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Access to specialized care is essential for people with Parkinson´s disease (PD). Given the growing number of people with PD and the lack of general practitioners and neurologists, particularly in rural areas in Germany, specialized PD staff (PDS), such as PD nurse specialists and Parkinson Assistants (PASS), will play an increasingly important role in the care of people with PD over the coming years. PDS have several tasks, such as having a role as an educator or adviser for other health professionals or an advocate for people with PD to represent and justify their needs. PD nurse specialists have been established for a long time in the Netherlands, England, the USA, and Scandinavia. In contrast, in Germany, distinct PDS models and projects have been established. However, these projects and models show substantial heterogeneity in terms of access requirements, education, theoretical and practical skills, principal workplace (inpatient vs. outpatient), and reimbursement. This review provides an overview of the existing forms and regional models for PDS in Germany. PDS reimbursement concepts must be established that will foster an implementation throughout Germany. Additionally, development of professional roles in nursing and more specialized care in Germany is needed.
Die Ibbenbürener Aa oberhalb des Aasees sowie drei Nebengewässer wurden über einen Zeitraum von 12 Monaten (April 1981-April 1982) hydrochemisch untersucht. Im Herbst 1981 und im Frühjahr 1982 wurde anhand einer auf den Makrozoobenthos beschränkten Saprobienanalyse von 9 Probestellen der Aa sowie von 2 Probestellen eines durch Fabrikabwässer beeinflußten Vorfluters die Gewässergüte bestimmt. Im Winter 1981/82 beobachtete Mikroorganismenkolonien (vornehmlich Abwasserpilz und Schwefelbakterien) wurden kartographiert und stichprobenartig mikroskopiert. Im Gegensatz zur Aussage der Gewässergütekarte von NRW (Stand 1980) weisen die erhobenen hydrochemischen und hydrobiologischen Kenndaten der Ibbenbürener Aa oberhalb des Aasees auf eine Verschlechterung der Gewässergüte nach Güteklasse 11-111 ("kritisch belastet") hin. Der durch Fabrikabwässer beeinflußte Vorfluter mußte in die Güteklasse 11I ("stark verschmutzt") eingeordnet werden. Durch das im Winter beobachtete z. T. extrem starke Pilztreiben des Abwasserpilzes Leptomitus lacteus ist diese Güteklasse auch für einen Teil der Nebengewässer angezeigt. Mögliche Ursachen der ermittelten Güteklasse(n) werden diskutiert.
In dieser Arbeit wurde deutlich, dass die Multilevel Monte Carlo Methode eine signifikante Verbesserung gegenüber der Monte Carlo Methode darstellt. Sie schafft es den Rechenaufwand zu verringern und in fast allen Fällen die gewollte Genauigkeit zu erreichen. Die Erweiterung durch Richardson Extrapolation brachte immer eine Verringerung des Rechenaufwands oder zumindest keine Verschlechterung, auch wenn nicht in allen Fällen die schwache Konvergenzordnung verdoppelt wurde.
Im Falle der Optionssensitivitäten ist eine Anwendung des MLMC-Algorithmus problematisch. Das Funktional, das auf den Aktienkurs angewendet wird, darf keine Unstetigkeitsstelle besitzen, bzw. im Falle des Gammas muss es stetig differenzierbar sein. Die Anwendung der MLMC Methode macht dann vor allem Sinn, wenn sich die Sensitivität als Funktion des Aktienkurses umformen lässt, so dass nur der Pfad der Aktie simuliert werden muss. Nur wenn dies nicht möglich ist, wäre es sinnvoll, die in Kapitel 6.5 am Beispiel des Deltas vorgestellte Methode zu benutzen, in der man einen zweiten Pfad für das Delta simuliert.
Weitere Verbesserungsmöglichkeiten könnten in der Wahl von anderen varianzreduzierenden Methoden liegen oder durch Verwendung von Diskretisierungsverfahren mit höherer starker Ordnung als das Euler-Verfahren (vgl. [7], Verwendung des Milstein-Verfahrens). In diesem Fall ist theoretisch ein Rechenaufwand der Größenordnung O(ϵexp-2) möglich, da die Anzahl der zu erstellenden Samples nicht mehr mit steigendem L erhöht wird. Somit könnte das L so groß gewählt werden, dass der Bias verschwindet und der MSE ausschließlich von der Varianz des Schätzers abhängt. Um diese auf eine Größenordnung von O(ϵexp2) zu bringen, ist es nötig, O(ϵexp2) Pfade zu erstellen (siehe Gleichung (3.6)), was den Rechenaufwand begründet.
Mitochondria are dynamic eukaryotic organelles involved in a variety of essential cellular processes including the generation of adenosine triphosphate (ATP) and reactive oxygen species as well as in the control of apoptosis and autophagy. Impairments of mitochondrial functions lead to aging and disease. Previous work with the ascomycete Podospora anserina demonstrated that mitochondrial morphotype as well as mitochondrial ultrastructure change during aging. The latter goes along with an age-dependent reorganization of the inner mitochondrial membrane leading to a change from lamellar cristae to vesicular structures. Particularly from studies with yeast, it is known that besides the F1Fo-ATP-synthase and the phospholipid cardiolipin also the “mitochondrial contact site and cristae organizing system” (MICOS) complex, existing of the Mic60- and Mic10-subcomplex, is essential for proper cristae formation. In the present study, we aimed to understand the mechanistic basis of age-related changes in the mitochondrial ultrastructure. We observed that MICOS subunits are coregulated at the posttranscriptional level. This regulation partially depends on the mitochondrial iAAA-protease PaIAP. Most surprisingly, we made the counterintuitive observation that, despite the loss of lamellar cristae and of mitochondrial impairments, the ablation of MICOS subunits (except for PaMIC12) leads to a pronounced lifespan extension. Moreover, simultaneous ablation of subunits of both MICOS subcomplexes synergistically increases lifespan, providing formal genetic evidence that both subcomplexes affect lifespan by different and at least partially independent pathways. At the molecular level, we found that ablation of Mic10-subcomplex components leads to a mitohormesis-induced lifespan extension, while lifespan extension of Mic60-subcomplex mutants seems to be controlled by pathways involved in the control of phospholipid homeostasis. Overall, our data demonstrate that both MICOS subcomplexes have different functions and play distinct roles in the aging process of P. anserina.
The process of electron-loss to the continuum (ELC) has been studied for the collision systems U28++H2 at a collision energy of 50 MeV/u, U28++N2 at 30 MeV/u, and U28++Xe at 50 MeV/u. The energy distributions of cusp electrons emitted at an angle of 0∘ with respect to the projectile beam were measured using a magnetic forward-angle electron spectrometer. For these collision systems far from equilibrium charge state, a significantly asymmetric cusp shape is observed. The experimental results are compared to calculations based on first-order perturbation theory, which predict an almost symmetric cusp shape. Some possible reasons for this discrepancy are discussed.
Background: Patients with acutely decompensated cirrhosis (AD) may or may not develop acute-on-chronic liver failure (ACLF). ACLF is characterized by high-grade systemic inflammation, organ failures (OF) and high short-term mortality. Although patients with AD cirrhosis exhibit distinct clinical phenotypes at baseline, they have low short-term mortality, unless ACLF develops during follow-up. Because little is known about the association of profile of systemic inflammation with clinical phenotypes of patients with AD cirrhosis, we aimed to investigate a battery of markers of systemic inflammation in these patients.
Methods: Upon hospital admission baseline plasma levels of 15 markers (cytokines, chemokines, and oxidized albumin) were measured in 40 healthy controls, 39 compensated cirrhosis, 342 AD cirrhosis, and 161 ACLF. According to EASL-CLIF criteria, AD cirrhosis was divided into three distinct clinical phenotypes (AD-1: Creatinine<1.5, no HE, no OF; AD-2: creatinine 1.5–2, and or HE grade I/II, no OF; AD-3: Creatinine<1.5, no HE, non-renal OF).
Results: Most markers were slightly abnormal in compensated cirrhosis, but markedly increased in AD. Patients with ACLF exhibited the largest number of abnormal markers, indicating “full-blown” systemic inflammation (all markers). AD-patients exhibited distinct systemic inflammation profiles across three different clinical phenotypes. In each phenotype, activation of systemic inflammation was only partial (30% of the markers). Mortality related to each clinical AD-phenotype was significantly lower than mortality associated with ACLF (p < 0.0001 by gray test). Among AD-patients baseline systemic inflammation (especially IL-8, IL-6, IL-1ra, HNA2 independently associated) was more intense in those who had poor 28-day outcomes (ACLF, death) than those who did not experience these outcomes.
Conclusions: Although AD-patients exhibit distinct profiles of systemic inflammation depending on their clinical phenotypes, all these patients have only partial activation of systemic inflammation. However, those with the most extended baseline systemic inflammation had the highest the risk of ACLF development and death.
Activation of TRPC6 channels is essential for lung ischaemia–reperfusion induced oedema in mice
(2012)
Lung ischaemia–reperfusion-induced oedema (LIRE) is a life-threatening condition that causes pulmonary oedema induced by endothelial dysfunction. Here we show that lungs from mice lacking nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox2y/−) or the classical transient receptor potential channel 6 (TRPC6−/−) are protected from LIR-induced oedema (LIRE). Generation of chimeric mice by bone marrow cell transplantation and endothelial-specific Nox2 deletion showed that endothelial Nox2, but not leukocytic Nox2 or TRPC6, are responsible for LIRE. Lung endothelial cells from Nox2- or TRPC6-deficient mice showed attenuated ischaemia-induced Ca2+ influx, cellular shape changes and impaired barrier function. Production of reactive oxygen species was completely abolished in Nox2y/− cells. A novel mechanistic model comprising endothelial Nox2-derived production of superoxide, activation of phospholipase C-γ, inhibition of diacylglycerol (DAG) kinase, DAG-mediated activation of TRPC6 and ensuing LIRE is supported by pharmacological and molecular evidence. This mechanism highlights novel pharmacological targets for the treatment of LIRE.
Der Nordische Augentrost (Euphrasia frigida) ist eine boreal-montane Art, die einige vom Hauptareal abgesetzte Vorposten in deutschen Mittelgebirgen besitzt, wo sie extensiv genutztes, in der Regel ungedüngtes Grünland besiedelt. Aus den hessischen Mittelgebirgen lagen neuere Nachweise nur aus dem nördlichen Spessart vor (vier Populationen). Im Rahmen des Artenhilfsprogramms (und außerdem bei zwei FFH-Grunddatenerfassungen) konnten sechs weitere Spessart-Vorkommen festgestellt werden. Hinweise auf ein kleines Vorkommen im Hochtaunus (Neufund für den Naturraum) konnten bestätigt werden. Die Nachsuche an ehemaligen Wuchsorten im Vogelsberg, wo die Art bis in die 1970er Jahre vorkam, verlief hingegen durchweg erfolglos; allerdings gelang auch hier der Neufund einer kleinen Population. Auch im hessischen Teil der Hohen Rhön gelang inzwischen ein Erstnachweis (siehe Barth 2008). Insgesamt liegt mehr als die Hälfte aller bekannten deutschen Fundorte in Hessen. Dem Land kommt daher eine besondere Verantwortung für die Erhaltung der Art zu. Hauptgefährdungsursachen für die Art sind Nutzungsintensivierung (Düngung, zu früher Mahdtermin) und Nutzungsaufgabe sowie die Aufforstung von Grenzertragsgrünland. Die Erhaltung der Art ist am besten durch vertraglich vereinbarte extensive Grünlandnutzung (Verzicht auf Düngung, Mahd nicht vor Anfang Juli) zu gewährleisten.
The link between atmospheric radicals and newly formed particles at a spruce forest site in Germany
(2013)
It has been claimed for more than a century that atmospheric new particle formation is primarily influenced by the presence of sulphuric acid. However, the activation process of sulphuric acid related clusters into detectable particles is still an unresolved topic. In this study we focus on the PARADE campaign measurements conducted during August/September 2011 at Mt. Kleiner Feldberg in central Germany. During this campaign a set of radicals, organic and inorganic compounds and oxidants and aerosol properties were measured or calculated. We compared a range of organic and inorganic nucleation theories, evaluating their ability to simulate measured particle formation rates at 3 nm in diameter (J3) for a variety of different conditions. Nucleation mechanisms involving only sulphuric acid tentatively captured the observed noon-time daily maximum in J3, but displayed an increasing difference to J3 measurements during the rest of the diurnal cycle. Including large organic radicals, i.e. organic peroxy radicals (RO2) deriving from monoterpenes and their oxidation products in the nucleation mechanism improved the correlation between observed and simulated J3. This supports a recently proposed empirical relationship for new particle formation that has been used in global models. However, the best match between theory and measurements for the site of interest was found for an activation process based on large organic peroxy radicals and stabilized Criegee intermediates (sCI). This novel laboratory derived algorithm simulated the daily pattern and intensity of J3 observed in the ambient data. In this algorithm organic derived radicals are involved in activation and growth and link the formation rate of smallest aerosol particles with OH during daytime and NO3 during nighttime. Because of the RO2s lifetime is controlled by HO2 and NO we conclude that peroxy radicals and NO seem to play an important role for ambient radical chemistry not only with respect to oxidation capacity but also for the activation process of new particle formation. This is supposed to have significant impact of atmospheric radical species on aerosol chemistry and should to be taken into account when studying the impact of new particles in climate feedback cycles.
Measurements of OH, the sum of peroxy radicals (ROx), non-methane hydrocarbons (NMHCs) and various other trace gases were made at the Meteorological Observatory Hohenpeissenberg in June 2000. The data from an intensive measurement period characterised by high solar insolation (18-21 June) are analysed. The maximum midday OH concentration ranged between 4.5 x 106 molecules cm-3 and 7.4 x 106 molecules cm-3. The maximum total ROx mixing ratio increased from about 55 pptv on 18 June to nearly 70 pptv on 20 and 21 June. A total of 64 NMHCs, including isoprene and monoterpenes, were measured every 1 to 6 hours. The oxidation rate of the NMHCs by OH was calculated and reached a total of over 14 x 106 molecules cm-3 s-1 on two days. A simple photostationary state balance model was used to simulate the ambient OH and ROx concentrations with the measured data as input. The model was able to reproduce the main features of the diurnal profiles of both OH and ROx. The model results proved to be most sensitive to assumptions about the mixing ratio of formaldehyde (HCHO), which was included as a proxy for carbonyl compounds, and about the partitioning between HO2 and RO2. The measured OH concentration and ROx mixing ratios were reproduced well by assuming the presence of 3 ppbv HCHO and a ratio HO2/RO2 between 1:1 and 1:2. The most important source of OH, and conversely the greatest sink for ROx, was the recycling of HO2 radicals to OH. This reaction was responsible for the recycling of more than 45 x 106 molecules cm-3 s-1 on two days. The most important sink for OH, and the largest source of ROx, was the oxidation of NMHCs, in particular, of isoprene and the monoterpenes.