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kurz und kn@pp news : Nr. 39
(2017)
Ziel:
Vergleich der Veränderung der mütterlichen Einstellung zur Geburt anhand von Hebammen geführten Geburtsvorbereitungskursen oder hypnoreflexogenem Training zur Geburtsvorbereitung.
Methode:
Zu Beginn und nach Beendigung der Kurse wurde die mütterliche Einstellung zur Geburt unter Zuhilfenahme des Osgood-Ertel-Eindrucksdifferenzials gemessen. Der Gießen-Test zur Persönlichkeitsbeurteilung wurde einmalig angewendet.
Ergebnisse:
213 Frauen waren in die Studie eingeschlossen. 155 davon nahmen an, von Hebammen geführten, Geburtsvorbereitungskursen teil. 58 Frauen absolvierten ein hypnoreflexogenes Training. Es waren zu Beginn der Kurse keine statistisch signifikanten Unterschiede feststellbar in Bezug auf die Charakteristiken der Teilnehmerinnen sowie im Gießen-Test und in den Ergebnissen des Osgood-Ertel-Eindrucksdifferenzials. Nach der von Hebammen geführten Geburtsvorbereitung wurde die Geburt negativer wahrgenommen(Freudlosigkeit und Trübung in der Valenz-Dimension [p < 0,05]), während die Geburt nach dem Hypnosetraining emotional positiver bewertet wurde (Freude
und Harmonie in der Valenz-Dimension [p < 0,01] sowie Helligkeit [p < 0,05]).
Zusammenfassung:
Hypnoreflexogenes Selbsthypnosetraining zur Geburtsvorbereitung scheint stärkere und positivere mütterliche emotionale Veränderungen in Bezug auf die
Einstellung zur Geburt auszulösen als konventionelle, von Hebammen geführte Geburtsvorbereitungskurse. Weitere retrospektive randomisierte Studien sind nötig, um diese Ergebnisse zu überprüfen.
Background: Despite novel therapeutic agents, most multiple myeloma (MM) patients eventually relapse. Two large phase III trials have shown significantly improved response rates (RR) of lenalidomide/dexamethasone compared with placebo/dexamethasone in relapsed MM (RMM) patients. These results have led to the approval of lenalidomide for RMM patients and lenalidomide/dexamethasone has since become a widely accepted second-line treatment. Furthermore, in RMM patients consolidation with high-dose chemotherapy plus autologous stem cell transplantation has been shown to significantly increase progression free survival (PFS) as compared to cyclophosphamide in a phase III trial. The randomized prospective ReLApsE trial is designed to evaluate PFS after lenalidomide/dexamethasone induction, high-dose chemotherapy consolidation plus autologous stem cell transplantation and lenalidomide maintenance compared with the well-established lenalidomide/dexamethasone regimen in RMM patients.
Methods/Design: ReLApsE is a randomized, open, multicenter phase III trial in a planned study population of 282 RMM patients. All patients receive three lenalidomide/dexamethasone cycles and - in absence of available stem cells from earlier harvesting - undergo peripheral blood stem cell mobilization and harvesting. Subsequently, patients in arm A continue on consecutive lenalidomide/dexamethasone cycles, patients in arm B undergo high dose chemotherapy plus autologous stem cell transplantation followed by lenalidomide maintenance until discontinuation criteria are met. Therapeutic response is evaluated after the 3rd (arm A + B) and the 5th lenalidomide/dexamethasone cycle (arm A) or 2 months after autologous stem cell transplantation (arm B) and every 3 months thereafter (arm A + B). After finishing the study treatment, patients are followed up for survival and subsequent myeloma therapies. The expected trial duration is 6.25 years from first patient in to last patient out. The primary endpoint is PFS, secondary endpoints include overall survival (OS), RR, time to best response and the influence of early versus late salvage high dose chemotherapy plus autologous stem cell transplantation on OS.
Discussion: This phase III trial is designed to evaluate whether high dose chemotherapy plus autologous stem cell transplantation and lenalidomide maintenance after lenalidomide/dexamethasone induction improves PFS compared with the well-established continued lenalidomide/dexamethasone regimen in RMM patients. Trial registration: ISRCTN16345835 (date of registration 2010-08-24).
Background: The quantification of global DNA methylation has been established in epigenetic screening. As more practicable alternatives to the HPLC-based gold standard, the methylation analysis of CpG islands in repeatable elements (LINE-1) and the luminometric methylation assay (LUMA) of overall 5-methylcytosine content in “CCGG” recognition sites are most widely used. Both methods are applied as virtually equivalent, despite the hints that their results only partly agree. This triggered the present agreement assessments.
Results: Three different human cell types (cultured MCF7 and SHSY5Y cell lines treated with different chemical modulators of DNA methylation and whole blood drawn from pain patients and healthy volunteers) were submitted to the global DNA methylation assays employing LINE-1 or LUMA-based pyrosequencing measurements. The agreement between the two bioassays was assessed using generally accepted approaches to the statistics for laboratory method comparison studies. Although global DNA methylation levels measured by the two methods correlated, five different lines of statistical evidence consistently rejected the assumption of complete agreement. Specifically, a bias was observed between the two methods. In addition, both the magnitude and direction of bias were tissue-dependent. Interassay differences could be grouped based on Bayesian statistics, and these groups allowed in turn to re-identify the originating tissue.
Conclusions: Although providing partly correlated measurements of DNA methylation, interchangeability of the quantitative results obtained with LINE-1 and LUMA was jeopardized by a consistent bias between the results. Moreover, the present analyses strongly indicate a tissue specificity of the differences between the two methods.
The use of fetal bovine serum (FBS) as a cell culture supplement is discouraged by regulatory authorities to limit the risk of zoonoses and xenogeneic immune reactions in the transplanted host. Additionally, FBS production came under scrutiny due to animal welfare concerns. Platelet derivatives have been proposed as FBS substitutes for the ex-vivo expansion of mesenchymal stem/stromal cells (MSCs) since platelet-derived growth factors can promote MSC ex-vivo expansion. Platelet-derived growth factors are present in platelet lysate (PL) obtained after repeated freezing-thawing cycles of the platelet-rich plasma or by applying physiological stimuli such as thrombin or CaCl2.PL-expanded MSCs have been used already in the clinic, taking advantage of their faster proliferation compared with FBS-expanded preparations. Should PL be applied to other biopharmaceutical products, its demand is likely to increase dramatically. The use of fresh platelet units for the production of PL raises concerns due to limited availability of platelet donors. Expired units might represent an alternative, but further data are needed to define safety, including pathogen reduction, and functionality of the obtained PL. In addition, relevant questions concerning the definition of PL release criteria, including concentration ranges of specific growth factors in PL batches for various clinical indications, also need to be addressed. We are still far from a common definition of PL and standardized PL manufacture due to our limited knowledge of the mechanisms that mediate PL-promoting cell growth. Here, we concisely discuss aspects of PL as MSC culture supplement as a preliminary step towards an agreed definition of the required characteristics of PL for the requirements of manufacturers and users.
The genome of S. cerevisae encodes at least twenty hexose transporter-like proteins. Despite extensive research, the functions of Hxt8-Hxt17 have remained poorly defined. Here, we show that Hxt13, Hxt15, Hxt16 and Hxt17 transport two major hexitols in nature, mannitol and sorbitol, with moderate affinities, by a facilitative mechanism. Moreover, Hxt11 and Hxt15 are capable of transporting xylitol, a five-carbon polyol derived from xylose, the most abundant pentose in lignocellulosic biomass. Hxt11, Hxt13, Hxt15, Hxt16 and Hxt17 are phylogenetically and functionally distinct from known polyol transporters. Based on docking of polyols to homology models of transporters, we propose the architecture of their active site. In addition, we determined the kinetic parameters of mannitol and sorbitol dehydrogenases encoded in the yeast genome, showing that they discriminate between mannitol and sorbitol to a much higher degree than the transporters.
Background: Women’s participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom).
Case:The percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the ‘glass ceiling’ effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications.
Conclusion: Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.
The hallmark of classical Hodgkin lymphoma (cHL) is the presence of giant, mostly multinucleated Hodgkin-Reed-Sternberg (HRS) cells. Whereas it has recently been shown that giant HRS cells evolve from small Hodgkin cells by incomplete cytokinesis and re-fusion of tethered sister cells, it remains unsolved why this phenomenon particularly takes place in this lymphoma and what the differences between these cell types of variable sizes are. The aim of the present study was to characterize microdissected small and giant HRS cells by gene expression profiling and to assess differences of clonal growth behavior as well as susceptibility toward cytotoxic intervention between these different cell types to provide more insight into their distinct cellular potential. Applying stringent filter criteria, only two differentially expressed genes between small and giant HRS cells, SHFM1 and LDHB, were identified. With looser filter criteria, 13 genes were identified to be differentially overexpressed in small compared to giant HRS cells. These were mainly related to energy metabolism and protein synthesis, further suggesting that small Hodgkin cells resemble the proliferative compartment of cHL. SHFM1, which is known to be involved in the generation of giant cells, was downregulated in giant RS cells at the RNA level. However, reduced mRNA levels of SHFM1, LDHB and HSPA8 did not translate into decreased protein levels in giant HRS cells. In cell culture experiments it was observed that the fraction of small and big HRS cells was adjusted to the basic level several days after enrichment of these populations via cell sorting, indicating that small and big HRS cells can reconstitute the full spectrum of cells usually observed in the culture. However, assessment of clonal growth of HRS cells indicated a significantly reduced potential of big HRS cells to form single cell colonies. Taken together, our findings pinpoint to strong similarities but also some differences between small and big HRS cells.
Der vorliegende "Hephaistos"-Sonderband nimmt sich eines bislang auch im Kontext von Herrschaftsarchitektur und -repräsentation in der Antike eher wenig behandelten Themas an, nämlich des Zusammenhangs von "Bau- und Gartenkultur" auf der einen und "Herrschaftsverhältnisse[n] und Herrschaftslegitimation" auf der anderen Seite. Die hierin publizierten Beiträge sind das Ergebnis einer im Oktober 2014 an der Universität Hamburg veranstalteten Tagung und präsentieren anhand von Beispielstudien einen chronologisch sehr weit gefassten Überblick über das Thema, vom zweiten vorchristlichen Jahrtausend bis in das 20. Jahrhundert...
Die flavische Dynastie im Allgemeinen und ihr letzter princeps Domitian im Speziellen haben sich in den vergangenen Jahren ausgesprochen großer Beliebtheit erfreut. Vor dem Hintergrund des Unterganges des iulisch-claudischen Kaiserhauses und den einschneidenden Entwicklungen des Vierkaiserjahres stehen dabei Fragen nach dem herrschaftlichen Selbstverständnis der neuen principes sowie nach den Medien und Inhalten ihrer kaiserlichen Repräsentation im Mittelpunkt des Forschungsinteresses. Auch Jens Gering widmet sich mit seiner Osnabrücker Dissertation diesem Themenfeld. In seiner Arbeit verfolgt er "das Ziel, die Herrschafts- und Machtstrukturen der domitianischen Zeit anhand von ausgesuchten Aspekten römischer Politik längsschnittartig zu analysieren und in den Kontext der Principatsgenese einzuordnen" (S. 35), wobei er insbesondere den domitianischen Regierungsstil auf Kontinuitäten und Diskontinuitäten zu seinen Vorgängern und Nachfolgern untersuchen möchte...
In der anerkannten Reihe C(orpus) S(ignorum) I(mperii) R(omani), welche ihren Fokus auf die Untersuchung skulptierter, römischer Steindenkmäler legt, ist dieser neue Band für den Bereich Österreich erschienen. Gewidmet ist er den Grabstelen und -altären des Territoriums von Flavia Solva in Noricum. Hauptautor ist E. Pochmarski, die Bearbeitung des epigraphischen Materials ist I. Weber-Hiden zu verdanken, die auch einen Abschnitt zu den inschriftlich genannten Personen verfasst hat. Zeichnerisch unterstützt wurde der Band von M. Pochmarski-Nagele, weitere inhaltliche Hilfestellung leistete S. Lamm. O. Harl hat eine ganze Reihe an hervorragenden photographischen Aufnahmen zur Verfügung gestellt...
Der angezeigte Aufsatzband ist aus einer Tagung hervorgegangen, die im Mai 2011 an der McGill University in Montreal/Kanada veranstaltet wurde. In der "Introduction" (9- 17) skizzieren die Herausgeber die Zielsetzung der Konferenz und ihrer Akten: Untersucht werden soll, "how economic power and 'real' capital influenced and augmented the nature of aristocratic power at Rome and the driving forces behind the Republic’s foreign expansion" (12). Zwar gebe es einige wenige Studien, die sich dieser Thematik gewidmet hätten (verwiesen wird auf Publikationen von H. Schneider und I. Shatzmann), viele Detailfragen seien jedoch bislang ungeklärt. Im Anschluss an die kurze Einführung der Herausgeber folgt eine knappe inhaltliche Wiedergabe der dreizehn abgedruckten Artikel (13-17)...
Rezension zu: Verena Schulz, Die Stimme in der antiken Rhetorik, Hypomnemata 194 (Göttingen 2014)
(2017)
Die Stimme als vornehmlich akustisches Phänomen im Rahmen der antiken Rhetorik darstellen zu wollen, war schon den antiken Schriftstellern nach ein schwieriges Unterfangen, und umso willkommener ist eine derartige Darstellung zu begrüßen, insbesondere wenn sie sich, wie im Fall der vorliegenden Dissertation von Verena Schulz, eines interdisziplinären Ansatzes bedient. Bei der fast 400 Seiten starken Monographie handelt es sich einerseits um einen philologischen Kommentar zu den beiden ausführlichsten Quellentexten zur antiken Rhetorik, namentlich den Ausführungen des Auctor ad Herennium und denen des Quintilian. Andererseits aber stellt die Monographie eine Materialsammlung unter chronologischen und systematischen Gesichtspunkten dar, die die wesentlichen antiken Quellenstellen zur Stimme aus philologischer, medizinischer, musikalischer und historischer Perspektive in sich vereint und somit verschiedene Lesergruppen ansprechen soll. Ergänzt und erweitert um Exkurse, die sich dem heutigen Verständnis der Stimmphysiologie (S. 79-83), der antiken Terminologie von actio und pronuntiatio (S. 107-109) und den begrifflichen Vorstellungen der akustisch-physikalischen Stimmfaktoren zu Lautstärke und Tonhöhe (S. 178- 184) widmen, wird damit auf äußerst gelungene Weise eine Brücke von der Antike in die Rezeptionsgeschichte von Stimme und Rhetorik geschlagen, die abgrenzend zur bestehenden Forschung insbesondere um den medizinhistorischen Blickwinkel erweitert wurde...