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Medical students are exposed to infectious diseases during the course of their clinical training. Unfortunately, vaccination rates among medical students remain insufficient. However, immunizations against vaccine-preventable diseases should be carried out before the students enter clinical courses. This is vital in order to prevent nosocomial infections. We screened 366 medical students in their first clinical year for hospital-related viral diseases. Serum samples were collected between April and May 2007. Antibody testing was carried out using commercial ELISA systems against measles, mumps, rubella, varicella, hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Overall, 63.9% (n=234) of the students were sufficiently vaccinated against HBV. In contrast, 31.7% (n=116) had not received any HBV vaccine dosage, and 4.4% (n=16) had not completed the full vaccine cycle (<3 dosage). Remarkably, two students showed serological markers of resolved HBV infection. In addition, one student was HCV-positive and one was HIV-positive, respectively. The following seronegative rates were found: measles (7.9%), mumps (17.5%), rubella (6.5%), and varicella (2.2%). Further work is needed to identify optimal strategies for improving vaccination rates among medical students. It is imperative to identify and limit possible disparities in immunity of vaccine-preventable diseases before initial patient contact. With regard to the primary diagnosis of serious virus diseases including HBV, HCV and HIV, medical students should be screened for these blood borne pathogens.
Background Multimorbidity is a highly frequent condition in older people, but well designed longitudinal studies on the impact of multimorbidity on patients and the health care system have been remarkably scarce in numbers until today. Little is known about the long term impact of multimorbidity on the patients' life expectancy, functional status and quality of life as well as health care utilization over time. As a consequence, there is little help for GPs in adjusting care for these patients, even though studies suggest that adhering to present clinical practice guidelines in the care of patients with multimorbidity may have adverse effects. Methods The study is designed as a multicentre prospective, observational cohort study of 3.050 patients aged 65 to 85 at baseline with at least three different diagnoses out of a list of 29 illnesses and syndromes. The patients will be recruited in approx. 120 to 150 GP surgeries in 8 study centres distributed across Germany. Information about the patients' morbidity will be collected mainly in GP interviews and from chart reviews. Functional status, resources/risk factors, health care utilization and additional morbidity data will be assessed in patient interviews, in which a multitude of well established standardized questionnaires and tests will be performed. Discussion The main aim of the cohort study is to monitor the course of the illness process and to analyse for which reasons medical conditions are stable, deteriorating or only temporarily present. First, clusters of combinations of diseases/disorders (multimorbidity patterns) with a comparable impact (e.g. on quality of life and/or functional status) will be identified. Then the development of these clusters over time will be analysed, especially with regard to prognostic variables and the somatic, psychological and social consequences as well as the utilization of health care resources. The results will allow the development of an instrument for prediction of the deterioration of the illness process and point at possibilities of prevention. The practical consequences of the study results for primary care will be analysed in expert focus groups in order to develop strategies for the inclusion of the aspects of multimorbidity in primary care guidelines.
Ever since the discovery of neural networks, there has been a controversy between two modes of information processing. On the one hand, symbolic systems have proven indispensable for our understanding of higher intelligence, especially when cognitive domains like language and reasoning are examined. On the other hand, it is a matter of fact that intelligence resides in the brain, where computation appears to be organized by numerical and statistical principles and where a parallel distributed architecture is appropriate. The present claim is in line with researchers like Paul Smolensky and Peter Gärdenfors and suggests that this controversy can be resolved by a unified theory of cognition – one that integrates both aspects of cognition and assigns the proper roles to symbolic computation and numerical neural computation.
The overall goal in this contribution is to discuss formal systems that are suitable for grounding the formal basis for such a unified theory. It is suggested that the instruments of modern logic and model theoretic semantics are appropriate for analyzing certain aspects of dynamical systems like inferring and learning in neural networks. Hence, I suggest that an active dialogue between the traditional symbolic approaches to logic, information and language and the connectionist paradigm is possible and fruitful. An essential component of this dialogue refers to Optimality Theory (OT) – taken as a theory that likewise aims to overcome the gap between symbolic and neuronal systems. In the light of the proposed logical analysis notions like recoverability and bidirection are explained, and likewise the problem of founding a strict constraint hierarchy is discussed. Moreover, a claim is made for developing an "embodied" OT closing the gap between symbolic representation and embodied cognition.
The article aims to give an overview about the application of Optimality Theory (OT) to the domain of pragmatics. In the introductory part we discuss different ways to view the division of labor between semantics and pragmatics. Rejecting the doctrine of literal meaning we conform to (i) semantic underdetermination and (ii) contextualism (the idea that the mechanism of pragmatic interpretation is crucial both for determining what the speaker says and what he means). Taking the assumptions (i) and (ii) as essential requisites for a natural theory of pragmatic interpretation, section 2 introduces the three main views conforming to these assumptions: Relevance theory, Levinson’s theory of presumptive meanings, and the Neo-Gricean approach. In section 3 we explain the general paradigm of OT and the idea of bidirectional optimization. We show how the idea of optimal interpretation can be used to restructure the core ideas of these three different approaches. Further, we argue that bidirectional OT has the potential to account both for the synchronic and the diachronic perspective on pragmatic interpretation. Section 4 lists relevant examples of using the framework of bidirectional optimization in the domain of pragmatics. Section 5 provides some general conclusions. Modeling both for the synchronic and the diachronic perspective on pragmatics opens the way for a deeper understanding of the idea of naturalization and (cultural) embodiment in the context of natural language interpretation.
Im Beitrag wird auf aktuelle Ergebnisse der Forschung zum mentalen Lexikon eingegangen. Das mentale Lexikon wird dabei aus der Sicht der Netzwerktheorie untersucht. Der Netzwerkcharakter des mentalen Lexikons hat zur Folge, dass die gelernten Wörter nicht voneinander unabhängig existieren: Sie sind miteinander verknüpft. Diese Verknüpfungen sind nicht gleich stark; zudem ist die Richtung dieser Verknüpfung von großer Bedeutung. Assoziationstests in mehreren Sprachen zeigen, dass dasselbe Wort in verschiedenen Sprachen verschiedene Verknüpfungen hat bzw. dass die Stärke der Verknüpfungen zwischen zwei beliebigen Wörtern von Sprache zu Sprache variiert. Beim Fremdsprachenerwerb und Fremdsprachenunterricht werden diese Unterschiede kaum berücksichtigt. Der vorliegende Beitrag analysiert das mentale Lexikon aus der Perspektive der Netzwerke. Dabei wird das Projekt ConnectYourMind vorgestellt, das in mehreren Sprachen Assoziationsdaten sammelt.
This articles aims to present some of the main concepts of E. Husserl's phenomenology that can be applied to linguistic communication. The apprehension of those concepts is condition sine qua non for the use of the phenomenology as a matrix for research. The understanding of those concepts will serve as a work instrument in the field of applied linguistic.
Die paradigmatische Institution des Speichergedächtnisses ist das Archiv, das gern als „Schatzkammer des Wissens“ oder „Gedächtnis der Gesellschaft“ angesprochen wird. Welche Aufgaben erfüllt es, wie hat es sich im Medienwandel verändert, mit welchen Problemen ist es konfrontiert? Diese Fragen führen mich im dritten und letzten Teil zu einer Gegenüberstellung von Archiv und Internet. Ich beginne mit einigen Bemerkungen zur Struktur und Organisation des Archivs. Das Archiv ist ein Ort der Ansammlung und nicht der Sammlung. Hier spielt der Zufall eine größere Rolle als die gezielte Steuerung, denn Archivgut fällt an und wird nicht eigens gesucht und in aller Regel nicht käuflich erworben. Mit den Tätigkeiten des Sicherns und Erhaltens ist es ganz auf eine Schutzfunktion zugeschnitten. Der gesellschaftliche Auftrag des Archivs liegt in der Konservierungs-, Ordnungs- und Erschließungsfunktion von Dokumenten. Archivare sind Dienstleister des Speichergedächtnisses in einer Zwischenstellung: sie halten Informationen vor, die später von anderen bewertet, aufbereitet und interpretiert werden. All das kann nicht die Aufgabe der Archivare sein, weshalb sie sich mit der Entscheidung der Auswahl zwischen dem, was relevant und was redundant ist, auch schwer tun und oft überfordert fühlen: „Was wertvoll oder Informationsmüll (wertlos) ist, ist in generellem Sinn theoretisch nicht begründbar.“
Das Gedächtnis der Dinge
(2009)
Die politische Praxis von Raub und Plünderung kultureller Wertgegenstände hat eine lange Vorgeschichte. Eine Szene, die geradezu zum Emblem dieses Komplexes geworden ist, findet sich auf einem Relief im Triumphbogen des Titus auf dem Forum Romanum. Dieser Triumphbogen wurde erbaut zur Erinnerung an den Sieg des Titus über die Aufständischen in der römischen Provinz Judäa und die Zerstörung des zweiten Tempels von Jerusalem im Jahre 71 unserer Zeitrechnung. Die einzige Mauer, die von diesem Tempel heute noch erhalten ist, ist die berühmte Klagemauer. Die entscheidende Szene im römischen Triumphbogen zeigt die Soldaten des Titus, wie sie als Kriegsbeute den Tempelschatz von Jerusalem mit sich führen: einen Altar, Silbertrompeten und das wichtigste und älteste jüdische Symbol, das der Staat Israel 1948 als offizielles Symbol wieder eingeführt hat: einen großen siebenarmigen und vermutlich goldenen Leuchter, genannt Menora. […]Die symbolische Praxis, zentrale und kostbare Kunstschätze der feindlichen Kultur als Beute zu beschlagnahmen und sich anzueignen, gehört zur Vorgeschichte der modernen Institution des Museums. Kunst und Kultur gewinnen dabei einen symbolischen und materiellen Wert, der über kulturelle Grenzen hinweg vermittelbar ist und sich aus einer politischen in eine ästhetische Praxis übersetzen lässt. Enteignung und Aneignung gehen dabei Hand in Hand.
The paper investigates the origins of the German/Dutch particle toch/doch) in the hope of shedding light on a puzzle with respect to doch/toch and to shed some light on two theoretical issues. The puzzle is the nearly opposite meaning of the stressed and unstressed versions of the particle which cannot be accounted for in standard theories of the meaning of stress. One theoretical issue concerns the meaning of stress: whether it is possible to reduce the semantic contribution of a stressed item to the meaning of the item and the meaning of stress. The second issue is whether the complex use of a particle like doch/toch can be seen as an instance of spread or whether it has to be seen as having a core meaning which is differentiated by pragmatics operating in different contexts.
We use the etymology of doch and doch as to+u+h (that+ question marker+ emphatic marker) to argue for an origin as a question tag checking a hearer opinion. Stress on the tag indicates an opposite opinion (of the common ground or the speaker) and this sets apart two groups of uses spreading in different directions. This solves the puzzle, indicates that the assumption of spread is useful and offers a subtle correction of the interpretation of stress. While stress always means contrast with a contrasting item, if the particle use is due to spread, it is not guaranteed that the unstressed particle has a corresponding use (or inversely).
We previously proposed that the dimeric cytochrome bc(1) complex exhibits half-of-the-sites reactivity for ubiquinol oxidation and rapid electron transfer between bc(1) monomers (Covian, R., Kleinschroth, T., Ludwig, B., and Trumpower, B. L. (2007) J. Biol. Chem. 282, 22289-22297). Here, we demonstrate the previously proposed half-of-the-sites reactivity and intermonomeric electron transfer by characterizing the kinetics of ubiquinol oxidation in the dimeric bc(1) complex from Paracoccus denitrificans that contains an inactivating Y147S mutation in one or both cytochrome b subunits. The enzyme with a Y147S mutation in one cytochrome b subunit was catalytically fully active, whereas the activity of the enzyme with a Y147S mutation in both cytochrome b subunits was only 10-16% of that of the enzyme with fully wild-type or heterodimeric cytochrome b subunits. Enzyme with one inactive cytochrome b subunit was also indistinguishable from the dimer with two wild-type cytochrome b subunits in rate and extent of reduction of cytochromes b and c(1) by ubiquinol under pre-steady-state conditions in the presence of antimycin. However, the enzyme with only one mutated cytochrome b subunit did not show the stimulation in the steady-state rate that was observed in the wild-type dimeric enzyme at low concentrations of antimycin, confirming that the half-of-the-sites reactivity for ubiquinol oxidation can be regulated in the wild-type dimer by binding of inhibitor to one ubiquinone reduction site.