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Background: It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. We investigated whether depressive mood mediates the influence of social support on health-related quality of life.
Methods: Cross-sectional data of 3,189 multimorbid patients from the baseline assessment of the German MultiCare cohort study were used. Mediation was tested using the approach described by Baron and Kenny based on multiple linear regression, and controlling for socioeconomic variables and burden of multimorbidity.
Results: Mediation analyses confirmed that depressive mood mediates the influence of social support on health-related quality of life (Sobel's p < 0.001). Multiple linear regression showed that the influence of depressive mood (beta = -0.341, p < 0.01) on health-related quality of life is greater than the influence of multimorbidity (beta = -0.234, p < 0.01).
Conclusion: Social support influences health-related quality of life, but this association is strongly mediated by depressive mood. Depression should be taken into consideration in research on multimorbidity, and clinicians should be aware of its importance when caring for multimorbid patients.
Ultraviolet-B (UVB)-induced inflammation produces a dose-dependent mechanical and thermal hyperalgesia in both humans and rats, most likely via inflammatory mediators acting at the site of injury. Previous work has shown that the gene expression of cytokines and chemokines is positively correlated between species and that these factors can contribute to UVB-induced pain. In order to investigate other potential pain mediators in this model we used RNA-seq to perform genome-wide transcriptional profiling in both human and rat skin at the peak of hyperalgesia. In addition we have also measured transcriptional changes in the L4 and L5 DRG of the rat model. Our data show that UVB irradiation produces a large number of transcriptional changes in the skin: 2186 and 3888 genes are significantly dysregulated in human and rat skin, respectively. The most highly up-regulated genes in human skin feature those encoding cytokines (IL6 and IL24), chemokines (CCL3, CCL20, CXCL1, CXCL2, CXCL3 and CXCL5), the prostanoid synthesising enzyme COX-2 and members of the keratin gene family. Overall there was a strong positive and significant correlation in gene expression between the human and rat (R = 0.8022). In contrast to the skin, only 39 genes were significantly dysregulated in the rat L4 and L5 DRGs, the majority of which had small fold change values. Amongst the most up-regulated genes in DRG were REG3B, CCL2 and VGF. Overall, our data shows that numerous genes were up-regulated in UVB irradiated skin at the peak of hyperalgesia in both human and rats. Many of the top up-regulated genes were cytokines and chemokines, highlighting again their potential as pain mediators. However many other genes were also up-regulated and might play a role in UVB-induced hyperalgesia. In addition, the strong gene expression correlation between species re-emphasises the value of the UVB model as translational tool to study inflammatory pain.
Hypoxia enhances the antiglioma cytotoxicity of b10, a glycosylated derivative of betulinic acid
(2014)
B10 is a glycosylated derivative of betulinic acid with promising activity against glioma cells. Lysosomal cell death pathways appear to be essential for its cytotoxicity. We investigated the influence of hypoxia, nutrient deprivation and current standard therapies on B10 cytotoxicity. The human glioma cell lines LN-308 and LNT-229 were exposed to B10 alone or together with irradiation, temozolomide, nutrient deprivation or hypoxia. Cell growth and viability were evaluated by crystal violet staining, clonogenicity assays, propidium iodide uptake and LDH release assays. Cell death was examined using an inhibitor of lysosomal acidification (bafilomycin A1), a cathepsin inhibitor (CA074-Me) and a short-hairpin RNA targeting cathepsin B. Hypoxia substantially enhanced B10-induced cell death. This effect was sensitive to bafilomycin A1 and thus dependent on hypoxia-induced lysosomal acidification. Cathepsin B appeared to mediate cell death because either the inhibitor CA074-Me or cathepsin B gene silencing rescued glioma cells from B10 toxicity under hypoxia. B10 is a novel antitumor agent with substantially enhanced cytotoxicity under hypoxia conferred by increased lysosomal cell death pathway activation. Given the importance of hypoxia for therapy resistance, malignant progression, and as a result of antiangiogenic therapies, B10 might be a promising strategy for hypoxic tumors like malignant glioma.
Treatment with inhibitors of the receptor tyrosine kinase FLT3 are currently studied as promising therapies in acute myeloid leukemia (AML). However, only a subset of patients benefit from these treatments and the presence of activating mutations within FLT3 can predict response to a certain extent only. ...
Background: Health Authorities recommend influenza vaccination of healthcare personnel (HCP) to decrease the transmission of influenza to vulnerable patients. Recent studies have almost exclusively used quantitative questionnaires in order to identify determinants of vaccination behaviour. Interviews enable HCP to express freely why they think they are (not) willing to get vaccinated against influenza.
Methods: By means of semi-structured one-on-one interviews with 123 Belgian, Dutch and German HCP, reasons for and against vaccination, experiences with influenza vaccination, intention to get vaccinated and possible barriers, as well as willingness to advice influenza vaccination to patients were investigated. Data were processed with QSR NVivo 8.0 and analysed using a combination of a deductive and a general inductive approach.
Results: Across countries, self-protection, patient protection, and protection of family members were reported as most important reasons to get vaccinated against influenza. Reasons to not get vaccinated against influenza were fear of side effects caused by the vaccine, a low risk-perception, the disbelief in the effectiveness of influenza vaccination, organizational barriers, misconceptions, and undefined negative emotions.
Conclusions: The social cognitive variables underlying the decision of HCP to get vaccinated against influenza (or not) seem to be similar in Belgium, Germany, and the Netherlands, even though some differences surfaced. A quantitative investigation of those social cognitive variables is needed in order to determine the importance of the social cognitive variables in explaining the intention to get vaccinated and the importance of the similarities and differences between countries that have been found in this study.
Poster presentation at 1st International Workshop on Odor Spaces.
Mice are exceptional in their ability to capture their chemical environment, mapping the olfactory world into a basic sensory representation with over one thousand different types of chemical sensors, that is, olfactory sensory neurons (OSNs). OSNs of each type converge in the olfactory bulb onto exclusive distinct physiological areas called glomeruli. The glomeruli constitute the first relay station of olfactory stimulus representation in the mouse brain. Thus, the stimulus induced glomerular input pattern spatially embodies an important part of the sensory representation in the olfactory bulb. Still, topographic organization principles (chemotopy, tunotopy) are under debate. One reason might be that investigation are, due to experimental limitations, only performed on stimuli sets in the size of one hundred odors. But this represents only a tiny snapshot of the vast amount of molecules in the olfactory world and topographic relationships might be disguised in the incomplete representation of molecular receptive ranges (MRR). Therefore we investigated the problem with the MOR18-2 glomerulus as point of reference: First we determined it's MRR. Then, based on a measurement set covering this MRR, we elucidated the topographic embedding. It shows that MOR18-2 is embedded in a hierarchy of patchy tunotopic domains.
Background: Chronic particulate matter (PM) exposure is correlated to various health effects, even at low amounts. WHO has defined PM concentration limits as daily and annual mean values which were made legally binding in the European Union. While many studies have focused on PM concentrations in special environments, little is known about the average PM- exposure for both employees and passengers in the German public transportation system.
Methods: Particulate matter (PM10, PM2.5, PM1) - concentrations were monitored for 30 minutes at 15 different areas in Frankfurt am Main with major public traffic. Maximum and mean concentrations and, as a surrogate for the inhaled dosage, the Area Under the Curve (AUC) for 15 minutes of exposure were calculated.
Results: The WHO limits for PM10 and PM2.5 were exceeded at nearly all times and areas. Highest maximum concentrations were found at underground stations, subterranean railway stations and subterranean shopping arcades with much lower values obtained at surface points. In one measurement at a surface test point smokers who neglected the non-smoking policy could be identified as a major cause for a at least temporary strong increase of PM-load as seen in high maximum values and normal averages.
Conclusions: Subterranean areas have high particulate matter contamination exceeding WHO limits. Improvement may be achieved by increased ventilation. Subterranean shops and kiosks, being workplaces with long term exposure, should be equipped with external air supply. The non- smoking policy of the "Deutsche Bahn" for public spaces should be enforced.
Die zentralen Objekte der Dissertation sind Translationsflächen. Dabei handelt es sich um Riemann’sche Flächen, die aus in die euklidische Ebene eingebetteten Polygonen durch Verkleben von parallelen gleichlangen Seiten entstehen. Zwei Translationsflächen sind gleich, wenn es möglich ist, die Polygone durch ”Zerschneiden und mittels Translationen neu Zusammenkleben“ ineinander zu überführen. Die Gruppe GL_2(R) operiert auf der Menge der Translationsflächen via der linearen Abbildungen auf den Polygonen. Der Stabilisator einer Translationsfläche X unter dieser Operation wird die Veech-Gruppe von X genannt und mit SL(X) bezeichnet. Die Veech-Gruppe ist eine diskrete Untergruppe von SL_2(R) und damit eine Fuchs’sche Gruppe.
Fuchs’sche Gruppen werden je nach ihrer Limesmenge in elementare und nicht-elementare Gruppen eingeteilt. Letztere wiederum unterteilt man in Gruppen erster oder zweiter Art. Fuchs’sche Gruppen mit endlichem co-Volumen heißen Gitter und sind genau die endlich erzeugten Gruppen erster Art. Translationsflächen, deren Veech-Gruppe ein Gitter ist, heißen Veech-Flächen und sind von besonderem Interesse, da für sie die Veech Alternative gilt.
Ein feineres Maß für die Größe einer Fuchs’schen Gruppe ist der kritische Exponent. Er ist definiert als das Infimum aller reellen Zahlen, für die die Poincaré Reihe konvergiert und liegt für alle unendlichen Fuchs’schen Gruppen zwischen 0 und 1. Hauptziel der Dissertation ist der Beweis von Theorem 1. Es gibt Translationsflächen, für die der kritische Exponent ihrer Veech-Gruppe echt zwischen 1/2 und 1 liegt.
Der kritische Exponent von elementaren Gruppen ist höchstens 1/2, Translationsflächen mit elementaren Veech-Gruppen sind also als Kandidaten für das Theorem ausgeschlossen. Der kritische Exponent von Gittern ist 1. Also scheiden auch Veech-Flächen für das Theorem aus.
Bis zum Jahr 2003 waren Gitter die einzigen bekannten nicht-elementaren Veech-Gruppen. McMullen klassifizierte die Veech-Flächen vom Geschlecht 2 und zeigte, dass jede solche Fläche, die nur eine Singularität besitzt, in der GL_2(R)-Bahn der Fläche L_D liegt, die aus einem L-förmigen Polygon mit geeigneten von D abhängigen Seitenlängen entsteht.
Während auch heute noch keine Translationsfläche mit Veech-Gruppe zweiter Art bekannt ist, fanden McMullen und unabhängig davon Hubert und Schmidt Konstruktionen unendlich erzeugter Veech-Gruppen erster Art. Eine Abschätzung des kritischen Exponenten dieser Gruppen war 10 Jahre lang eine wichtige offene Frage, die nun durch Theorem 1 beantwortet wird.
Zentral in der Konstruktion von Hubert und Schmidt sind spezielle Punkte, nämlich Verbindungspunkte. Hubert und Schmidt konstruieren Translationsflächen, deren Veech-Gruppen kommensurabel zum Stabilisator SL(X;P) von P sind und damit den gleichen kritischen Exponenten haben. Für Verbindungspunkte mit unendlicher SL(X)- Bahn (diese Punkte heißen nicht-periodisch) ist SL(X;P) unendlich erzeugt und von erster Art.
Wir zeigen Theorem 1, indem wir zeigen, dass für jedes D kongruent 0 mod 4, (kein Quadrat), und jeden nicht-periodischen Verbindungspunkt P in L_D der kritische Exponent der Gruppe SL(L_D;P) echt zwischen 1/2 und 1 liegt.
Eine natürliche Frage in diesem Zusammenhang ist die Abhängigkeit von P: Punkte Q in der SL(L_D)-Bahn von P sind auch er nicht-periodische Verbindungspunkte und die zugehö̈rigen Gruppen SL(L_D;P) und SL(L_D;Q) sind konjugiert zueinander. Daher widmen wir uns in Kapitel 4 der Bestimmung der Bahnen nicht-periodischer Verbindungspunkte.
Die Verbindungspunkte haben die Form P=(x_r+x_iw;y_r+y_iw) mit x_r,x_i,y_r,y_i aus Q. Wir zeigen, dass der Hauptnenner N(P) dieser (gekürzten) Brüche eine Invariante der Bahn ist. Daraus folgt:
Theorem 2. Es gibt unendlich viele verschiedene Bahnen von Verbindungspunkten von L_D.
Wir kennen die Operation der horizontalen und der vertikalen Scherungen A und B aus SL(L_D). Im Spezialfall D=8 erzeugen diese beiden Elemente die ganze Gruppe und wir geben je ein Verfahren an, um eine untere und eine obere Schranke an die Anzahl der Bahnen von nicht-periodischen Verbindungspunkten P mit fixiertem Hauptnenner N(P) zu finden. Damit zeigen wir:
Theorem 3. Die Menge der Verbindungspunkte P mit festem Wert N(P) zerfällt in eine endliche Anzahl von SL(L_8)-Bahnen.
Im Beweis von Theorem 1 ist es nötig, die Nicht-Mittelbarkeit eines Graphen zu zeigen. Da wir nur sehr wenige Informationen über dessen Struktur in unserer konkreten Situation haben, entwickeln wir in Kapitel 1 die folgende Methode:
Theorem 4. Sei G ein Graph, den man durch Weglassen von Kanten in einen Wald G′ ohne Blätter überführen kann, bei dem das Supremum der Längen von zusammenhängenden Valenz-2-Teilgraphen von G′ beschränkt ist. Dann ist G nicht mittelbar.
Um diese Methode anzuwenden, ordnen wir jeder Ecke P von G ein Komplexitätsmaß s(P) zu und weisen nach, dass dieser Wert für die Operation von Worten in A- und B-Potenzen mit wachsender Wortlänge ”tendenziell wächst“.
Acute kidney injury (AKI) is one of the most important complications in hospitalized patients and its pathomechanisms are not completely elucidated. We hypothesize that signaling via toll-like receptor (TLR)-3, a receptor that is activated upon binding of double-stranded nucleotides, might play a crucial role in the pathogenesis of AKI following ischemia and reperfusion (IR). Male adult C57Bl6 wild-type (wt) mice and TLR-3 knock-out (-/-) mice were subjected to 30 minutes bilateral selective clamping of the renal artery followed by reperfusion for 30 min 2.5h and 23.5 hours or subjected to sham procedures. TLR-3 down-stream signaling was activated already within 3 h of ischemia and reperfusion in post-ischemic kidneys of wt mice lead to impaired blood perfusion followed by a strong pro-inflammatory response with significant neutrophil invasion. In contrast, this effect was absent in TLR-3-/- mice. Moreover, the quick TLR-3 activation resulted in kidney damage that was histomorphologically associated with significantly increased apoptosis and necrosis rates in renal tubules of wt mice. This finding was confirmed by increased kidney injury marker NGAL in wt mice and a better preserved renal perfusion after IR in TLR-3-/- mice than wt mice. Overall, the absence of TLR-3 is associated with lower cumulative kidney damage and maintained renal blood perfusion within the first 24 hours of reperfusion. Thus, we conclude that TLR-3 seems to participate in the pathogenesis of early acute kidney injury.
Vasointestinal peptide metabolism plays a key physiological role in multimodular levels of vasodilatory, smooth muscle cell proliferative, parenchymal, and inflammatory lung reactions. In animal studies, vasointestinal peptide relaxes isolated pulmonary arterial segments from several mammalian species in vitro and neutralizes the pulmonary vasoconstrictor effect of endothelin. In some animal models, it reduces pulmonary vascular resistance in vivo and in monocrotaline-induced pulmonary hypertension. A 58-year-old woman presented with dyspnea and mild edema of the lower extremities. A bronchoscopy was performed without any suspicious findings suggesting a central tumor or other infiltrative disease. Endobronchial ultrasound revealed enlarged pulmonary arteries containing thrombi, a few enlarged lymph nodes, and enlarged mediastinal tissue anatomy with suspicion for mediastinal infiltration of a malignant process. We estimated that less than 10% of the peripheral vascular bed of the lung was involved in direct consolidated fibrosis as demonstrated in the left upper lobe apex. Further, direct involvement of fibrosis around the main stems of the pulmonary arteries was assumed to be low from positron emission tomography and magnetic resonance imaging scans. Assuming a positive influence of low-dose radiation, it was not expected that this could have reduced pulmonary vascular resistance by over two thirds of the initial result. However; it was noted that this patient had idiopathic pulmonary arterial hypertension mixed with "acute" (mediastinal) fibrosis which could have contributed to the unexpected success of reduction of pulmonary vascular resistance. To the best of our knowledge, this is the first report of successful treatment of idiopathic pulmonary arterial hypertension, probably as a result of low-dose radiation to the pulmonary arterial main stems. The patient continues to have no specific complaints concerning her idiopathic pulmonary arterial hypertension.
Background: Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients.
Methods: Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine) in addition to medical history and demographics.
Results: Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1%) in a mild form. Anemia was primarily due to iron deficiency (65%), frequently due to underlying chronic infection (62.1%), or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role.
Conclusion: Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.
Background: Acute leukemia in early age (EAL) is characterized by acquired genetic alterations such as MLL rearrangements (MLL-r). The aim of this case-controlled study was to investigate whether single nucleotide polymorphisms (SNPs) of IKZF1, ARID5B, and CEBPE could be related to the onset of EAL cases (<24 months-old at diagnosis).
Methods: The SNPs (IKZF1 rs11978267, ARID5B rs10821936 and rs10994982, CEBPE rs2239633) were genotyped in 265 cases [169 acute lymphoblastic leukemia (ALL) and 96 acute myeloid leukaemia (AML)] and 505 controls by Taqman allelic discrimination assay. Logistic regression was used to evaluate the association between SNPs of cases and controls, adjusted on skin color and/or age. The risk was determined by calculating odds ratios (ORs) with 95% confidence interval (CI).
Results: Children with the IKZF1 SNP had an increased risk of developing MLL-germline ALL in white children. The heterozygous/mutant genotype in ARID5B rs10994982 significantly increased the risk for MLL-germline leukemia in white and non-white children (OR 2.60, 95% CI: 1.09-6.18 and OR 3.55, 95% CI: 1.57-8.68, respectively). The heterozygous genotype in ARID5B rs10821936 increased the risk for MLL-r leukemia in both white and non-white (OR 2.06, 95% CI: 1.12-3.79 and OR 2.36, 95% CI: 1.09-5.10, respectively). Furthermore, ARID5B rs10821936 conferred increased risk for MLL-MLLT3 positive cases (OR 7.10, 95% CI:1.54-32.68). Our data do not show evidence that CEBPE rs2239633 confers increased genetic susceptibility to EAL.
Conclusions: IKZF1 and CEBPE variants seem to play a minor role in genetic susceptibility to EAL, while ARID5B rs10821936 increased the risk of MLL-MLLT3. This result shows that genetic susceptibility could be associated with the differences regarding MLL breakpoints and partner genes.
Background: In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle. The current study investigates whether stage at diagnosis differs between migrants and non-migrants with colorectal cancer in an area of high migration and attempts to identify factors that can explain any differences.
Methods/Design: Data on tumour and migration status will be collected for 1,200 consecutive patients that have received a new, histologically verified diagnosis of colorectal cancer in a high migration area in Germany in the previous three months. The recruitment process is expected to take 16 months and will include gastroenterological private practices and certified centres for intestinal diseases. Descriptive and analytical analysis will be performed: the distribution of variables for migrants versus non-migrants and participants versus non-participants will be analysed using appropriate χ2-, t-, F- or Wilcoxon tests. Multivariable, logistic regression models will be performed, with the dependent variable being the dichotomized stage of the tumour (UICC stage I versus more advanced than UICC stage I). Odds ratios and associated 95%-confidence intervals will be calculated. Furthermore, ordered logistic regression models will be estimated, with the exact stage of the tumour at diagnosis as the dependent variable. Predictors used in the ordered logistic regression will be patient characteristics that are specific to migrants as well as patient characteristics that are not. Interaction models will be estimated in order to investigate whether the effects of patient characteristics on stage of tumour at the time of the initial diagnosis is different in migrants, compared to non-migrants.
Discussion: An association of migration status or other socioeconomic variables with stage at diagnosis of colorectal cancer would be an important finding with respect to equal health care access among migrants. It would point to access barriers or different symptom appraisal and, in the long term, could contribute to the development of new health care concepts for migrants.
Trial registration: German Clinical Trials Register DRKS00005056.
Background: Multimorbidity is a common phenomenon in primary care. Until now, no clinical guidelines for multimorbidity exist. For the development of these guidelines, it is necessary to know whether or not patients are aware of their diseases and to what extent they agree with their doctor. The objectives of this paper are to analyze the agreement of self-reported and general practitioner-reported chronic conditions among multimorbid patients in primary care, and to discover which patient characteristics are associated with positive agreement.
Methods: The MultiCare Cohort Study is a multicenter, prospective, observational cohort study of 3,189 multimorbid patients, ages 65 to 85. Data was collected in personal interviews with patients and GPs. The prevalence proportions for 32 diagnosis groups, kappa coefficients and proportions of specific agreement were calculated in order to examine the agreement of patient self-reported and general practitioner-reported chronic conditions. Logistic regression models were calculated to analyze which patient characteristics can be associated with positive agreement.
Results: We identified four chronic conditions with good agreement (e.g. diabetes mellitus κ = 0.80;PA = 0,87), seven with moderate agreement (e.g. cerebral ischemia/chronic stroke κ = 0.55;PA = 0.60), seventeen with fair agreement (e.g. cardiac insufficiency κ = 0.24;PA = 0.36) and four with poor agreement (e.g. gynecological problems κ = 0.05;PA = 0.10).Factors associated with positive agreement concerning different chronic diseases were sex, age, education, income, disease count, depression, EQ VAS score and nursing care dependency. For example: Women had higher odds ratios for positive agreement with their GP regarding osteoporosis (OR = 7.16). The odds ratios for positive agreement increase with increasing multimorbidity in almost all of the observed chronic conditions (OR = 1.22-2.41).
Conclusions: For multimorbidity research, the knowledge of diseases with high disagreement levels between the patients' perceived illnesses and their physicians' reports is important. The analysis shows that different patient characteristics have an impact on the agreement. Findings from this study should be included in the development of clinical guidelines for multimorbidity aiming to optimize health care. Further research is needed to identify more reasons for disagreement and their consequences in health care.
A third Supplement to the 1992 Catalog of the Scolytidae and Platypodidae (Coleoptera) of the World (Wood and Bright 1992) is presented. This Supplement updates the taxonomy, distribution, and biology pertaining to these families of Coleoptera from 2000 to the end of 2010. A few 2011 taxonomic references are included in order to make the nomenclature as current as possible. The format of this Supplement differs slightly from the format of the original 1992 Catalog and the two previous Supplements. Only references relating to general biology, systematics and distribution were selected to be included. Tribal arrangement follows the scheme established in the 1992 World Catalog, with additions. Each genus is listed alphabetically under the current tribe and the species are listed alphabetically under the current genus. Additional information on figures, distribution, hosts, and references relating to the above are given. The bibliography used with this Supplement lists 580 references, most published from 2000 to the end of 2010. New synonymy proposed: Phloeotribus carinatus Burgos and Equihua, 2003 (= Phloeotribus ebeneus Wood, 2007). New combinations proposed: Phloeosinus kinabaluensis Bright to Hyledius; Phloeosinus phyllocladus Bright to Hyledius.
An argument is made for the retention of the family status of the Scolytidae and Platypodidae as members of the superfamily Curculionoidea. A new subfamily and tribal arrangement is proposed: SCOLYTIDAE comprising 13 subfamilies, Hylesininae, with 12 tribes, Hyorrhynchinae, with one tribe; Scolytinae, with one tribe; Hexacolinae, with one tribe; Cylindrobrotinae, with one tribe; Scolytoplatypodinae, with one tribe; Cactopininae, with one tribe; Carphodicticinae, with one tribe; Micracidinae, with one tribe; Crypturginae, with one tribe; Ipinae, with six tribes; Cryphalinae, with one tribe and Corthylinae, with two tribes and PLATYPODIDAE comprising three subfamilies, Coptonotinae, with three tribes; Tesserocerinae, with two tribes and Platypodinae, with one tribe.
The term compensation is widely used in every-day language, in psychological research, and also discussed in the context of Attention Deficit Hyperactivity Disorder (ADHD). However, few studies have looked at psychological compensation in ADHD systematically and theory based. Compensation can be inferred if a deficit (i.e., a mismatch between skill and environmental demand) is counterbalanced by the investment of more effort, the utilization of latent or the acquisition of new skills. Based on the application of a theoretical framework (Bäckman & Dixon, 1992) to ADHD, I developed the following aims: (1) To reassess the awareness of deficits in ADHD and (2) to explore psychological compensation in a group with ADHD that accomplishes high achievement.
The results of Study 1 showed that children with ADHD did not overestimate their own skills compared to a group matched for academic achievement. In Study 2, college students with ADHD reported higher achievement motivation compared to college students without ADHD. Furthermore, results indicated that women with ADHD compensate by adopting compensatory effort and obsessive-compulsive behavior. Study 3 showed that female college students compensate for possible deficits in solving a flanker task by being overly cautious, which may reflect more obsessive-compulsive behavior.
The studies are discussed within the framework of psychological compensation. They add to the understanding of compensation in ADHD by (1) the reassessment of awareness of deficits in ADHD by including a group without ADHD but with low achievement, and by (2) suggesting that overly cautious behavior could be a form of psychological compensation in females with ADHD enabling them to enter college, leading to a late diagnosis and to good performance in cognitive tasks (i.e., flanker task).
Limitations are, that I did not test all components of the theoretical framework in one study and that I did not include adults with ADHD that did not enter college in Study 2 and 3 to test if achievement motivation or overly cautious behavior explains why some adults with ADHD gain admittance to higher education and show good performance in cognitive tasks and others do not.
Background: Health-related and disease-specific quality of life (HRQoL) has been increasingly valued as relevant clinical parameter in cystic fibrosis (CF) clinical care and clinical trials. HRQoL measures should assess – among other domains – daily functioning from a patient’s perspective. However, validation studies for the most frequently used HRQoL questionnaire in CF, the Cystic Fibrosis Questionnaire (CFQ), have not included measures of physical activity or fitness. The objective of this study was, therefore, to determine the cross-sectional and longitudinal relationships between HRQoL, physical activity and fitness in patients with CF.
Methods: Baseline (n = 76) and 6-month follow-up data (n = 70) from patients with CF (age ≥12 years, FEV1 ≥35%) were analysed. Patients participated in two multi-centre exercise intervention studies with identical assessment methodology. Outcome variables included HRQoL (German revised multi-dimensional disease-specific CFQ (CFQ-R)), body composition, pulmonary function, physical activity, short-term muscle power, and aerobic fitness by peak oxygen uptake and aerobic power.
Results: Peak oxygen uptake was positively related to 7 of 13 HRQoL scales cross-sectionally (r = 0.30-0.46). Muscle power (r = 0.25-0.32) and peak aerobic power (r = 0.24-0.35) were positively related to 4 scales each, and reported physical activity to 1 scale (r = 0.29). Changes in HRQoL-scores were directly and significantly related to changes in reported activity (r = 0.35-0.39), peak aerobic power (r = 0.31-0.34), and peak oxygen uptake (r = 0.26-0.37) in 3 scales each. Established associates of HRQoL such as FEV1 or body mass index correlated positively with fewer scales (all 0.24 < r < 0.55).
Conclusions: HRQoL was associated with physical fitness, especially aerobic fitness, and to a lesser extent with reported physical activity. These findings underline the importance of physical fitness for HRQoL in CF and provide an additional rationale for exercise testing in this population.
Trial registration: ClinicalTrials.gov, NCT00231686
pH and Na+ homeostasis in all cells requires Na+/H+ antiporters. The crystal structure, obtained at pH 4, of NhaA, the main antiporter of Escherichia coli, has provided general insights into an antiporter mechanism and its unique pH regulation. Here, we describe a general method to select various NhaA mutants from a library of randomly mutagenized NhaA. The selected mutants, A167P and F267C are described in detail. Both mutants are expressed in Escherichia coli EP432 cells at 70–95% of the wild type but grow on selective medium only at neutral pH, A167P on Li+ (0.1 M) and F267C on Na+ (0.6 M). Surprising for an electrogenic secondary transporter, and opposed to wild type NhaA, the rates of A167P and F267C are almost indifferent to membrane potential. Detailed kinetic analysis reveals that in both mutants the rate limiting step of the cation exchange cycle is changed from an electrogenic to an electroneutral reaction.