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Institute
Gerber, Alexander ; Bohn, Julia ; Groneberg, Jan David Alexander ; Schulze, Johannes B. ; Bundschuh, Matthias
Background: Chronic particulate matter (PM) exposure is correlated to various health effects, even at low amounts. WHO has defined PM concentration limits as daily and annual mean values which were made legally binding in the European Union. While many studies have focused on PM concentrations in special environments, little is known about the average PM- exposure for both employees and passengers in the German public transportation system.
Methods: Particulate matter (PM10, PM2.5, PM1) - concentrations were monitored for 30 minutes at 15 different areas in Frankfurt am Main with major public traffic. Maximum and mean concentrations and, as a surrogate for the inhaled dosage, the Area Under the Curve (AUC) for 15 minutes of exposure were calculated.
Results: The WHO limits for PM10 and PM2.5 were exceeded at nearly all times and areas. Highest maximum concentrations were found at underground stations, subterranean railway stations and subterranean shopping arcades with much lower values obtained at surface points. In one measurement at a surface test point smokers who neglected the non-smoking policy could be identified as a major cause for a at least temporary strong increase of PM-load as seen in high maximum values and normal averages.
Conclusions: Subterranean areas have high particulate matter contamination exceeding WHO limits. Improvement may be achieved by increased ventilation. Subterranean shops and kiosks, being workplaces with long term exposure, should be equipped with external air supply. The non- smoking policy of the "Deutsche Bahn" for public spaces should be enforced.
Geisel, Tabea ; Martin, Julia ; Schulze, Bettina ; Schaefer, Roland ; Bach, Matthias ; Virgin, Garth ; Stein, Jürgen
Background: Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients.
Methods: Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine) in addition to medical history and demographics.
Results: Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1%) in a mild form. Anemia was primarily due to iron deficiency (65%), frequently due to underlying chronic infection (62.1%), or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role.
Conclusion: Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.
Braczynski, Anne Kristin ; Vlaho, Stefan ; Müller, Klaus ; Wittig, Ilka ; Blank, Anna-Eva ; Tews, Dominique Suzanne ; Drott, Ulrich ; Kleinle, Stephanie ; Abicht, Angela ; Horvath, Rita ; Plate, Karl ; Stenzel, Werner ; Goebel, Hans Hilmar ; Schulze-Bonhage, Andreas ; Harter, Patrick Nikolaus ; Kieslich, Matthias ; Mittelbronn, Michel Guy André
TMEM70 is involved in the biogenesis of mitochondrial ATP synthase and mutations in the TMEM70 gene impair oxidative phosphorylation. Herein, we report on pathology and treatment of ATP synthase deficiency in four siblings. A consanguineous family of Roma (Gipsy) ethnic origin gave birth to 6 children of which 4 were affected presenting with dysmorphic features, failure to thrive, cardiomyopathy, metabolic crises, and 3-methylglutaconic aciduria as clinical symptoms. Genetic testing revealed a homozygous mutation (c.317-2A>G) in the TMEM70 gene. While light microscopy was unremarkable, ultrastructural investigation of muscle tissue revealed accumulation of swollen degenerated mitochondria with lipid crystalloid inclusions, cristae aggregation, and exocytosis of mitochondrial material. Biochemical analysis of mitochondrial complexes showed an almost complete ATP synthase deficiency. Despite harbouring the same mutation, the clinical outcome in the four siblings was different. Two children died within 60 h after birth; the other two had recurrent life-threatening metabolic crises but were successfully managed with supplementation of anaplerotic amino acids, lipids, and symptomatic treatment during metabolic crisis. In summary, TMEM70 mutations can cause distinct ultrastructural mitochondrial degeneration and almost complete deficiency of ATP synthase but are still amenable to treatment.
Bewegung im Satz : Remnant Movement – Syntaktische Grundlagenforschung am Institut für Linguistik
(2013)
Wasel, Julia ; Boll, Michael ; Schulze, Michaela ; Mueller, Daniel ; Bundschuh, Matthias ; Groneberg, Jan David Alexander ; Gerber, Alexander
Background: Second hand smoke (ETS)-associated particulate matter (PM) contributes considerably to indoor air contamination and constitutes a health risk for passive smokers. Easy to measure, PM is a useful parameter to estimate the dosage of ETS that passive smokers are exposed to. Apart from its suitability as a surrogate parameter for ETS-exposure, PM itself affects human morbidity and mortality in a dose-dependent manner. We think that ETS-associated PM should be considered an independent hazard factor, separately from the many other known harmful compounds of ETS. We believe that brand-specific and tobacco-product-specific differences in the release of PM matter and that these differences are of public interest. Methods: To generate ETS of cigarettes and cigarillos as standardized and reproducible as possible, an automatic second hand smoke emitter (AETSE) was developed and placed in a glass chamber. L&M cigarettes ("without additives", "red label", "blue label"), L&M filtered cigarillos ("red") and 3R4F standard research cigarettes (as reference) were smoked automatically according to a self-developed, standardized protocol until the tobacco product was smoked down to 8 mm distance from the tipping paper of the filter. Results: Mean concentration (Cmean) and area under the curve (AUC) in a plot of PM2.5 against time were measured, and compared. CmeanPM2.5 were found to be 518 μg/m3 for 3R4F cigarettes, 576 μg/m3 for L&M "without additives" ("red"), 448 μg/m3 for L&M "blue label", 547 μg/m3 for L&M "red label", and 755 μg/m3 for L&M filtered cigarillos ("red"). AUCPM2.5-values were 208,214 μg/m3·s for 3R4F reference cigarettes, 204,629 μg/m3·s for L&M "without additives" ("red"), 152,718 μg/m3·s for L&M "blue label", 238,098 μg/m3·s for L&M "red label" and 796,909 μg/m3·s for L&M filtered cigarillos ("red"). Conclusion: Considering the large and significant differences in particulate matter emissions between cigarettes and cigarillos, we think that a favorable taxation of cigarillos is not justifiable.
Cunliffe, Andrew M. ; Anderson, Karen ; Boschetti, Fabio ; Brazier, Richard E. ; Graham, Hugh A. ; Myers-Smith, Isla H. ; Astor, Thomas ; Boer, Matthias M. ; Calvo, Leonor G. ; Clark, Patrick E. ; Cramer, Michael D. ; Encinas-Lara, Miguel S. ; Escarzaga, Stephen M. ; Fernández-Guisuraga, José M. ; Fisher, Adrian G. ; Gdulová, Kateřina ; Gillespie, Breahna M. ; Griebel, Anne ; Hanan, Niall P. ; Hanggito, Muhammad S. ; Haselberger, Stefan ; Havrilla, Caroline A. ; Heilman, Phil ; Ji, Wenjie ; Karl, Jason W. ; Kirchhoff, Mario ; Kraushaar, Sabine ; Lyons, Mitchell B. ; Marzolff, Irene ; Mauritz, Marguerite E. ; McIntire, Cameron D. ; Metzen, Daniel ; Méndez-Barroso, Luis A. ; Power, Simon C. ; Prošek, Jiří ; Sanz-Ablanedo, Enoc ; Sauer, Katherine J. ; Schulze-Brüninghoff, Damian ; Šímová, Petra ; Sitch, Stephen ; Smit, Julian L. ; Steele, Caiti M. ; Suárez-Seoane, Susana ; Vargas, Sergio A. ; Villarreal, Miguel ; Visser, Fleur ; Wachendorf, Michael ; Wirnsberger, Hannes ; Wojcikiewicz, Robert
Non-forest ecosystems, dominated by shrubs, grasses and herbaceous plants, provide ecosystem services including carbon sequestration and forage for grazing, and are highly sensitive to climatic changes. Yet these ecosystems are poorly represented in remotely sensed biomass products and are undersampled by in situ monitoring. Current global change threats emphasize the need for new tools to capture biomass change in non-forest ecosystems at appropriate scales. Here we developed and deployed a new protocol for photogrammetric height using unoccupied aerial vehicle (UAV) images to test its capability for delivering standardized measurements of biomass across a globally distributed field experiment. We assessed whether canopy height inferred from UAV photogrammetry allows the prediction of aboveground biomass (AGB) across low-stature plant species by conducting 38 photogrammetric surveys over 741 harvested plots to sample 50 species. We found mean canopy height was strongly predictive of AGB across species, with a median adjusted R2 of 0.87 (ranging from 0.46 to 0.99) and median prediction error from leave-one-out cross-validation of 3.9%. Biomass per-unit-of-height was similar within but different among, plant functional types. We found that photogrammetric reconstructions of canopy height were sensitive to wind speed but not sun elevation during surveys. We demonstrated that our photogrammetric approach produced generalizable measurements across growth forms and environmental settings and yielded accuracies as good as those obtained from in situ approaches. We demonstrate that using a standardized approach for UAV photogrammetry can deliver accurate AGB estimates across a wide range of dynamic and heterogeneous ecosystems. Many academic and land management institutions have the technical capacity to deploy these approaches over extents of 1–10 ha−1. Photogrammetric approaches could provide much-needed information required to calibrate and validate the vegetation models and satellite-derived biomass products that are essential to understand vulnerable and understudied non-forested ecosystems around the globe.
Schäfer, Guido ; Hoffmann, Christian ; Arasteh, Keikawus ; Schürmann, Dirk ; Stephan, Christoph ; Jensen, Björn ; Stoll, Matthias ; Bogner, Johannes ; Fätkenheuer, Gerd ; Rockstroh, Jürgen ; Klinker, Hartwig ; Härter, Georg ; Stöhr, Albrecht ; Degen, Olaf ; Freiwald, Eric ; Hüfner, Anja ; Jordan, Sabine ; Schulze zur Wiesch, Julian Constantin Raimar ; Addo, Marylyn M. ; Lohse, Ansgar W. ; Van Lunzen, Jan ; Schmiedel, Stefan
Background: To evaluate clinical outcomes after either immediate or deferred initiation of antiretroviral therapy in HIV-1-infected patients, presenting late with pneumocystis pneumonia (PCP) or toxoplasma encephalitis (TE).
Methods: Phase IV, multicenter, prospective, randomized open-label clinical trial. Patients were randomized into an immediate therapy arm (starting antiretroviral therapy (ART) within 7 days after initiation of OI treatment) versus a deferred arm (starting ART after completing the OI-therapy). All patients were followed for 24 weeks. The rates of clinical progression (death, new or relapsing opportunistic infections (OI) and other grade 4 clinical endpoints) were compared, using a combined primary endpoint. Secondary endpoints were hospitalization rates after completion of OI treatment, incidence of immune reconstitution inflammatory syndrome (IRIS), virologic and immunological outcome, adherence to proteinase-inhibitor based antiretroviral therapy (ART) protocol and quality of life.
Results: 61 patients (11 patients suffering TE, 50 with PCP) were enrolled. No differences between the two therapy groups in all examined primary and secondary endpoints could be identified: immunological and virologic outcome was similar in both groups, there was no significant difference in the incidence of IRIS (11 and 10 cases), furthermore 9 events (combined endpoint of death, new/relapsing OI and grade 4 events) occurred in each group.
Conclusions: In summary, this study supports the notion that immediate initiation of ART with a ritonavir-boosted proteinase-inhibitor and two nucleoside reverse transcriptase inhibitors is safe and has no negative effects on incidence of disease progression or IRIS, nor on immunological and virologic outcomes or on quality of life.
Der deutsche und französische Innenminister haben eine Initiative gestartet um gegen Verschlüsselung vorzugehen. Ihr Argument, was von mehr oder weniger allen Geheimdiensten/Strafverfolgungsbehörden unisono vorgetragen wird lautet, dass verschlüsselte Kommunikation die Arbeit der Behörden behindere. Bereits im Jahr 1993 wurde die gleiche Debatte geführt, endete aber mit dem Konsens, dass die Vorteile von Verschlüsselung die Nachteile deutlich überwiegen. Dieser Konsens, getragen von Industrie, Datenschützern und Politik (sowohl Liberale als auch Konservative) schien sicher, war er doch die vernünftigste Antwort auf ein komplexes Problem. Heute stellen die von Rechtspopulisten getriebenen Innenminister wieder einmal die Verschlüsselung in Frage. Warum das eine schlechte Idee ist, soll dieser Beitrag klären.NSA Chef Inman argumentierte bereits 1980: “There is
a very real and critical danger that unrestrained public discussion of crypto-logic matters will seriously damage the ability of this government to conduct signals intelligence and the ability of this government to carry out its mission of protecting national security information from hostile exploitation” (1980). Kern dieses “going dark” Arguments ist also, dass digitale Überwachung schwerer würde, wenn alle verschlüsseln. Terroristen und andere bad guys könnten also nicht mehr gefangen werden. Die Debatte ist also gar nicht so neu und überraschend wie immer behauptet wird....
Tony, Hans-Peter ; Burmester, Gerd-Rüdiger ; Schulze-Koops, Hendrik ; Grunke, Mathias ; Henes, Jörg Christoph ; Kötter, Ina ; Haas, Judith ; Unger, Leonore ; Lovric, Svjetlana ; Haubitz, Marion ; Fischer-Betz, Rebecca ; Chehab, Gamal ; Rubbert-Roth, Andrea ; Specker, Christof ; Weinerth, Jutta ; Holle, Julia Ulrike ; Müller-Ladner, Ulf ; König, Ramona ; Fiehn, Christoph ; Burgwinkel, Philip ; Budde, Klemens ; Sörensen, Helmut ; Meurer, Michael ; Aringer, Martin ; Kieseier, Bernd ; Erfurt-Berge, Cornelia ; Sticherling, Michael ; Veelken, Roland ; Ziemann, Ulf ; Strutz, Frank ; Wussow, Praxis von ; Meier, Florian Matthias Peter ; Hunzelmann, Nico ; Schmidt, Nico ; Bergner, Raoul ; Schwarting, Andreas ; Eming, Rüdiger ; Hertl, Michael ; Stadler, Rudolf ; Schwarz-Eywill, Michael ; Wassenberg, Siegfried ; Fleck, Martin ; Metzler, Claudia ; Zettl, Uwe Klaus ; Westphal, Jens ; Heitmann, Stefan ; Herzog, Anna Laura ; Wiendl, Heinz ; Jakob, Waltraud ; Schmidt, Enno ; Freivogel, Klaus ; Dörner, Thomas
Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting.
Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators.
Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm).
Conclusions: Data from this registry indicate that rituximab is a commonly employed, well-tolerated therapy with potential beneficial effects in standard of care-refractory autoimmune diseases, and support the results from other open-label, uncontrolled studies.