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- Springer Nature (137) (remove)
We apply the charge simulation method (CSM) in order to compute the logarithmic capacity of compact sets consisting of (infinitely) many “small” components. This application allows to use just a single charge point for each component. The resulting method therefore is significantly more efficient than methods based on discretizations of the boundaries (for example, our own method presented in Liesen et al. (Comput. Methods Funct. Theory 17, 689–713, 2017)), while maintaining a very high level of accuracy. We study properties of the linear algebraic systems that arise in the CSM, and show how these systems can be solved efficiently using preconditioned iterative methods, where the matrix-vector products are computed using the fast multipole method. We illustrate the use of the method on generalized Cantor sets and the Cantor dust.
Background
Neuroinflammation and maladaptive neuroplasticity play pivotal roles in migraine (MIG), trigeminal autonomic cephalalgias (TAC), and complex regional pain syndrome (CRPS). Notably, CRPS shares connections with calcitonin gene-related peptide (CGRP) in its pathophysiology. This study aims to assess if the documented links between CRPS and MIG/TAC in literature align with clinical phenotypes and disease progressions. This assessment may bolster the hypothesis of shared pathophysiological mechanisms.
Methods
Patients with CRPS (n = 184) and an age-/gender-matched control group with trauma but without CRPS (n = 148) participated in this case–control study. Participant answered well-established questionnaires for the definition of CRPS symptoms, any headache complaints, headache entity, and clinical management.
Results
Patients with CRPS were significantly more likely to suffer from migraine (OR: 3.23, 95% CI 1.82–5.85), TAC (OR: 8.07, 95% CI 1.33–154.79), or non-classified headaches (OR: 3.68, 95% CI 1.88–7.49) compared to the control group. Patients with MIG/TAC developed CRPS earlier in life (37.2 ± 11.1 vs 46.8 ± 13.5 years), had more often a central CRPS phenotype (60.6% vs. 37.0% overall) and were three times more likely to report allodynia compared to CRPS patients with other types of headaches. Additionally, these patients experienced higher pain levels and more severe CRPS, which intensified with an increasing number of headache days. Patients receiving monoclonal antibody treatment targeting the CGRP pathway for headaches reported positive effects on CRPS symptoms.
Conclusion
This study identified clinically relevant associations of MIG/TAC and CRPS not explained by chance. Further longitudinal investigations exploring potentially mutual pathomechanisms may improve the clinical management of both CRPS and primary headache disorders.
Trial registration
German Clinical Trials Register (DRKS00022961).
Einleitung/Hintergrund
DC_TRAIN_APHASIA ist eine multizentrische, randomisiert-kontrollierte Studie, die seit November 2019 unter Federführung der Universitätsmedizin Greifswald durchgeführt wird (ClinicalTrials.gov Identifier: NCT03930121). Die Studie untersucht, ob adjuvante transkranielle Gleichstromstimulation („transcranial direct current stimulation“, tDCS) den Erfolg einer 3‑wöchigen intensiven Sprachtherapie bei chronischer Aphasie steigern kann.
Material und Methode
Bis Ende 2024 sollen bundesweit 130 Patient:innen eingeschlossen werden. Die Entwicklung innovativer Rekrutierungsstrategien stellt seit Beginn der Studie eine Herausforderung dar. Neben gängigen Rekrutierungsmethoden wie der direkten Ansprache von Menschen mit Aphasie in Kliniken, Logopädiepraxen, Rehabilitationseinrichtungen und Selbsthilfegruppen wurden Radiowerbespots, Fernsehbeiträge und Auftritte in sozialen Medien erprobt.
Zwischenergebnisse
Bis zum aktuellen Zeitpunkt konnten 110 Patient:innen in die Studie eingeschlossen werden. Zum größten kurzzeitigen Rücklauf führte die Rekrutierung über einen Fernseh- bzw. Radiobeitrag. Den größten langfristigen Rücklauf ergab die Rekrutierung über Logopädie- und Neurologiepraxen, Selbsthilfegruppen und soziale Medien. Teilnehmer:innen berichteten als „Testimonials“ positiv von der Sprachtherapie und der Anwendung von tDCS, die sich als gut verträglich erwies.
Diskussion
Die multizentrische Studie DC_TRAIN_APHASIA prüft die Wirksamkeit von tDCS als adjuvante Applikation für intensive Sprachtherapie bei chronischer Aphasie. Die vorliegende Übersicht soll künftigen Studien als Leitfaden zur Rekrutierung von Stichproben dienen, die Menschen mit eingeschränkten kommunikativen Fähigkeiten umfassen.
Perception of climate change-related forest dieback in mountain forests among the local population
(2023)
Mountain forests provide multiple benefits but are threatened by climate change-induced forest dieback. Although many studies summarize perceptions of forest ecosystem services, relatively few deal with mountain forests. The local population’s perception of forest dieback in mountain forests in relation to climate change has rarely been investigated so far. Their perspective is relevant as local people are often deeply attached to “their” forests, they actively use forest ecosystems and—as voters and taxpayers—they need to support the state’s adaptation and funding measures. Therefore, this study investigates the climate change and forest dieback perception of local inhabitants in two mountain areas of Southern Germany (the German Alps and the Bavarian Forest) with a quantitative survey based on representative online samples (n = 709). Relying conceptually on van der Linden’s (J Environ Psychol 41:112–124, 2015. https://doi.org/10.1016/j.jenvp.2014.11.012) climate change risk perception model, the results show that experiential processing, cognitive and socio-cultural factors are related to locals’ forest dieback and climate change perception, while socio-demographics show no or few connections. Nearly two-thirds (64.7%) of the respondents perceive moderate to strong forest dieback, while more than half (55.0%) of the respondents already observe consequences of climate change. The perceptions of climate change and forest dieback are positively correlated with medium to high strength. This shows that forest dieback could be interpreted as an indicator of climate change, which is difficult to observe due to its long-term nature. We identify three groups of respondents regarding preferred forest adaptation strategies to climate change. In general, respondents support nature-based forest adaptation strategies over intense measures.
Toarciconiopteryx dipterosimilis gen. et sp. nov. is described from the Lower Toarcian of Grimmen (Western Pomerania, Germany) based on a hind wing. This enigmatic wing superficially resembles a dipteran forewing, but analysis in detail establishes that it belongs to the Neuroptera. We assign it to the Coniopterygidae with great confidence by its great concordance with the hind wings of that family, but a small possibility remains that it might belong to the Dipteromantispidae, although the very derived haltere-like hind wings of all its known members are entirely unlike it. We, therefore, consider it to be the oldest record of Coniopterygidae. We create the new subfamily Toarciconiopteryginae subfam. nov. for it, which is distinguished from other Coniopterygidae by its hind wings possessing two branches of RP and a proximal forking of M. These conditions are also known in some Sialidae (Megaloptera), supporting the hypothesis that Coniopterygidae is the sister group of all other Neuroptera, as Megaloptera is considered by most authors to be sister to Neuroptera. New interpretations of some aspects of the Coniopterygidae venation are proposed.
Purpose
The significance of the underlying literature in clinical guidelines can be weakened by the risk of bias, which could negatively affect the recommendations. Especially in controversial matters, such as fluoride use for caries prevention in children, biased results may be not reliable and lead to incorrect conclusions. This study was performed to detect bias in underlying literature of the German guideline for caries prevention using fluoride in children, where no consensus was reached between paediatricians and paediatric dentists.
Methods
Three tools used for risk of bias assessments of different study designs were RoB 2 for RCTs, ROBINS-I for non-randomized studies, and ROBIS for systematic reviews. For each study cited in the guideline two independent risk of bias assessments were performed. Disagreements were resolved by consensus.
Results
Out of 58 papers, 48.3% (n = 28) showed high risk of bias, with the majority in sections regarding fluoride tablets, fluoridated toothpaste, and paediatricians’ recommendations. 9 out of 20 recommendations and statements were based on studies with high risk of bias, all of which were in these three controversial sections. 13 out of 29 RCTs showed high risk of bias (44.8%), as all 13 non-randomized trials did, while only 2 of 16 (12.5%) systematic reviews had high risk of bias.
Conclusion
Considering risk of bias of cited studies in clinical guidelines may result in substantial changes in its recommendations and aid in reaching consensus. Efforts should be made to assess risk of bias of underlying literature in future clinical guidelines.
Urbanization, industrialization, and intensification of agriculture have led to considerable heavy metal pollution across the globe, harming our ecosystems. Concentrations of arsenic (As), cadmium (Cd), copper (Cu), and lead (Pb) have been analysed in 249 eggshells collected between 2006 and 2021 from 83 female Common Cranes (Grus grus) nesting within north-eastern Germany. Information on the presence of trace elements in cranes from Europe and their potential adverse effects on the reproduction are largely missing. Only Cu and Pb were found to be present in eggshell samples. Levels of both metals did not exceed concentrations considered potentially toxic in birds and unhatched eggs did not contain higher metal concentrations compared to eggshell residues from hatched eggs. Statistical analysis revealed that trace element concentrations decreased significantly over the course of the study period. The ban of leaded gasoline in the early twenty-first century and strict limitations of heavy metal-based biocontrol products are likely responsible for this decrease over the years. However, as Cu levels gradually increase with increasing proportions of agricultural areas within the cranes’ home ranges, we suggest that considerable amounts of Cu originating from agricultural practises are still being released into the environment. We found no increase in metal concentrations in eggshells with increasing female age, suggesting that heavy metals do not accumulate in the circulatory systems of the adults over time. This study is the first to assess heavy metal contamination in Common Cranes and indicates the suitability of crane’s eggshells as bioindicator for monitoring environmental pollution.
Medieval texts reveal the normalised presence of Saami peoples in medieval Fennoscandia, suggesting close interactions involving trade, relationships, rituals, and magic. Despite growing recognition of these relations, the Saami remain overlooked in general studies of the Middle Ages, often relegated to symbolic roles or footnotes. As a result, Saami characters are typically depicted as the exotic Other within Norse society, often being stripped of agency and humanity in historical narratives. To counter these biases and distorted narratives, an essential step is analysing exclusionary structures in medieval literature and critically reviewing existing research on Saami representation. This process challenges dehumanising portrayals and confronts present-day stereotypes. The present study aims to ‘re-humanize’ (as Paulette F. C. Steeves puts it) the medieval Saami past by using decolonising frameworks and perspectives offered by the so-called ‘Indigenous turn’ of medieval studies, bridging medieval studies and Indigenous studies within a Norse context.
This study investigated, if a mixed electroactive bacterial (EAB) culture cultivated heterotrophically at a positive applied potential could be adapted from oxidative to reductive or bidirectional extracellular electron transfer (EET). To this end, a periodic potential reversal regime between − 0.5 and 0.2 V vs. Ag/AgCl was applied. This yielded biofilm detachment and mediated electroautotrophic EET in combination with carbonate, i.e., dissolved CO2, as the sole carbon source, whereby the emerged mixed culture (S1) contained previously unknown EAB. Using acetate (S2) as well as a mixture of acetate and carbonate (S3) as the main carbon sources yielded primarily alternating electrogenic organoheterotropic metabolism with the higher maximum oxidation current densities recorded for mixed carbon media, exceeding on average 1 mA cm−2. More frequent periodic polarization reversal resulted in the increase of maximum oxidative current densities by about 50% for S2-BES and 80% for S3-BES, in comparison to half-batch polarization. The EAB mixed cultures developed accordingly, with S1 represented by mostly aerobes (84.8%) and being very different in composition to S2 and S3, dominated by anaerobes (96.9 and 96.5%, respectively). S2 and S3 biofilms remained attached to the electrodes. There was only minor evidence of fully reversible bidirectional EET. In conclusion the three triplicates fed with organic and/or inorganic carbon sources demonstrated two forms of diauxie: Firstly, S1-BES showed a preference for the electrode as the electron donor via mediated EET. Secondly, S2-BES and S3-BES showed a preference for acetate as electron donor and c-source, as long as this was available, switching to CO2 reduction, when acetate was depleted.
Osteoporosis, a complex chronic disease with increasing prevalence, is characterised by reduced bone mineral density (BMD) and increased fracture risk. The high heritability of BMD suggests substantial impact of the individual genetic disposition on bone phenotypes and the development of osteoporosis. In the past years, genome-wide association studies (GWAS) identified hundreds of genetic variants associated with BMD or osteoporosis. Here, we analysed 1103 single nucleotide polymorphisms (SNPs), previously identified as associated with estimated BMD (eBMD) in the UK Biobank. We assessed whether these SNPs are related to heel stiffness index obtained by quantitative ultrasound in 5665 adult participants of the Study of Health in Pomerania (SHIP). We confirmed 45 significant associations after correction for multiple testing. Next, we analysed six selected SNPs in 631 patients evaluated for osteoporosis [rs2707518 (CPED1/WNT16), rs3779381 (WNT16), rs115242848 (LOC101927709/EN1), rs10239787 (JAZF1), rs603424 (PKD2L1) and rs6968704 (JAZF1)]. Differences in minor allele frequencies (MAF) of rs2707518 and rs3779381 between SHIP participants (higher MAF) and patients evaluated for osteoporosis (lower MAF) indicated a protective effect of the minor allele on bone integrity. In contrast, differences in MAF of rs603424 indicated a harmful effect. Co-localisation analyses indicated that the rs603424 effect may be mediated via stearoyl-CoA desaturase (SCD) expression, an enzyme highly expressed in adipose tissue with a crucial role in lipogenesis. Taken together, our results support the role of the WNT16 pathway in the regulation of bone properties and indicate a novel causal role of SCD expression in adipose tissue on bone integrity.
In dem Maß, in dem Gegenwartsliteratur gängige Auffassungen von Literatur wie von Gegenwart irritieren kann, kann sie auch als Impulsgeber und Korrektiv für eine Literaturwissenschaft fungieren, die nicht immer schon voraussetzt zu wissen, was Literatur ist. Sichtbar geworden ist dies zuletzt in Auseinandersetzungen mit Sozialen Medien, bei denen in Experimenten mit digitalen Tools wie im Rahmen konventionellerer Formen von Literatur und korrespondierender Theoriediskurse literarische und zeitdiagnostische Schreibweisen aneinanderrücken und auf je verschiedene Weise das hervorbringen, was als »Gegenwartsvergegenwärtigung« bezeichnet werden kann.
Der Nationale Kompetenzbasierte Lernzielkatalog Zahnmedizin (NKLZ) wurde 2015 verabschiedet und definiert die Lernziele für die zahnmedizinische Ausbildung in Deutschland. Er legt fest, welche Kompetenzen Studierende erwerben sollen, und dient als Grundlage für die curriculare Gestaltung des Studiums, der Prüfungen und der Unterrichtsmaterialien. Der NKLZ fördert eine umfassende Ausbildung, die neben fachlichem Wissen auch klinische Fähigkeiten und Fertigkeiten, professionelles Verhalten und kommunikative Kompetenzen einschließt. Er trägt zur Vorbereitung angehender Zahnmediziner:innen auf ihren Beruf bei und standardisiert die Ausbildung, um Qualität und Vergleichbarkeit sicherzustellen.
Der vorliegende Artikel beschreibt Hintergründe, Geschichte, Aufbau und die Weiterentwicklung des NKLZ. Derzeit wird der NKLZ zur Version 2.0 in einem mehrstufigen Prozess weiterentwickelt. Seine Struktur orientiert sich am NKLM 2.0, dem Nationalen Kompetenzbasierten Lernzielkatalog Medizin. Ziel ist es, die Anforderungen für die Zahnärztliche Approbationsordnung umfassend abzubilden.
Eine wichtige Voraussetzung für die offizielle Anerkennung des NKLZ als grundlegender Leitfaden für die Ausbildung von Zahnmediziner:innen ist die Verankerung in einer zeitnah zu reformierenden Approbationsordnung Zahnmedizin. Dadurch werden Klarheit und Verbindlichkeit für Lehrende und Studierende geschaffen. Eine solche Verankerung ermöglicht zudem eine bessere Abstimmung zwischen Ausbildungszielen und den Anforderungen der Berufspraxis. Da die Approbationsordnung weniger häufig angepasst wird, bietet die Einbindung des NKLZ die Möglichkeit, Aktualisierungen und Anpassungen des Lernzielkatalogs strukturiert und reguliert vorzunehmen. Dies gewährleistet, dass die Ausbildung den aktuellen Standards und Entwicklungen entspricht.
Numerous insertions of mitochondrial DNA in the genome of the northern mole vole, Ellobius talpinus
(2024)
Background
Ellobius talpinus is a subterranean rodent representing an attractive model in population ecology studies due to its highly special lifestyle and sociality. In such studies, mitochondrial DNA (mtDNA) is widely used. However, if nuclear copies of mtDNA, aka NUMTs, are present, they may co-amplify with the target mtDNA fragment, generating misleading results. The aim of this study was to determine whether NUMTs are present in E. talpinus.
Methods and results
PCR amplification of the putative mtDNA CytB-D-loop fragment using ‘universal’ primers from 56 E. talpinus samples produced multiple double peaks in 90% of the sequencing chromatograms. To reveal NUMTs, molecular cloning and sequencing of PCR products of three specimens was conducted, followed by phylogenetic analysis. The pseudogene nature of three out of the seven detected haplotypes was confirmed by their basal positions in relation to other Ellobius haplotypes in the phylogenetic tree. Additionally, ‘haplotype B’ was basal in relation to other E. talpinus haplotypes and found present in very distant sampling sites. BLASTN search revealed 195 NUMTs in the E. talpinus nuclear genome, including fragments of all four PCR amplified pseudogenes. Although the majority of the NUMTs studied were short, the entire mtDNA had copies in the nuclear genome. The most numerous NUMTs were found for rrnL, COXI, and D-loop.
Conclusions
Numerous NUMTs are present in E. talpinus and can be difficult to discriminate against mtDNA sequences. Thus, in future population or phylogenetic studies in E. talpinus, the possibility of cryptic NUMTs amplification should always be taken into account.
Objective
To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.
Materials and methods
A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.
Results
The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: −0.69; −0.41) after 3 months compared to the control group.
Conclusion
Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.
Trial registration
This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
Das vorliegende Essay gibt einen Überblick zum Standortauswahlprozess für die Endlagerung des hochradioaktiven Abfalls in der Bundesrepublik Deutschland. Dieses Verfahren stellt einen Paradigmenwechsel gegenüber dem früheren Versuch der Ausweisung eines Standortes dar, indem zunächst einzig geologische Kriterien hinsichtlich der Sicherheit der Einlagerung und nicht politisch-wirtschaftliche Einzelinteressen von Regionen entscheidend sein sollen. Der aktuelle Stand der Forschung bildet weitergehende Wissensbedarfe gut ab. Derzeit besonders diskutierte Aspekte im Rahmen der Einengung der großen Teilgebiete auf Standortregionen zur übertägigen Erkundung werden angesprochen.
Binding of general transcription factors TFIID and TFIIA to basal promoters is rate-limiting for transcriptional initiation of eukaryotic protein-coding genes. Consequently, activator proteins interacting with subunits of TFIID and/or TFIIA can drastically increase the rate of initiation events. Yeast transcriptional activator Ino2 interacts with several Taf subunits of TFIID, among them the multifunctional Taf1 protein. In contrast to mammalian Taf1, yeast Taf1 lacks bromodomains which are instead encoded by separate proteins Bdf1 and Bdf2. In this work, we show that Bdf1 not only binds to acetylated histone H4 but can also be recruited by Ino2 and unrelated activators such as Gal4, Rap1, Leu3 and Flo8. An activator-binding domain was mapped in the N-terminus of Bdf1. Subunits Toa1 and Toa2 of yeast TFIIA directly contact sequences of basal promoters and TFIID subunit TBP but may also mediate the influence of activators. Indeed, Ino2 efficiently binds to two separate structural domains of Toa1, specifically with its N-terminal four-helix bundle structure required for dimerization with Toa2 and its C-terminal β-barrel domain contacting TBP and sequences of the TATA element. These findings complete the functional analysis of yeast general transcription factors Bdf1 and Toa1 and identify them as targets of activator proteins.
Neutron scattering is a very high-performance method for studying the structure and dynamics of condensed matter with similar approaches in wide ranges of space and time, matching dimensions in space from single atoms to macromolecules and in time from atomic vibrations over crystal phonons to low-lying transitions in the microwave range, and to motions of large molecular units. Concerning the number and depth of physical concepts, neutron scattering may be compared to modern nuclear magnetic resonance. Neutrons have contributed essential results to the understanding of atomic and molecular processes and are, in this respect, complementary to other materials science probes. Among others, three properties of thermal neutrons make them especially appropriate for such work: the neutron mass is similar to atomic masses, and both neutron energies and the wavelengths of the neutron material wave match typical values for condensed matter. A further important feature of neutron scattering, making it especially valuable in biochemistry and polymer sciences, is that hydrogen and deuterium atoms very significantly and specifically contribute to the signal in both diffraction and spectroscopy. Additionally, neutrons are scattered at the nuclei and directly reflect the nuclear structure and motions. Results from neutron scattering are of great general interest. This paper aims to provide an introduction for chemists on a level understandable also to students and researchers who are not going to become part of the neutron community and will not be involved in the experiments, but shall be able to understand the basic concepts of the method and its relevance to modern chemistry. The paper focuses on basic theory, typical experiments, and some examples demonstrating the applications. As for many modern experimental techniques, the interpretation of the results of neutron scattering is based on theoretical models and requires a significant mathematical overhead. Most results are only meaningful when compared with computer simulations. For understanding this, in this paper, the theory of scattering is developed, starting with intuitive models and presenting typical concepts such as the scattering triangle, energy and momentum transfer, and the relation of inelastic and elastic scattering to space- and time-dependent information. The interaction of neutrons with matter, scattering cross sections, beam attenuation, and coherent versus incoherent scattering are explained in detail. Two further typical concepts that are not generally familiar to scientists outside the community are the use of wave and particle equivalence, and of handling results as a scattering function that depends simultaneously on momentum and energy transfers. The possibility of obtaining neutron beams for scattering experiments at a few research centers around high-performance sources is explained, and experimentally relevant features of research reactors and spallation sources are mentioned. As neutron experiments always have to deal with small flux and extended beams and shielding, experimental conditions are very far away from laboratory methods where handling of samples and instruments is concerned. Experimental details are given for making experiments more understandable and familiarizing the reader with the method. Related to this are extended possibilities for handling samples in a large variety of different environments. In a further part of the manuscript, a variety of techniques and typical instruments are presented, together with some characteristic applications bringing alive the theory developed so far. This covers powder diffraction and structure of liquid water, triple-axis spectrometers and lattice phonons, backscattering spectrometry and rotational tunneling, time-of-flight spectrometry, and simultaneously probing the energy and shape of low lying vibrations and diffusion, filter spectrometer and vibrational spectroscopy without selection rules, small-angle neutron scattering and protein unfolding, as well as micelles, neutron spin echo spectroscopy, and polymer dynamics.
Die Analyse von und die Reflexion über Unterricht sind zentrale Elemente universitärer Lehrkräftebildung. Dabei kann sowohl in der Lehre als auch in der Forschung begriffliche Heterogenität bzgl. Reflexion konstatiert werden. Auch fehlt eine klare Abgrenzung zwischen Analyse und Reflexion von Unterricht. Aufbauend auf der Konzeption des Selbstbezugs als ein zentrales Unterscheidungsmerkmal wird mittels eines quasi-experimentellen Prä-Post-Interventions-Kontrollgruppendesigns geprüft, inwiefern sich Unterrichtsanalysen von Unterrichtsreflexionen in ihren Auswirkungen auf die professionelle Unterrichtswahrnehmung (PUW) und die klassenführungsbezogene Selbstwirksamkeit (SW) unterscheiden. An einer Stichprobe von 194 angehenden Lehrkräften im Master of Education einer Hochschule kann gezeigt werden, dass Unterrichtsanalyse und -reflexion vergleichbar positive Effekte auf die PUW zeigten (besser als eine Kontrollgruppe ohne spezifische Intervention). Allerdings zeigt die Reflexionsgruppe eine stärkere Zunahme klassenführungsbezogener SW im Vergleich zu den anderen beiden Gruppen. Die Ergebnisse deuten somit darauf hin, dass durch den expliziten Selbstbezug selbstgerichtete Kognitionen verstärkt thematisiert werden und damit zusätzliche Aspekte professioneller Kompetenz adressiert werden können.
Lack of a shared vision has been identified as a major obstacle in transdisciplinary research involving both scientists and other stakeholders. Without a shared vision, the implementation of scientific findings is difficult. The diverse partners of collaborative research, however, imply a plurality in the valuation of nature and a need for deliberative mechanisms. If visioning processes are to do justice to local contexts, research must apply deliberative mechanisms to cover the plurality in the valuation of nature. This paper proposes a visioning approach for local communities, based on prior transdisciplinary research. This participatory workshop method invites stakeholders to approach nature conservation and livelihoods via a deliberation of desirable futures, barriers for achieving them and associated responsibilities for taking action. The paper explores this method via a case study of visioning workshops on sacred swamps in the Western Ghats (India), and their role for both freshwater swamp protection and livelihoods. The visioning exercise offered discussion opportunities facilitating conscientization, conciliation and collaboration in local bottom-up nature conservation. For conserving the tropical freshwater swamps, the results show the need for a more participatory forest governance, providing space for shared value creation. They also point to the need for further research on inter-faith nature conservation possibilities, along with innovations on value addition and value chain development for livelihood promotion and protection.
The cultivation of common reed (Phragmites australis) is one of the most promising practices of paludiculture on fen peatlands. This highly productive grass has a high adaptation capacity via high levels of genetic diversity and phenotypic plasticity. In this study, a reed experimental site established on a degraded fen in 1996/97 with a mixture of monoclonally (meristematically propagated plantlets) and polyclonally (pre-grown seedlings) planted plots was investigated by microsatellite genotyping. All nine genotypes of the monoclonal planted plots were recovered and could be genetically characterized; invasion by other genotypes was negligible. Similarly, the polyclonal plots sustained high clonal diversity with no prevalence of a single genotype. The growth characteristics of the five quantitatively investigated genotypes significantly differed from each other (α = 0.05): dry biomass per stem 5–18 g, panicles per m2 20–60, average stem diameter 3.5–6 mm, height 170–250 cm. Similarly, the persistence of genotypes at the planted plots and their invasiveness (ability to invade neighboured plots) varied. These results show that common reed stands are extremely persistent even if established with genotypes that are likely not to be locally adapted. Their genetic structure remained stable for at least 24 years regardless of the planting density (1, 4, and 10 plants per m2). Our results indicate that farmers may be able to maintain favourable genotypes for many years, thus the selection and breeding of common reed as a versatile crop for rewetted peatlands is a promising objective for paludiculture research.
Purpose
Patient-reported outcome (PRO) measures are increasingly important in evaluating medical care. The increased integration of technology within the healthcare systems allows for collection of PROs electronically. The objectives of this study were to Ashley et al. J Med Internet Res (2013) implement an electronic assessment of PROs in inpatient cancer care and test its feasibility for patients and Dawson et al. BMJ (2010) determine the equivalence of the paper and electronic assessment.
Methods
We analyzed two arms from a study that was originally designed to be an interventional, three-arm, and multicenter inpatient trial. A self-administered questionnaire based on validated PRO-measures was applied and completed at admission, 1 week after, and at discharge. For this analysis — focusing on feasibility of the electronic assessment — the following groups will be considered: Group A (intervention arm) received a tablet version, while group B (control arm) completed the questionnaire on paper. A feasibility questionnaire, that was adapted from Ashley et al. J Med Internet Res (2013), was administered to group A.
Results
We analyzed 103 patients that were recruited in oncology wards. ePRO was feasible to most patients, with 84% preferring the electronic over paper-based assessment. The feasibility questionnaire contained questions that were answered on a scale ranging from “1” (illustrating non achievement) to “5” (illustrating achieving goal). The majority (mean 4.24, SD .99) reported no difficulties handling the electronic tool and found it relatively easy finding time for filling out the questionnaire (mean 4.15, SD 1.05). There were no significant differences between the paper and the electronic assessment regarding the PROs.
Conclusion
Results indicate that electronic PRO assessment in inpatient cancer care is feasible.
Objective
Maternal pre-pregnancy underweight, overweight and obesity might increase the risk for worse short- and long-term outcome in the offspring. There is a need for further study into the relationship between maternal pre-pregnancy body mass index (BMI) and the combined outcome of physical development, state of health and social behavior in children. Question: Is maternal pre-pregnancy BMI associated with the child outcome in terms of physical development, state of health and social behavior (school and leisure time behavior) at the age of 9 to 15 years?
Methods
In the population-based birth cohort study Survey of Neonates in Pomerania (SNIP) children at the age 9–15 years and their families were re-examined by questionnaire-based follow-up. 5725 mother–child pairs were invited to SNiP-follow-up. This analysis is based on the recall fraction of 24.1% (n = 1379). Based on the maternal pre-pregnancy BMI (ppBMI), 4 groups were formed: underweight (ppBMI < 19 kg/m2, n = 117), normal weight (ppBMI 19–24.99 kg/m2, n = 913, reference), overweight (ppBMI 25–30 kg). /m2, n = 237) and obesity (ppBMI > 30 kg/m2, n = 109).
Results
In the multiple regression model, the BMI-z-score for children of mothers in the underweight group was −0.50 lower, and 0.50/1.07 higher in the overweight/obese group (p < 0.001) compared to reference at median age of 12 years. No differences were found in children of underweight mothers with regard to social behavior (interaction with friends and family), school and sports performance (coded from “very good” to “poor”), other leisure activities (watching television, using mobile phones, gaming), and health (occurrence of illnesses) compared to children of normal weight mothers. In contrast, maternal pre-pregnancy overweight and obesity were associated with lower school and sports performance, and higher screen time (smart phone, gaming, television) compared to children of normal weight mothers.
Conclusion
Maternal pre-pregnancy overweight and obesity but not underweight was negatively associated with school performance and leisure time behavior in the offspring at 9–15 years of age.
Deteriorations in slow wave sleep (SWS) have been linked to brain aging and Alzheimer’s disease (AD), possibly due to its key role in clearance of amyloid-beta and tau (Aß/tau), two pathogenic hallmarks of AD. Spermidine administration has been shown to improve sleep quality in animal models. So far, the association between spermidine levels in humans and parameters of SWS physiology are unknown but may be valuable for therapeutic strategies. Data from 216 participants (age range 50–81 years) of the population-based Study of Health in Pomerania TREND were included in our analysis. We investigated associations between spermidine plasma levels, key parameters of sleep macroarchitecture and microarchitecture that were previously associated with AD pathology, and brain health measured via a marker of structural brain atrophy (AD score). Higher spermidine levels were significantly associated with lower coupling between slow oscillations and spindle activity. No association was evident for SWS, slow oscillatory, and spindle activity throughout non-rapid eye movement sleep. Furthermore, elevated spermidine blood levels were significantly associated with a higher AD score, while sleep markers revealed no association with AD score. The association between higher spermidine levels and brain health was not mediated by coupling between slow oscillations and spindle activity. We report that higher spermidine blood levels are associated not only with deteriorated brain health but also with less advantageous markers of sleep quality in older adults. Future studies need to evaluate whether sleep, spermidine, and Aß/tau deposition are interrelated and whether sleep may play a mediating role.
This study primarily aims to determine the frequency of life-threatening conditions among pediatric patients served by the DRF, a German helicopter emergency service (HEMS) provider. It also seeks to explore the necessity of invasive procedures in this population, discussing the implications for HEMS crew training and service configuration based on current literature. We analyzed the mission registry from 31 DRF helicopter bases in Germany, focusing on 7954 children aged 10 or younger over a 5-year period (2014–2018). Out of 7954 identified children (6.2% of all primary missions), 2081 (26.2%) had critical conditions. Endotracheal intubation was needed in 6.5% of cases, while alternative airway management methods were rare (n = 14). Half of the children required intravenous access, and 3.6% needed intraosseous access. Thoracostomy thoracentesis and sonography were only performed in isolated cases.
Conclusions: Critically ill or injured children are infrequent in German HEMS operations. Our findings suggest that the likelihood of HEMS teams encountering such cases is remarkably low. Besides endotracheal intubation, life-saving invasive procedures are seldom necessary. Consequently, we conclude that on-the-job training and mission experience alone are insufficient for acquiring and maintaining the competencies needed to care for critically ill or injured children.
In general, concepts such as chemical equilibria and classical analytical chemistry, as well as instrumental methods such as potentiometry and flow injection analysis (FIA), are taught separately in the curricula of chemistry-related degree programs. However, FIA provides an opportunity to connect all of these important topics. This article shows how simple experiments can be used to link the fundamentals of FIA and potentiometry to the fundamentals of chemical equilibria and teach them in a sustainable way. The experiments were designed for undergraduate environmental science students with basic knowledge of chemical equilibria and classical analytical chemistry and minimal knowledge of electrochemistry. However, they can also be integrated into various courses on instrumental analysis in chemistry-related degree programs.
Hintergrund
Die Zertifizierung von Zentren für Beatmungsentwöhnung in der neurologisch-neurochirurgischen Frührehabilitation (NNFR) durch die Deutsche Gesellschaft für Neurorehabilitation (DGNR) ist seit dem 01.10.2021 möglich.
Ziel der Arbeit
Die Ergebnisse der Zertifizierung von Einrichtungen im ersten Jahr nach Aufnahme des Verfahrens werden vorgestellt.
Material und Methoden
Im Rahmen der Zertifizierung werden 28 Kriterien geprüft, darunter eine Reihe mandatorisch zu erfüllender Charakteristika der Einrichtung. Die Kriterien gliedern sich in Strukturkriterien (i = 7), Diagnostikkriterien (i = 6), Personalkriterien (i = 3), Kriterien der internen Organisation (i = 7) und Qualitätsmanagementkriterien (i = 5).
Ergebnisse
Insgesamt 13 Zentren wurden im ersten Jahr zertifiziert, die zusammen über 283 Betten zur Beatmungsentwöhnung („weaning“) in der NNFR verfügen und im Jahr vor der Zertifizierung 2278 Personen im Weaning betreuten, im Median pro Einrichtung 134 (Bereich [Min-Max] 44–414). Nur selten war das Weaning nicht erfolgreich, sodass vor Entlassung auf eine Heimbeatmung eingestellt werden musste (invasive Heimbeatmung Median pro Einrichtung 10 Personen, Bereich 2–25; nichtinvasive Heimbeatmung Median 0 Personen, Bereich 0–57). Festgestellt wurde ein hohes Maß an Prozess- und Strukturqualität in den zertifizierten Zentren: Über alle Prüfbereiche hinweg waren die Prüfkriterien zu allermeist erfüllt (Median Erfüllungsgrad 86 %) bzw. erfüllt mit von den Auditor*innen dokumentierten Verbesserungspotenzialhinweisen (Median 11 %).
Schlussfolgerung
Erfolgreiches Weaning in der NNFR und ein hohes Maß an Prozess- und Strukturqualität lassen sich anhand der Zertifizierungsergebnisse der Zentren belegen, die diesen integrativen Ansatz bei der Beatmungsentwöhnung verfolgen.
Background
One of the main treatment goals in cochlear implant (CI) patients is to improve speech perception. One of the target parameters is speech intelligibility in quiet. However, treatment results show a high variability, which has not been sufficiently explained so far. The aim of this noninterventional retrospective study was to elucidate this variability using a selected population of patients in whom etiology was not expected to have a negative impact on postoperative speech intelligibility.
Materials and methods
Audiometric findings of the CI follow-up of 28 adult patients after 6 months of CI experience were evaluated. These were related to the preoperative audiometric examination and evaluated with respect to a recently published predictive model for the postoperative monosyllabic score.
Results
Inclusion of postoperative categorical loudness scaling and hearing loss for Freiburg numbers in the model explained 55% of the variability in fitting outcomes with respect to monosyllabic word recognition.
Conclusion
The results of this study suggest that much of the cause of variability in fitting outcomes can be captured by systematic postoperative audiometric checks. Immediate conclusions for CI system fitting adjustments may be drawn from these results. However, the extent to which these are accepted by individual patients and thus lead to an improvement in outcome must be subject of further studies, preferably prospective.
Hintergrund
Die chronische Nierenkrankheit (CKD) ist eine häufige Erkrankung, insbesondere im höheren Alter. Um der Progression der Erkrankung und deren Komplikationen vorzubeugen, ist eine leitliniengerechte ambulante Versorgung von Patient:innen mit CKD anzustreben. Zur Messung und Bewertung der Versorgungsqualität können Qualitätsindikatoren (QI) genutzt werden. In Deutschland existieren bisher keine QI für CKD. Ziel der Arbeit war die Entwicklung von QI für die Qualitätsüberprüfung der ambulanten Versorgung von Patient:innen über 70 Jahren mit nichtdialysepflichtiger CKD.
Material und Methoden
Auf Grundlage der nationalen S3-Leitlinie CKD und eines Reviews internationaler QI wurde eine Liste von QI erstellt. Die ausgewählten QI wurden in 2 Sets eingeteilt: basierend auf Routinedaten (z. B. Abrechnungsdaten der Krankenkassen) und auf Datenerhebung in der Praxis (Chart-Review). Expert:innen verschiedener Fachrichtungen sowie ein Patient:innenvertreter bewerteten diese in einem Delphi-Verfahren mit 2‑stufiger Onlinebefragung im Oktober 2021 und Januar 2022 und abschließender Konsensuskonferenz im März 2022. Zusätzlich wurden Ranglisten der wichtigsten QI von jedem Set erstellt.
Ergebnisse
Ein Inzidenz- und ein Prävalenzindikator wurden a priori festgelegt und standen nicht zur Abstimmung. Weitere 21 QI standen zur Abstimmung durch die Expert:innen. Für jedes QI-Set wurden die 7 wichtigsten Indikatoren ausgewählt. Nur 1 QI wurde von dem Expert:innenpanel für den zusätzlichen Einsatz bei Erwachsenen unter 70 Jahren als nicht geeignet eingestuft.
Diskussion
Die QI sollen es ermöglichen, die Qualität der ambulanten Versorgung von Patient:innen mit CKD zu untersuchen, mit dem Ziel, die leitlinienkonforme ambulante Versorgung zu optimieren.
Die zweite Leichenschau vor der Feuerbestattung dient im Wesentlichen der Erkennung von nichtnatürlichen Todesfällen, die im Rahmen der ersten Leichenschau nicht als solche erkannt wurden. Immer wieder fallen dabei punktförmige Einblutungen im Gesichtsbereich, insbesondere in die Lid- und Lidbindehäute auf. Neben krankhaften und lagebedingten Ursachen können diese Einblutungen der einzige äußerlich erkennbare Hinweis auf eine stattgehabte Halskompression sein. Bei Feststellung derartiger Einblutungen im Rahmen der zweiten Leichenschau wird der Sterbefall „angehalten“ und bei der Kriminalpolizei angezeigt. Für einen 12-Jahres-Zeitraum (2010–2021) wurden retrospektiv alle angehaltenen Sterbefälle mit festgestellten Petechien analysiert. In diesem Zeitraum wurden in den Krematorien, für die das Institut für Rechtsmedizin Greifswald verantwortlich ist, insgesamt 2822 Sterbefälle angehalten. In 282 Fällen erfolgte diese Anhaltung aufgrund petechialer Einblutungen im Gesichtsbereich. Durch die zuständige Staatsanwaltschaft wurde in 47 % dieser Fälle eine gerichtliche Obduktion angeordnet. Im Beobachtungszeitraum fanden sich 2 Tötungsdelikte, die erst durch die zweite Leichenschau vor der Feuerbestattung im Krematorium festgestellt wurden. Die Untersuchung zeigt, dass petechiale Einblutungen als Anhaltspunkt für einen nichtnatürlichen Tod nicht ausreichend bei Leichenschauärzten bekannt sind.
The classical Buscher rules d escribe T-duality for metrics and B-fields in a topologically trivial setting. On the other hand, topological T-duality addresses aspects of non-trivial topology while neglecting metrics and B-fields. In this article, we develop a new unifying framework for both aspects.
The German Centre for Cardiovascular Research (DZHK) is one of the German Centres for Health Research and aims to conduct early and guideline-relevant studies to develop new therapies and diagnostics that impact the lives of people with cardiovascular disease. Therefore, DZHK members designed a collaboratively organised and integrated research platform connecting all sites and partners. The overarching objectives of the research platform are the standardisation of prospective data and biological sample collections among all studies and the development of a sustainable centrally standardised storage in compliance with general legal regulations and the FAIR principles. The main elements of the DZHK infrastructure are web-based and central units for data management, LIMS, IDMS, and transfer office, embedded in a framework consisting of the DZHK Use and Access Policy, and the Ethics and Data Protection Concept. This framework is characterised by a modular design allowing a high standardisation across all studies. For studies that require even tighter criteria additional quality levels are defined. In addition, the Public Open Data strategy is an important focus of DZHK. The DZHK operates as one legal entity holding all rights of data and biological sample usage, according to the DZHK Use and Access Policy. All DZHK studies collect a basic set of data and biosamples, accompanied by specific clinical and imaging data and biobanking. The DZHK infrastructure was constructed by scientists with the focus on the needs of scientists conducting clinical studies. Through this, the DZHK enables the interdisciplinary and multiple use of data and biological samples by scientists inside and outside the DZHK. So far, 27 DZHK studies recruited well over 11,200 participants suffering from major cardiovascular disorders such as myocardial infarction or heart failure. Currently, data and samples of five DZHK studies of the DZHK Heart Bank can be applied for.
Aims
Sphingosine-1-phosphate (S1P) is a signaling lipid, which is involved in several cellular processes including cell growth, proliferation, migration and apoptosis. The associations of serum S1P levels with cardiac geometry and function are still not clear. We investigated the associations of S1P with cardiac structure and systolic function in a population-based sample.
Methods and results
We performed cross-sectional analyses of 858 subjects (467 men; 54.4%), aged 22 to 81 years, from a sub-sample of the population-based Study of Health in Pomerania (SHIP-TREND-0). We analyzed the associations of serum S1P with structural and systolic function left ventricular (LV) and left atrial (LA) parameters as determined by magnetic resonance imaging (MRI) using sex-stratified multivariable-adjusted linear regression models. In men, MRI data showed that a 1 µmol/L lower S1P concentration was associated with an 18.1 mL (95% confidence interval [CI] 3.66–32.6; p = 0.014) larger LV end-diastolic volume (LVEDV), a 0.46 mm (95% CI 0.04–0.89; p = 0.034) greater LV wall thickness (LVWT) and a 16.3 g (95% CI 6.55–26.1; p = 0.001) higher LV mass (LVM). S1P was also associated with a 13.3 mL/beat (95% CI 4.49–22.1; p = 0.003) greater LV stroke volume (LVSV), an 18.7 cJ (95% CI 6.43–30.9; p = 0.003) greater LV stroke work (LVSW) and a 12.6 mL (95% CI 1.03–24.3; p = 0.033) larger LA end-diastolic volume (LAEDV). We did not find any significant associations in women.
Conclusions
In this population-based sample, lower levels of S1P were associated with higher LV wall thickness and mass, larger LV and LA chamber sizes and greater stroke volume and work of the LV in men, but not in women. Our results indicate that lower levels of S1P were associated with parameters related with cardiac geometry and systolic function in men, but not in women.
Marine algae produce complex polysaccharides, which can be degraded by marine heterotrophic bacteria utilizing carbohydrate-active enzymes. The red algal polysaccharide porphyran contains the methoxy sugar 6-O-methyl-D-galactose (G6Me). In the degradation of porphyran, oxidative demethylation of this monosaccharide towards D-galactose and formaldehyde occurs, which is catalyzed by a cytochrome P450 monooxygenase and its redox partners. In direct proximity to the genes encoding for the key enzymes of this oxidative demethylation, genes encoding for zinc-dependent alcohol dehydrogenases (ADHs) were identified, which seem to be conserved in porphyran utilizing marine Flavobacteriia. Considering the fact that dehydrogenases could play an auxiliary role in carbohydrate degradation, we aimed to elucidate the physiological role of these marine ADHs. Although our results reveal that the ADHs are not involved in formaldehyde detoxification, a knockout of the ADH gene causes a dramatic growth defect of Zobellia galactanivorans with G6Me as a substrate. This indicates that the ADH is required for G6Me utilization. Complete biochemical characterizations of the ADHs from Formosa agariphila KMM 3901T (FoADH) and Z. galactanivorans DsijT (ZoADH) were performed, and the substrate screening revealed that these enzymes preferentially convert aromatic aldehydes. Additionally, we elucidated the crystal structures of FoADH and ZoADH in complex with NAD+ and showed that the strict substrate specificity of these new auxiliary enzymes is based on a narrow active site.
Transcriptional corepressors Sin3, Cyc8 and Tup1 are important for downregulation of gene expression by recruiting various histone deacetylases once they gain access to defined genomic locations by interaction with pathway-specific repressor proteins. In this work we systematically investigated whether 17 yeast repressor proteins (Cti6, Dal80, Fkh1, Gal80, Mig1, Mot3, Nrg1, Opi1, Rdr1, Rox1, Sko1, Ume6, Ure2, Xbp1, Yhp1, Yox1 and Whi5) representing several unrelated regulatory pathways are able to bind to Sin3, Cyc8 and Tup1. Our results show that paired amphipathic helices 1 and 2 (PAH1 and PAH2) of Sin3 are functionally redundant for some regulatory pathways. WD40 domains of Tup1 proved to be sufficient for interaction with repressor proteins. Using length variants of selected repressors, we mapped corepressor interaction domains (CIDs) in vitro and assayed gene repression in vivo. Systematic comparison of CID minimal sequences allowed us to define several related positional patterns of hydrophobic amino acids some of which could be confirmed as functionally supported by site-directed mutagenesis. Although structural predictions indicated that certain CIDs may be α-helical, most repression domains appear to be randomly structured and must be considered as intrinsically disordered regions (IDR) adopting a defined conformation only by interaction with a corepressor.
Purpose
The WHO 2016 re-classification of myeloproliferative neoplasms resulted in a separation of essential thrombocythemia (ET) from the pre-fibrotic and fibrotic (overt) phases of primary myelofibrosis (MF). This study reports on a chart review conducted to evaluate the real life approach regarding clinical characteristics, diagnostic assessment, risk stratification and treatment decisions for MPN patients classified as ET or MF after implementation of the WHO 2016 classification.
Methods
In this retrospective chart review, 31 office-based hematologists/oncologists and primary care centers in Germany participated between April 2021 and May 2022. Physicians reported available data obtained from patient charts via paper–pencil based survey (secondary use of data). Patient features were evaluated using descriptive analysis, also including diagnostic assessment, therapeutic strategies and risk stratification.
Results
Data of 960 MPN patients diagnosed with essential thrombocythemia (ET) (n = 495) or myelofibrosis (MF) (n = 465) after implementation of the revised 2016 WHO classification of myeloid neoplasms was collected from the patient charts. While they met at least one minor WHO-criteria for primary myelofibrosis, 39.8% of those diagnosed with ET did not have histological BM testing at diagnosis. 63.4% of patients who were classified as having MF, however, did not obtain an early prognostic risk assessment. More than 50% of MF patients showed characteristics consistent with the pre-fibrotic phase, which was emphasized by the frequent use of cytoreductive therapy. Hydroxyurea was the most frequently used cytoreductive medication in 84.7% of ET and 53.1% of MF patients. While both ET and MF cohorts showed cardiovascular risk factors in more than 2/3 of the cases, the use of platelet inhibitors or anticoagulants varied between 56.8% in ET and 38.1% in MF patients.
Conclusions
Improved histopathologic diagnostics, dynamic risk stratification including genetic risk factors for cases of suspected ET and MF are recommended for precise risk assessment and therapeutic stratification according to WHO criteria.
Monitoring and assessing groundwater quality according to European directives and national regulations is usually based on interpolation techniques, e.g. Kriging. However, contour maps of hydrochemical parameters often suggest a spurious local accuracy and can therefore lead to inappropriate action measures. Here, the early concept of extension variance combined with the Voronoi tessellation regionalization is proposed. The mosaic-like representation of pollutant concentrations in Voronoi polygons avoids misinterpretations caused by interpolation. The additional calculation of the extension variance, which is based on fundamental geostatistical assumptions, allows for estimating the probability that a given threshold is exceeded. This concept is further extended to hydraulically delimitable groundwater bodies, thus ensuring that hydraulic boundaries are considered. A method is here described for the assessment of groundwater quality with respect to nitrate concentration in the principal aquifer of the state Mecklenburg-Western Pomerania in Germany.
Ausgehend von den Erfahrungswerten sechs Klinischer Ethiker*innen an Universitätsklinika in Deutschland wurde eine strukturierte Auseinandersetzung mit dem Arbeitsfeld der Fortbildungen im Rahmen der Klinischen Ethikarbeit vorgenommen. Die Zusammenarbeit wurde von der Fragestellung geleitet, was bei der Konzeption einer Ethik-Fortbildung innerhalb einer Einrichtung zu berücksichtigen ist. Der methodische Zugang zur Beantwortung der explorativen Fragestellung bestand in einem mehrstufigen, deskriptiven Verfahren, das alternierend in gemeinsamen Arbeitssitzungen und individueller Arbeit zwischen den Sitzungen umgesetzt wurde.
Als Resultat zeigt der Aufsatz eine Übersicht über die Bandbreite möglicher Fortbildungsformate auf, die denjenigen Hilfestellung bieten kann, die in ihrer Einrichtung Fortbildungen zu ethischen Themen konzipieren und durchführen wollen. Darüber hinaus bietet er einen Überblick über die bei der Umsetzung jeweils zu berücksichtigenden direkt strukturierenden sowie indirekt strukturierenden Merkmale. Es wird an Beispielen aufgezeigt, welche Formatvarianten sich in Kombination mit welchen direkt strukturierenden Merkmalen in den ausgewählten Universitätsklinika bewährt haben.
Der Beitrag liefert eine Diskussionsgrundlage, um die strukturierte Auseinandersetzung mit konzeptionellen Fragen ethischer Fortbildung in der Klinik zu befördern.
Mobile Apps for Sexual and Reproductive Health Education: a Systematic Review and Quality Assessment
(2023)
Purpose of Review
The aim of this study was to present the current state of research on mobile health apps for sexual and reproductive health (SRH) education. Apps were analysed based on contents (by using the World Health Organization’s SRH framework), features, intended audiences and quality of evidence (by applying the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach). Taking German sexuality education apps as an example, the rapid development in the field of SRH apps over the last 3 years has been revealed by comparing the quality of apps available in 2019 with apps from 2022.
Recent Findings
SRH apps allow health information to be disseminated quickly, at low thresholds and in a practical and cost-effective manner. Moreover, they allow for anonymous usage independently of time and place. In the absence of network coverage, offline use is also possible. Previous research focused on individual SRH aspects (e.g. human immunodeficiency virus (HIV), contraception). However, some studies were designed to cover a broader range of SRH topics, but identified only a few relevant apps.
Summary
To improve SRH, it would be helpful if the apps would be of high-quality design and be made up of relevant content. Furthermore, they should be tailored to the target group and have been tested in real-life settings. A total of 50 SRH apps with sufficiently high-quality ratings were included. The apps cover a variety of SRH topics, but they often lack field-based evaluation. The effectiveness of SRH apps has not yet been sufficiently studied in a scientific manner. Only 9 apps were deemed to be adequate for a moderate GRADE level. Despite this grading, the study nevertheless shows that there are several apps that could potentially promote SRH.
The potential of several ion-sensitive electrodes responds to the incorporated cations and anions. This has led some authors to misinterpret the potential of metal salt membrane electrodes and of electrodes of the second kind. Neglecting the kinetics of potential establishment and interpreting the potentials solely based on thermodynamics produce completely irrelevant data and suggest that ion concentrations down to 10−45 mol L−1 are accessible by simple potentiometric measurements. The switching from cation to anion response mechanism cannot be derived from thermodynamic equations. It bears complete similarity to the switching of response in the case of foreign interfering ions.
Purpose
A setting-sensitive instrument for assessing Quality of Life (QoL) in Telemedicine (TM) was unavailable. To close this gap, a content-valid “add-on” measure was developed. In parallel, a brief index was derived featuring six items that summarise the main content of the multidimensional assessment. After pre- and pilot-testing, the psychometric performance of the final measures was investigated in an independent validation study.
Methods
The questionnaires were applied along with other standardised instruments of similar concepts as well as associated, yet disparate concepts for validation purposes. The sample consisted of patients with depression or heart failure, with or without TM (n = 200). Data analyses were aimed at calculating descriptive statistics and testing the psychometric performance on item, scale, and instrument level, including different types of validity and reliability.
Results
The proposed factor structure of the multidimensional Tele-QoL measure has been confirmed. Reliability coefficients for internal consistency, split-half, and test-retest reliability of the subscales and index reached sufficient values. The Tele-QoL subscales and the index demonstrated Rasch scalability. Validity of both instruments can be assumed. Evidence for discriminant construct validity was provided. Known-groups validity was indicated by respective score differences for various classes of disease severity.
Conclusion
Both measures show convincing psychometric properties. The final multidimensional Tele-QoL assessment consists of six outcome scales and two impact scales assessing (un-)intended effects of TM on QoL. In addition, the Tele-QoL index provides a short alternative for outcome assessment. The Tele-QoL measures can be used as complementary modules to existing QoL instruments capturing healthcare-related aspects of QoL from the patients’ perspective.
Der inhabergeführte Einzelhandel steht vor besonderen Herausforderungen bei der Einführung und Etablierung digitaler Kundenkommunikationsmaßnahmen (KKM). Im vorliegenden Beitrag wird untersucht, welche Maßnahmen im Zuge der Coronapandemie eingeführt worden sind und welche dieser Maßnahmen besonders zukunftsfähig sein können. Darüber hinaus wird die Bedeutung von regionalen Netzwerken beim Wissenstransfer über digitale Maßnahmen betrachtet. Für die Untersuchung wurde in den drei Bundesländern Nordrhein-Westfalen, Sachsen und Sachsen-Anhalt im März 2022 eine Online-Befragung von Inhabern durchgeführt und durch fünf Experteninterviews im April und Mai 2022 ergänzt. Für die Vergleichbarkeit der gewonnenen Ergebnisse wird eine großflächige Handelsstudie der IHK Köln und dem ibi Research Institut Regensburg aus dem Jahr 2020 herangezogen. Dabei stellte sich heraus, dass insbesondere die digitale Sichtbarkeit für den Erhalt der inhabergeführten Einzelhandelsgeschäfte in Zukunft von zentraler Bedeutung sein wird. Ferner präsentieren sich die sozialen Medien mit ihrer perspektivisch ausgestatteten Verkaufsfunktion als geeignetes Instrument. Außerdem konnten durch eine differenzierte Betrachtung von Branchen und Zielgruppen sowie unterschiedlichen Ansätzen für den Einstieg in die digitale Kundenkommunikation zukunftsfähige und individuelle Maßnahmen identifiziert werden.
SLC35F1 is a member of the sugar-like carrier (SLC) superfamily that is expressed in the mammalian brain. Malfunction of SLC35F1 in humans is associated with neurodevelopmental disorders. To get insight into the possible roles of Slc35f1 in the brain, we generated Slc35f1-deficient mice. The Slc35f1-deficient mice are viable and survive into adulthood, which allowed examining adult Slc35f1-deficient mice on the anatomical as well as behavioral level. In humans, mutation in the SLC35F1 gene can induce a Rett syndrome-like phenotype accompanied by intellectual disability (Fede et al. Am J Med Genet A 185:2238–2240, 2021). The Slc35f1-deficient mice, however, display only a very mild phenotype and no obvious deficits in learning and memory as, e.g., monitored with the novel object recognition test or the Morris water maze test. Moreover, neuroanatomical parameters of neuronal plasticity (as dendritic spines and adult hippocampal neurogenesis) are also unaltered. Thus, Slc35f1-deficient mice display no major alterations that resemble a neurodevelopmental phenotype.
How can powerful states best extract domestic concessions from their junior allies? What are the conditions under which the powerful state is more likely to succeed in inducing such domestic policy change? This article explores the link between US security commitments and Washington’s ability to attain favourable policy outcomes within the allied domestic arena. It provides an illustrative case of how the USA, using security guarantees as leverage, can enter allied domestic space and shape its decision-making process. After it was revealed that Latvia had served as a key node through which North Korea attempted to evade the sanctions regime, the USA, by playing its security guarantor card, pressured Riga to carry out substantial policy reforms in relation to its financial system. This approach yielded considerable results. In order to preserve the existing security arrangements with the dominant alliance member, Latvia offered significant policy concessions. This finding demonstrates that US security alliances come with side benefits that are often underrated or neglected in the scholarly literature.
Background
A bidirectional functional link between vestibular and fear-related disorders has been previously suggested.
Objective
To test a potential overlap of vestibular and fear systems with regard to their brain imaging representation maps.
Methods
By use of voxel-based mapping permutation of subject images, we conducted a meta-analysis of earlier functional magnetic resonance imaging (fMRI) studies applying vestibular stimulation and fear conditioning in healthy volunteers.
Results
Common clusters of concordance of vestibular stimulation and fear conditioning were found in the bilateral anterior insula cortex, ventrolateral prefrontal cortex and the right temporal pole, bilaterally in the adjacent ventrolateral prefrontal cortex, cingulate gyrus, secondary somatosensory cortex, superior temporal and intraparietal lobe, supplementary motor area and premotor cortex, as well as subcortical areas, such as the bilateral thalamus, mesencephalic brainstem including the collicular complex, pons, cerebellar vermis and bilateral cerebellar hemispheres. Peak areas of high concordance for activations during vestibular stimulation but deactivations during fear conditioning were centered on the posterior insula and S2.
Conclusions
The structural overlap of both networks allows the following functional interpretations: first, the amygdala, superior colliculi, and antero-medial thalamus might represent a release of preprogramed sensorimotor patterns of approach or avoidance. Second, the activation (vestibular system) and deactivation (fear system) of the bilateral posterior insula is compatible with the view that downregulation of the fear network by acute vestibular disorders or unfamiliar vestibular stimulation makes unpleasant perceived body accelerations less distressing. This also fits the clinical observation that patients with bilateral vestibular loss suffer from less vertigo-related anxiety.
Background and objective
Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions.
Methods
We develop a conceptual framework model of cross-border healthcare and apply it to the Polish–German border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve.
Results
Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients.
Conclusion
Strong effort should be invested to overcome political and cultural borders to improve the health of the population in border regions. Similarly, increased cross-border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.
Animals often respond to climate change with changes in morphology, e.g., shrinking body size with increasing temperatures, as expected by Bergmann’s rule. Because small body size can have fitness costs for individuals, this trend could threaten populations. Recent studies, however, show that morphological responses to climate change and the resulting fitness consequences cannot be generalized even among related species. In this long-term study, we investigate the interaction between ambient temperature, body size and survival probability in a large number of individually marked wild adult female Natterer’s bats (Myotis nattereri). We compare populations from two geographical regions in Germany with a different climate. In a sliding window analysis, we found larger body sizes in adult females that were raised in warmer summers only in the northern population, but not in the southern population that experienced an overall warmer climate. With a capture-mark-recapture approach, we showed that larger individuals had higher survival rates, demonstrating that weather conditions in early life could have long-lasting fitness effects. The different responses in body size to warmer temperatures in the two regions highlight that fitness-relevant morphological responses to climate change have to be viewed on a regional scale and may affect local populations differently.
Cationic and anionic clusters of the group-14 elements carbon, silicon, germanium, tin, and lead are produced by high-vacuum laser ablation and studied with a multi-reflection time-of-flight mass spectrometer. In-trap photodissociation is performed for cluster species in the size range n=2–10. The clusters’ production rates as well as their dissociation pathways are used to probe the nonmetal–metal transition throughout the group. Carbon clusters show neutral-trimer break-off, while those of the other elements evaporate neutral monomers and, in some cases, form specific charged fragment sizes.
Purpose
Outcomes of multiple myeloma (MM) patients who are refractory to daratumumab are dismal and no standard of treatment exists for this patients’ population. Here, we investigate the role of pomalidomide combinations in daratumumab-refractory MM patients.
Methods
We performed a retrospective analysis of myeloma patients treated at four referral centers (three in Germany and one in Italy). Review chart identified 30 patients with relapsed and refractory myeloma, who progressed during treatment with daratumumab and were treated with pomalidomide-based combinations in the subsequent lines of therapy.
Results
Responses improved from 37% with daratumumab to 53% with pomalidomide. Of seven patients with extramedullary MM (EMM), four achieved a clinical stabilization with pomalidomide, including one patient with a long-lasting complete response. Median progression-free survival and overall survival were 6 and 12 months, respectively. Pomalidomide combinations were well tolerated, no patient discontinued treatment due to adverse events.
Conclusion
These data show that pomalidomide-based combinations can be an effective and safe salvage regimen for daratumumab-refractory patients, including those with EMM.