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We use lattice QCD to investigate the existence of strong-interaction-stable antiheavy-antiheavy-light-light tetraquarks. We study the ¯𝑏¯𝑏𝑢𝑠 system with quantum numbers 𝐽𝑃=1+ as well as the ¯𝑏¯𝑐𝑢𝑑 systems with quantum numbers 𝐼(𝐽𝑃)=0(0+) and 𝐼(𝐽𝑃)=0(1+). We carry out computations on five gauge-link ensembles with 2+1 flavors of domain-wall fermions, including one at the physical pion mass. The bottom quarks are implemented using lattice nonrelativistic QCD, and the charm quarks using an anisotropic clover action. In addition to local diquark-antidiquark and local meson-meson interpolating operators, we include nonlocal meson-meson operators at the sink, which facilitates the reliable determination of the low-lying energy levels. We find clear evidence for the existence of a strong-interaction-stable ¯𝑏¯𝑏𝑢𝑠 tetraquark with binding energy (−86±22±10) MeV and mass (10609±22±10) MeV. For the ¯𝑏¯𝑐𝑢𝑑 systems we do not find any indication for the existence of bound states, but cannot rule out their existence either.
A search for the charged lepton flavor violating decay 𝐽/𝜓→𝑒±𝜏∓ with 𝜏∓→𝜋∓𝜋0𝜈𝜏 is performed with about 10×109 𝐽/𝜓 events collected with the BESIII detector at the BEPCII. No significant signal is observed, and an upper limit is set on the branching fraction ℬ(𝐽/𝜓→𝑒±𝜏∓)<7.5×10−8 at the 90% confidence level. This improves the previously published limit by two orders of magnitude.
The crowdfunding of altruism
(2022)
This paper introduces a machine learning approach to quantify altruism from the linguistic style of textual documents. We apply our method to a central question in (social) entrepreneurship: How does altruism impact entrepreneurial success? Specifically, we examine the effects of altruism on crowdfunding outcomes in Initial Coin Offerings (ICOs). The main result suggests that altruism and ICO firm valuation are negatively related. We, then, explore several channels to shed some light on whether the negative altruism-valuation relation is causal. Our findings suggest that it is not altruism that causes lower firm valuation; rather, low-quality entrepreneurs select into altruistic projects, while the marginal effect of altruism on high-quality entrepreneurs is actually positive. Altruism increases the funding amount in ICOs in the presence of high-quality projects, low asymmetric information, and strong corporate governance.
Low-caloric formula diets can improve hemodynamic parameters of patients with type 2 diabetes. We, therefore, hypothesized that persons with overweight or obesity can benefit from a high-protein, low-glycemic but moderate-caloric formula diet. This post-hoc analysis of the Almased Concept against Overweight and Obesity and Related Health Risk- (ACOORH) trial investigated the impact of a lifestyle intervention combined with a formula diet (INT, n = 308) compared to a control group with lifestyle intervention alone (CON, n = 155) on hemodynamic parameters (systolic and diastolic blood pressure (SBP, DBP), resting heart rate (HR), and pulse wave velocity (PWV)) in high-risk individuals with prehypertension or hypertension. INT replaced meals during the first 6 months (1 week: 3 meals/day; 2–4 weeks: 2 meals/day; 5–26 weeks: 1 meal/day). Study duration was 12 months. From the starting cohort, 304 (68.3%, INT: n = 216; CON: n = 101) participants had a complete dataset. Compared to CON, INT significantly reduced more SBP (−7.3 mmHg 95% CI [−9.2; −5.3] vs. −3.3 mmHg [−5.9; −0.8], p < 0.049) and DBP (−3.7 mmHg [−4.9; −2.5] vs. −1.4 mmHg [−3.1; 0.2], p < 0.028) after 12 months. Compared to CON, INT showed a pronounced reduction in resting HR and PWV after 6 months but both lost significance after 12 months. Changes in SBP, DBP, and PWV were significantly associated positively with changes in body weight and fat mass (all p < 0.05) and resting HR correlated positively with fasting insulin (p < 0.001) after 12 months. Combining a lifestyle intervention with a high-protein and low-glycemic formula diet improves hemodynamic parameters to a greater extent than lifestyle intervention alone in high-risk individuals with overweight and obesity.
ALICE is the dedicated heavy-ion experiment at the CERN Large Hadron Collider (LHC). Its main tracking and particle-identification detector is a large volume Time Projection Chamber (TPC). The TPC has been designed to perform well in the high-track density environment created in high-energy heavy-ion collisions. In this proceeding, we describe the track reconstruction procedure in ALICE. In particular, we focus on the two main challenges that were faced during the Run 2 data-taking period (2015–2018) of the LHC, which were the baseline fluctuations and the local space charge distortions in the TPC. We present the corresponding solutions in detail and describe the software tools that allowed us to circumvent these challenges.
Soil-Transmitted Helminths (STH) is a group of nematodes that infect people and transmitted through soil media. STH occurs especially among pre-school and school-aged children, and commonly related to environmental sanitation and personal hygiene. The study objected to determine the factors related to the incidence of STH in children 5-15 years who lived surrounding the Sukawinatan district of Palembang city. The observational analytic using the cross-sectional design, consisted of 110 subjects sampled by consecutive sampling. Data on environmental sanitation and personal hygiene were obtained by questionnaires, while infection status using the Kato-Katz faecal technic. The results were analyzed using Chi-square test (α = 0.05), showed that 24.5% of population where infected with STH. A number of 1-24-2 children were infected with hookworm-Ascaris lumbricoides-Trichuris trichiura infection, respectively. Based on statistical test results, the association of STH infection with variables were: waste disposal (p = 0.268), water facilities (p = 1.000), sewage disposal (p = 0.224), latrine (p = 0.021), hand washing prior to meal (p = 0.001), hand washing after defecate (p = 0.028), use of footwear (p = 0.013), and nail hygiene (p = 1.000). Concluded that the significant factors related to STH were use of latrine, hand washing behaviour, and use of footwear. Further research will be necessary to successfully eliminate this neglected tropical disease.
The time-dependent Schrödinger equation for quadratic Hamiltonians has Gaussian wave packets as exact solutions. For the parametric oscillator with frequency ω(t), the width of these wave packets must be time-dependent. This time-dependence can be determined by solving a complex nonlinear Riccati equation or an equivalent real nonlinear Ermakov equation. All quantum dynamical properties of the system can easily be constructed from these solutions, e.g., uncertainties of position and momentum, their correlations, ground state energies, etc. In addition, the link to the corresponding classical dynamics is supplied by linearizing the Riccati equation to a complex Newtonian equation, actually representing two equations of the same kind: one for the real and one for the imaginary part. If the solution of one part is known, the missing (linear independent) solution of the other can be obtained via a conservation law for the motion in the complex plane. Knowing these two solutions, the solution of the Ermakov equation can be determined immediately plus the explicit expressions for all the quantum dynamical properties mentioned above. The effect of a dissipative, linear velocity dependent friction force on these systems is discussed.
Using an 𝑒+𝑒− collision data sample of (27.08±0.14)×108 𝜓(3686) events collected by the BESIII detector, we report the first observation of 𝜒𝑐𝐽→Ω−¯Ω+ (𝐽=0, 1, 2) decays with significances of 5.6𝜎, 6.4𝜎, and 18𝜎, respectively, where the 𝜒𝑐𝐽 mesons are produced in the radiative 𝜓(3686) decays. The branching fractions are determined to be ℬ(𝜒𝑐0→Ω−¯Ω+) = (3.51±0.54±0.29)×10−5, ℬ(𝜒𝑐1→Ω−¯Ω+)=(1.49±0.23±0.10)×10−5, and ℬ(𝜒𝑐2→Ω−¯Ω+)=(4.52±0.24±0.18)×10−5, where the first and second uncertainties are statistical and systematic, respectively.
Using (1.0087±0.0044)×1010 𝐽/𝜓 events collected by the BESIII detector at the BEPCII collider, we report the first search for the baryon and lepton number violating decays Ξ0→𝐾−𝑒+ with Δ(𝐵−𝐿)=0 and Ξ0→𝐾+𝑒− with |Δ(𝐵−𝐿)|=2, where 𝐵 (𝐿) is the baryon (lepton) number. While no signal is observed, the upper limits on the branching fractions of these two decays are set to ℬ(Ξ0→𝐾−𝑒+)<3.6×10−6 and ℬ(Ξ0→𝐾+𝑒−)<1.9×10−6 at the 90% confidence level, respectively. These results offer a direct probe of baryon number violating interactions involving a strange quark.
The Ξ0 asymmetry parameters are measured using entangled quantum Ξ0 − Ξ¯ 0 pairs from a sample of ð448.1 2.9Þ × 106 ψð3686Þ events collected with the BESIII detector at BEPCII. The relative phase between the transition amplitudes of the Ξ0Ξ¯ 0 helicity states is measured to be ΔΦ ¼ −0.050 0.150 0.020 rad, which implies that there is no obvious polarization at the current level of statistics. The decay parameters of the Ξ0 hyperon ðαΞ0 ; αΞ¯ 0 ; ϕΞ0 ; ϕΞ¯ 0 Þ and the angular distribution parameter ½αψð3686Þ and ΔΦ are measured simultaneously for the first time. In addition, the CP asymmetry observables are determined to be AΞ0 CP ¼ ðαΞ0 þ αΞ¯ 0 Þ=ðαΞ0 − αΞ¯ 0 Þ ¼ −0.007 0.082 0.025 and ΔϕΞ0 CP ¼ ðϕΞ0 þ ϕΞ¯ 0 Þ=2 ¼ −0.079 0.082 0.010 rad, which are consistent with CP conservation.
We report on the first search for ¯Λ−Λ oscillations in the decay 𝐽/𝜓→𝑝𝐾−¯Λ+c.c. by analyzing 1.31×109 𝐽/𝜓 events accumulated with the BESIII detector at the BEPCII collider. The 𝐽/𝜓 events are produced using 𝑒+𝑒− collisions at a center of mass energy √𝑠=3.097 GeV. No evidence for hyperon oscillations is observed. The upper limit for the oscillation rate of ¯Λ to Λ hyperons is determined to be 𝒫(Λ)=[ℬ(𝐽/𝜓→𝑝𝐾−Λ+c.c.)/ℬ(𝐽/𝜓→𝑝𝐾−¯Λ+c.c.)]<4.4×10−6 corresponding to an oscillation parameter 𝛿𝑚Λ¯Λ of less than 3.8×10−18 GeV at the 90% confidence level.
Introduction: Older patients with multimorbidity, polypharmacy and related complex care needs represent a growing proportion of the population and a challenge for healthcare systems. Particularly in transitional care (hospital admission and hospital discharge), medical errors, inappropriate treatment, patient concerns and lack of confidence in healthcare are major problems that may arise from a lack of information continuity. The aim of this study is to develop an intervention to improve informational continuity of care at the interface between general practice and hospital care.
Methods and analysis: A qualitative approach will be used to develop our participatory intervention. Overall, 32 semistructured interviews with relevant stakeholders will be conducted and analysed. The stakeholders will include healthcare professionals from the outpatient setting (general practitioners, healthcare assistants, ambulatory care nurses) and the inpatient setting (clinical doctors, nurses, pharmacists, clinical information scientists) as well as patients and informal caregivers. At a series of workshops based on the results of the stakeholder analyses, we aim to develop a participatory intervention that will then be implemented in a subsequent pilot study. The same stakeholder groups will be invited for participation in the workshops.
Ethics and dissemination: Ethical approval for this study was waived by the Ethics Committee of Goethe University Frankfurt because of the nature of the proposed study. Written informed consent will be obtained from all study participants prior to participation. Results will be tested in a pilot study and disseminated at (inter)national conferences and via publication in peer-reviewed journals.
Research on the Heteroptera fauna of Turkey has not been extensive enough to illustrate its true diversity. Although several factors contribute to this, the lack of an up-to-date and comprehensive review is a basic factor. To address this issue, we compiled a list of all the Heteroptera species recorded from Turkey in the literature and iNaturalist. In addition, we re-examined several specimens preserved in the Lodos Entomological Museum, İzmir, Turkey (LEMT). Consequently, we excluded 24 species from the checklist of Heteroptera fauna of Turkey, and proposed a new synonymy: Psallus (Psallus) pardalis Seidenstücker, 1966 = Psallus (Psallus) oenderi Wagner, 1976 syn. nov. Furthermore, we recorded following six species from Turkey for the first time: Blissus hirtulus Burmeister, 1835 (Blissidae), Loricula (Loricula) pselaphiformis Curtis, 1833 (Microphysidae), Globiceps (Globiceps) coryli V.G. Putshkov, 1970, Heterocordylus (Heterocordylus) cytisi Josifov, 1958, Mesopsallus fagi (Drapolyuk, 1990) and Psallus (Psallus) helenae Josifov, 1969 (Miridae); and described following six species as new for science: Orthonotus efei Çerçi & Koçak sp. nov., Orthotylus (Parapachylops) oenderi Çerçi, Tezcan & Koçak sp. nov., Orthotylus (Pinocapsus) girayi Çerçi & Tezcan sp. nov., Psallus (Psallus) eceae Çerçi & Koçak sp. nov., Psallus (Psallus) pehlivani Çerçi & Tezcan sp. nov. and Ribautocapsus tezcani Çerçi sp. nov. Altogether, 1668 species of Heteroptera have been recorded from Turkey (664 species in the European part and 1633 species in the Anatolian part) until now, out of them, the presence of 37 species needs confirmation. We determined the chorotypical composition of species as follows: Mediterranean (399 spp., 23.9%), European (380 spp., 22.8%), Local (280 spp., 16.8%), Widespread (182 spp., 10.9%), Endemic (128 spp., 7.7%), Turanian (127 spp., 7.5%), Turano-Mediterranean (89 spp., 5.3%), Europeo-Mediterranean (68 spp., 4.1%) and Alien (12 spp., 0.7%). We showed that provinces in the Eastern Anatolian, Southeastern Anatolian, and Black Sea regions had lower numbers of species recorded, compared to the provinces in the remaining regions. Finally, we underlined that 109 species, absent from Turkey, were recorded from three or more neighboring countries of Turkey. In summary, our findings emphasize that despite the abundant research devoted over the last 150 years to the Heteroptera fauna of Turkey, our understanding of it remains incomplete in the majority, if not in all, of the regions. Our findings strongly encourage further research, particularly in regions with small numbers of recorded species. This endeavor will undoubtedly lead to numerous novel discoveries and provide a better understanding of the true Heteroptera diversity in Turkey.
We search for an axion-like particle (ALP) a through the process ψ(3686)→π+π−J/ψ, J/ψ→γa, a→γγ in a data sample of (2.71±0.01)×109 ψ(3686) events collected by the BESIII detector. No significant ALP signal is observed over the expected background, and the upper limits on the branching fraction of the decay J/ψ→γa and the ALP-photon coupling constant gaγγ are set at 95% confidence level in the mass range of 0.165≤ma≤2.84GeV/c2. The limits on B(J/ψ→γa) range from 8.3×10−8 to 1.8×10−6 over the search region, and the constraints on the ALP-photon coupling are the most stringent to date for 0.165≤ma≤1.468GeV/c2.
Using data samples with an integrated luminosity of 22.42 fb−1 collected by the BESIII detector operating at the BEPCII storage ring, we measure the cross sections of the 𝑒+𝑒−→𝜂𝐽/𝜓 process at center-of-mass energies from 3.808 to 4.951 GeV. Three structures are observed in the line shape of the measured cross sections. A maximum-likelihood fit with 𝜓(4040), two additional resonances, and a nonresonant component are performed. The mass and width of the first additional state are (4219.7±2.5±4.5) MeV/𝑐2 and (80.7±4.4±1.4) MeV, respectively, consistent with the 𝜓(4230). For the second state, the mass and width are (4386±13±17) MeV/𝑐2 and (177±32±13) MeV, respectively, consistent with the 𝜓(4360). The first uncertainties are statistical, and the second ones are systematic. The statistical significance of 𝜓(4040) is 8.0𝜎 and those for 𝜓(4230) and 𝜓(4360) are more than 10.0𝜎.
Based on e+e− collision data collected at center-of-mass energies from 2.000 to 3.080 GeV by the BESIII detector at the BEPCII collider, a partial wave analysis isperformed for the process e+e− → K0SK0Lπ0. The results allow the Born cross sections of the process e+e− → K0SK0Lπ0, as well as its subprocesses e+e− → K∗(892)0K¯ 0 and K∗2(1430)0K¯ 0 to be measured. The Born cross sections for e+e− → K0SK0 Lπ 0 are consistent with previous measurements by BaBar, but with substantially improved precision. The Born cross section lineshape of the process e+e − → K∗(892)0K¯ 0 is consistent with a vector meson state around 2.2 GeV with a signifcance of 3.2σ. A Breit-Wigner ft determines its mass as MY = (2164.7 ± 9.1 ± 3.1) MeV/c2 and its width as ΓY = (32.4 ± 21.0 ± 1.8) MeV.
We study the decays of J/ψ and ψ(3686) to the final states Σ(1385)0Σ¯(1385)0 and Ξ0Ξ¯0 based on a single baryon tag method using data samples of (1310.6±7.0)×106 J/ψ and (447.9±2.9)×106 ψ(3686) events collected with the BESIII detector at the BEPCII collider. The decays to Σ(1385)0Σ¯(1385)0 are observed for the first time. The measured branching fractions of J/ψ and ψ(3686)→Ξ0Ξ¯0 are in good agreement with, and much more precise, than the previously published results. The angular parameters for these decays are also measured for the first time. The measured angular decay parameter for J/ψ→Σ(1385)0Σ¯(1385)0, α=−0.64±0.03±0.10, is found to be negative, different to the other decay processes in this measurement. In addition, the "12\% rule" and isospin symmetry in the J/ψ and ψ(3686)→ΞΞ¯ and Σ(1385)Σ¯(1385) systems are tested.
Using a sample of (10087±44)×106 𝐽/𝜓 events, which is about 45 times larger than that was previously analyzed, a further investigation on the 𝐽/𝜓→𝛾3(𝜋+𝜋−) decay is performed. A significant distortion at 1.84 GeV/𝑐2 in the line shape of the 3(𝜋+𝜋−) invariant mass spectrum is observed for the first time, which could be resolved by two overlapping resonant structures, 𝑋(1840) and 𝑋(1880). The new state 𝑋(1880) is observed with a statistical significance larger than 10𝜎. The mass and width of 𝑋(1880) are determined to be 1882.1±1.7±0.7 MeV/𝑐2 and 30.7±5.5±2.4 MeV, respectively, which indicates the existence of a 𝑝¯ 𝑝 bound state.
By analyzing 2.93 fb−1 of data taken at the ψ(3770) resonance peak with the BESIII detector, we measure the branching fractions for the hadronic decays D+ → K0S K0S K +, D+ → K0S K0Sπ+, D0 → K0S K0S and D0 → K0S K0S K0S . They are determined to be B(D+ → K0S K0S K +) = (2.54 ± 0.05stat. ± 0.12sys.) × 10−3, B(D+ → K0S K0Sπ+) = (2.70 ± 0.05stat. ± 0.12sys.) × 10−3, B(D0 → K0S K0S ) = (1.67 ± 0.11stat. ± 0.11sys.) × 10−4 and B(D0 → K0S K0S K0S ) = (7.21 ± 0.33stat. ± 0.44sys.) × 10−4, where the second one is measured for the first time and the others are measured with significantly improved precision over the previous measurements.
Based on 4.5 fb−1 data taken at seven center-of-mass energies ranging from 4.600 to 4.699 GeV with the BESIII detector at the BEPCII collider, we measure the branching fractions of Λ + c → Σ + + hadrons relative to Λ + c → Σ +π +π −. Combining with the world average branching fraction of Λ + c → Σ +π +π −, their branching fractions are measured to be (0.377 ± 0.042 ± 0.020 ± 0.021)% for Λ + c → Σ +K+K−, (0.200 ± 0.023 ± 0.011 ± 0.011)% for Λ + c → Σ+K+π−, (0.414 ± 0.080 ± 0.030 ± 0.023)% for Λ + c → Σ +φ and (0.197 ± 0.036 ± 0.009 ± 0.011)% for Λ + c → Σ +K+K−(non-φ). In all the above results, the first uncertainties are statistical, the second are systematic and the third are from external input of the branching fraction of Λ + c → Σ +π +π −. Since no signal for Λ + c → Σ +K+π−π 0 is observed, the upper limit of its branching fraction is determined to be 0.13% at the 90% confidence level.
We search for the semi-leptonic decays Λ + c → Λπ+π−e+νe and Λ + c → pK0 Sπ−e+νe in a sample of 4.5 fb−1 of e+e− annihilation data collected in the center-of-mass energy region between 4.600 GeV and 4.699 GeV by the BESIII detector at the BEPCII. No significant signals are observed, and the upper limits on the decay branching fractions are set to be B(Λ+c → Λπ+π−e+νe ) < 3.9 × 10−4 and B(Λ + c → pK0Sπ−e+νe ) < 3.3 × 10−4 at the 90% confidence level, respectively.
During the 2016-17 and 2018-19 running periods, the BESIII experiment collected 7.5 fb -1 of e+e− collision data at center-of-mass energies ranging from 4.13 to 4.44 GeV. These data samples are primarily used for the study of excited charmonium and charmoniumlike states. By analyzing the di-muon process e+e− (γISR/FSR)µ -> +µ-, we measure the center-of-mass energies of the data samples with a precision of 0.6 MeV. Through a run-by-run study, we find that the center-of-mass energies were stable throughout most of the data-collection period.
Background: Particulate matter (PM) emission caused by tobacco combustion leads to severe health burdens worldwide. Second-hand smoke exposure is extraordinarily high in enclosed spaces (e.g., indoor rooms, car cabins) and poses a particular threat to the health of vulnerable individuals (e.g., children, elderly, etc.). This study aimed to establish a new measuring platform and investigate PM emissions under four different ventilation conditions inside a car cabin without exposing any person to harmful tobacco smoke.
Methods: PM concentrations were measured during the smoking of 3R4F reference cigarettes in a Mitsubishi Space Runner (interior volume 3.709 m3). The cigarettes were smoked with a machine, eliminating exposure of the researchers. Cigarettes were extinguished 4.5 min after ignition, and PM measurements continued until 10 min after ignition.
Results: High mean PM concentrations were measured for cigarettes without ventilation after 4.5 min (PM10: 1150 µg/m3, PM2.5: 1132 µg/m3, PM1: 861.6 µg/m3) and after 10 min (PM10: 1608 µg/m3, PM2.5: 1583 µg/m3, PM1: 1133 µg/m3). 3R4F smoked under conditions with turned on ventilation resulted in reduction of PM compared to those smoked without ventilation after 4.5 min (PM10:-47.5 to -58.4%, PM2.5:-47.2 to -58%, PM1:-39.6 to -50.2%) and after 10 min (PM10:-70.8 to -74.4%, PM2.5:-70.6 to -74.3%, PM1:-64.0 to -68.0%). Cigarettes smoked without ventilation generated high PM peaks at 4.5 min (PM10: 2207 µg/m3, PM2.5: 2166 µg/m3, PM1: 1421 µg/m3) and at 10 min (PM10: 1989 µg/m3, PM2.5: 1959 µg/m3, PM1: 1375 µg/m3). PM peaks of cigarettes smoked under different ventilation modes varied at 4.5 min (PM10: 630-845 µg/m3, PM2.5: 625-836 µg/m3, PM1: 543 - 693 µg/m3) and 10 min (PM10: 124 - 130 µg/m3, PM2.5: 124 - 129 µg/m3, PM1: 118 - 124 µg/m3).
Conclusion: The new measuring platform provides a safer way for researchers to investigate PM emissions of cigarettes. These data are comparable to published research and show that smoking in a parked vehicle with the windows closed generates harmful PM emissions even when the vehicle ventilation is in operation. Future studies should be carried out using the new measuring platform investigating PM exposure and PM distribution of in-vehicle smoking under a wide range of conditions.
Geometry is part of the core of mathematics. It has been relevant ever since people have interacted with nature and its phenomena. Geometry’s relevance to the teaching and learning of mathematics can be emphasized, too. Nevertheless, a current potential shift in the topics of mathematics education to the detriment of geometry might be emerging. That is, other topics related to mathematics are seeming to grow in importance in comparison to geometry. Despite this, or perhaps because of it, geometry is an important component of current research in mathematics education. In the literature review, we elaborate relevant foci on the basis of current conference proceedings. By means of about 50 journal articles, five main topics are elaborated in more detail: geometric thinking and practices, geometric contents and topics, teacher education in geometry, argumentation and proof in geometry, as well as the use of digital tools for the teaching and learning of geometry. Conclusions and limitations for current and future research on geometry are formulated at the end of the article. In particular, the transfer to the practices of geometric teaching is explored on the basis of the elaborated research findings in order to combine both aspects of the teaching and learning of geometry.
Background: A good physician should be empathic and altruistic, among other qualities. Therefore, the levels of socially undesirable personality traits (Dark Triad) as well as implicit motives of achievement, affiliation and power (Multi-Motive Grid) among medical students as future physicians were analyzed at two different points in their medical training.
Methods: This study includes 380 medical students in their first year and 217 in their third year in Germany. All participants completed the Dirty Dozen (DD) and Multi-Motive Grid (MMG) questionnaires at the end of two different classes as paper-and-pencil tests. Relevant differences of the Dark Triad traits between the medical students and reference sample and the two different cohorts, as well as their implicit motives, the associations of Dark Triad traits and MMG components and gender differences of the Dark Triad traits were calculated.
Results: There were no significant group differences between year one and year three medical students in narcissism, psychopathy and Machiavellianism (Dark Triad). There were no significant differences between the medical students and reference sample except in psychopathy. Male students scored significantly higher in the Dark Triad traits than female students. In the MMG, first-year students scored significantly higher levels in Fear of Rejection, and lower levels in Hope of Success and Hope of Power than the third-year students. Some associations were found between narcissism and Machiavelliansim with Hope of Success, Hope of Power and Fear of power.
Conclusions: Dark Triad traits already appear to exist before the commencement of medical studies. These traits do not differ significantly between the medical students and reference sample; only a few MMG components seem to differ at different stages of their studies. This lack of differences between the medical students and validation cohort indicates that tests based on (undesirable) personality traits are not suitable criteria for the admission selection of medical students.
In this paper, we use the “gender as a social structure” framework to assess macro-, interactional-, and micro-level mechanisms explaining the stalled revolution in gender ideologies. Using the European Values Study 2008 data and latent class analysis, we look at the spread of gender ideologies and examine their association with national levels of gendered ascription of work and care roles, work–family compatibility, social inequality and societal affluence, individual characteristics, and cross-level interactions with gender and education in 36 (post-)industrialized countries. By including a large number of Central, Eastern, and South-Eastern European countries, we provide a new and comprehensive picture of the gender ideology landscapes of Europe, reflected in two unidimensional classes—egalitarian and traditional—and four multidimensional classes, covering more than 60 percent of respondents—family oriented, choice egalitarian, intensive motherhood, and neotraditional. By modeling key features of macro-level variation, we show how the spread of gender ideologies is associated with distinct contextual conditions. We consolidate previous findings on multidimensional gender ideologies, which were based on fewer countries.
Argonaute 2 (AGO2) is an indispensable component of the RNA-induced silencing complex, operating at the translational or posttranscriptional level. It is compartmentalized into structures such as GW- and P-bodies, stress granules and adherens junctions as well as the midbody. Here we show using immunofluorescence, image and bioinformatic analysis and cytogenetics that AGO2 also resides in membrane protrusions such as open- and close-ended tubes. The latter are cytokinetic bridges where AGO2 colocalizes at the midbody arms with cytoskeletal components such as α-Τubulin and Aurora B, and various kinases. AGO2, phosphorylated on serine 387, is located together with Dicer at the midbody ring in a manner dependent on p38 MAPK activity. We further show that AGO2 is stress sensitive and important to ensure the proper chromosome segregation and cytokinetic fidelity. We suggest that AGO2 is part of a regulatory mechanism triggered by cytokinetic stress to generate the appropriate micro-environment for local transcript homeostasis.
We present a relativistic Shakhov-type generalization of the Anderson-Witting relaxation time model for the Boltzmann collision integral to modify the ratio of momentum diffusivity to thermal diffusivity. This is achieved by modifying the path on which the single particle distribution function fk approaches local equilibrium f0k by constructing an intermediate Shakhov-type distribution fSk similar to the 14-moment approximation of Israel and Stewart. We illustrate the effectiveness of this model in case of the Bjorken expansion of an ideal gas of massive particles and the damping of longitudinal waves through an ultrarelativistic ideal gas.
In Ref. [1] the BESIII collaboration published a cross section measurement of the process e+e− → π+π− in the energy range between 600 and 900 MeV. In this corrigendum, we report a corrected evaluation of the statistical errors in terms of a fully propagated covariance matrix. The correction also yields a reduced statistical uncertainty for the hadronic vacuum polarization contribution to the anomalous magnetic moment of the muon, which now reads as aππ,LO μ (600 − 900 MeV) = (368.2 ± 1.5stat ± 3.3syst) × 10−10. The central values of the cross section measurement and of aππ,LO μ , as well as the systematic uncertainties remain unchanged.
The free energy of TAP-solutions for the SK-model of mean field spin glasses can be expressed as a nonlinear functional of local terms: we exploit this feature in order to contrive abstract REM-like models which we then solve by a classical large deviations treatment. This allows to identify the origin of the physically unsettling quadratic (in the inverse of temperature) correction to the Parisi free energy for the SK-model, and formalizes the true cavity dynamics which acts on TAP-space, i.e. on the space of TAP-solutions. From a non-spin glass point of view, this work is the first in a series of refinements which addresses the stability of hierarchical structures in models of evolving populations.
Background/aim: The aim of this study was to analyze a population of patients who had suffered from traumatic dental injuries (TDIs) by using different patient-, trauma- and treatment-related parameters.
Material and methods: All dental records of patients ≥ 3 years old who had presented at the dental emergency service between Jan 1, 2009 and Dec 31, 2016 for the treatment of dental trauma were analyzed. A total of 2758 patients were invited for a recall examination at the Department for Dental Surgery and Implantology, ZZMK Carolinum, Goethe University Frankfurt, Germany; of these, 269 patients attended their recall appointments.
Results: The enrolled patient population consisted of 1718 males and 1040 females, with a mean age of 19.63 years (median 12.00 ± 17.354 years). A total of 4909 injured teeth were assessed, with a mean of 1.78 injured teeth per patient (median 2.00 ± 1.279). Males were found to be more frequently affected by TDIs compared to females (1.65:1). The majority of these injuries occurred in the first two decades of life (66.1%; n = 1824). The majority of the patients presented for initial treatment within 24 h of their accident (95.7%). The most frequent TDIs were isolated luxation injuries 49.4% (n = 2426) and isolated crown fractures 30% (n = 1472). Combination injuries were diagnosed in 20.6% of the cases (n = 1011).
Conclusions: Based on the findings of the present analysis, it can be concluded that males were more frequently affected by TDIs than females. Most patients had suffered from TDI before they had turned 10 years of age. Overall, the enamel–dentin fracture was found to be the most frequent injury, followed by concussions and lateral luxations.
Multiplex families with a high prevalence of a psychiatric disorder are often examined to identify rare genetic variants with large effect sizes. In the present study, we analysed whether the risk for bipolar disorder (BD) in BD multiplex families is influenced by common genetic variants. Furthermore, we investigated whether this risk is conferred mainly by BD-specific risk variants or by variants also associated with the susceptibility to schizophrenia or major depression. In total, 395 individuals from 33 Andalusian BD multiplex families (166 BD, 78 major depressive disorder, 151 unaffected) as well as 438 subjects from an independent, BD case/control cohort (161 unrelated BD, 277 unrelated controls) were analysed. Polygenic risk scores (PRS) for BD, schizophrenia (SCZ), and major depression were calculated and compared between the cohorts. Both the familial BD cases and unaffected family members had higher PRS for all three psychiatric disorders than the independent controls, with BD and SCZ being significant after correction for multiple testing, suggesting a high baseline risk for several psychiatric disorders in the families. Moreover, familial BD cases showed significantly higher BD PRS than unaffected family members and unrelated BD cases. A plausible hypothesis is that, in multiplex families with a general increase in risk for psychiatric disease, BD development is attributable to a high burden of common variants that confer a specific risk for BD. The present analyses demonstrated that common genetic risk variants for psychiatric disorders are likely to contribute to the high incidence of affective psychiatric disorders in the multiplex families. However, the PRS explained only part of the observed phenotypic variance, and rare variants might have also contributed to disease development.
DNA methylation profiles of aggressive behavior may capture lifetime cumulative effects of genetic, stochastic, and environmental influences associated with aggression. Here, we report the first large meta-analysis of epigenome-wide association studies (EWAS) of aggressive behavior (N = 15,324 participants). In peripheral blood samples of 14,434 participants from 18 cohorts with mean ages ranging from 7 to 68 years, 13 methylation sites were significantly associated with aggression (alpha = 1.2 × 10−7; Bonferroni correction). In cord blood samples of 2425 children from five cohorts with aggression assessed at mean ages ranging from 4 to 7 years, 83% of these sites showed the same direction of association with childhood aggression (r = 0.74, p = 0.006) but no epigenome-wide significant sites were found. Top-sites (48 at a false discovery rate of 5% in the peripheral blood meta-analysis or in a combined meta-analysis of peripheral blood and cord blood) have been associated with chemical exposures, smoking, cognition, metabolic traits, and genetic variation (mQTLs). Three genes whose expression levels were associated with top-sites were previously linked to schizophrenia and general risk tolerance. At six CpGs, DNA methylation variation in blood mirrors variation in the brain. On average 44% (range = 3–82%) of the aggression–methylation association was explained by current and former smoking and BMI. These findings point at loci that are sensitive to chemical exposures with potential implications for neuronal functions. We hope these results to be a starting point for studies leading to applications as peripheral biomarkers and to reveal causal relationships with aggression and related traits.
Off-central heavy-ion collisions are known to feature magnetic fields with magnitudes and characteristic gradients corresponding to the scale of the strong interactions. In this work, we employ equilibrium lattice simulations of the underlying theory, QCD, involving similar inhomogeneous magnetic field profiles to achieve a better understanding of this system. We simulate three flavors of dynamical staggered quarks with physical masses at a range of magnetic fields and temperatures, and extrapolate the results to the continuum limit. Analyzing the impact of the field on the quark condensate and the Polyakov loop, we find non-trivial spatial features that render the QCD medium qualitatively different as in the homogeneous setup, especially at temperatures around the transition. In addition, we construct leading-order chiral perturbation theory for the inhomogeneous background and compare its prediction to our lattice results at low temperature. Our findings will be useful to benchmark effective theories and low-energy models of QCD for a better description of peripheral heavy-ion collisions.
The compulsive habit of cars
(2014)
The car dependence of people living in contemporary cities is a major concern for policy makers, who often find it difficult to persuade people into more sustainable transport modes. By contrast, recent insights from neuroscience have shown that a broad spectrum of behaviors can become habitual and, thus, resistant to change. Here, we outline the potential of collaboration between neuroscience and human geography aiming at a better understanding of habits that determine everyday commuting routines.
Measurement of the e+e−→π+π− cross section between 600 and 900 MeV using initial state radiation
(2016)
We extract the e+e− →π+π− cross section in the energy range between 600 and 900 MeV, exploiting the method of initial state radiation. A data set with an integrated luminosity of 2.93 fb−1 taken at a center-of-mass energy of 3.773 GeV with the BESIII detector at the BEPCII collider is used. The cross section is measured with a systematic uncertainty of 0.9%. We extract the pion form factor |Fπ|2 as well as the contribution of the measured cross section to the leading-order hadronic vacuum polarization contribution to (g−2)μ. We find this value to be aππ,LO μ (600–900 MeV) = (368.2 ±2.5stat±3.3sys) ·10−10, which is between the corresponding values using the BaBar or KLOE data.
By analyzing the large-angle Bhabha scattering events e+e− → (γ)e+e− and diphoton events e+e− → (γ)γγ for the data sets collected at center-of-mass (c.m.) energies between 2.2324 and 4.5900 GeV (131 energy points in total) with the upgraded Beijing Spectrometer (BESIII) at the Beijing Electron-Positron Collider (BEPCII), the integrated luminosities have been measured at the different c.m. energies, individually. The results are important inputs for the R value and J/ψ resonance parameter measurements.
Mitigating climate change necessitates global cooperation, yet global data on individuals’ willingness to act remain scarce. In this study, we conducted a representative survey across 125 countries, interviewing nearly 130,000 individuals. Our findings reveal widespread support for climate action. Notably, 69% of the global population expresses a willingness to contribute 1% of their personal income, 86% endorse pro-climate social norms and 89% demand intensified political action. Countries facing heightened vulnerability to climate change show a particularly high willingness to contribute. Despite these encouraging statistics, we document that the world is in a state of pluralistic ignorance, wherein individuals around the globe systematically underestimate the willingness of their fellow citizens to act. This perception gap, combined with individuals showing conditionally cooperative behaviour, poses challenges to further climate action. Therefore, raising awareness about the broad global support for climate action becomes critically important in promoting a unified response to climate change.
It is widely acknowledged that biodiversity change is affecting human well-being by altering the supply of Nature's Contributions to People (NCP). Nevertheless, the role of individual species in this relationship remains obscure. In this article, we present a framework that combines the cascade model from ecosystem services research with network theory from community ecology. This allows us to quantitatively link NCP demanded by people to the networks of interacting species that underpin them. We show that this “network cascade” framework can reveal the number, identity and importance of the individual species that drive NCP and of the environmental conditions that support them. This information is highly valuable in demonstrating the importance of biodiversity in supporting human well-being and can help inform the management of biodiversity in social-ecological systems.
Coercion or privatization? Crisis and planned economies in the debates of the early Frankfurt School
(2023)
The 1930s–1940s underwent profound structural economic and political turmoil following the collapse of the nineteenth century liberal market economies. The intellectual debates of the time were dominated by the question of whether Marx’s theory of the tendency of rate of profit to fall was true, or what consequence could be imagined in the survival of capitalist societies. Placed in the middle of such debates was also the reorganization of national productions into war economies. By means of reconstructive analysis, the paper provides a critical overview of the debates that took place within the circle of the Frankfurt School during those years. It also advances an interpretive thesis suggesting that remedies to capitalist crises of the time turned state powers into privatized, illiberal coercive entities. Coercion and privatization reinforced each other. This general tendency is well illustrated by the famous Pollock-Neumann debate. These intellectuals expressed views not only intended to shed light on the historical period of time, but also to formulate long-term considerations on the authoritarian trends embedded in our contemporary democracies. Through historical reconstruction, the paper’s aim is to identify a long-term structural thread of transformation starting from the transformation of the German economy in 1930s and touching upon post Second World War problems of states’ restructuring along privatization/coercion divides.
Detailed feedback on exercises helps learners become proficient but is time-consuming for educators and, thus, hardly scalable. This manuscript evaluates how well Generative Artificial Intelligence (AI) provides automated feedback on complex multimodal exercises requiring coding, statistics, and economic reasoning. Besides providing this technology through an easily accessible web application, this article evaluates the technology’s performance by comparing the quantitative feedback (i.e., points achieved) from Generative AI models with human expert feedback for 4,349 solutions to marketing analytics exercises. The results show that automated feedback produced by Generative AI (GPT-4) provides almost unbiased evaluations while correlating highly with (r = 0.94) and deviating only 6 % from human evaluations. GPT-4 performs best among seven Generative AI models, albeit at the highest cost. Comparing the models’ performance with costs shows that GPT-4, Mistral Large, Claude 3 Opus, and Gemini 1.0 Pro dominate three other Generative AI models (Claude 3 Sonnet, GPT-3.5, and Gemini 1.5 Pro). Expert assessment of the qualitative feedback (i.e., the AI’s textual response) indicates that it is mostly correct, sufficient, and appropriate for learners. A survey of marketing analytics learners shows that they highly recommend the app and its Generative AI feedback. An advantage of the app is its subject-agnosticism—it does not require any subject- or exercise-specific training. Thus, it is immediately usable for new exercises in marketing analytics and other subjects.
New U–Pb ages of detrital and igneous zircons of the Uppermost Unit of Crete shed light on its provenance and on Eohellenic to Eoalpine imprints in the eastern Mediterranean. The detrital zircons of all nappes show Variscan ages and are characterized by a Minoan-type age spectrum, which is typical for the NE margin of Gondwana. Parts of the metasedimentary rocks are unexpectedly young. Their detrital zircon ages continue via the Permian until the Late Triassic, Middle Jurassic and Early Cretaceous. The high-grade metamorphic rocks of the Asterousia crystalline complex are likely equivalents of the low-grade metamorphic trench and fore-arc deposits of the Vatos nappe pointing to Late Cretaceous slab roll back. The presence of both late Permian detrital zircons and Late Cretaceous arc-type granitoids suggest that the Uppermost Unit of Crete is derived from the late Permian/Late Cretaceous magmatic belt situated north of the Sava–Vardar–Izmir–Ankara Suture in the Strandja–Rhodope area. To achieve their recent position on Crete, the nappes had to travel more than 500 km. The traveling path is well tracked by rocks of the Upper Cycladic Unit, which are similar to those of the Uppermost Unit of Crete. The large displacement of the Cretan nappes was controlled not only by nappe transport, but probably also by dextral strike–slip along the North Anatolian Fault Zone and related counterclockwise rotation of the Anatolian block since the Eocene.
Highlights
• Solidification and cooling of an intruded dyke or sill within the middle or shallow crust generate stresses of order 200 MPa, which relax on time scales of a few years to million years.
• Stresses may exceed the brittle strength forming tensile fractures.
• Combined with the pressure gradient within the over-pressurized felsic melts, this explains the migration of felsic contact melt into shrinkage cracks (Sederholm-type veins).
Abstract
Rapid emplacement of a mafic dyke or sill at mid-crustal depth heats and possibly melts the felsic wall rock followed by solidification. Associated volume changes generate stresses, possibly enforcing brittle failure and melt migration. We model the evolution of melting, solidification, temperature, and stress including visco-elastic relaxation in 1D - dykes or -sills using realistic rock rheologies of the Weschnitz pluton (Odenwald). For deep emplacement (Case 1, 15.3 km) extensive contact melting of the wall rock occurs, for shallow emplacement (Case 2, 10 km) it is negligible. The stresses are zero at high melt fractions, but increase during solidification and cooling: The intrusion orthogonal stress is always zero. The intrusion parallel stress σ‖ within the intrusion is tensile (O(200 MPa)). It relaxes on a time scale between a few years (Case 1) and 0.6 m.y. (Case 2). Within the wall rock σ‖ is compressive during heating, but becomes tensile under solidification and cooling. Wall rock stresses relax on a time scale of months to 100 years. A Deborah number is defined based on viscous to thermal relaxation allowing generalization of our results. Adding lithostatic stresses, the total stresses of Case 1 remain below the brittle strength, while for Case 2 they may exceed it. Adding the lithostatic pressure to the melt pressure, the effective stresses exceed the brittle strength and intrusion orthogonal tensile fractures are predicted. Combined with the pressure gradient within the over-pressurized felsic melts generated in the wall rock, this explains the migration of felsic contact melt into shrinkage cracks of the mafic sill in the Weschnitz pluton.
Highlights
• It is important to distinguish acute provoked seizures due to autoimmune encephalitis from chronic unprovoked seizures due to autoimmune-associated epilepsy.
• Currently it is hardly possible in an individual AIE/ALE/RE patient to separate acute provoked seizures from chronic unprovoked seizures due to limitations in determining seizure outcomes, unclear time courses, potential causal interactions between both seizure origins, compartmentalized immune-inflammation, and a lack of licensed drugs to reliably resolve immune-inflammation in the brain parenchyma.
• This makes it hard to decide when to terminate ASMs and to counsel the individual patient regarding driving abilities and other behavioral restrictions and recommendations.
• Studies are urgently needed to define clinical and paraclinical biomarkers in a hypothesis-free, data-driven approach reliably predicting (or not) the development of AAE and the cognitive and behavioral outcome in the due course of an individual patient´s disease.
• These studies should be experimentally validated in suitable animal models.
Abstract
The current International League Against Epilepsy (ILAE) definition and classification guidelines for the first time introduced the category of immune-mediated focal epilepsy in addition to structural, genetic, infectious, and metabolic aetiologies. Moreover, the ILAE Autoimmunity and Inflammation Taskforce recently provided a conceptual framework for the distinction between acute “provoked” seizures in the acute phase of autoimmune encephalitis from chronic “unprovoked” seizures due to autoimmune-associated epilepsy. The first category predominately applies to those autoimmune encephalitis patients with autoantibodies against cell surface neural antigens, in whom autoantibodies are assumed to exert a direct ictogenic effect without overt structural damage. These patients do not exhibit enduring predisposition to seizures after the “acute phase” encephalitis, and thus do not fulfil the definition of epilepsy. The second category applies to those autoimmune encephalitis patients with autoantibodies against intracellular neural antigens and Rasmussen's encephalitis, in whom T cells are assumed to cause epileptogenic effects through immune-inflammation and overt structural damage. These patients do exhibit enduring predisposition to seizures after the “acute phase” of encephalitis and thus fulfil the definition of epilepsy. AAE may result from both, ongoing brain autoimmunity and associated structural brain damage according to the current ILAE definition and classification guideline. We here discuss the shortcomings and defaults of this concept and suggest an unbiased translationally validated and data-driven approach to predict in an individual encephalitis patient the propensity to develop (or not) AAE and the cognitive and behavioural outcome.
Despite antagonizing attempts from the tobacco industry, passive inhalation of tobacco smoke is known to be cancerogenic and toxic to human health for decades. Nonetheless, millions of non-smoking adults and children are still victims of second-hand smoke. Accumulation of particulate matter (PM) in confined spaces such as the car are particularly harmful due to high concentrations. We here aimed to analyze the specific effects of ventilation conditions in the setting of a car. By the use of the measuring platform TAPaC (tobacco-associated particulate matter emissions inside a car cabin), 3R4F reference cigarettes, Marlboro red, and Marlboro gold were smoked in a car interior with a volume of 3.709 m3. Seven different ventilation conditions (C1–C7) were analyzed. Under C1, all windows were closed. Under C2–C7, the car ventilation was turned on power level 2/4 with the air directed towards the windshield. Only the passenger side window was opened, where an outer placed fan could create an airstream speed of 15.9–17.4 km/h at one meter distance to simulate a driving car. C2: Window 10 cm opened. C3: Window 10 cm opened with the fan turned on. C4: Window half-opened. C5: Window half-opened with the fan turned on. C6: Window fully opened. C7: Window fully opened with the fan turned on. Cigarettes were remotely smoked by an automatic environmental tobacco smoke emitter and a cigarette smoking device. Depending on the ventilation condition the cigarettes emitted different mean PM concentrations after 10 min under condition C1 (PM10: 1272–1697 µg/m3, PM2.5: 1253–1659 µg/m3, PM1: 964–1263 µg/m3) under C2, C4, and C6 (PM10: 68.7–196.2 µg/m3, PM2.5: 68.2–194.7 µg/m3, PM1: 66.1–183.8 µg/m3) C3, C5, and C7 (PM10: 73.7–139 µg/m3, PM2.5: 72–137.9 µg/m3, PM1:68.9–131.9 µg/m3). Vehicle ventilation is insufficient to protect passengers from toxic second-hand smoke completely. Brand-specific variations of tobacco ingredients and mixtures markedly influence PM emissions under ventilation conditions. The most efficient ventilation mode to reduce PM exposure was achieved by opening the passenger´s window 10 cm and turning the onboard ventilation on power level 2/4. In-vehicle smoking should be banned to preserve innocent risk groups (e.g., children) from harm.
Die Digitalisierung aller Lebensbereiche stellt die Bildungsarbeit in Schulen, Kirchgemeinden und in der Gedenkstättenpädagogik vor neue Herausforderungen. Der Artikel beschreibt vor diesem Hintergrund Digitalisierungsprojekte an der Goethe-Universität in Frankfurt am Main, die sich mit virtuellen Realitäten, ambivalenten Narrativen und fiktiven Entscheidungssituationen beschäftigen. Besondere Aufmerksamkeit erhalten dabei das Judentum und die bildungstheoretischen Anliegen einer Didaktik der Multiperspektivität.
Two new species of Perinereis with single bar-shaped paragnaths on area VI (Group 1) from the rocky shores of Mumbai, Maharashtra, India, are described with barely (Subgroup 1A) or largely (Subgroup 1B) expanded proximal region of dorsal ligule in posterior parapodia. Perinereis malabarensis sp. nov. can be distinguished from the morphologically similar 1B species P. euiini Park & Kim, 2017 by the paragnath count in area I, the laterally isolated paragnaths in area III, and the length of the dorsal cirrus and dorsal ligule. Additionally, P. misrai sp. nov. is more similar to 1A species P. falsovariegata Monro, 1933 and P. villalobosi Rioja, 1947, but differs by the paragnath count in areas III–V and VII–VIII, the isolated paragnaths in area III, and the number of rows in the anterior band of areas VII–VIII. The morphological characters of the current 44 species within Perinereis G1 are compared, and an identification key to the species belonging to this group is also provided.
The taxonomic status of recently described Isophya taxa from Serbia (Tettigoniidae, Phaneropterinae)
(2024)
During recent decades, increasing research of the taxonomy of the genus Isophya resulted in taxonomic descriptions of several new species. The delimitation of these species is mainly based on oscillographic song analysis of the male song in combination with morphological characters, such as the shape of male cerci, tegmina and ovipositor. In the present paper, we used an integrative taxonomic approach in order to resolve the status of four recently described Isophya taxa from Serbia. Based on our molecular and bioacoustic analyses, all analyzed taxa belong to a single species: Isophya modestior. The majority of the morphological characters used to differentiate the taxa showed strong intra- and interpopulational variability, proving that describing new species within the genus Isophya should not rely on morphological characters alone, but needs to consider bioacoustic analyses as the main tool and a larger series of specimens.
A collection of 1149 otoliths of the Ypresian and Ypresian–Lutetian transition (early Eocene) from 18 sites across five states in the eastern and southern regions of the USA was analyzed. In total, 33 otolith-based taxa are documented, of which 27 are identified at the species level. Nine of these are introduced as new species: “Conger” biaculeatus sp. nov., Bauzaia gibbosa sp. nov., Ampheristus brevicaudatus sp. nov., Symmetrosulcus virginicus sp. nov., Neobythites longesulcatus sp. nov., “Neobythites” pamunkeyensis sp. nov., “Neobythites” stringeri sp. nov., Waitakia dorsogibbosa sp. nov., and “Haemulon” ypresiensis sp. nov. The assemblages are distinct when compared to their younger Eocene counterparts in America. This distinction is primarily characterized by the high proportion of the newly introduced species or exclusive Ypresian species. Additionally, we highlight the presence of 10 amphi-Atlantic species originally described in European deposits. Significantly, the composition of the otolith collection supports the interpretation of a shallow-water environment for the sampled sites during the Ypresian. This ecological setting appears to persist into the subsequent middle and late Eocene within the same geographic region.
Sparse sensor networks for Lamb wave-based structural health monitoring (SHM) can detect defects in plate-like structures. However, the limited number of sensor positions provides little information to characterize the unknown scatterer. This can be achieved by full wavefield analysis e.g. using Laser Doppler vibrometry measurements.
This paper proposes deconvolution processing that enhances the acoustic wavefield interpretation by increasing the temporal resolution of the underlying ultrasound signals. Applying this preprocessor to the whole wavefield allows improved non-destructive assessment of the defect. This approach is verified experimentally through a case study on an isotropic aluminum plate with four cracks.
The article presents the results of numerical and experimental investigations of guided wave propagation in aluminum plates with variable thickness. The shapes of plate surfaces have been specially designed and manufactured using a CNC milling machine. The shapes of the plates were defined by sinusoidal functions varying in phase shift, which forced the changes in thickness variability alongside the propagation path. The main aim of the study is to analyze the wave propagation characteristics caused by non-uniform thickness. In the first step, the influence of thickness variability on the time course of propagating waves has been analyzed theoretically. The study proves that the wave propagation signals can be determined based on knowledge about the statistical description of the specimen geometry. The histograms of thickness distribution together with the a priori knowledge of the dispersion curves were used to develop an iterative procedure assuming that the signal from the previous step becomes the excitation in the next step. Such an approach allowed for taking into account the complex geometry of the plate and rejecting the assumption about the constant average thickness alongside the propagation path. In consequence, it was possible to predict correctly the signal time course, as well as the time of flight and number of propagating wave modes in specimens with variable thickness. It is demonstrated that theoretical signals predicted in this way coincide well with numerical and experimental results. Moreover, the novel procedure allowed for the correct prediction of the occurrence of higher-order modes.
The topic of the article is the status of translation and homophony in philosophy, psychoanalysis and philology. The article focuses on the question of how translation is carried out using the basic principle of equivalence of meaning by homophony and what effects this can produce. The analysis of two case studies by Freud and Lacan shows that homophonic transfer from one language to another can be extremely productive for the subjective traversal of a phantasm. It is then shown that this is not, however, of purely subjective interest. Werner Hamacher has sketched the future of philology starting from such homophonic translations; Lacan has tried to advance to another theory of language through homophonic formations.
Die TPTZ-Citrat-Methode für die Eisenbestimmung im Serum bzw. Plasma zeichnet sich durch verschiedene Vorteile gegenüber anderen handelsüblichen Methoden aus.
1. Der Eisennachweis wird nur zu 2% durch Kupfer falsch-positiv gestört.
2. Die Farbreaktion erfolgt in Citratpuffer bei einem pH von 2,1 bis 2,5. Dieses Milieu ist günstig für die Freisetzung von Eisen aus der Transferrinbindung und gleichzeitig optimal für die Farbentwicklung. Es verhindert in der Regel Proteinpräzipitation, so daß ohne Enteiweißung gemessen werden kann. Die Freisetzung von Eisen aus Hämoglobin wird minimiert. Die Automation dieses Eisentests ist unproblematisch.
3. Die TPTZ-Citrat-Methode ist kostengünstig im Vergleich zu handelsüblichen Tests. Auf Reagenzienbasis reduziert sich der Preis pro Analyse auf 1/4 bis 1/10.
Insgesamt 311 Stämme gramnegativer harnwegspathogener Enterobacteriaceen und Nonfermenter, davon 200 Isolate aus frischem Urin der täglichen Routine und 111 ausgewählte, bezüglich ihrer Identifikation problematische Keime aus der Stammsammlung des Zentrums der Hygiene, Frankfurt/Main, wurden mit den Systemen RAS-ID-Gramne9, und API 20 E bzw. NE, vergleichend getestet. Das RAS~ID-Gramne9-System benutzt 10 biochemische Reaktionen zur Identifizierung gramnegativer Bakterien sowie 10 Chemotherapeutika zur Resistenzbestimmung. Von den 200 Routinestämmen zeigten 196 (98%), von den 111 Stämmen aus der Stammsammlung 98 (88,3 %) Übereinstimmung. Die gute Übereinstimmung und die schnelle und einfache Handhabung läßt das RAS-ID-Gramne9-System für die Identifizierung harnwegs-pathogener Routinekeime als kostengünstige Alternative zu anderen aufwendigeren Identifizierungssystemen erscheinen.
Das Virus der Frühsommermeningoenzephalitis (FSME) und Borrelia burgdorferi als Erreger der Lyme-Borreliose sind die klinischbedeutsamsten durch Zecken übertragenen Infektionserreger in Europa. Der vorliegende Fall beschreibt eine serologisch gesicherte. Doppelinfektion mit dem FSME-Virus und Borellia burgdorferi bei einer 69jährigen deutschen Patientin nach einem Zeckenstich in einem österreichischen Endemiegebiet. Klinisch bestand zum Zeitpunkt der Krankenhausaufnahme eine ausgeprägte Somnolenz und ein hochgradiges Doppelbildsehen. Ein passive Immunisierung gegen FSME war postexpositionell erfolgt, konnte eine Infektion jedoch nicht verhindern. Eine Doppelinfektion durch beide Erreger wurde durch den serologischen Nachweis von spezifischen IgG und IgM Antikörpern gegen das FSME-Virus und im weiteren Verlauf auch gegen Borrelia burgdorferi im ELISA beziehungsweise im rekombinanten Immunoblot gesichert. Obwohl Doppelinfektionen durch die beiden genannten Erregerselten sind, sollten sie bei zeckenübertragenen Erkrankungen mit untypischem Verlauf in der Differentialdiagnose berücksichtigt werden.
Im vorliegenden Fall wird von einer Fehldiagnose auf der Grundlage eines falsch-reaktiven Anti-HCV-Tests und eines falsch-reaktiven HCV-Nukleinsäureamplifikationstests (NAT) berichtet, die bei einem 58-jährigen chirurgischen Oberarzt im Rahmen einer arbeitsmedizinischen Vorsorgeuntersuchung im krankenhauseigenen Labor gestellt wurde und zu einem knapp zweimonatigen Berufsverbot führte. Basis dieser Fehldiagnose war ein wiederholt schwach reaktiver HCV-Antikörper-ELISA, der mit einem Nukleinsäureamplifikationstest, der ebenfalls schwach positiv ausfiel, überprüft wurde. Ein Antikörperbestätigungs- bzw. Ergänzungstest (Immunoblot) wurde nicht durchgeführt. Die Fehldiagnose ist jedoch nicht durch einen Testfehler, sondern durch ein Missverständnis entstanden, indem beim Kliniker zwei Laborindizien zu einem Beweis aufsummiert wurden.
Die steigende Zahl von Pilzinfektionen, die Entwicklung und Einführung neuer anti-mykotischer Substanzen sowie die Möglichkeit der Resistenzentwicklung unter Therapie mit Antimykotikahaben in der Vergangenheit zu einem ständig wachsenden Bedarf an standardisierten Verfahren zur Empfindlichkeitstestung von pathogenen Pilzen geführt. Hierbei entstand unter anderem eine Vielzahl kommerzieller Testverfahren, bei denen mit Hilfe vorgefertigter Testkits eine einfache und schnelle Durchführung der Empfindlichkeitsprüfung erzielt werden soll. Eine dieser Methoden, welche in manchen Laboratorien in Deutschland angewendet wird, ist das so genannte LD 2Ring-Verfahren, welches auf dem Prinzip der Agardiffusion beruht unter Verwendung vorgefertigter, antimy-kotika-beschichteter Papierringe. In der vorliegenden Arbeit wird dieses Verfahren auf seine Reproduzierbarkeit bei der Testung von zehn Qualitätskontrollstämmen hin überprüft. Die Ergebnisse zeigen eine starke Schwankungsbreite und somit eine schlechte Reproduzierbarkeit, so dass dieses Verfahren zwar für die Bearbeitung von wissenschaftlichen Fragestellungen, nicht jedoch für die Routinetestung als geeignet angesehen werden kann. Des Weiteren erfolgte eine Untersuchung auf das Vor-liegen eines so genannten "minor error", man erhält für einen sensiblen Stamm das Ergebnis "resistent", "major error", man erhält für einen intermediären Stamm das Ergebnis "sensibel", und "very major error", man erhaält für einen resistenten Stamm das Ergebnis "sensibel". Hierbei kam es in 16,25% der untersuchten Fälle zum Vorliegen eines "minor errors". Ein "major error" wurde nicht beobachtet
Background: Novel treatments are needed to control refractory status epilepticus (SE). This study aimed to assess the potential effectiveness of fenfluramine (FFA) as an acute treatment option for SE. We present a summary of clinical cases where oral FFA was used in SE.
Methods: A case of an adult patient with Lennox–Gastaut syndrome (LGS) who was treated with FFA due to refractory SE is presented in detail. To identify studies that evaluated the use of FFA in SE, we performed a systematic literature search.
Results: Four case reports on the acute treatment with FFA of SE in children and adults with Dravet syndrome (DS) and LGS were available. We report in detail a 30-year-old woman with LGS of structural etiology, who presented with generalized tonic and dialeptic seizures manifesting at high frequencies without a return to clinical baseline constituting the diagnosis of SE. Treatment with anti-seizure medications up to lacosamide 600 mg/d, brivaracetam 300 mg/d, valproate 1,600 mg/d, and various benzodiazepines did not resolve the SE. Due to ongoing refractory SE and following an unremarkable echocardiography, treatment was initiated with FFA, with an initial dose of 10 mg/d (0.22 mg/kg body weight [bw]) and fast up-titration to 26 mg/d (0.58 mg/kg bw) within 10 days. Subsequently, the patient experienced a resolution of SE within 4 days, accompanied by a notable improvement in clinical presentation and regaining her mobility, walking with the assistance of physiotherapists. In the three cases reported in the literature, DS patients with SE were treated with FFA, and a cessation of SE was observed within a few days. No treatment-emergent adverse events were observed during FFA treatment in any of the four cases.
Conclusions: Based on the reported cases, FFA might be a promising option for the acute treatment of SE in patients with DS and LGS. Observational data show a decreased SE frequency while on FFA, suggesting a potentially preventive role of FFA in these populations.
Key points
* We summarize four cases of refractory status epilepticus (SE) successfully treated with fenfluramine.
* Refractory SE resolved after 4–7 days on fenfluramine.
* Swift fenfluramine up-titration was well-tolerated during SE treatment.
* Treatment-emergent adverse events on fenfluramine were not observed.
* Fenfluramine might be a valuable acute treatment option for SE in Dravet and Lennox–Gastaut syndromes.
Purpose: Seizures pose a significant burden in patients with primary and secondary brain tumors during the end-of-life period. A wide range of 6 to 56% of clinically observed epileptic seizures at the end of life has been reported. We aimed to analyse the incidence of epileptic seizures at the end of life in brain tumor patients more accurately using not only clinical but also electrophysiological findings.
Methods: This retrospective, single center study included brain tumor patients who died during the stay on the ward or within 7 days after discharge between 01/2015 and 08/2020. Clinical observation of seizures derived from the original medical records and EEG findings (within 45 days prior to death) were analyzed to determine the incidence of seizures in that period.
Results: Of the 68 eligible patients, 50 patients (73.5%) suffered from seizures within 45 days prior to death, of which n = 24 had a status epilepticus. The diagnosis of seizures/ status epilepticus was determined either by the presentation of clinical signs in 45 patients and if not, by the detection of a (possible) non-convulsive status epilepticus in the EEG of five patients.
Conclusion: In the presence of neurologically trained staff and with the frequent use of routine EEG, we were able to identify seizures and to distinguish status epilepticus from encephalopathy/ hypoactive delirium. We detected a higher incidence of seizures and status epilepticus at the end of life in neurooncological patients than previously reported.
The article investigates the results obtained from numerical simulations and experimental tests concerning the propagation of guided waves in corroded steel plates. Developing innovative methodologies for assessing corrosion-induced degradation is crucial for accurately diagnosing offshore and ship structures exposed to harsh environmental conditions. The main aim of the research is to analyze how surface irregularities affect wave propagation characteristics. An investigation was conducted for antisymmetric fundamental mode A0. Specifically, the study examines the asymmetrical wavefronts generated by nonuniform thickness in damaged specimens. Initially, numerical analysis explores the impact of thickness variation on wave field symmetry. Corroded plates with varying levels of degradation are modeled using the random fields approach, with degradation levels ranging from 0 % to 60 %. Subsequently, the research investigates how the standard deviation of thickness distribution (from 5 % to 20 % of the initial thickness) and excitation frequency (from 50 to 150 kHz) influence recorded signals and the shape of reconstructed wavefronts. Each scenario compares wavefront symmetry levels estimated using rotational and bilateral symmetry degrees as indicative parameters. The numerical simulations are complemented by experimental tests conducted on plates with three different degradation levels. The results demonstrate the efficacy of the proposed wave field analysis approach for assessing structural integrity, as evidenced by the agreement between numerical predictions and experimental observations.
Oncogenic transformation of lung epithelial cells is a multistep process, frequently starting with the inactivation of tumour suppressors and subsequent development of activating mutations in proto-oncogenes, such as members of the PI3K or MAPK families. Cells undergoing transformation have to adjust to changes, including altered metabolic requirements. This is achieved, in part, by modulating the protein abundance of transcription factors. Here, we report that the ubiquitin carboxyl-terminal hydrolase 28 (USP28) enables oncogenic reprogramming by regulating the protein abundance of proto-oncogenes such as c-JUN, c-MYC, NOTCH and ∆NP63 at early stages of malignant transformation. USP28 levels are increased in cancer compared with in normal cells due to a feed-forward loop, driven by increased amounts of oncogenic transcription factors such as c-MYC and c-JUN. Irrespective of oncogenic driver, interference with USP28 abundance or activity suppresses growth and survival of transformed lung cells. Furthermore, inhibition of USP28 via a small-molecule inhibitor resets the proteome of transformed cells towards a ‘premalignant’ state, and its inhibition synergizes with clinically established compounds used to target EGFRL858R-, BRAFV600E- or PI3KH1047R-driven tumour cells. Targeting USP28 protein abundance at an early stage via inhibition of its activity is therefore a feasible strategy for the treatment of early-stage lung tumours, and the observed synergism with current standard-of-care inhibitors holds the potential for improved targeting of established tumours.
Background and objectives: Our study aimed at examining the long-time inflammatory effects of rheumatoid arthritis (RA) as chronic immune-mediated disease on pain sensation and neuropathy development compared to healthy subjects (HS).
Methods: We used the quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain and Electroencephalography (EEG)–based contact heat evoked potentials (CHEPs) before and after topical capsaicin application. We recruited 16 RA patients in remission or low disease activity state (mean age: 59.38 years [± 10.18]) and 16 healthy subjects (mean age: 56.69 years [± 8.92]).
Results: The application of capsaicin cream on the thigh provoked a stronger effect in HS for both mechanical and heat pain thresholds (MPT and HPT, resp.), according to the area under the receiver operation characteristic (AUROC) (HS: HPT: 0.8965, MPT: 0.7402; RA: HPT: 0.7012, MPT: 0.6113). We observed contrary effects regarding changes in CHEPs (HS: g*max = − 0.65; RA patients: g*max = 0.72).
Conclusion: As the overall effect of topical capsaicin application was higher in HS for QST, we suggest the existence of a sensitization of TRPV1 channels in RA patients caused by long-time chronical inflammation, despite a lack of clinical signs of inflammation due to adequate treatment. The effect in CHEPs probably uncovers neuropathic symptoms. The effect of topical capsaicin on HPTs and CHEPs can act as a marker for the extent of sensitization and the development of neuropathic symptoms. Further studies are needed to prove if our proposed method can act as a marker for the success of anti-inflammatory treatment.
The ligand-sensing transcription factor Nurr1 emerges as a promising therapeutic target for neurodegenerative pathologies but Nurr1 ligands for functional studies and therapeutic validation are lacking. Here pronounced Nurr1 modulation by statins for which clinically relevant neuroprotective effects are demonstrated, is reported. Several statins directly affect Nurr1 activity in cellular and cell-free settings with low micromolar to sub-micromolar potencies. Simvastatin as example exhibits anti-inflammatory effects in astrocytes, which are abrogated by Nurr1 knockdown. Differential gene expression analysis in native and Nurr1-silenced cells reveals strong proinflammatory effects of Nurr1 knockdown while simvastatin treatment induces several neuroprotective mechanisms via Nurr1 involving changes in inflammatory, metabolic and cell cycle gene expression. Further in vitro evaluation confirms reduced inflammatory response, improved glucose metabolism, and cell cycle inhibition of simvastatin-treated neuronal cells. These findings suggest Nurr1 involvement in the well-documented but mechanistically elusive neuroprotection by statins.
Human feline leukaemia virus subgroup C receptor-related proteins 1 and 2 (FLVCR1 and FLVCR2) are members of the major facilitator superfamily1. Their dysfunction is linked to several clinical disorders, including PCARP, HSAN and Fowler syndrome2,3,4,5,6,7. Earlier studies concluded that FLVCR1 may function as a haem exporter8,9,10,11,12, whereas FLVCR2 was suggested to act as a haem importer13, yet conclusive biochemical and detailed molecular evidence remained elusive for the function of both transporters14,15,16. Here, we show that FLVCR1 and FLVCR2 facilitate the transport of choline and ethanolamine across the plasma membrane, using a concentration-driven substrate translocation process. Through structural and computational analyses, we have identified distinct conformational states of FLVCRs and unravelled the coordination chemistry underlying their substrate interactions. Fully conserved tryptophan and tyrosine residues form the binding pocket of both transporters and confer selectivity for choline and ethanolamine through cation–π interactions. Our findings clarify the mechanisms of choline and ethanolamine transport by FLVCR1 and FLVCR2, enhance our comprehension of disease-associated mutations that interfere with these vital processes and shed light on the conformational dynamics of these major facilitator superfamily proteins during the transport cycle.
Die Epoche des Vormärz ist von einer Intensivierung staatlicher Geheimdiensttätigkeit sowie einer Professionalisierung und Institutionalisierung der staatlichen Überwachungs- und Zensurbehörden gekennzeichnet. Die in dieser Zeit sich herausbildenden Kontrolltechniken und -strukturen bildeten die Grundlage für spätere Überwachungsregime. Es war eine Zäsur für die deutsche Geschichte generell und für die Geschichte der deutschen Inlandsspionage im Besonderen. Von 1833 bis 1842 wurden die Ermittlungen des Deutschen Bundes gegen politisch Andersdenkende durch die Bundeszentralbehörde in Frankfurt am Main und das Mainzer Informationsbüro durchgeführt; in Preußen wurde 1833 die zweite Ministerialkommission ins Leben gerufen, die bereits 1819 bis 1828 aktiv gewesen war und sämtliche "politischen Umtriebe" in Preußen überwachte. [...] Die staatlichen Überwachungsapparate funktionierten nur mit Hilfe von zahlreichen beteiligten Menschen: von hohen Ministerialbeamten über Polizeibeamte bis zu informellen Zuträgern, die unter vielen Namen bekannt sind - Konfidenten, Informanten, Agenten, V-Leute, Spitzel. Über die Biographien und die konkreten Tätigkeiten dieser untergeordneten Akteure liegen bislang nur verstreute Forschungen vor. Der vorliegende Aufsatz stellt einen von ihnen vor - den Literaten und geheimen Informanten Joel Jacoby. Joel Jacoby (1811-1863) war eine der berüchtigtsten Figuren des Vormärz. Um sein Leben und Wirken als preußischer Spitzel rankten sich schon zu Lebzeiten zahlreiche Legenden. Doch bislang gab es nur wenig gesichertes Faktenwissen darüber, worin sein geheimdienstliches Wirken eigentlich genau bestand. Neu aufgefundene Geheimberichte, die Jacoby an die preußischen Überwachungsbehörden sandte, erlauben nun erstmals Einblicke in seine Tätigkeit. Jacobys Berichte stellen einen Schatz sowohl für die Erforschung seiner Biographie als auch des Geheimdienstwesens im Vormärz dar. Ich gebe im Folgenden einen ersten Überblick über die Berichte aus der Frühzeit von Jacobys Spitzeltätigkeit. Sie führen vor Augen, wie umfangreich, akribisch, aber auch widersprüchlich die Arbeit eines Agenten sein konnte, der die Rollen eines Verfolgers und Verfolgten, eines Spitzels und Schriftstellers in seiner Person vereinte. Es wird sich zeigen, welch großen Stellenwert Literatur und Presse für die Agententätigkeit hatte und wie sehr die Berichte an dem jeweiligen Empfänger ausgerichtet waren.
Charles Cros, Erfinder technischer Reproduzierbarkeit von Wahrnehmung in Nachmärz und Moderne
(2023)
Charles Cros (1842-1888) verkörpert den Weg der französischen Lyrik von der Spätromantik über Parnass und Symbolismus zur Moderne in überraschender Dichte, anders, aber nicht weniger typisch als Verlaine, Rimbaud und Mallarmé. [...] Die naturwissenschaftlichen Erfindungen von Charles Cros sind durchweg kommunikativer Natur und zielen auf die Reproduzierbarkeit von Sinneseindrücken wie seine Poesie auf die "Wiederholbarkeit von Träumen". Der Zusammenhang von technischer Reproduzierbarkeit - hier durchaus im Sinne von Walter Benjamins einschlägigem Essay verstanden - und der lyrischen 'Chansons perpétuelles' von Cros ist indessen noch niemals untersucht worden.
Der eurozentrische Blick des 18. und 19. Jahrhunderts, den es hier zu untersuchen gilt, definiert und interpretiert das Wahrgenommene über vergleichende Studien. Stets steht eine Differenz in der Subjekt-Objekt Beziehung zwischen Beobachtendem und Wahrgenommenem. Dies gelingt am ehesten, wenn das Objekt der Betrachtung abstrahiert und verallgemeinert und zugleich aus einer sicher wirkenden Distanz beschrieben wird. Beschreibungen von Menschen verschiedener Herkunft basieren auf Vergleichen, deren Kriterien die Untersuchungsergebnisse von vornherein festlegen. Sie fokussieren sich auf Körpermerkmale und deren unterstellte Einflüsse auf intellektuelle und kulturelle Entwicklungsmöglichkeiten. Sie betrachten gesellschaftliche Strukturen und ziehen daraus ihre verallgemeinernden Schlüsse. Solche Untersuchungen entstehen auf unterschiedlichen Ebenen: Im bildungsbürgerlichen Haushalt finden sich populärwissenschaftliche Publikationen wie Lexika für Erwachsene und Kinder. Die sich etablierende Anthropologie bedient sich ebenfalls der Vergleichsmodelle in der Beschreibung des Andersseins. Versuche, die Perspektive zu ändern und einen kulturellen Transfer überhaupt erst zu denken, lenken den Blick auf ein weiteres wichtiges Phänomen der Wahrnehmung in Selbsterkenntnis. Als Quellentexte und Anschauungsmaterialien sind solche Publikationen zusammengestellt, in welchen die Differenz zwischen Europäer:innen und Afrikaner:innen herausgearbeitet wird. Der afrikanische Kontinent gewinnt im 19. Jahrhundert zunehmend an Bedeutung. Das Innere des Kontinents lockt Forschungsreisende, Missionare und später Kolonialmächte an. Aus den Begegnungen und Beschreibungen leiten sich nicht nur Bilder, sondern zugleich Argumentationslinien für europäische Handlungsstrategien ab, die bis heute nachwirken.
Was in diesem Aufsatz unternommen werden soll, lässt sich als eine Phänomenologie der pathischen Wahrnehmung charakterisieren: Es geht um die Wahrnehmung, insofern sie als ein leibliches Widerfahrnis erlebt wird. Genauer gesagt: In der Wahrnehmung geschieht eine Einwirkung des Wahrgenommenen auf den Wahrnehmenden, also eine angenehme oder unangenehme Einwirkung des Wahrnehmungsobjekts auf das Wahrnehmungssubjekt, die sich als phänomenaler Bestand erfassen lässt. Das Widerfahrnis gehört daher selbst zum Wahrnehmungsgehalt des wahrnehmenden Subjekts, und nur insoweit ist es das Thema einer Phänomenologie der pathischen Wahrnehmung. [...] Das Ziel dieser Untersuchung besteht darin, die Aufmerksamkeit auf bestimmte Qualitäten der Wahrnehmungsobjekte zu richten, welche in einer jeden Wahrnehmungsphilosophie unter den Tisch fallen, welche sich üblicherweise an epistemischen Fragestellungen orientiert und die Wahrnehmung deshalb primär als sinnliche Erkenntnis befragt. [...] Eine entscheidende Hürde, die einer Phänomenologie der pathischen Wahrnehmung im Wege steht, ist nun jene bereits erwähnte und in Philosophie und Wissenschaft weit verbreitete Auffassung, Wahrnehmung sei sinnliche Erkenntnis und sonst gar nichts - zumindest nichts, was einer philosophischen Untersuchung wert sei. Es bietet sich an, diese Hürde als Primat der Erkenntnis zu charakterisieren. Allerdings ist dies nicht die einzige Hürde, die es zu überwinden gilt, um die Philosophie weiter ins Dickicht der Wahrnehmung hinein zu führen. Es lassen sich immerhin noch zwei weitere unterscheiden, die als Primat der Praxis und Primat des Leibes bezeichnen werden können. Von einem Primat der Praxis lässt sich dort sprechen, wo eine pragmatische Verkürzung in dem Sinne vorliegt, dass Widerfahrnisse nur als Widerstände gegen unser Handeln berücksichtigt werden und das Unangenehme sich damit auf das Hinderliche reduziert. Demgegenüber soll von einem Primat des Leibes, bei dem die häufige Leibvergessenheit der Wahrnehmungsphilosophie geradezu durch eine Leibversessenheit überkompensiert wird, dann die Rede sein, wenn zwar pathische Qualitäten im Mittelpunkt stehen, diese jedoch lediglich als eigenleibliche Zustände verstanden und damit von jeglicher Wahrnehmung weltlicher Objekte abgetrennt werden. In den nun anschließenden Überlegungen sollen zunächst durch eine kritische Abgrenzung gegenüber den genannten drei Hürden die Konturen eines alternativen wahrnehmungsphilosophischen Ansatzes tentativ sichtbar werden. Nach dieser kritischen Auseinandersetzung folgt dann der positive Gegenentwurf, in dem anhand von konkreten Beispielen der Versuch einer Phänomenologie der pathischen Wahrnehmung unternommen wird.
Der Mediziner und Psychiater Erwin Straus (1891-1975) hat für die Welt der Wahrnehmung eine eigene Ästhesiologie, in der er Wahrnehmung selbst als ein leibliches Empfinden differenziert, entwickelt und gewinnt über seine Kritik der Trennung von Wahrnehmung und Wirklichkeit ein eigenes Konzept der kommunikativen Struktur von Wahrnehmung und Welt jenseits der polaren Struktur von Subjekt und Objekt. [...] Im Folgenden werde ich Straus' Ästhesiologie in drei Schritten vorstellen: Beginnen werde ich mit den leiblichen wie welthaften Grundlagen der Wahrnehmung im Empfinden, dem inkarnierten Subjekt in pathischer und gnostischer Kommunikation mit der Welt, wie Straus dies differenziert. Zweitens bauen sich aus der raum-zeitlichen Struktur dieser Kommunikation Erfahrungen in einem historischen - einem Lebenskontext - auf; hier rekurriert Straus dann auch auf das spezifisch menschliche Wahrnehmen. Abschließend werde ich Straus' Entwicklung einer aus der Situation des Wahrnehmenden gewonnenen Theorie der Norm vorstellen, mit der er nicht nur auf dem Feld der Psychiatrie psychopathologisch wie auch ärztlich argumentiert, sondern auch generell für die Grundlage sinnhafter Erfahrungen unserer Wirklichkeit als sinnliche Subjekte in einer Welt für Selbst- und Fremdwahrnehmung, um gegen Reduktionismen mancher empirischen Forschungen wieder den Reichtum einer gemeinsam erlebten Welt wiederzugewinnen: Als Reichtum der phänomenalen Vielfalt, der unreduzierbaren Eigen- und Andersheit, nicht als Regel, sondern als Sinn der Sinne. Eben jenes, worum Büchner und die Personen seiner Vormärz-Dramen ringen.
Der Gestank der Armen : philosophische Notizen zur Topografie eines moralisch anästhesierten Sinnes
(2023)
In seiner reich instrumentierten Kulturgeschichte des Geruchs beschreibt der französische Historiker Alain Corbin die Großstädte des 18. Jahrhunderts als Orte olfaktorischer Zumutungen. Als der junge Rousseau 1731 nach Paris kam, fand er ein "Amphitheater von Latrinen" vor. Selbst in den Tuilerien und in den Gärten des Palais Royal konnte man den übelerregenden Dunstschwaden, die von den Ufern der Seine herüberwehten, nicht entgehen. Paris stank buchstäblich zum Himmel. [...] Noch taten sich Standesunterschiede nicht in der Abwesenheit von schlechten Gerüchen kund. Die Ordnung von Macht und Stand fand ihren Ausdruck in einer Steigerung "sozialer Sichtbarkeit", um die sich Angehörige höherer Stände ohnehin nicht besorgen mussten, weil sie ihnen qua Geburt schon immer gegeben war. Man musste sich nicht waschen, um das gemeine Volk in seine Schranken zu weisen. Selbst der Souverän stank. [...] Alain Corbin beschreibt die Phase von der zweiten Hälfte des 18. bis zum Ende des 19. Jahrhunderts als eine Epoche der Desodorierung, die mit einem grundlegenden Wandel in der Wahrnehmung, Bewertung und Interpretation von Gerüchen einhergeht. Der Fokus verschiebt sich "vom Lebenden zum Sozialen", wie Corbin betont. Die Geruchstoleranz gegenüber der sozialen Mitwelt sinkt. Hygiene und Sauberkeit markieren zunehmend "soziale Positionen, soziale Unterschiede und soziale Pflichten". Insbesondere der öffentliche Raum wird zum Schauplatz hygienischer Disziplinierung. [...] Wenngleich sich Corbins Analysen nur zeitverschoben auf das vormärzliche Deutschland übertragen lassen, wächst auch hier mit den demografischen und industriellen Umwälzungen das Interesse an 'sozialen' Gerüchen. Gerüche werden zu affektiven Operatoren "sozialer Fremd-eigen Differenzen".
Die folgenden Überlegungen zielen darauf ab, den Übergangscharakter der Erkenntnislehre Feuerbachs auszuweisen, die einerseits an die objektivistische Linie der empiristisch-sensualistischen Philosophie unter den französischen Materialisten anschließt und andererseits auf die ökologische Fundierung des menschlichen Bewusstseins und seiner Leistungen vorausweist, die seit dem letzten Drittel des neunzehnten Jahrhunderts in Philosophie und Wissenschaften Verbreitung gefunden und der aktuellen, in Philosophie und Neurowissenschaften vertretenen Embodiment-Forschung den Weg bereitet hat. So stehen Feuerbachs 'reformatorische' Bemühungen um eine Erneuerung der deutschsprachigen Philosophie nach dem Idealismus in einer bislang noch unbeachtet gebliebenen Fernbeziehung mit den Bemühungen der Gegenwart um eine Revision des klassischen Leib-Seele-Dualismus. Zur Veranschaulichung des Kerngehalts von Feuerbachs französischen Vorläufern greife ich zunächst auf die Radikalisierung des Empirismus einerseits durch den erkenntnistheoretischen Sensualismus und andererseits durch den physiologischen Materialismus zurück, indem ich exemplarisch Etienne Bonnot de Condillacs "Traité des sensations" und Julien Offray de La Mettrie's "L'Homme Machine" als realtypische Ausdrucksgestalten dieser französischen Entwicklungslinie darstelle (1). In einem zweiten Schritt zeige ich Gemeinsamkeiten und Differenzen Ludwig Feuerbachs im Verhältnis zu dieser sensualistischmaterialistischen Traditionslinie des empiristischen Philosophierens auf (2) und schließe damit, wie Feuerbachs Umformung dieser Tradition zugleich auf die Ökologisierung der Erkenntnistheorie um 1900 und vermittelt darüber auch auf die gegenwärtige Forschung zur Philosophie der Verkörperung vorausweist (3).
So unterschiedlich auch immer J. G. Fichtes und Hegels Auffassung des Ich sind, unterscheidet sich I. H. Fichte - der posthume Herausgeber der Werke seines Vaters - in der "Erste[n] Abtheilung: Das Erkennen als Selbsterkennen" seiner Grundzüge zum Systeme der Philosophie 1833 in mehreren Hinsichten, die für den Vormärz charakteristisch sind, noch stärker von ihnen als die beiden voneinander: 1. Am Anfang dessen Entwicklung steht das Ich weder Sachen gegenüber noch setzt es ein Objekt sich gegenüber, sondern das Ich wird von einer Mannigfaltigkeit der Empfindung geradezu besetzt. 2. Die Entwicklung des Ich beginnt nicht mit einer völligen Aktivität, sondern mit einer völligen Passivität, aus der allmählich (keine unbegrenzte) Aktivität entsteht. 3. Das Ich ist am Anfang dessen Entwicklung Mannigfaltigkeit; es konstituiert sich als Ich erst allmählich. 4. Das Ich ist am Anfang weder ein rein universelles Subjekt, in dem Sinne, in dem jedes Ich jedem Ich gleich ist, sondern das Ich ist individuell. Auch im Laufe dessen Entwicklung entsteht kein reines, universelles Ich, sondern es bleibt immer individuell. 5. Anders als das reine Ich bei J. G. Fichte und Hegel steht I. H. Fichtes Ich am "Anfang" seines "System der Philosophie". Die Wahrnehmung steht als "Erste Epoche" am Anfang der Entwicklung des Ich. Die erste Epoche enthält wiederum drei "Stufen" der Wahrnehmung.
Das Wachsein ist kein Privileg, sondern ein besonderes Ergebnis förderlicher Umstände. Wir können die Figurationen solcher Privilegien, d. h. auch die Umstände, auf denen sie beruhen, nicht verlassen, ohne dass Elemente starker Dysfunktion den Frieden dieser Anordnung einmal gestört hätten. Im 19. Jahrhundert sind die Sinne nicht nur bezogen auf das, was sie wahrnehmen, sondern tangieren jenseits der Inhaltsschübe die Strukturen und Selbstverhältnisse derjenigen, die zu diesem Zeitpunkt das symbolische Medium der Sprache verwenden. Im Vormärz störte eine Krise des Autoritarismus die unbefangene Herrschaft; Metternich et al. wurden zu Chiffren dessen, was eine staatliche Ordnung nicht mehr reibungslos beförderte, sondern im Zuge revolutionierender Prozesse Fragen aufwarf: Nach Geltung, der Verlässlichkeit der eigenen Wahrnehmung, die bislang meist von autoritären Strukturen geleitet worden war, nach möglichen Eigenanteilen an dem, was die politische Struktur bisher hergegeben hatte. Strukturwandel trat als Wahrnehmungswandel in die Geschichte ein. Die Sinne und allgemein die Wahrnehmungsfähigkeit werden im Vormärz im Gesehenen herausgefordert. Wahrnehmung ist eine 'contested area', ein umkämpftes Gebiet, in dem sich alte und neue Wahrnehmungsformen überlagern und kreuzen. Gezeigt werden soll, dass Wahrnehmung, mit Erwin Straus, ästhesiologisch aufzufassen ist, d. h. dass im alltäglichen Vollzug des sinnlichen Erlebens unser Interesse beim Gegenstand, der Welt, dem Anderen ist, nicht nur beim bestätigenden Sehen des Gesehenen, sondern dem Gesehenen als Quelle möglicher Änderung. Es gibt immer die Möglichkeit der Bewegung, die Möglichkeit, sich zum Wahrgenommenen zu verhalten. In diesem Sinne sind die Bewegung und Bewegtheit des Vormärz ein politisches Phänomen: aus den sensuellen Erfahrungen folgt etwas. Die bewegte und bewegende Beziehung zum Wahrgenommenen begründet im Vormärz einen Anspruch auf Partizipation, der einem Wachwerden der Sinne gleichkommt.
Die Vormärzforschung befasste sich in der Vergangenheit vor allem mit Themen des Liberalismus, insbesondere mit juristischen Fragen und der Gründung einer verfassungsgebenden Versammlung. Dabei wurde die Kluft zwischen einem - oft akademisch geschulten - 'gehobenen Bürgertum' und der großen Mehrzahl der Menschen in Dörfern, Kleinstädten und einer sich noch vielfach als Heimarbeit etablierenden Industrie oft übersehen. Diese Arbeit wird sich auf die allmählich einsetzende Wahrnehmung dieser Mehrzahl konzentrieren, mit dem Ziel, ihr politisches Verständnis und ihren Willen zur demokratischen Partizipation zu analysieren. Hierbei geht es vornehmlich um ein "Gewahrwerden sinnlich vermittelter Gegebenheiten" und ihrer geistigen Verarbeitung. Bei diesem Prozess wird das geistig rationale 'Verständnis' der Gegebenheiten erweckt und zu einer empirisch vermittelten 'Sicht' der Dinge hingeführt. Bei solchen Sinneswahrnehmungen geht es in erster Linie um das Sehvermögen; das von den Augen Gesehene wird über Nerven an das Gehirn transportiert, wir machen uns ein 'Bild' davon, das im weiteren Verlauf zu einer 'Ansicht' oder 'Anschauung' werden kann. Ähnliches gilt für andere Sinneseinwirkungen: Das 'Gefühlte' komprimiert sich zu einem 'Gefühl', wobei neben anderen Sinneswahrnehmungen auch ein mentaler Prozess mit im Spiel ist. Von der Forschung wenig beachtet ist eine Umkehrung dieses Vorgangs: Mental Wahrgenommenes kann über die Imagination auch sinnlich anschaulich werden, ein Prozess, der vor allem in der Romantik häufig stattfand. Eine genauere Erörterung der Begriffe 'Wahrnehmung' oder 'Perzeption' ist hier nicht vorgesehen, doch wird im Kontext der dargestellten Beispiele auf weitere, vor allem literarische und philosophische Diskussionen dieser Begriffe eingegangen.
Wahrnehmung wurde zu Beginn des 20. Jahrhunderts bestimmt als "Organ unseres ursprünglichen Welt-Erlebens." Das ursprüngliche Welterleben war das des Flaneurs, der mit allen Sinnen Umwelt wahrnimmt, um sich zu situieren und aus dieser Verortung Sicherheit und Anderssein zu gewinnen; die Verortung war aber auch über die Individualebene hinaus von politischer, sozialer, ökonomischer und kultureller Bedeutung. Man greift nicht zu hoch, wenn der Vormärz als Zeitspanne betrachtet wird, in der eine vollere Realität in sehr spezifischer Weise greifbar wurde. Die Vielschichtigkeit der Vormärz-Welt war dabei eine konstanter Innovation, die eine Initiierung jener Selbstbilder bedeutete, die über das Wahrnehmen bestätigt wurden, das selbst ein anderes geworden war. Nicht mehr informierte Wahrnehmung über die tautologisch so genannten sozialen Tatsachen; sie schuf diese vielmehr um und damit neu - das Organ des Welterlebens wirkte hier auf die Welt ein und musste Erlebnisse nicht mehr erleiden. Die Erfahrung der Welt-Erlebnisse bestand auch darin, die Sinne als sinnenöffnend zu sehen, indem die theoretische Vorrangstellung des Informationsaspekts der Wahrnehmung zurücktrat und Indices von Engagement, Eingreifen und Emanzipation deutlich werden konnten. Dies bedeutete, eine Form des "Wirklichkeitskontakts" zu suchen, die bisher nicht bestanden hatte. War der Kontakt vorher so geschehen, dass die Sinne eine bestätigende Funktion den sozialen und politischen Valeurs gegenüber einnahmen, die bezogen auf Emanzipationsprozesse und deren Möglichkeit einer Schließung gleichkam, öffnete nun die Veränderung der Wahrnehmung neue Formen des Wirklichkeitskontakts. In diesem Kontakt war vor allem entscheidend, dass nun die Bedingungen der Wahrnehmung ersichtlich wurden, sich als veränderbar auswiesen und nicht mehr im umfassenden Konstrukt "Wahrnehmung" aufgingen.
In natural environments, background noise can degrade the integrity of acoustic signals, posing a problem for animals that rely on their vocalizations for communication and navigation. A simple behavioral strategy to combat acoustic interference would be to restrict call emissions to periods of low-amplitude or no noise. Using audio playback and computational tools for the automated detection of over 2.5 million vocalizations from groups of freely vocalizing bats, we show that bats (Carollia perspicillata) can dynamically adapt the timing of their calls to avoid acoustic jamming in both predictably and unpredictably patterned noise. This study demonstrates that bats spontaneously seek out temporal windows of opportunity for vocalizing in acoustically crowded environments, providing a mechanism for efficient echolocation and communication in cluttered acoustic landscapes.
Forest wildflowers bloom earlier as Europe warms: lessons from herbaria and spatial modelling
(2022)
Today plants often flower earlier due to climate warming. Herbarium specimens are excellent witnesses of such long-term changes. However, the magnitude of phenological shifts may vary geographically, and the data are often clustered. Therefore, large-scale analyses of herbarium data are prone to pseudoreplication and geographical biases.
We studied over 6000 herbarium specimens of 20 spring-flowering forest understory herbs from Europe to understand how their phenology had changed during the last century. We estimated phenology trends with or without taking spatial autocorrelation into account.
On average plants now flowered over 6 d earlier than at the beginning of the last century. These changes were strongly associated with warmer spring temperatures. Flowering time advanced 3.6 d per 1°C warming. Spatial modelling showed that, in some parts of Europe, plants flowered earlier or later than expected. Without accounting for this, the estimates of phenological shifts were biased and model fits were poor.
Our study indicates that forest wildflowers in Europe strongly advanced their phenology in response to climate change. However, these phenological shifts differ geographically. This shows that it is crucial to combine the analysis of herbarium data with spatial modelling when testing for long-term phenology trends across large spatial scales.
Background: Despite advances in treatment of patients with non-small cell lung cancer, carriers of certain genetic alterations are prone to failure. One such factor frequently mutated, is the tumor suppressor PTEN. These tumors are supposed to be more resistant to radiation, chemo- and immunotherapy.
Results: We demonstrate that loss of PTEN led to altered expression of transcriptional programs which directly regulate therapy resistance, resulting in establishment of radiation resistance. While PTEN-deficient tumor cells were not dependent on DNA-PK for IR resistance nor activated ATR during IR, they showed a significant dependence for the DNA damage kinase ATM. Pharmacologic inhibition of ATM, via KU-60019 and AZD1390 at non-toxic doses, restored and even synergized with IR in PTEN-deficient human and murine NSCLC cells as well in a multicellular organotypic ex vivo tumor model.
Conclusion: PTEN tumors are addicted to ATM to detect and repair radiation induced DNA damage. This creates an exploitable bottleneck. At least in cellulo and ex vivo we show that low concentration of ATM inhibitor is able to synergise with IR to treat PTEN-deficient tumors in genetically well-defined IR resistant lung cancer models.
We conducted a systematic review investigating the efficacy and tolerability of adrenocorticotropic hormone (ACTH) and corticosteroids in children with epilepsies other than infantile epileptic spasm syndrome (IESS) that are resistant to anti-seizure medication (ASM). We included retrospective and prospective studies reporting on more than five patients and with clear case definitions and descriptions of treatment and outcome measures. We searched multiple databases and registries, and we assessed the risk of bias in the selected studies using a questionnaire based on published templates. Results were summarized with meta-analyses that pooled logit-transformed proportions or rates. Subgroup analyses and univariable and multivariable meta-regressions were performed to examine the influence of covariates. We included 38 studies (2 controlled and 5 uncontrolled prospective; 31 retrospective) involving 1152 patients. Meta-analysis of aggregate data for the primary outcomes of seizure response and reduction of electroencephalography (EEG) spikes at the end of treatment yielded pooled proportions (PPs) of 0.60 (95% confidence interval [CI] 0.52–0.67) and 0.56 (95% CI 0.43–0.68). The relapse rate was high (PP 0.33, 95% CI 0.27–0.40). Group analyses and meta-regression showed a small benefit of ACTH and no difference between all other corticosteroids, a slightly better effect in electric status epilepticus in slow sleep (ESES) and a weaker effect in patients with cognitive impairment and “symptomatic” etiology. Obesity and Cushing's syndrome were the most common adverse effects, occurring more frequently in trials addressing continuous ACTH (PP 0.73, 95% CI 0.48–0.89) or corticosteroids (PP 0.72, 95% CI 0.54–0.85) than intermittent intravenous or oral corticosteroid administration (PP 0.05, 95% CI 0.02–0.10). The validity of these results is limited by the high risk of bias in most included studies and large heterogeneity among study results. This report was registered under International Prospective Register of Systematic Reviews (PROSPERO) number CRD42022313846. We received no financial support.
Key points
* Systematic review resulting in low to moderately solid evidence on the efficacy and tolerability of adrenocorticotropic hormone (ACTH) and corticosteroid treatment in children with epilepsy other than infantile spasms.
* Meta-analysis based on aggregate data from 2 controlled prospective, 5 uncontrolled prospective, and 31 retrospective studies.
* Pooled data showing a seizure response in 60% and electroencephalography (EEG) response in 56% of patients, with no major differences between drugs. However, 30%–40% of patients relapse after the cessation of treatment.
* The most frequent adverse effects are obesity and Cushing's syndrome, occurring in 70% of patients under continuous treatment for some weeks, but in less than 10% undergoing pulsed, intermittent regimens.
* More prospective, randomized-controlled studies are needed to improve the level of evidence and define the optimal doses and treatment duration.
Background: Epilepsy surgery is an established treatment for drug-resistant focal epilepsy (DRFE) that results in seizure freedom in about 60% of patients. Correctly identifying an epileptogenic lesion in magnetic resonance imaging (MRI) is challenging but highly relevant since it improves the likelihood of being referred for presurgical diagnosis. The epileptogenic lesion’s etiology directly relates to the surgical intervention’s indication and outcome. Therefore, it is vital to correctly identify epileptogenic lesions and their etiology presurgically.
Methods: We compared the final histopathological diagnoses of all patients with DRFE undergoing epilepsy surgery at our center between 2015 and 2021 with their MRI diagnoses before and after presurgical diagnosis at our epilepsy center, including MRI evaluations by expert epilepsy neuroradiologists. Additionally, we analyzed the outcome of different subgroups.
Results: This study included 132 patients. The discordance between histopathology and MRI diagnoses significantly decreased from 61.3% for non-expert MRI evaluations (NEMRIs) to 22.1% for epilepsy center MRI evaluations (ECMRIs; p < 0.0001). The MRI-sensitivity improved significantly from 68.6% for NEMRIs to 97.7% for ECMRIs (p < 0.0001). Identifying focal cortical dysplasia (FCD) and amygdala dysplasia was the most challenging for both subgroups. 65.5% of patients with negative NEMRI were seizure-free 12 months postoperatively, no patient with negative ECMRI achieved seizure-freedom. The mean duration of epilepsy until surgical intervention was 13.6 years in patients with an initial negative NEMRI and 9.5 years in patients with a recognized lesion in NEMRI.
Conclusions: This study provides evidence that for patients with DRFE—especially those with initial negative findings in a non-expert MRI—an early consultation at an epilepsy center, including an ECMRI, is important for identifying candidates for epilepsy surgery. NEMRI-negative findings preoperatively do not preclude seizure freedom postoperatively. Therefore, patients with DRFE that remain MRI-negative after initial NEMRI should be referred to an epilepsy center for presurgical evaluation. Nonreferral based on NEMRI negativity may harm such patients and delay surgical intervention. However, ECMRI-negative patients have a reduced chance of becoming seizure-free after epilepsy surgery. Further improvements in MRI technique and evaluation are needed and should be directed towards improving sensitivity for FCDs and amygdala dysplasias.
Background: Patients with epilepsy often require a specialized treatment, which may differ because of the responsibility of the federal states for healthcare policy in Germany.
Objective: State-specific differences in healthcare structures based on inpatient hospital cases of epilepsy patients between 2000 and 2020 in relation to specialized treatment offers.
Material and methods: The inpatient hospital cases of the German federal states were evaluated using the Friedman test and time series trend analysis. A state-specific inpatient undertreatment or overtreatment of inpatient hospital cases outside the registered state was analyzed by comparing residence-related and treatment site-related case numbers with a threshold of ±5%.
Results: After age adjustment, significantly more inpatient cases were found in the “new states” compared to the “old states” (p < 0.001); the highest number of cases nationwide was found in Saarland with 224.8 ± 11.5 cases per 100,000 inhabitants. The trend analysis showed an increase in cases until the end of 2016 with a trend reversal from 2017 and a further significant decrease in hospital cases in the COVID year 2020. A relative inpatient undertreatment was shown for Brandenburg, Lower Saxony, Rhineland-Palatinate, Saxony-Anhalt, Schleswig-Holstein and Thuringia. Additional, possibly compensatory, inpatient care was found for all city states (Hamburg, Bremen and Berlin) and Baden-Wuerttemberg. In federal states with a relative inpatient undertreatment and/or high inpatient hospital case numbers, there was often a lower availability of specialized epilepsy centers, specialized outpatient clinics and epilepsy outpatient clinics.
Conclusion: In Germany there are state-specific differences in the structure of care, with higher inpatient hospital care in the “new states” and Saarland. In addition, there were federal states with disproportionately higher treatment of patients not registered in this federal state. A potential influencing factor may be the availability of centers with specialized treatment for epilepsy patients.
Der Status epilepticus (SE) stellt eine schwerwiegende akute Erkrankung dar, die eine frühzeitige und gezielte Therapie erfordert. Insbesondere der refraktäre SE (RSE) sowie der superrefraktäre SE (SRSE) sind bereits bei jungen Menschen eine interdisziplinäre therapeutische Herausforderung. Bei Patienten in höherem Lebensalter sind hierbei weitere relevante Aspekte zu beachten, die sich einerseits aufgrund einer abweichenden Pharmakokinetik und -dynamik ergeben, andererseits aber auch aus Komorbiditäten, Polypharmazie und möglichen medizinischen Therapielimitationen bzw. Patientenpräferenzen resultieren. Ziel dieses Artikels ist es, diese besonderen Aspekte im Rahmen der SE-Versorgung älterer Menschen aufzuarbeiten und potenzielle Therapiestrategien jenseits der Leitlinie aufzuzeigen. Insbesondere wird hierbei auf alternative Applikationswege und mögliche konservative Eskalationsformen der Therapie eingegangen, die v. a. bei relevant vorerkrankten Patienten von Bedeutung sind, bei denen eine intensivmedizinische Behandlung die ohnehin schon hohe Mortalität des SE im gehobenen Alter weiter erhöhen würde. Mit unterschiedlichen parenteralen Applikationsformen von Benzodiazepinen im SE sowie dem mittlerweile gut beschriebenen Einsatz weiterer Antikonvulsiva wie Brivaracetam, Perampanel, Stiripentol, Topiramat und Zonisamid in RSE und SRSE stehen auch für diese vulnerable Patientengruppe adäquate Therapieoptionen zur Verfügung. Nichtsdestotrotz sollte in der Therapie des SE im gehobenen Alter insbesondere in Anbetracht der per se hohen Mortalität verstärkt auf Patientenpräferenzen und medizinethische Aspekte geachtet werden.
The developmental and epileptic encephalopathies encompass a group of rare syndromes characterised by severe drug-resistant epilepsy with onset in childhood and significant neurodevelopmental comorbidities. The latter include intellectual disability, developmental delay, behavioural problems including attention-deficit hyperactivity disorder and autism spectrum disorder, psychiatric problems including anxiety and depression, speech impairment and sleep problems. Classical examples of developmental and epileptic encephalopathies include Dravet syndrome, Lennox–Gastaut syndrome and tuberous sclerosis complex. The mainstay of treatment is with multiple anti-seizure medications (ASMs); however, the ASMs themselves can be associated with psychobehavioural adverse events, and effects (negative or positive) on cognition and sleep. We have performed a targeted literature review of ASMs commonly used in the treatment of developmental and epileptic encephalopathies to discuss the latest evidence on their effects on behaviour, mood, cognition, sedation and sleep. The ASMs include valproate (VPA), clobazam, topiramate (TPM), cannabidiol (CBD), fenfluramine (FFA), levetiracetam (LEV), brivaracetam (BRV), zonisamide (ZNS), perampanel (PER), ethosuximide, stiripentol, lamotrigine (LTG), rufinamide, vigabatrin, lacosamide (LCM) and everolimus. Bromide, felbamate and other sodium channel ASMs are discussed briefly. Overall, the current evidence suggest that LEV, PER and to a lesser extent BRV are associated with psychobehavioural adverse events including aggressiveness and irritability; TPM and to a lesser extent ZNS are associated with language impairment and cognitive dulling/memory problems. Patients with a history of behavioural and psychiatric comorbidities may be more at risk of developing psychobehavioural adverse events. Topiramate and ZNS may be associated with negative effects in some aspects of cognition; CBD, FFA, LEV, BRV and LTG may have some positive effects, while the remaining ASMs do not appear to have a detrimental effect. All the ASMs are associated with sedation to a certain extent, which is pronounced during uptitration. Cannabidiol, PER and pregabalin may be associated with improvements in sleep, LTG is associated with insomnia, while VPA, TPM, LEV, ZNS and LCM do not appear to have detrimental effects. There was variability in the extent of evidence for each ASM: for many first-generation and some second-generation ASMs, there is scant documented evidence; however, their extensive use suggests favourable tolerability and safety (e.g. VPA); second-generation and some third-generation ASMs tend to have the most robust evidence documented over several years of use (TPM, LEV, PER, ZNS, BRV), while evidence is still being generated for newer ASMs such as CBD and FFA. Finally, we discuss how a variety of factors can affect mood, behaviour and cognition, and untangling the associations between the effects of the underlying syndrome and those of the ASMs can be challenging. In particular, there is enormous heterogeneity in cognitive, behavioural and developmental impairments that is complex and can change naturally over time; there is a lack of standardised instruments for evaluating these outcomes in developmental and epileptic encephalopathies, with a reliance on subjective evaluations by proxy (caregivers); and treatment regimes are complex involving multiple ASMs as well as other drugs.
Eine barrierefreie Teilnahme am alltäglichen Leben stellt für Menschen mit aktiver Epilepsie häufig eine Herausforderung dar. Epileptische Anfälle können in Kindergarten, Schule und am Arbeitsplatz sowie im häuslichen Umfeld Unsicherheit und Überforderung hervorrufen. Individuell erstellte Pläne für Betreuende, Angehörige, Aufsichtspersonen und den Rettungsdienst sollen im Falle eines akuten Anfalls geeignete Handlungsanweisungen geben. Bisher gibt es hierfür im deutschsprachigen Raum keine standardisierten Vorlagen. Mit den Handlungsplänen bei epileptischen Anfällen für Laien (HEAL) bzw. Therapeuten (HEAT) werden hier 2 Formulare vorgestellt, die zum einen eine standardisierte Grundlage bieten und andererseits leicht auf den individuellen Bedarf angepasst werden können.
Eine barrierefreie Teilnahme am alltäglichen Leben stellt für Menschen mit aktiver Epilepsie häufig eine Herausforderung dar. Epileptische Anfälle können in Kindergarten, Schule und am Arbeitsplatz sowie im häuslichen Umfeld Unsicherheit und Überforderung hervorrufen. Individuell erstellte Pläne für Betreuende, Angehörige, Aufsichtspersonen und den Rettungsdienst sollen im Falle eines akuten Anfalls geeignete Handlungsanweisungen geben. Bisher gibt es hierfür im deutschsprachigen Raum keine standardisierten Vorlagen. Mit den Handlungsplänen bei epileptischen Anfällen für Laien (HEAL) bzw. Therapeuten (HEAT) werden hier 2 Formulare vorgestellt, die zum einen eine standardisierte Grundlage bieten und andererseits leicht auf den individuellen Bedarf angepasst werden können.
Tuberous sclerosis complex (TSC) is a rare genetic disease that is, besides cutaneous and visceral organ manifestations, typically associated with a severe, usually drug refractory epilepsy at a very early stage of the disease. Due to its direct effect on the mTOR signaling pathway dysregulated by TSC and its synergistic effects on other organ manifestations, the rapamycin derivative everolimus (EVE) is increasingly being used. The aim of this systematic review is to evaluate the efficacy, safety and tolerability of EVE in patients with TSC-associated, refractory epilepsy.
The hydrothermal vent tubeworm Riftia pachyptila hosts a single 16S rRNA phylotype of intracellular sulfur-oxidizing symbionts, which vary considerably in cell morphology and exhibit a remarkable degree of physiological diversity and redundancy, even in the same host. To elucidate whether multiple metabolic routes are employed in the same cells or rather in distinct symbiont subpopulations, we enriched symbionts according to cell size by density gradient centrifugation. Metaproteomic analysis, microscopy, and flow cytometry strongly suggest that Riftia symbiont cells of different sizes represent metabolically dissimilar stages of a physiological differentiation process: While small symbionts actively divide and may establish cellular symbiont-host interaction, large symbionts apparently do not divide, but still replicate DNA, leading to DNA endoreduplication. Moreover, in large symbionts, carbon fixation and biomass production seem to be metabolic priorities. We propose that this division of labor between smaller and larger symbionts benefits the productivity of the symbiosis as a whole.
We investigate the possible formation of a Bose-Einstein condensed phase of pions in the early Universe at nonvanishing values of lepton flavor asymmetries. A hadron resonance gas model with pion interactions, based on first-principle lattice QCD simulations at nonzero isospin density, is used to evaluate cosmic trajectories at various values of electron, muon, and tau lepton asymmetries that satisfy the available constraints on the total lepton asymmetry. The cosmic trajectory can pass through the pion condensed phase if the combined electron and muon asymmetry is sufficiently large: |le+lμ|≳0.1, with little sensitivity to the difference le−lμ between the individual flavor asymmetries. Future constraints on the values of the individual lepton flavor asymmetries will thus be able to either confirm or rule out the condensation of pions during the cosmic QCD epoch. We demonstrate that the pion condensed phase leaves an imprint both on the spectrum of primordial gravitational waves and on the mass distribution of primordial black holes at the QCD scale, e.g., the black hole binary of recent LIGO event GW190521 can be formed in that phase.
Hintergrund: Die chirurgische Facharztweiterbildung erfordert neben dem Erlernen theoretischen Wissens ebenfalls den Erwerb praktisch-chirurgischer Kompetenzen. Eine Alternative zur Aus- und Weiterbildung am Patienten stellen simulationsbasierte Lehrkonzepte dar. Ziel der vorliegenden Studie ist die Analyse der Verteilung und des Einsatzes chirurgischer Simulatoren in deutschen Kliniken.
Methoden: Die Datenanalyse erfolgte auf Basis eines individuellen Onlinefragebogens mit insgesamt 19 standardisierten Fragen. Dieser wurde über die E‑Mail-Verteiler der deutschen chirurgischen Fachgesellschaften an die leitenden chirurgischen Klinikärzte versendet.
Ergebnisse: Insgesamt 267 vollständige Antwortdatensätze wurden analysiert (Rücklaufquote 12,0 %). 84,0 % der Teilnehmer gaben ihre Tätigkeit an einem Lehrkrankenhaus an. Zum Zeitpunkt der Untersuchung waren 143 chirurgische Simulatoren an 35,0 % der in die Auswertung eingeschlossenen Kliniken vorhanden. Regional zeigten sich deutliche Unterschiede zwischen den einzelnen Bundesländern. 21,1 % der Teilnehmer, an deren Klinik kein Simulator zur Verfügung steht, planten eine Neubeschaffung. Studierende (41,1 %) und Ärzte in Weiterbildung (ÄiW, 32,5 %) nutzten das Simulationstraining am häufigsten. Eine Integration in die chirurgische Weiterbildung bestand zu 81,8 % nicht. 94,0 % der beteiligten Kliniken zeigten Interesse an einer zukünftigen Integration in die chirurgische Facharztweiterbildung.
Schlussfolgerung: Die vorliegenden Ergebnisse bestätigen die besondere Bedeutung des simulationsbasierten Trainings für die chirurgische Weiterbildung an deutschen Kliniken. Gleichzeitig bestehen deutliche Informationsdefizite über das Nutzungsverhalten sowie eine defizitär empfundene Integration des Simulationstrainings in die chirurgische Weiterbildung.