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Background: The treatment of high-risk neuroblastoma patients consists of multimodal induction therapy to achieve remission followed by consolidation therapy to prevent relapses. However, the type of consolidation therapy is still discussed controversial. We applied metronomic chemotherapy in the prospective NB90 trial and monoclonal anti-GD2-antibody (MAB) ch14.18 in the NB97 trial. Here, we present the long term outcome data of the patient cohort. Methods: A total of 334 stage 4 neuroblastoma patients one year or older were included. All patients successfully completed the induction therapy. In the NB90 trial, 99 patients received at least one cycle of the oral maintenance chemotherapy (NB90 MT, 12 alternating cycles of oral melphalan/etoposide and vincristine/cyclophosphamide). In the NB97 trial, 166 patients commenced the MAB ch14.18 consolidation therapy (six cycles over 12 months). Patients who received no maintenance therapy according to the NB90 protocol or by refusal in NB97 (n = 69) served as controls. Results: The median observation time was 11.11 years. The nine-year event-free survival rates were 41 ± 4%, 31 ± 5%, and 32 ± 6% for MAB ch14.18, NB90 MT, and no consolidation, respectively (p = 0.098). In contrast to earlier reports, MAB ch14.18 treatment improved the long-term outcome compared to no additional therapy (p = 0.038). The overall survival was better in the MAB ch14.18-treated group (9-y-OS 46 ± 4%) compared to NB90 MT (34 ± 5%, p = 0.026) and to no consolidation (35 ± 6%, p = 0.019). Multivariable Cox regression analysis revealed ch14.18 consolidation to improve outcome compared to no consolidation, however, no difference between NB90 MT and MAB ch14.18-treated patients was found. Conclusions: Follow-up analysis of the patient cohort indicated that immunotherapy with MAB ch14.18 may prevent late relapses. Finally, metronomic oral maintenance chemotherapy also appeared effective.
This dissertation investigated the development of the complementiser that from the demonstrative pronoun in the Germanic languages; each chapter dealt with a different aspect. In the introduction, the terms ‘reanalysis’ and ‘analogy’ and their relevance for grammaticalisation were explained, and the issues of the chapters were presented. The second chapter introduced some information about the Germanic language family and the languages which were relevant for this investigation, namely Gothic, Old English, Old Icelandic, Old Saxon and Old High German. Previous assumptions about the diachrony of that were presented and discussed. One of these proposals which mainly draws on evidence from West Germanic involves the idea that the source construction contained two independent main clauses with a demonstrative pronoun (that) at the end of the first clause (cf. e.g. Paul 1962, § 248). In contrast to this, the Gothic evidence showed that the source construction of the reanalysis of ϸatei was not a proper paratactic construction (at least in Gothic) but already a complex construction which contained a complementiser (ei) in the appositional subordinate clause (cf. also e.g. Longobardi 1994 for the diachrony of ϸatei). This contradiction raised the question whether the analysis of the Gothic that-complementiser also applies to the diachrony of that in West Germanic. This issue was taken up in the third chapter which presented an overview of subordination and complementisers in Northwest Germanic. The aim was to show that the Northwest Germanic languages also show a subordinating particle, which functions like the Gothic ei, namely ϸe (OE), er/es (OI), the (OHG, OS). As a result, the subordinating particle could be observed in relative and adverbial clauses in all Northwest Germanic languages. In complement clauses, which are most crucial for the argumentation, the subordinating particle is found in Old English and Old Icelandic but not in Old Saxon. In Old High German, there are only combinations of the with a following pronoun, theih and theiz, in ‘Otfrids Evangelienbuch’ (see Wunder 1965). Consequently, the presence of a subordinating particle is confirmed in North and West Germanic. The fact that the patterns of subordination are quite similar in all Germanic languages suggested a unitary analysis of the development of that in Germanic was appropriate. In chapter four, the similarities and differences between the Germanic languages with respect to the development of that were explained. It was argued that the preconditions of the reanalysis were the same, whereas the consequences of the reanalysis are realised differently in each language. The most important precondition was that the appositional source construction (explained in more detail below) was generally available in Germanic. Since the demonstrative pronoun at the end of the matrix clause and the subordinating particle of the subordinate clause were adjacent, phonological combination might have been crucial for the subsequent reanalysis to take place. After reanalysis, however, different changes can be observed in the different languages. For instance, it appears that during the Old English period the final syllable of the form ϸætte was deleted (see chapter 4 for references), whereas the final –ei is still present in the Gothic ϸatei, and completely absent in Old High German and Old Saxon. The source structure of the reanalysis was discussed in detail in a separate subsection. The appositional source construction, which was already assumed for the reanalysis of Gothic ϸatei, was compared with analyses of clitic left dislocation which propose that two constituents with the same theta-role derive from a Big DP (see e.g. Grewendorf 2009, Belletti 2005). Based on the Big DP analysis of Grewendorf (2009), it was claimed that the appositional clause, introduced by the subordinating particle, is generated in the Spec of a DP, and adjoined to this DP on the surface. It was argued that this whole complement DP-node occurred in an extraposed position in OV-languages so that the verb, when it stays in-situ, does not appear between the demonstrative pronoun and the subordinating particle. The structure in (1) illustrates the syntactic source structure which is assumed to apply to the development of the complementiser that in Germanic. ...
Background: Many cancer patients seek homeopathy as a complementary therapy. It has rarely been studied systematically, whether homeopathic care is of benefit for cancer patients. Methods: We conducted a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n=259), and one cohort with conventionally treated cancer patients (CG; n=380). For a direct comparison, matched pairs with patients of the same tumour entity and comparable prognosis were to be formed. Main outcome parameter: change of quality of life (FACT-G, FACIT-Sp) after 3 months. Secondary outcome parameters: change of quality of life (FACT-G, FACIT-Sp) after a year, as well as impairment by fatigue (MFI) and by anxiety and depression (HADS). Results: HG: FACT-G, or FACIT-Sp, respectively improved statistically significantly in the first three months, from 75.6 (SD 14.6) to 81.1 (SD 16.9), or from 32.1 (SD 8.2) to 34.9 (SD 8.32), respectively. After 12 months, a further increase to 84.1 (SD 15.5) or 35.2 (SD 8.6) was found. Fatigue (MFI) decreased; anxiety and depression (HADS) did not change. CG: FACT-G remained constant in the first three months: 75.3 (SD 17.3) at t0, and 76.6 (SD 16.6) at t1. After 12 months, there was a slight increase to 78.9 (SD 18.1). FACIT-Sp scores improved significantly from t0 (31.0 - SD 8.9) to t1 (32.1 - SD 8.9) and declined again after a year (31.6 - SD 9.4). For fatigue, anxiety, and depression, no relevant changes were found. 120 patients of HG and 206 patients of CG met our criteria for matched-pairs selection. Due to large differences between the two patient populations, however, only 11 matched pairs could be formed. This is not sufficient for a comparative study. Conclusion: In our prospective study, we observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment. It would take considerably larger samples to find matched pairs suitable for comparison in order to establish a definite causal relation between these effects and homeopathic treatment.
Mohammeds Frage : Versuche zur theologischen Differenzierung von Vergeltung und Vergebung im Islam
(2011)
Martin Luther und der Islam
(2011)
HDL, through sphingosine-1-phosphate (S1P), exerts direct cardioprotective effects on ischemic myocardium. It remains unclear whether other HDL-associated sphingophospholipids have similar effects. We therefore examined if HDL-associated sphingosylphosphorylcholine (SPC) reduces infarct size in a mouse model of transient myocardial ischemia/reperfusion. Intravenously administered SPC dose-dependently reduced infarct size after 30 minutes of myocardial ischemia and 24 hours reperfusion compared to controls. Infarct size was also reduced by postischemic, therapeutical administration of SPC. Immunohistochemistry revealed reduced polymorphonuclear neutrophil recruitment to the infarcted area after SPC treatment, and apoptosis was attenuated as measured by TUNEL. In vitro, SPC inhibited leukocyte adhesion to TNFα-activated endothelial cells and protected rat neonatal cardiomyocytes from apoptosis. S1P3 was identified as the lysophospholipid receptor mediating the cardioprotection by SPC, since its effect was completely absent in S1P3-deficient mice. We conclude that HDL-associated SPC directly protects against myocardial reperfusion injury in vivo via the S1P3 receptor.
Im Rahmen dieser Dissertation wurde die spätpleistozäne und holozäne Landschaftsentwicklung im Umfeld der im Tal des Wadis Chuera in Nordsyrien liegenden bronzezeitlichen Siedlung Tell Chuera untersucht. Durch die Kombination von hochgenauen Vermessungen, Satellitenbildauswertungen und Untersuchungen der Wadisedimente konnten mehrere flussgeschichtliche Entwicklungsphasen erarbeitet und in einen chronostratigraphischen Rahmen eingeordnet werden. Über ein grobsandig-kiesiges System eines verzweigten Flusses wurden mindestens bis ins Obere Pleistozän mächtige Kieslagen im Untersuchungsgebiet sedimentiert. Innerhalb einer fossilen Rinne abgelagerte lössähnliche Sedimente, welche die Kiesfolgen partiell überlagern, konnten relativchronologisch ins Obere Pleistozän gestellt werden und dokumentieren vermutlich eine trockene Phase. Durch die mit scharfer Diskordanz über den Kiesen abgelagerten pelitischen Hochflutsedimente wird ein abrupter flussdynamischer Umbruch von dem eines ursprünglich verzweigten Flusses zu dem eines mäandrierenden Flusses mit Hochflutsedimentation nachgewiesen. IRSL-Datierungen stellen den Beginn der Ablagerung der Hochflutsedimente ins letzte Glazial. Der größte Teil der Sedimente wurde jedoch im frühen und mittleren Holozän (ca. 9 und 5 kaBP) abgelagert, so dass zu Beginn der Hauptsiedlungsphase am Tell Chuera (3. Jahrtausend v.Chr.) die Oberfläche der Überschwemmungsebene ihr heutiges Niveau nahezu erreicht hatte. Bis dahin führten großflächige Überschwemmungen zur Hochflutsedimentation in der Aue. Ein erneuter Wechsel der fluvialen Geomorphodynamik und der Sedimentationsverhältnisse zeigt sich darin, dass die letzten ca. 5000 Jahre keine nennenswerte Sedimentation in der Hochflutebene zu verzeichnen war. Es kam zu einer bis heute stattfindenden, lateralen Verlagerung der Mäander des Wadis und damit der Aufarbeitung von Teilen der Kiese und Hochflutsedimente. Siedlungsspuren im Wadiverlauf weisen auf eine Periodizität des Abflusses des Wadis Chuera zwischen etwa 4.7 und 4.2 kaBP hin. Die Theorie einer verstärkten Akkumulation von Kolluvien der Rahmenhöhen im Wadital als direkte Folge eines steigenden Siedlungsdrucks während der Hauptsiedlungsphase konnte widerlegt werden. Vielmehr handelt es sich bei den vermeintlichen Kolluvien um fluvial aufgearbeitete Hochflutsedimente. Anthropogene Eingriffe in den Landschaftshaushalt lassen sich in Form von Kalkkrustensteinbrüchen und einem komplexen Wegenetz nachweisen.
In total, this dissertation comprises three research papers. Objective of all of these papers are to detect mistakes of private investors when conducting mutual funds investments and to analyze the implications. Moreover, the question is addressed whether financial advisors help private investors to avoid these investment mistakes. All three research papers use the same data base which has been provided by a German online brokerage house. The detailed data set allows contributing to existing literature on mutual fund investments, smart decision making, household finance as well as financial advice on an investor- and transaction-specific level. The first paper addresses the question which particular decision criteria private investors use when purchasing mutual funds. It can be shown that funds volume is the dominating decision criterion, whereas historical performance is only of minor importance. As performance persistence exists in the underlying data set, it can be concluded that the majority of investors make investment mistakes. In the second paper it is shown that smart investors, i.e. investors who purchase mutual funds by chasing historical performance, are older, wealthier, more experienced and less likely to be overconfident. In addition, it can be verified that there exists a positive impact of the ability to select mutual funds by chasing historical performance on the overall investment success. Hence, the quality of mutual fund selection ability is an ex-ante measure for investment success. Finally, the third paper analyzes the influence of financial advice on mutual fund decision making of private investments. Evidence can be provided that financial advisors do not help their customers to purchase mutual funds by chasing historical performance. In fact, advisors recommend high-volume mutual funds from well-known fund families. Apparently, financial advisors are much more salesmen than real advisors. These results hold when controlling for potential endogeneity issues.