OHS were compared to those made by calibrated OHS, and sensitivity and specificity computed. Among 324 participants, the majority were black (73%), men (66%), and the median CD4+ cell count 138 cells/mm(3). The overall frequency of oral mucosal disease diagnosed by OHS was 43% in US sites, and 90% in Haiti. Oral candidiasis (OC) was detected in 153 (47%) by OHS, with erythematous candidiasis (EC) the most common type (39%) followed by pseudomembranous candidiasis (PC; 26%). The highest prevalence of OC (79%) was among participants in Haiti, and among those with CD4+ cell count ≤ 200 cells/mm(3) and HIV-1 RNA > 1000 copies/mL (71%). The sensitivity and specificity of OC diagnoses by non-OHS were 90% and 92% (for EC: 81% and 94%; PC: 82% and 95%). Sensitivity and specificity were also high for KS (87% and 94%, respectively), but sensitivity was < 60% for HL and oral warts in all sites combined. The Candida culture confirmation of OC clinical diagnoses (as defined by ≥ 1 colony forming unit per mL of oral/throat rinse) was ≥ 93% for both PC and EC. Trained non-OHS showed high accuracy of clinical diagnoses of OC in comparison with OHS, suggesting their usefulness in studies in resource-poor settings, but detection of less common lesions may require OHS.

Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany.

PubMed

Langner, Ingo; Mikolajczyk, Rafael; Garbe, Edeltraut

2011-08-17

Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM). Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs) in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. We analysed hospitalisation diagnoses for oesophageal bleeding (OB) and upper gastrointestinal bleeding (UGIB) from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided) or "unspecific" (origin of bleeding not provided) coding. We studied regional (former East versus West Germany) differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32) for specific and 0.67 (95% CI 0.60-0.74) for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51) for specific and 0.83 (95% CI 0.80-0.87) for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. During the study period, there were substantial regional and temporal variations in the coding of OB and UGIB diagnoses in hospitalised patients. Possible explanations for the observed regional variations are different coding preferences, further influenced by changes in coding and reimbursement rules. Analysing groups of diagnoses including specific and unspecific codes reduces the influence of varying coding practices.

Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden - a longitudinal population-based register study.

PubMed

Polyzoi, Maria; Ahnemark, Ewa; Medin, Emma; Ginsberg, Ylva

2018-01-01

Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. National Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. The estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics. In Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations.

Time interval between infective endocarditis first symptoms and diagnosis: relationship to infective endocarditis characteristics, microorganisms and prognosis.

PubMed

N'Guyen, Yohan; Duval, Xavier; Revest, Matthieu; Saada, Matthieu; Erpelding, Marie-Line; Selton-Suty, Christine; Bouchiat, Coralie; Delahaye, François; Chirouze, Catherine; Alla, François; Strady, Christophe; Hoen, Bruno

2017-03-01

To analyze the characteristics and outcome of infective endocarditis (IE) according to the time interval between IE first symptoms and diagnosis. Among the IE cases of a French population-based epidemiological survey, patients having early-diagnosed IE (diagnosis of IE within 1 month of first symptoms) were compared with those having late-diagnosed IE (diagnosis of IE more than 1 month after first symptoms). Among the 486 definite-IE, 124 (25%) had late-diagnosed IE whereas others had early-diagnosed IE. Early-diagnosed IE were independently associated with female gender (OR = 1.8; 95% CI [1.0-3.0]), prosthetic valve (OR= 2.6; 95% CI [1.4-5.0]) and staphylococci as causative pathogen (OR = 3.7; 95% CI [2.2-6.2]). Cardiac surgery theoretical indication rates were not different between early and late-diagnosed IE (56.3% vs 58.9%), whereas valve surgery performance was lower in early-diagnosed IE (41% vs 53%; p = .03). In-hospital mortality rates were higher in early-diagnosed IE than in late-diagnosed IE (25.1% vs 16.1%; p < .001). The time interval between IE first symptoms and diagnosis is closely related to the IE clinical presentation, patient characteristics and causative microorganism. Better prognosis reported in late-diagnosed IE may be related to a higher rate of valvular surgery. KEY MESSAGES Infective endocarditis, which time interval between first symptoms and diagnosis was less than one month, were mainly due to Staphylococcus aureus in France. Staphylococcus aureus infective endocarditis were associated with septic shock, transient ischemic attack or stroke and higher mortality rates than infective endocarditis due to other bacteria or infective endocarditis, which time interval between first symptoms and diagnosis was more than one month. Infective endocarditis, which time interval between first symptoms and diagnosis was more than one month, were accounting for one quarter of all infective endocarditis in our study and were associated with vertebral osteomyelitis and a higher rate of cardiac surgery performed for hemodynamic indication than other infective endocarditis.

Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden – a longitudinal population-based register study

PubMed Central

Polyzoi, Maria; Ahnemark, Ewa; Medin, Emma; Ginsberg, Ylva

2018-01-01

Background Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. Methods National Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. Results The estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics. Conclusion In Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations. PMID:29765219

Integrated Source Case Investigation for Tuberculosis (TB) and HIV in the Caregivers and Household Contacts of Hospitalised Young Children Diagnosed with TB in South Africa: An Observational Study

PubMed Central

Lala, Sanjay G.; Little, Kristen M.; Tshabangu, Nkeko; Moore, David P.; Msandiwa, Reginah; van der Watt, Martin; Chaisson, Richard E.; Martinson, Neil A.

2015-01-01

Background Contact tracing, to identify source cases with untreated tuberculosis (TB), is rarely performed in high disease burden settings when the index case is a young child with TB. As TB is strongly associated with HIV infection in these settings, we used source case investigation to determine the prevalence of undiagnosed TB and HIV in the caregivers and household contacts of hospitalised young children diagnosed with TB in South Africa. Methods Caregivers and household contacts of 576 young children (age ≤7 years) with TB diagnosed between May 2010 and August 2012 were screened for TB and HIV. The primary outcome was the detection of laboratory-confirmed, newly-diagnosed TB disease and/or HIV-infection in close contacts. Results Of 576 caregivers, 301 (52·3%) self-reported HIV-positivity. Newly-diagnosed HIV infection was detected in 63 (22·9%) of the remaining 275 caregivers who self-reported an unknown or negative HIV status. Screening identified 133 (23·1%) caregivers eligible for immediate anti-retroviral therapy (ART). Newly-diagnosed TB disease was detected in 23 (4·0%) caregivers. In non-caregiver household contacts (n = 1341), the prevalence of newly-diagnosed HIV infection and TB disease was 10·0% and 3·2% respectively. On average, screening contacts of every nine children with TB resulted in the identification of one case of newly-diagnosed TB disease, three cases of newly diagnosed HIV-infection, and three HIV-infected persons eligible for ART. Conclusion In high burden countries, source case investigation yields high rates of previously undiagnosed HIV and TB infection in the close contacts of hospitalised young children diagnosed with TB. Furthermore, integrated screening identifies many individuals who are eligible for immediate ART. Similar studies, with costing analyses, should be undertaken in other high burden settings–integrated source case investigation for TB and HIV should be routinely undertaken if our findings are confirmed. PMID:26378909

Acute care hospital utilization among medical inpatients discharged with a substance use disorder diagnosis.

PubMed

Walley, Alexander Y; Paasche-Orlow, Michael; Lee, Eugene C; Forsythe, Shaula; Chetty, Veerappa K; Mitchell, Suzanne; Jack, Brian W

2012-03-01

Hospital discharge may be an opportunity to intervene among patients with substance use disorders to reduce subsequent hospital utilization. This study determined whether having a substance use disorder diagnosis was associated with subsequent acute care hospital utilization. We conducted an observational cohort study among 738 patients on a general medical service at an urban, academic, safety-net hospital. The main outcomes were rate and risk of acute care hospital utilization (emergency department visit or hospitalization) within 30 days of discharge. The main independent variable was presence of a substance use disorder primary or secondary discharge diagnosis code at the index hospitalization. At discharge, 17% of subjects had a substance use disorder diagnosis. These patients had higher rates of recurrent acute care hospital utilization than patients without substance use disorder diagnoses (0.63 vs 0.32 events per subject at 30 days, P < 0.01) and increased risk of any recurrent acute care hospital utilization (33% vs 22% at 30 days, P < 0.05). In adjusted Poisson regression models, the incident rate ratio at 30 days was 1.49 (95% confidence interval, 1.12-1.98) for patients with substance use disorder diagnoses compared with those without. In subgroup analyses, higher utilization was attributable to those with drug diagnoses or a combination of drug and alcohol diagnoses, but not to those with exclusively alcohol diagnoses. Medical patients with substance use disorder diagnoses, specifically those with drug use-related diagnoses, have higher rates of recurrent acute care hospital utilization than those without substance use disorder diagnoses.

The impact of transmission clusters on primary drug resistance in newly diagnosed HIV-1 infection.

PubMed

Yerly, Sabine; Junier, Thomas; Gayet-Ageron, Angèle; Amari, Emmanuelle Boffi El; von Wyl, Viktor; Günthard, Huldrych F; Hirschel, Bernard; Zdobnov, Evgeny; Kaiser, Laurent

2009-07-17

To monitor HIV-1 transmitted drug resistance (TDR) in a well defined urban area with large access to antiretroviral therapy and to assess the potential source of infection of newly diagnosed HIV individuals. All individuals resident in Geneva, Switzerland, with a newly diagnosed HIV infection between 2000 and 2008 were screened for HIV resistance. An infection was considered as recent when the positive test followed a negative screening test within less than 1 year. Phylogenetic analyses were performed by using the maximum likelihood method on pol sequences including 1058 individuals with chronic infection living in Geneva. Of 637 individuals with newly diagnosed HIV infection, 20% had a recent infection. Mutations associated with resistance to at least one drug class were detected in 8.5% [nucleoside reverse transcriptase inhibitors (NRTIs), 6.3%; non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.5%; protease inhibitors, 1.9%]. TDR (P-trend = 0.015) and, in particular, NNRTI resistance (P = 0.002) increased from 2000 to 2008. Phylogenetic analyses revealed that 34.9% of newly diagnosed individuals, and 52.7% of those with recent infection were linked to transmission clusters. Clusters were more frequent in individuals with TDR than in those with sensitive strains (59.3 vs. 32.6%, respectively; P < 0.0001). Moreover, 84% of newly diagnosed individuals with TDR were part of clusters composed of only newly diagnosed individuals. Reconstruction of the HIV transmission networks using phylogenetic analysis shows that newly diagnosed HIV infections are a significant source of onward transmission, particularly of resistant strains, thus suggesting an important self-fueling mechanism for TDR.

A retrospective observational analysis of post-pandemic influenza-related outcomes in the United Kingdom, 2010-2014.

PubMed

Rajaram, Sankarasubramanian; Wiecek, Witold; Lawson, Richard; Blak, Betina; Zhao, Yanli; Hackett, Judith; Brody, Robert; Salimi, Tehseen; Amzal, Billy; Patel, Vishal

2018-02-01

This study set out to evaluate influenza- and respiratory-related illnesses recorded during primary care physician consultations in England following the H1N1 pandemic in 2009 and to enable the development of a dynamic disease model. Data were obtained from the Clinical Practice Research Datalink of primary care records over four influenza seasons (2010-2014). The primary outcome of the study was incidence of influenza- and respiratory-related diagnoses, calculated per practice and by season and age group. Upper respiratory tract infection diagnoses were most frequently recorded (mean seasonal practice level incidence; 3,762 consultations per 100,000 [SD = 1,989]), and influenza-related diagnoses were least frequently recorded across all seasons, except one. Incidence rates for the under 18 population were higher than those for the general population, in particular for upper respiratory tract infection (range of 8,024-9,950 versus 3,228-4,120, respectively) and otitis media diagnoses (2,668-3,652 versus 782-1,057, respectively). For influenza-related diagnoses, the 65+ age group, the 0 to <2 and 2 to <4 groups had a higher risk (risk ratio = 1.33, 1.12 and 1.16, respectively) than other age groups. This study provides valuable insight into the incidence of influenza- and respiratory-related diagnoses in the primary care setting in England, and suggests a higher burden of disease in young children and the elderly. The study also indicates that some influenza illness is likely to be reported under respiratory-related diagnoses, given the low incidence of influenza-related diagnoses in the study.

Direct-to-consumer and physician promotion of tegaserod correlated with physician visits, diagnoses, and prescriptions.

PubMed

Dorn, Spencer D; Farley, Joel F; Hansen, Richard A; Shah, Nilay D; Sandler, Robert S

2009-08-01

Direct-to-consumer advertisement (DTCA) and physician promotion of drugs can influence patient and physician behaviors. We sought to determine the relationship between promotion of tegaserod and the number of office visits for abdominal pain, constipation, and bloating; diagnoses of irritable bowel syndrome (IBS); and tegaserod prescriptions. We used an Integrated Promotional Services database to estimate tegaserod DTCA and promotion expenditures; the National Ambulatory/Hospital Medical Care Surveys (1997-2005) to estimate the number of ambulatory care visits for abdominal pain, constipation, and bloating and diagnoses of IBS; and IMS Health's National Prescription Audit Plus (Fairfield, CT) to estimate the number of prescriptions. We constructed segmented and multivariate regression models to analyze the data. In the 3 months immediately following the start of tegaserod DTCA, there was a significant increase in physician visits (by 1 million; 95% confidence interval [CI], 0.5-1.6 million) and IBS diagnoses (by 397,025; 95% CI, 3909-790,141). Subsequently, the trend of visits and IBS diagnoses was reduced. In multivariate analyses that examined the overall relationship of promotion with visits, diagnoses, and prescriptions, only the relationship between physician promotion and tegaserod prescribing was significant; every $1 million spent on physician promotion resulted in an additional 4108 prescriptions (95% CI, 2526-5691). The initial DTCA of tegaserod was associated with a significant, immediate increase in physician visits and IBS diagnoses. This trend reversed and, in multivariate models, neither DTCA nor physician promotion correlated with visits or diagnoses. Physician promotion (although not DTCA) correlated with tegaserod prescription volume.

Psychiatric Disorders in Smokers Seeking Treatment for Tobacco Dependence: Relations with Tobacco Dependence and Cessation

PubMed Central

Piper, Megan E.; Smith, Stevens S.; Schlam, Tanya R.; Fleming, Michael F.; Bittrich, Amy A.; Brown, Jennifer L.; Leitzke, Cathlyn J.; Zehner, Mark E.; Fiore, Michael C.; Baker, Timothy B.

2009-01-01

Objective The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Method Data were collected from 1504 smokers (58.2% women, 83.9% white, 44.67 [SD = 11.08] years old) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined using the Composite International Diagnostic Interview (CIDI) structured clinical interview. Tobacco dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Results Diagnostic groups included those who were never diagnosed, ever diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group (p’s < .05). At 8 weeks post-quit, strong associations were found between cessation outcome and both past-year mood disorder and ever-diagnosed anxiety disorder. At 6 months post-quit those ever diagnosed with an anxiety disorder (OR = .72, p = .02) and those ever diagnosed with more than one psychiatric diagnosis (OR = .74, p = .03) had lower abstinence rates. The diagnostic categories did not differ in smoking heaviness or the FTND, but they did differ in dependence motives assessed with the WISDM. Conclusion Information on recent or lifetime psychiatric disorders may help clinicians gauge relapse risk and may suggest dependence motives that are particularly relevant to affected patients. These findings also illustrate the importance of using multidimensional tobacco dependence assessments. PMID:20099946

HIV Care Continuum Applied to the US Department of Veterans Affairs: HIV Virologic Outcomes in an Integrated Health Care System.

PubMed

Backus, Lisa; Czarnogorski, Maggie; Yip, Gale; Thomas, Brittani P; Torres, Marisa; Bell, Tierney; Ross, David

2015-08-01

The Department of Veterans Affairs (VA), the largest integrated HIV care provider in the United States (US), used the HIV Care Continuum to compare clinical care within the VA HIV population with the general US HIV population and to identify areas for improvement. National data from the VA's HIV Clinical Case Registry were used to construct measures along the Continuum for Veterans in VA care diagnosed with HIV by June 2013 and alive by December 31, 2013. Comparisons were made to recent estimates for the same measures for the US HIV population. Additional comparisons were performed for demographic subgroups of sex, race/ethnicity, and age. Of 25,480 Veterans diagnosed with HIV, 77.4% were engaged in care compared with 46.3% in the US population diagnosed with HIV (P < 0.001). Seventy-three percent of Veterans diagnosed with HIV received antiretroviral therapy compared with 43% of the US population diagnosed with HIV (P < 0.001). Nearly two-thirds (65.3%) of HIV-diagnosed Veterans had suppressed HIV viral loads compared with 35.0% of the US population diagnosed with HIV (P < 0.001). The VA health care system performed better at every stage of the HIV Care Continuum compared with the general US estimates. Comparable high rates with some variation were noted among the demographic groups in the VA cohort. The high viral suppression rate in VA, which was almost double the estimate for the HIV-diagnosed US population, demonstrates that improved outcomes along the HIV Care Continuum can be achieved in a comprehensive integrated health care system.

Social and diagnostic inequality in health.

PubMed

Bringedal, Berit; Tufte, Per Arne

2012-11-01

Empirical studies of social inequalities in health commonly take the diagnosing of disease for granted. Social inequalities in health are seen as the result of social processes, yet the diagnosis itself is rarely considered to contribute to such inequality. We argue that the influence of sociocultural and cognitive bias in the diagnosing process follows a social pattern, such that certain diagnoses are disproportionally over- or underrepresented in different socioeconomic groups due to interpretive bias of underlying symptoms. Norwegian data on sick leave for diffuse musculoskeletal and diffuse psychiatric disease in 2006 were analysed to study the distribution of the two diagnoses in different status groups. Socioeconomic status was measured by years of education. Diagnoses and occupational codes were based on national registers; diagnoses in accordance with the International Classification of Primary Care second edition. We compared occupations in technical sectors to occupations in the health sector and the relative number of cases of sick leave controlled for years of education, gender, occupational sector, and diagnosis. Data were analysed by cross-tabulation, ratio of diffuse psychiatric/musculoskeletal diseases, and logistic regression. The ratio of diffuse psychiatric/musculoskeletal diseases increases with education and decreases if the employee works in a technical job. The results challenge the traditional explanation that job features alone can explain the distribution of disease and suggest that a part of the persistent social inequality in health can be caused by the diagnosing process. In order to reach a better understanding of the processes behind the social inequalities in health, the diagnosing process itself should also be studied.

Direct to consumer and physician promotion of tegaserod correlated with physician visits, diagnoses, and prescriptions

PubMed Central

Dorn, Spencer D.; Farley, Joel F.; Hansen, Richard A.; D. Shah, Nilay; Sandler, Robert S.

2009-01-01

Background & Aims Direct to consumer advertisement (DTCA) and physician promotion of drugs can influence patient and physician behaviors. We sought to determine the relationship between promotion of tegaserod and the number of office visits for abdominal pain, constipation, and bloating; diagnoses of irritable bowel syndrome (IBS); and tegaserod prescriptions. Methods We used an Integrated Promotional Services database to estimate tegaserod DTCA and promotion expenditures, The National Ambulatory/Hospital Medical Care Surveys (1997–2005) to estimate the number of ambulatory care visits for abdominal pain, constipation, and bloating and diagnoses of IBS, and IMS Health's National Prescription Audit Plus to estimate the number of prescriptions. We constructed segmented and multivariate regression models to analyze the data. Results In the 3 months immediately following the start of tegaserod DTCA, there was a significant increase in physician visits (by 1 million; 95% CI 0.5–1.6 million) and IBS diagnoses (by 397,025; 95% CI 3,909–790,141). Subsequently, the trend of visits and IBS diagnoses reduced. In multivariate analyses that examined the overall relationship of promotion with visits, diagnoses, and prescriptions, only the relationship between physician promotion and tegaserod prescribing was significant; every $1 million spent on physician promotion resulted in an additional 4,108 prescriptions (95% CI: 2,526–5,691). Conclusions The initial DTCA of tegaserod was associated with a significant, immediate increase in physician visits and IBS diagnoses. This trend reversed and in multivariate models, neither DTCA nor physician promotion correlated with visits or diagnoses. Physician promotion (though not DTCA) correlated with tegaserod prescription volume. PMID:19445943

Depression and the Subsequent Risk of Parkinson’s Disease in the NIH-AARP Diet and Health Study

PubMed Central

Fang, Fang; Xu, Qun; Park, Yikyung; Huang, Xuemei; Hollenbeck, Albert; Blair, Aaron; Schatzkin, Arthur; Kamel, Freya; Chen, Honglei

2010-01-01

We conducted a case-control study to examine the association between depression and Parkinson’s disease (PD). Participants included 992 PD cases diagnosed after 2000 and 279,958 individuals without PD from the NIH-AARP Diet and Health Study Follow-up Survey. Physician-diagnosed depression and PD were self-reported with information on the year of diagnosis in the following categories: before 1985, 1985–1994, 1995–1999, and 2000-present. Only PD cases diagnosed after 2000 were included in the analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression models, adjusted for age, gender, educational level, marital status, smoking, and coffee drinking. Individuals with depression diagnosed after 2000 were more likely to report a concurrent diagnosis of PD than those without depression (OR=4.7,95% CI = 3.9,5.7). Depression diagnosed before 2000 was also associated with higher odds of PD diagnosed after 2000(OR= 2.0,95% CI=1.6,2.4). This association was stronger for depression diagnosed in 1995–1999 (OR = 2.7,95% CI = 2.0,3.6), but was also noted for depression diagnosed in 1985–1994 (OR = 1.6,95% CI = 1.1,2.3) or even before 1985 (OR=1.7,95% CI=1.3,2.3). This association was not modified by other factors and persisted in an analysis excluding participants who reported poor health status. The results suggest that depression may either be a very early symptom of PD or share common etiological factors with PD. PMID:20310050

Age biases in a large HIV and sexual behaviour-related internet survey among MSM.

PubMed

Marcus, Ulrich; Hickson, Ford; Weatherburn, Peter; Schmidt, Axel J

2013-09-10

Behavioural data from MSM are usually collected in non-representative convenience samples, increasingly on the internet. Epidemiological data from such samples might be useful for comparisons between countries, but are subject to unknown participation biases. Self-reported HIV diagnoses from participants of the European MSM Internet Survey (EMIS) living in the Czech Republic, Germany, The Netherlands, Portugal, Sweden and the United Kingdom were compared with surveillance data, for both the overall diagnosed prevalence and for new diagnoses made in 2009. Country level prevalence and new diagnoses rates per 100 MSM were calculated based on an assumed MSM population size of 3% of the adult male population. Survey-surveillance discrepancies (SSD) for survey participation, diagnosed HIV prevalence and new HIV diagnoses were determined as ratios of proportions. Results are calculated and presented by 5-year age groups for MSM aged 15-64. Surveillance derived estimates of diagnosed HIV prevalence among MSM aged 15-64 ranged from 0.63% in the Czech Republic to 4.93% in The Netherlands. New HIV diagnoses rates ranged between 0.10 per 100 MSM in the Czech Republic and 0.48 per 100 in The Netherlands. Self-reported rates from EMIS were consistently higher, with prevalence ranging from 2.68% in the Czech Republic to 12.72% in The Netherlands, and new HIV diagnoses rates from 0.36 per 100 in Sweden to 1.44 per 100 in The Netherlands. Across age groups, the survey surveillance discrepancies (SSD) for new HIV diagnoses were between 1.93 in UK and 5.95 in the Czech Republic, and for diagnosed prevalence between 1.80 in Germany and 4.26 in the Czech Republic.Internet samples of MSM were skewed towards younger age groups when compared to an age distribution of the general adult male population. Survey-surveillance discrepancies (SSD) for EMIS participation were inverse u-shaped across the age range. The two HIV-related SSD were u- or j-shaped with higher values for the very young and for older MSM. The highest discrepancies between survey and surveillance data regarding HIV-prevalence were observed in the oldest age group in Sweden and the youngest age group in Portugal. Internet samples are biased towards a lower median age because younger men are over-represented on MSM dating websites and therefore may be more likely to be recruited into surveys. Men diagnosed with HIV were over-represented in the internet survey, and increasingly so in the older age groups. A similar effect was observed in the age groups younger than 25 years. Self-reported peak prevalence and peak HIV diagnoses rates are often shifted to higher age groups in internet samples compared to surveillance data. Adjustment for age-effects on online accessibility should be considered when linking data from internet surveys with surveillance data.

Counselor Supervisees' Experiences of Supervision When Working with Clients Diagnosed with an Eating Disorder

ERIC Educational Resources Information Center

LaSelle, Nicole M.

2017-01-01

The purpose of this phenomenological study was to reveal the supervisory experiences of counselor supervisees when working with clients diagnosed with eating disorders. Research questions were: "What are the reported supervisory experiences of counselor supervisees who work with clients diagnosed with eating disorders?" and "What…

Sex and race determination of crania by calipers and computer : a test of the Giles and Elliot discriminant functions in 52 forensic cases.

DOT National Transportation Integrated Search

1979-01-01

The Giles and Elliot discriminant functions diagnosing sex and race from cranial measurements were tested on a series of forensically examined crania of known sex and race. Of 52 crania of known sex, 46 (88%) were correctly diagnosed. Racial diagnose...

ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD

ERIC Educational Resources Information Center

Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

2012-01-01

Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…

Social Perception and WAIS-IV Performance in Adolescents and Adults Diagnosed with Asperger's Syndrome and Autism

ERIC Educational Resources Information Center

Holdnack, James; Goldstein, Gerald; Drozdick, Lisa

2011-01-01

Previous research using the Wechsler scales has identified areas of cognitive weaknesses in children, adolescents, and adults diagnosed with Autism or Asperger's syndrome. The current study evaluates cognitive functioning in adolescents and adults diagnosed with Autism or Asperger's syndrome using the Wechsler Adult Intelligence Scale-Fourth…

Educational Outcomes of Students First Diagnosed with Learning Disabilities in Postsecondary School

ERIC Educational Resources Information Center

Canto, Angela I.; Proctor, Briley E.; Prevatt, Frances

2005-01-01

The researchers examined the educational outcomes of three groups of college students who received an evaluation due to academic difficulties: those diagnosed with a learning disability (LD) who subsequently registered for services through the university student disability resource center; those diagnosed with an LD who did not register for…

Preparation of Family Nurse Practitioners at the Uniformed Services University of the Health Sciences for Their Role in Humanitarian Assistance Operations

DTIC Science & Technology

2001-04-11

all diagnoses seen. Some of the other diagnoses seen in smaller numbers were stress, medication refills, malnutrition, pregnancy and childbirth...Prevention 1 __ 2 __ 3 __ 4 __ 5 __ GU Assess/diagnose 1 __ 2 __ 3 __ 4 __ 5 __ (STD, UTI , Vaginitis) Treat 1

TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

ERIC Educational Resources Information Center

Elias, Eileen; Weider, Katie; Mustafa, Ruman

2011-01-01

This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…

Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy.

PubMed

Owe, Jone Furlund; Næss, Halvor; Gjerde, Ivar Otto; Bødtker, Jørn Eilert; Tysnes, Ole-Bjørn

2016-02-09

Chronic fatigue is a frequently occurring problem in both the primary and specialist health services. The Department of Neurology at Haukeland University Hospital has established a standard assessment for patients referred with suspected CFS/ME. This study reports diagnoses and findings upon assessment, and considers the benefit of supplementary examinations. Diagnoses and findings from examinations of 365 patients assessed for suspected CFS/ME are retrospectively reported. A total of 48 patients (13.2%) were diagnosed with CFS/ME, while a further 18 patients (4.9%) were diagnosed with post-infectious fatigue. Mental and behavioural disorders were diagnosed in 169 patients (46.3%), and these represented by far the largest group. Serious, but unrecognised somatic illness was discovered in two patients, while changes of uncertain significance were identified by MRI and lumbar puncture in a few patients. Fatigue is a frequently occurring symptom in the population. Thorough somatic and psychiatric investigation is necessary before referral to the specialist health services. Mental disorders and reactions to life crises are common and important differential diagnoses for CFS/ME. Long waiting times in the specialist health services may result in delayed diagnosis for these patients.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

PubMed

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

The recognition of diagnosable psychiatric disorders in suicide cases' last medical contacts.

PubMed

Pan, Yi-Ju; Lee, Ming-Been; Chiang, Hung-Chi; Liao, Shih-Cheng

2009-01-01

The objective of this study is to examine physicians' awareness of diagnosable psychiatric disorders in suicide cases' last medical contacts (MCs). The contact rates and proportions of both psychiatric and somatic diagnoses in a national cohort of suicide subjects (N=3468) in Taiwan seeking psychiatric or nonpsychiatric medical services within 1 month and 1 year preceding death were examined. The overall rates of MCs were 72.6% within 1 month and 89.2% within 1 year preceding suicide. While around 99.9% of the suicide subjects who contacted psychiatrists within 1 month preceding death were diagnosed as having psychiatric disorders, only 19.7% of those visiting nonpsychiatric physicians had psychiatric diagnoses. Suicide subjects, however, frequently complained of somatic symptoms, for example, gastrointestinal discomfort, headache/dizziness and back problem during their contacts with nonpsychiatric physicians within 1 month preceding death. Despite the high rates of MCs preceding suicide, the majority of suicide subjects were not diagnosed. Emphasizing psychosomatic manifestations of psychiatric disorders in physician education programs may help enhance the awareness of psychiatric disorders/suicide risk in clinical settings.

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009–2014

PubMed Central

Clark, Hollie; Babu, Aruna Surendera; Wiewel, Ellen Weiss; Opoku, Jenevieve; Crepaz, Nicole

2017-01-01

Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009–2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people. PMID:28035497

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009-2014.

PubMed

Clark, Hollie; Babu, Aruna Surendera; Wiewel, Ellen Weiss; Opoku, Jenevieve; Crepaz, Nicole

2017-09-01

Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009-2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people.

Study of cognitive functions in newly diagnosed cases of subclinical and clinical hypothyroidism.

PubMed

Sharma, Kirti; Behera, Joshil Kumar; Sood, Sushma; Rajput, Rajesh; Satpal; Praveen, Prashant

2014-01-01

Hypothyroidism is associated with significant neurocognitive deficits because hypothyroidism prevents the brain from adequately sustaining the energy consuming processes needed for neurotransmission, memory, and other higher brain functions. Hence, the study was done to assess the cognitive functions of newly diagnosed subclinical and clinical hypothyroid patients by evoked response potential P300. 75 patients each of newly diagnosed subclinical and clinical hypothyroid patients attending endocrinology clinic and 75 healthy age and sex matched euthyroid controls were considered for the study. P300 was recorded with Record Medicare System Polyrite, Chandigarh using auditory "oddball paradigm". The data was analyzed using ANOVA followed by post Tukey's test. Newly diagnosed clinical hypothyroid patients showed a significant increase in P300 latency compared to control (P < 0.05) and subclinical cases (P < 0.01) while there was no significant difference between the P300 latency of subclinical cases and control group. Also, there was no significant difference in P300 amplitude among the three groups. P300 latency in case of newly diagnosed hypothyroid clinical cases is significantly increased compared to newly diagnosed subclinical cases and control.

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

PubMed

Chen, Peizhu; Hou, Xuhong; Hu, Gang; Wei, Li; Jiao, Lei; Wang, Hongmei; Chen, Siyu; Wu, Jingzhu; Bao, Yuqian; Jia, Weiping

2018-06-26

Previous studies have documented that visceral adipose tissue is positively associated with the risk of diabetes. However, the association of subcutaneous adipose tissue with diabetes risk is still in dispute. We aimed to assess the associations between different adipose distributions and the risk of newly diagnosed diabetes in Chinese adults. The Shanghai Nicheng Cohort Study was conducted among Chinese adults aged 45-70 years. The baseline data of 12,137 participants were analyzed. Subcutaneous and visceral fat area (SFA and VFA) were measured by magnetic resonance imaging. Diabetes was newly diagnosed using a 75 g oral glucose tolerance test. The multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) of newly diagnosed diabetes per 1-standard deviation increase in SFA and VFA were 1.29 (1.19-1.39) and 1.61 (1.49-1.74) in men, and 1.10 (1.03-1.18) and 1.56 (1.45-1.67) in women, respectively. However, the association between SFA and newly diagnosed diabetes disappeared in men and was reversed in women (OR 0.86 [95% CI, 0.78-0.94]) after additional adjustment for body mass index (BMI) and VFA. The positive association between VFA and newly diagnosed diabetes remained significant in both sexes after further adjustment for BMI and SFA. Areas under the receiver operating characteristic curve of newly diagnosed diabetes predicted by VFA (0.679 [95% CI, 0.659-0.699] for men and 0.707 [95% CI, 0.690-0.723] for women) were significantly larger than by the other adiposity indicators. SFA was beneficial for lower risk of newly diagnosed diabetes in women but was not associated with newly diagnosed diabetes in men after taking general obesity and visceral obesity into account. VFA, however, was associated with likelihood of newly diagnosed diabetes in both Chinese men and women.

Seasonal variations in tuberculosis diagnosis among HIV-positive individuals in Southern Africa: analysis of cohort studies at antiretroviral treatment programmes

PubMed Central

Ballif, Marie; Zürcher, Kathrin; Reid, Stewart E; Boulle, Andrew; Fox, Matthew P; Prozesky, Hans W; Chimbetete, Cleophas; Egger, Matthias; Fenner, Lukas

2018-01-01

Objectives Seasonal variations in tuberculosis diagnoses have been attributed to seasonal climatic changes and indoor crowding during colder winter months. We investigated trends in pulmonary tuberculosis (PTB) diagnosis at antiretroviral therapy (ART) programmes in Southern Africa. Setting Five ART programmes participating in the International Epidemiology Database to Evaluate AIDS in South Africa, Zambia and Zimbabwe. Participants We analysed data of 331 634 HIV-positive adults (>15 years), who initiated ART between January 2004 and December 2014. Primary outcome measure We calculated aggregated averages in monthly counts of PTB diagnoses and ART initiations. To account for time trends, we compared deviations of monthly event counts to yearly averages, and calculated correlation coefficients. We used multivariable regressions to assess associations between deviations of monthly ART initiation and PTB diagnosis counts from yearly averages, adjusted for monthly air temperatures and geographical latitude. As controls, we used Kaposi sarcoma and extrapulmonary tuberculosis (EPTB) diagnoses. Results All programmes showed monthly variations in PTB diagnoses that paralleled fluctuations in ART initiations, with recurrent patterns across 2004–2014. The strongest drops in PTB diagnoses occurred in December, followed by April–May in Zimbabwe and South Africa. This corresponded to holiday seasons, when clinical activities are reduced. We observed little monthly variation in ART initiations and PTB diagnoses in Zambia. Correlation coefficients supported parallel trends in ART initiations and PTB diagnoses (correlation coefficient: 0.28, 95% CI 0.21 to 0.35, P<0.001). Monthly temperatures and latitude did not substantially change regression coefficients between ART initiations and PTB diagnoses. Trends in Kaposi sarcoma and EPTB diagnoses similarly followed changes in ART initiations throughout the year. Conclusions Monthly variations in PTB diagnosis at ART programmes in Southern Africa likely occurred regardless of seasonal variations in temperatures or latitude and reflected fluctuations in clinical activities and changes in health-seeking behaviour throughout the year, rather than climatic factors. PMID:29330173

Reliability in the DSM-III field trials: interview v case summary.

PubMed

Hyler, S E; Williams, J B; Spitzer, R L

1982-11-01

A study compared the reliability of psychiatric diagnoses obtained from the live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a "live" interview.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) supplement.

PubMed

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J; Kessler, Ronald C; Merikangas, Kathleen R; Sampson, Nancy A; Zaslavsky, Alan M

2011-06-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. Copyright © 2011 John Wiley & Sons, Ltd.

Cognitive vulnerabilities and depression versus other psychopathology symptoms and diagnoses in early adolescence.

PubMed

Alloy, Lauren B; Black, Shimrit K; Young, Mathew E; Goldstein, Kim E; Shapero, Benjamin G; Stange, Jonathan P; Boccia, Angelo S; Matt, Lindsey M; Boland, Elaine M; Moore, Lauren C; Abramson, Lyn Y

2012-01-01

We examined the concurrent associations between multiple cognitive vulnerabilities to depression featured in hopelessness theory, Beck's theory, and response styles theory and depressive symptoms and diagnoses in a sample of early adolescents. We also examined the specificity of these cognitive vulnerabilities to depression versus anxiety and externalizing psychopathology, controlling for co-occurring symptoms and diagnoses. Male and female, Caucasian and African American, 12- to 13-year-old adolescents were assessed in a cross-sectional design. Cognitive vulnerabilities of hopelessness, inferential style, rumination, and self-referent information processing were assessed with self-reports and behavioral tasks. Symptoms and diagnoses of depressive, anxiety, and externalizing disorders were assessed with self-report questionnaires and diagnostic interviews. Hopelessness exhibited the greatest specificity to depressive symptoms and diagnoses, whereas negative inferential styles, rumination, and negative self-referent information processing were associated with both depressive and anxiety symptoms and diagnoses and, in some cases, with externalizing disorders. Consistent with cognitive theories of depression, hopelessness, negative inferential styles, rumination, and negative self-referent information processing were associated with depressive symptoms and diagnoses. However, with the exception of hopelessness, most of the remaining cognitive vulnerabilities were not specific to depression. With further maturation of our sample, these cognitive vulnerabilities may become more specific to depression as cognitive styles further develop and consolidate, the rates of depression increase, and individuals' presentations of psychopathology become more differentiated.

Cognitive Vulnerabilities and Depression versus Other Psychopathology Symptoms and Diagnoses in Early Adolescence

PubMed Central

Alloy, Lauren B.; Black, Shimrit K.; Young, Mathew E.; Goldstein, Kim E.; Shapero, Benjamin G.; Stange, Jonathan P.; Boccia, Angelo S.; Matt, Lindsey M.; Boland, Elaine M.; Moore, Lauren C.; Abramson, Lyn Y.

2012-01-01

Objective We examined the concurrent associations between multiple cognitive vulnerabilities to depression featured in Hopelessness Theory, Beck’s Theory, and Response Styles Theory and depressive symptoms and diagnoses in a sample of early adolescents. We also examined the specificity of these cognitive vulnerabilities to depression versus anxiety and externalizing psychopathology, controlling for co-occurring symptoms and diagnoses. Method Male and female, Caucasian and African-American, 12–13 year old adolescents were assessed in a cross-sectional design. Cognitive vulnerabilities of hopelessness, inferential style, rumination, and self-referent information processing were assessed with self-reports and behavioral tasks. Symptoms and diagnoses of depressive, anxiety, and externalizing disorders were assessed with self-report questionnaires and diagnostic interviews. Results Hopelessness exhibited the greatest specificity to depressive symptoms and diagnoses, whereas negative inferential styles, rumination, and negative self-referent information processing were associated with both depressive and anxiety symptoms and diagnoses and, in some cases, with externalizing disorders. Conclusions Consistent with cognitive theories of depression, hopelessness, negative inferential styles, rumination, and negative self-referent information processing were associated with depressive symptoms and diagnoses. However, with the exception of hopelessness, most of the remaining cognitive vulnerabilities were not specific to depression. With further maturation of our sample, these cognitive vulnerabilities may become more specific to depression as cognitive styles further develop and consolidate, the rates of depression increase, and individuals’ presentations of psychopathology become more differentiated. PMID:22853629

Costs of newly diagnosed neovascular age-related macular degeneration among medicare beneficiaries, 2004-2008.

PubMed

Qualls, Laura G; Hammill, Bradley G; Wang, Fang; Lad, Eleonora M; Schulman, Kevin A; Cousins, Scott W; Curtis, Lesley H

2013-04-01

To examine associations between newly diagnosed neovascular age-related macular degeneration and direct medical costs. This retrospective observational study matched 23,133 Medicare beneficiaries diagnosed with neovascular age-related macular degeneration between 2004 and 2008 with a control group of 92,532 beneficiaries on the basis of age, sex, and race. The index date for each case-control set corresponded to the first diagnosis for the case. Main outcome measures were total costs per patient and age-related macular degeneration-related costs per case 1 year before and after the index date. Mean cost per case in the year after diagnosis was $12,422, $4,884 higher than the year before diagnosis. Postindex costs were 41% higher for cases than controls after adjustment for preindex costs and comorbid conditions. Age-related macular degeneration-related costs represented 27% of total costs among cases in the postindex period and were 50% higher for patients diagnosed in 2008 than in 2004. This increase was attributable primarily to the introduction of intravitreous injections of vascular endothelial growth factor antagonists. Intravitreous injections averaged $203 for patients diagnosed in 2004 and $2,749 for patients diagnosed in 2008. Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.

Diagnosing comorbidity in psychiatric hospital: challenging the validity of administrative registers.

PubMed

Oiesvold, Terje; Nivison, Mary; Hansen, Vidje; Skre, Ingunn; Ostensen, Line; Sørgaard, Knut W

2013-01-08

This study will explore the validity of psychiatric diagnoses in administrative registers with special emphasis on comorbid anxiety and substance use disorders. All new patients admitted to psychiatric hospital in northern Norway during one year were asked to participate. Of 477 patients found eligible, 272 gave their informed consent. 250 patients (52%) with hospital diagnoses comprised the study sample. Expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) together with retrospective checking of the records. The hospital diagnoses were blind to the expert. The agreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. The expert gave a mean of 3.4 diagnoses per patient, the clinicians gave 1.4. The agreement ranged from poor to good (schizophrenia). For anxiety disorders (F40-41) the agreement is poor (kappa = 0.12). While the expert gave an anxiety disorder diagnosis to 122 patients, the clinicians only gave it to 17. The agreement is fair concerning substance use disorders (F10-19) (kappa = 0.27). Only two out of 76 patients with concurrent anxiety and substance use disorders were identified by the clinicians. The validity of administrative registers in psychiatry seems dubious for research purposes and even for administrative and clinical purposes. The diagnostic process in the clinic should be more structured and treatment guidelines should include comorbidity.

Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.

PubMed

Schneider, Barbara; Maurer, Konrad; Sargk, Dieter; Heiskel, Harald; Weber, Bernhard; Frölich, Lutz; Georgi, Klaus; Fritze, Jürgen; Seidler, Andreas

2004-06-30

The validity and reliability of using psychological autopsies to diagnose a psychiatric disorder is a critical issue. Therefore, interrater and test-retest reliability of the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders and the usefulness of these instruments for the psychological autopsy method were investigated. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 35 persons. Interrater reliability and test-retest reliability were assessed in 33 and 29 persons, respectively. Chi-square analysis, kappa and intraclass correlation coefficients, and Kendall's tau were used to determine agreement of diagnoses. Kappa coefficients were above 0.84 for substance-related disorders, mood disorders, and anxiety and adjustment disorders, and above 0.65 for Axis II disorders for interrater and test-retest reliability. Agreement by personal and relative's interview generated kappa coefficients above 0.79 for most Axis I and above 0.65 for most personality disorder diagnoses; Kendall's tau for dimensional individual personality disorder scores ranged from 0.22 to 0.72. Despite of a small number of psychiatric disorders in the selected population, the present results provide support for the validity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders. This instrument can be recommended as a tool for the psychological autopsy procedure in post-mortem research. Copyright 2004 Elsevier Ireland Ltd.

Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California

PubMed Central

Mehta, Sanjay R.; Murrell, Ben; Anderson, Christy M.; Kosakovsky Pond, Sergei L.; Wertheim, Joel O.; Young, Jason A.; Freitas, Lorri; Richman, Douglas D.; Mathews, W. Chris; Scheffler, Konrad; Little, Susan J.; Smith, Davey M.

2016-01-01

Background. Because recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego. Methods. The Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data. Results. Over time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P < .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83). Conclusions. These findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. PMID:27174704

Pulmonary disease at autopsy in patients with the acquired immunodeficiency syndrome.

PubMed

Wallace, J M; Hannah, J B

1988-08-01

To characterize the postmortem pulmonary disease and analyze the effectiveness of antemortem diagnosis, we examined the clinical records and autopsy material from 54 patients who died of the acquired immunodeficiency syndrome. At autopsy, all patients had pulmonary disease. One or more specific diagnoses were made in 53, including opportunistic infection, nonopportunistic infection, and Kaposi's sarcoma. Multiple postmortem pulmonary diagnoses were established in 37. Respiratory failure was the most common cause of death. Of the 97 pulmonary disorders discovered at autopsy, only 31 were diagnosed before death. The frequency with which infections were diagnosed during life varied according to the organism, and was significantly higher for Pneumocystis carinii than for cytomegalovirus or bacterial agents. Pulmonary Kaposi's sarcoma was diagnosed in only 7% of patients with autopsy documentation. The yield of diagnostic procedures also varied according to the disease present. Sputum culture was relatively effective in detecting Cryptococcus neoformans and Mycobacterium avium-intracellulare, fiber-optic bronchoscopy was extremely useful for diagnosing P Carinii, and one or more diagnoses were provided in 4 of 7 patients who underwent thoracotomy, but significant disease including cytomegalovirus infection and pulmonary Kaposi's sarcoma was frequently missed. Although the spectrum of lung disease found at autopsy is similar to that observed during life, the frequency of some pathologic processes including cytomegalovirus infection and Kaposi's sarcoma may be underrepresented in antemortem series.

Pulmonary Disease at Autopsy in Patients With the Acquired Immunodeficiency Syndrome

PubMed Central

Wallace, Jeanne M.; Hannah, James B.

1988-01-01

To characterize the postmortem pulmonary disease and analyze the effectiveness of antemortem diagnosis, we examined the clinical records and autopsy material from 54 patients who died of the acquired immunodeficiency syndrome. At autopsy, all patients had pulmonary disease. One or more specific diagnoses were made in 53, including opportunistic infection, nonopportunistic infection, and Kaposi's sarcoma. Multiple postmortem pulmonary diagnoses were established in 37. Respiratory failure was the most common cause of death. Of the 97 pulmonary disorders discovered at autopsy, only 31 were diagnosed before death. The frequency with which infections were diagnosed during life varied according to the organism, and was significantly higher for Pneumocystis carinii than for cytomegalovirus or bacterial agents. Pulmonary Kaposi's sarcoma was diagnosed in only 7% of patients with autopsy documentation. The yield of diagnostic procedures also varied according to the disease present. Sputum culture was relatively effective in detecting Cryptococcus neoformans and Mycobacterium avium-intracellulare, fiber-optic bronchoscopy was extremely useful for diagnosing P Carinii, and one or more diagnoses were provided in 4 of 7 patients who underwent thoracotomy, but significant disease including cytomegalovirus infection and pulmonary Kaposi's sarcoma was frequently missed. Although the spectrum of lung disease found at autopsy is similar to that observed during life, the frequency of some pathologic processes including cytomegalovirus infection and Kaposi's sarcoma may be underrepresented in antemortem series. PMID:3266812

Exploring the Diagnosis of "Gifted/LD": Characterizing Postsecondary Students with Learning Disability Diagnoses at Different IQ Levels

ERIC Educational Resources Information Center

Lovett, Benjamin J.; Sparks, Richard L.

2010-01-01

Increasing numbers of students are being diagnosed as simultaneously gifted and having a learning disability, although the identification procedures and characteristics of these students are matters of continuing debate. In the present study, postsecondary students with learning disability diagnoses (N = 357) were grouped according to their IQ…

The Emotional Impact of Being Recently Diagnosed with Dyslexia from the Perspective of Chiropractic Students

ERIC Educational Resources Information Center

Kong, Shelley Young

2012-01-01

Increased awareness and improved tests have contributed to the identification of rising numbers of dyslexic students entering higher education in the United Kingdom. Nearly half of these students are not diagnosed until they start their HE courses. Studies of experiences of dyslexic students diagnosed as children exist; however, there is little…

Motor Abilities of Children Diagnosed with Fragile X Syndrome with and without Autism

ERIC Educational Resources Information Center

Zingerevich, C.; Greiss-Hess, L.; Lemons-Chitwood, K.; Harris, S. W.; Hessl, D.; Cook, K.; Hagerman, Randi J.

2009-01-01

Background: Previous studies suggested that children diagnosed with fragile X syndrome (FXS) often meet criteria for autism or PDD. This study describes the fine motor abilities of children diagnosed with FXS with and without autism spectrum disorder, and compares the motor scores of those groups controlling for cognitive level. Method:…

Estimation of Post-Test Probabilities by Residents: Bayesian Reasoning versus Heuristics?

ERIC Educational Resources Information Center

Hall, Stacey; Phang, Sen Han; Schaefer, Jeffrey P.; Ghali, William; Wright, Bruce; McLaughlin, Kevin

2014-01-01

Although the process of diagnosing invariably begins with a heuristic, we encourage our learners to support their diagnoses by analytical cognitive processes, such as Bayesian reasoning, in an attempt to mitigate the effects of heuristics on diagnosing. There are, however, limited data on the use ± impact of Bayesian reasoning on the accuracy of…

Attention Deficit Hyperactivity Disorder Erroneously Diagnosed and Treated as Bipolar Disorder

ERIC Educational Resources Information Center

Atmaca, Murad; Ozler, Sinan; Topuz, Mehtap; Goldstein, Sam

2009-01-01

Objective: There is a dearth of literature on patients erroneously diagnosed and treated for bipolar disorder. Method: The authors report a case of an adult with attention deficit hyperactivity disorder erroneously diagnosed and treated for bipolar disorder for 6 years. At that point, methylphenidate was initiated. The patient was judged to be a…

Which Variables Predict Teachers Diagnostic Competence When Diagnosing Students' Learning Behavior at Different Stages of a Teacher's Career?

ERIC Educational Resources Information Center

Klug, Julia; Bruder, Simone; Schmitz, Bernhard

2016-01-01

Diagnosing is one of teachers' key competences. Lately, a new model of teachers' diagnostic competence and therewith a new measurement method focusing on diagnosing students' learning behavior in an interdisciplinary approach have been developed. They can build a basis for promoting teachers' diagnostic competence. However, some questions relevant…

Diagnosis Lost: Differences between Children Who Had and Who Currently Have an Autism Spectrum Disorder Diagnosis

ERIC Educational Resources Information Center

Blumberg, Stephen J.; Zablotsky, Benjamin; Avila, Rosa M.; Colpe, Lisa J.; Pringle, Beverly A.; Kogan, Michael D.

2016-01-01

Autism spectrum disorder diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey--the Survey of Pathways to Diagnosis and Services--to compare currently diagnosed (n = 1,420) and previously diagnosed (n = 187) children aged 6-17 years based on retrospective parental reports of…

Evaluating the Acceptability and Feasibility of Project ACCEPT: An Intervention for Youth Newly Diagnosed with HIV

ERIC Educational Resources Information Center

Hosek, Sybil G.; Lemos, Diana; Harper, Gary W.; Telander, Kyle

2011-01-01

Given the potential for negative psychosocial and medical outcomes following an HIV diagnosis, Project ACCEPT, a 12-session behavioral intervention, was developed and pilot-tested for youth (aged 16-24) newly diagnosed with HIV. Fifty participants recently diagnosed with HIV were enrolled from 4 sites selected through the Adolescent Medicine…

School Age Outcomes of Children Diagnosed Early and Later with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Clark, Megan Louise Erin; Vinen, Zoe; Barbaro, Josephine; Dissanayake, Cheryl

2018-01-01

Early diagnosis of Autism Spectrum Disorder is considered best practice, increasing access to early intervention. Yet, many children are diagnosed after 3-years. The current study investigated the school age outcomes of children who received an early and later diagnosis of ASD. The cognitive and behavioural outcomes of children diagnosed early (n…

A Tale of Three Cases: Examining Accuracy, Efficiency, and Process Differences in Diagnosing Virtual Patient Cases

ERIC Educational Resources Information Center

Doleck, Tenzin; Jarrell, Amanda; Poitras, Eric G.; Chaouachi, Maher; Lajoie, Susanne P.

2016-01-01

Clinical reasoning is a central skill in diagnosing cases. However, diagnosing a clinical case poses several challenges that are inherent to solving multifaceted ill-structured problems. In particular, when solving such problems, the complexity stems from the existence of multiple paths to arriving at the correct solution (Lajoie, 2003). Moreover,…

Psychiatric Symptoms in Children Diagnosed with an Autism Spectrum Disorder: An Examination of Gender Differences

ERIC Educational Resources Information Center

Worley, Julie A.; Matson, Johnny L.

2011-01-01

In addition to the triad of impairments experienced by children and adolescents diagnosed with Autism Spectrum Disorders (ASD), they often present with symptoms of psychiatric disorders. To date, very few studies have examined gender differences in regards to psychiatric symptoms in children and adolescents diagnosed with an ASD. Thus, the current…

School Functioning in Youth with and without Anxiety Disorders: Comparisons by Diagnosis and Comorbidity

ERIC Educational Resources Information Center

Mychailyszyn, Matthew P.; Mendez, Julia L.; Kendall, Philip C.

2010-01-01

This article reports on school functioning for 227 youth ages 7-14 (M = 10.3) with principal diagnoses of separation anxiety disorder (n = 40), social phobia (n = 58), generalized anxiety disorder (n = 76), or no diagnoses (n = 53). School functioning data were gathered via parent and teacher report. Youth with no diagnoses demonstrated…

Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

ERIC Educational Resources Information Center

Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

2008-01-01

This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…