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Serum GFAP for stroke diagnosis in regions with limited access to brain imaging (BE FAST India)
(2021)
Introduction: Despite a high burden of stroke, access to rapid brain imaging is limited in many middle- and low-income countries. Previous studies have described the astroglial protein GFAP (glial fibrillary acidic protein) as a biomarker of intracerebral hemorrhage. The aim of this study was to test the diagnostic accuracy of GFAP for ruling out intracranial hemorrhage in a prospective cohort of Indian stroke patients. Patients and methods: This study was conducted in an Indian tertiary hospital (Christian Medical College, Ludhiana). Patients with symptoms suggestive of acute stroke admitted within 12 h of symptom onset were enrolled. Blood samples were collected at hospital admission. Single Molecule Array technology was used for determining serum GFAP concentrations. Results: A total number of 155 patients were included (70 intracranial hemorrhage, 75 ischemic stroke, 10 stroke mimics). GFAP serum concentrations were elevated in intracranial hemorrhage patients compared to ischemic stroke patients [median (interquartile range) 2.36 µg/L (0.61–7.16) vs. 0.18 µg/L (0.11–0.38), p < 0.001]. Stroke mimics patients had a median GFAP serum level of 0.14 µg/L (0.09–0.26). GFAP values below the cut-off of 0.33 µg/L (area under the curve 0.871) ruled out intracranial hemorrhage with a negative predictive value of 89.7%, (at a sensitivity for detecting intracranial hemorrhage of 90.0%). Discussion: The high negative predictive value of a GFAP test system allows ruling out patients with intracranial hemorrhage. Conclusion: In settings where immediate brain imaging is not available, this would enable to implement secondary prevention (e.g., aspirin) in suspected ischemic stroke patients as soon as possible.
In Johannes Fried’s The Middle Ages, the author makes his case for an alternative interpretation of the medieval period as much more sophisticated than commonly thought, writes Ignas Kalpokas. The book intricately traces how ideas and systems of thought that we now consider quintessentially modern European ways of life, thinking and culture stemmed from this time period.
A glenohumeral internal rotation deficit (GIRD) of the shoulder, is associated with an increased risk of shoulder injuries in tennis athletes. The aim of the present study was to reveal the impact of 1) age, sex, specific training data (i.e. training volume, years of tennis practice, years of competitive play) and 2) upper extremity injuries on GIRD in youth competitive tennis athletes.
A cross-sectional retrospective study design was adopted. Youth tennis players (n = 27, 12.6 ± 1.80 yrs., 18 male) belonging to an elite tennis squad were included. After documenting the independent variables (anthropometric data, tennis specific data and history of injury), the players were tested for internal (IR) and external (ER) shoulder rotation range of motion (RoM, [°]). From these raw values, the GIRD parameters ER/IR ratio and side differences and TRoM side differences were calculated. Pearson’s correlation analyses were performed to find potential associations of the independent variables with the GIRD outcomes.
A significant positive linear correlation between the years of tennis training and IR side asymmetry occurred (p < .05). A significant negative linear relation between the years of tennis training and the ratio of ER to IR range of motion (RoM) in the dominant side (p < .05) was found. The analysis of covariance showed a significant influence of the history of injuries on IR RoM (p < .05).
Injury and training history but not age or training volume may impact on glenohumeral internal rotation deficit in youth tennis athletes. We showed that GIRD in the dominant side in youth tennis players is progressive with increasing years of tennis practice and independent of years of practice associated with the history of injuries. Early detection of decreased glenohumeral RoM (specifically IR), as well as injury prevention training programs, may be useful to reduce GIRD and its negative consequences.
Knee acoustic emissions provide information about joint health and loading in motion. As the reproducibility of knee acoustic emissions by vibroarthrography is yet unknown, we evaluated the intrasession and interday reliability of knee joint sounds. In 19 volunteers (25.6 ± 2.0 years, 11 female), knee joint sounds were recorded by two acoustic sensors (16,000 Hz; medial tibial plateau, patella). All participants performed four sets standing up/sitting down (five repetitions each). For measuring intrasession reliability, we used a washout phase of 30 min between the first three sets, and for interday reliability we used a washout phase of one week between sets 3 and 4. The mean amplitude (dB) and median power frequency (Hz, MPF) were analyzed for each set. Intraclass correlation coefficients (ICCs (2,1)), standard errors of measurement (SEMs), and coefficients of variability (CVs) were calculated. The intrasession ICCs ranged from 0.85 to 0.95 (tibia) and from 0.73 to 0.87 (patella). The corresponding SEMs for the amplitude were ≤1.44 dB (tibia) and ≤2.38 dB (patella); for the MPF, SEMs were ≤13.78 Hz (tibia) and ≤14.47 Hz (patella). The intrasession CVs were ≤0.06 (tibia) and ≤0.07 (patella) (p < 0.05). The interday ICCs ranged from 0.24 to 0.33 (tibia) and from 0 to 0.82 (patella) for both the MPF and amplitude. The interday SEMs were ≤4.39 dB (tibia) and ≤6.85 dB (patella) for the amplitude and ≤35.39 Hz (tibia) and ≤15.64 Hz (patella) for the MPF. The CVs were ≤0.14 (tibia) and ≤0.08 (patella). Knee joint sounds were highly repeatable within a single session but yielded inconsistent results for the interday reliability.
Background: Knee osteoarthritis is associated with higher kinetic friction in the knee joint, hence increased acoustic emissions during motion. Decreases in compressive load and improvements in movement quality might reduce this friction and, thus, sound amplitude. We investigated if an exercise treatment acutely affects knee joint sounds during different activities of daily life.
Methods: Eighteen participants with knee osteoarthritis (aged 51.8 ± 7.3 years; 14 females) were included in this randomized crossover trial. A neuromuscular exercise intervention and a placebo laser needle acupuncture treatment were performed. Before and after both interventions, knee joint sounds were measured during three different activities of daily living (standing up/sitting down, walking, descending stairs) by means of vibroarthrography. The mean amplitude (dB) and the median power frequency (MPF, Hz) were assessed at the medial tibial plateau and the patella. Differences in knee acoustic emissions between placebo and exercise interventions were calculated by analyses of covariance.
Results: Controlled for participant's age, knee demanding activity level and osteoarthritis stage, the conditions significantly differed in their impact on the MPF (mean(± SD) pre-post-differences standing up: placebo: 9.55(± 29.15) Hz/ exercise: 13.01(± 56.06) Hz, F = 4.9, p < 0.05) and the amplitude (standing up: placebo:0.75(± 1.43) dB/ exercise: 0.51(± 4.68) dB, F = 5.0, p < 0.05; sitting down: placebo: 0.07(± 1.21) dB/ exercise: -0.16(± .36) dB, F = 4.7, p < 0.05) at the tibia. There were no differences in the MPF and amplitude during walking and descending stairs (p > 0.05). At the patella, we found significant differences in the MPF during walking (placebo 0.08(± 1.42) Hz/ exercise: 15.76(± 64.25) Hz, F = 4.8, p < .05) and in the amplitude during descending stairs (placebo: 0.02 (± 2.72) dB/ exercise: -0.73(± 2.84) dB, F = 4.9, p < 0.05). There were no differences in standing up/ sitting down for both parameters, nor in descending stairs for the MPF and walking for the amplitude (p > 0.05).
Conclusion: The MPF pre-post differences of the exercise intervention were higher compared to the MPF pre-post differences of the placebo treatment. The amplitude pre-post differences were lower in the exercise intervention. In particular, the sound amplitude might be an indicator for therapy effects in persons with knee osteoarthritis.
Trial registration: The study was retrospectively registered in the German Clinical Trials Register (DRKS00022936, date of registry: 26/08/2020).
Wie arbeitet ein spätmittelalterlicher Verfasser didaktischer Texte, wenn er sein Material zusammenstellt? Orientiert er sich an Florilegien, die ihm einen Fundus an Autoritätenzitaten zur Verfügung stellen, welchen er dann nach Bedarf verwenden kann? Benutzt er so etwas wie einen Zettelkasten, in dem er sich einzelne Dicta und Sentenzen zusammenstellt, und die er immer wieder neu sortiert? Oder arbeitet er vielleicht doch in einer Bibliothek mit Texten, die ihm nicht nur Zitate, sondern auch Kontexte für seine eigene Umsetzung des Materials liefern und es ihm erst ermöglichen, kompetent auf die Inhalte der vorhandenen Texte zurückzugreifen? […] In der Vorbereitung zur Neuedition des ›Ritterspiegels‹ sind wir den Autoritätenzitaten nachgegangen. Nicht immer ließ sich zu dem jeweils genannten Autor eine passende Vorlage zu finden, insbesondere die Identifikation von Zitaten der Kirchenväter (Gregorius, Augustinus, Cassiodorus, Hieronymus) machte größere Schwierigkeiten. Mitunter kommen mehrere mögliche Quellen in Betracht. Aussagen etwa, für die Rothe Aristoteles oder Seneca als Autorität angibt, könnte er aus Zusammenstellungen wie den ›Auctoritates‹ exzerpiert haben. Angesichts der Übereinstimmung zwischen den Sentenzen und Dicta in den Exzerpten und den umfassenderen Originaltexten ist jedoch aus dem Einzelzitat in der Regel nicht entscheidbar, ob das Florilegium oder das Original zitiert wurde. Umso aufschlussreicher sind solche Quellenfunde, die signifikante Besonderheiten aufweisen. Eine derartige Quelle ist mir auf der Suche nach Vorlagen für die Memento-Mori-Teile und die Ubi-sunt-Topik in prägnanter Weise aufgefallen und soll im Vordergrund der folgenden Ausführungen stehen. Sie spricht meiner Ansicht nach deutlich gegen die Florilegienthese, zumindest relativiert sie diese.
Spätestens seit der PISA-Studie aus dem Jahre 2000 ist der im deutschen Bildungssystem bestehende hohe Zusammenhang zwischen Bildungserfolg und Bildungsherkunft nicht nur für Akteure und Institutionen im Bildungssektor, sondern auch der breiten Öffentlichkeit als Gerechtigkeitsproblem deutlich geworden. ...
Starting from the basic observation that, across languages, the anticausative variant of an alternating verb systematically involves morphological marking that is shared by passive verbs, the goal of this paper is to provide a uniform and formal account of these arguably two different construction types. The central claim that I put forward is that passives and anticausatives differ only with respect to the event-type features of the verb but both arise through the same operation, namely suppression by special morphology of a feature in v that encodes the ontological event type of the verb. Crucially, I argue for two syntactic primitives, namely act and cause, whereto I trace the passive/anticausative distinction. Passive constructions across languages are made compatible by relegating the differences to simple combinatorial properties of verb and prepositional types and their interactions with other event functors, which are in turn encoded differently morphologically across languages. New arguments are brought forward for a causative analysis of anticausatives. Agentive adverbials are examined, and doubt is cast on the usefulness of by-phrases as a diagnostic for argumenthood.
Tree-local MCTAG with shared nodes : an analysis of word order variation in German and Korean
(2004)
Tree Adjoining Grammars (TAG) are known not to be powerful enough to deal with scrambling in free word order languages. The TAG-variants proposed so far in order to account for scrambling are not entirely satisfying. Therefore, an alternative extension of TAG is introduced based on the notion of node sharing. Considering data from German and Korean, it is shown that this TAG-extension can adequately analyse scrambling data, also in combination with extraposition and topicalization.
This paper proposes a corpus encoding standard that meets the needs of linguistic research using a variety of linguistic data structures. The standard was developed in SFB 441, a research project at the University of Tuebingen. The principal concern of SFB 441 are the empirical data structures which feed into linguistic theory building. SFB 441 consists of several projects, most of which are building corpora to empirically investigate various linguistic phenomena in various languages (e.g. modal verbs in German, forms of address and politeness in Russian). These corpora will form the components of the "Tuebingen collection of reusable, empirical, linguistic data structures (TUSNELDA)". The TUSNELDA annotation standard aims at providing a uniform encoding scheme for all subcorpora and texts of TUSNELDA such that they can be processed with uniform standardized tools. To guarantee maximal reusability we use XML for encoding. Previous SGML standards for text encoding were provided by the Text Encoding Initiative (TEI) and the Expert Advisory Group on Language Engineering Standards (Corpus Encoding Standard, CES). The TUSNELDA standard is based on TEI and XCES (XML version of CES) but takes into account the specific needs of the SFB projects, i.e. the peculiarities of the examined languages and linguistic phenomena.