Search

The aim of this study was to evaluate the effect of exposure to manganese (Mn) on fine motor functions. A total of 48 welders and 30 unexposed workers as controls completed questionnaires, underwent blood examinations, and a motor test battery. The shift exposure of welders to respirable Mn was measured with personal samplers. For all subjects accumulations of Mn in the brain were assessed with T1-weighted magnetic resonance imaging. Welders showed normal motor functions on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale part III. Furthermore welders performed excellent on a steadiness test, showing better results than controls. However, welders were slightly slower than controls in motor tests. There was no association between fine motor test results and the relaxation rates R1 in globus pallidus and substantia nigra as MRI-based biomarkers to quantify Mn deposition in the brain.

Light is the strongest zeitgeber currently known for the synchronization of the human circadian timing system. Especially shift workers are exposed to altered daily light profiles. Our objective is the characterization of differences in blue-light exposures between day and night shift taking into consideration modifying factors such as chronotype. We describe 24-hour blue-light profiles as measured with ambient light data loggers (LightWatcher) during up to three consecutive days with either day or night shifts in 100 female hospital staff including 511 observations. Linear mixed models were applied to analyze light profiles and to select time-windows for the analysis of associations between shift work, individual factors, and log mean light exposures as well as the duration of darkness per day. Blue-light profiles reflected different daily activities and were mainly influenced by work time. Except for evening (7–9 p.m.), all time windows showed large differences in blue-light exposures between day and night shifts. Night work reduced the duration of darkness per day by almost 4 h ( β ^ = −3:48 hh:mm, 95% CI (−4:27; −3.09)). Late chronotypes had higher light exposures in the morning and evening compared to women with intermediate chronotype (e.g. morning β ^ = 0.50 log(mW/m2/nm), 95% CI (0.08; 0.93)). Women with children had slightly higher light exposures in the afternoon than women without children ( β ^ = 0.48, 95% CI (−0.10; 1,06)). Time windows for the description of light should be chosen carefully with regard to timing of shifts. Our results are helpful for future studies to capture relevant light exposure differences and potential collinearities with individual factors. Improvement of well-being of shift workers with altered light profiles may therefore require consideration of both – light at the workplace and outside working hours.

Background For the detection of malignant mesothelioma additional markers are needed besides the established panel consisting of calretinin and mesothelin. The aim of this study was the identification and verification of long non-coding RNAs (lncRNAs) as complementing circulating markers. Methods Candidate lncRNAs were identified in silico using previously published RNA expression profiles and verified using quantitative PCR (qPCR) in mesothelioma cell lines as well as human plasma samples from mesothelioma patients and asbestos-exposed controls. Results GAS5 (growth arrest-specific transcript 5) as a single marker is marked by a low sensitivity of 14%, but the combination of GAS5 with calretinin and mesothelin increased the panel’s sensitivity from 64 to 73% at a predefined specificity of 97%. Circulating GAS5 is not affected by pleurectomy before blood collection, age, or smoking status. Conclusions GAS5 is verified as an appropriate circulating marker for the supplement of calretinin and mesothelin to detect malignant mesothelioma. Although the sensitivity of GAS5 is too low for the use as a single marker, the addition of GAS5 as a third marker improves the performance of the established marker panel. The benefit of GAS5 for the detection of malignant mesothelioma at early stages needs to be validated in a prospective study.

Nitric oxide (NO) from upper (nasal NO, nNO) or lower airways (fractional exhaled NO, FeNO) is considered a surrogate marker for Th2-type inflammation, which is influenced by atopy. The aim of this study was to analyze nNO and FeNO in regard to qualitative and quantitative aspects of sensitization. We evaluated 244 non-smoking young adults. All of them were first-year students recruited for a longitudinal study. An inhalation allergy screening tool was used for atopy definition (specific immunoglobulin E (sIgE) to sx1 ≥ 0.35 kU/L), and also sIgE response to three inhalant perennial allergens, house dust mite (HDM, d1), cat (e1), and dog (e5), was determined in the non-pollen season. With respect to sx1, 100 subjects could be classified as atopic. Sensitization to one, two, or three perennial allergens could be demonstrated in 46, 10, and 16 students, respectively. The subjects with positive IgE response to sx1, but not sensitized to HDM, cat, and/or dog, had FeNO levels comparable to those of non-atopic subjects (13.5 vs. 13.0 ppb, respectively; p = 0.485). These levels were significantly lower compared to atopic subjects being sensitized to any perennial allergen (19.0 ppb; p = 0.0003). After grouping the atopic subjects for perennial sensitization patterns, significantly higher FeNO could be detected in subjects with poly-sensitization (n = 26; 26.0 ppb) compared to the mono-sensitized ones (n = 46; 18.0 ppb; p = 0.023). Regarding nNO, no differences could be observed. Applying a two-way ANOVA, we could reveal a significant correlation of specific HDM-IgE CAP-class with FeNO (p < 0.0001) and nNO levels (p = 0.007). Finally, a significant relationship was found between nNO and FeNO for the whole cohort (p < 0.0001). In summary, our findings support the argument that atopy and perennial sensitization should be considered for the interpretation of NO.

Practical work in veterinary medicine provides exposure to various allergens which could increase the risk of sensitization. With the ongoing prospective “AllergoVet” study, we are investigating patterns of allergic symptoms and sensitization among veterinary students. Here, we report the results of the introductory self-reported survey on the presence of allergies in the first-year students of veterinary medicine, who had begun their studies in the years 2013–2016. The survey included 553 students who answered a questionnaire (63% response rate, 83% female ratio). The median age was 20 years (IQR: 19–22 years). About half of the responders indicated an interest in participating in the prospective study (“candidates”). Those who were uninterested in participating were termed “noncandidates”. A doctor’s diagnosis of any kind of atopic disease was reported by every fourth student. Hay fever was reported by 71 (13%) and allergic asthma by 38 (6.9%) students. The prevalence of hay fever in “candidates” (n = 294) and “noncandidates” (n = 259) was 13.5% and 12.2%, respectively. Allergic asthma was reported by 9.9% of “candidates” and 3.5% of “noncandidates”, the difference being significant (p = 0.003). We conclude that the prevalence of self-reported allergic symptoms in the first-year students of veterinary medicine is similar to that in the general population. Pre-existing allergic asthma may have increased the motivation for the enrolment into the longitudinal “AllergoVet-study”.

Deciding which business processes to improve is a challenge for all organizations. The literature on business process management (BPM) offers several approaches that support process prioritization. As many approaches share the individual process as unit of analysis, they determine the processes’ need for improvement mostly based on performance indicators, but neglect how processes are interconnected. So far, the interconnections of processes are only captured for descriptive purposes in process model repositories or business process architectures (BPAs). Prioritizing processes without catering for their interconnectedness, however, biases prioritization decisions and causes a misallocation of corporate funds. What is missing are process prioritization approaches that consider the processes’ individual need for improvement and their interconnectedness. To address this research problem, the authors propose the ProcessPageRank (PPR) as their main contribution. The PPR prioritizes processes of a given BPA by ranking them according to their network-adjusted need for improvement. The PPR builds on knowledge from process performance management, BPAs, and network analysis – particularly the Google PageRank. As for evaluation, the authors validated the PPR’s design specification against empirically validated and theory-backed design propositions. They also instantiated the PPR’s design specification as a software prototype and applied the prototype to a real-world BPA.

Purpose Despite an obvious connection, business process improvement and business process management (BPM) capability development have been studied intensely, but in isolation. The authors thus aim to make the case for the research located at the intersection of both streams. The authors thereby focus on the integrated planning of business process improvement and BPM capability development as this is where, in the authors’ opinion, both streams have the closest interaction. The authors refer to the research field located at the intersection of business process improvement and BPM capability development as process project portfolio management. The paper aims to discuss these issues. Design/methodology/approach The authors structure the field of process project portfolio management drawing from extant knowledge related to BPM, project portfolio management, and performance management. The authors also propose a research agenda in terms of exemplary research questions and research methods. Findings The proposed structure shows which business objects and interactions should be considered when engaging in process project portfolio management. The research agenda contains exemplary questions structured along the intersections of BPM, project portfolio management, and performance management. Research limitations/implications This paper’s main limitation is that it reflects the authors’ individual viewpoints based on experiences of several industry projects and prior research. Originality/value This paper addresses a neglected research field, opens up new avenues for interdisciplinary BPM research, and contributes a novel perspective to the ongoing discussion about the future of BPM.

The malignant mesothelioma is a rare malignancy and mainly caused by occupational exposure to asbestos. German cancer registries are providing a national database to investigate temporal and regional patterns of mesothelioma incidence. These may be of interest for healthcare planning and for surveillance programs aiming at the formerly exposed workforce. We analyzed population-based incidence data of malignant mesothelioma by site, type, sex, age, as well as district and state of patient’s residence. Age-standardized incidence rates (AIRs40+) were calculated according to the European standard population truncated to the age of 40 years and older. We present rates at national, state, and district level and trends of incidence of northern states of Germany. In total, 7,547 malignant mesotheliomas were reported to German cancer registries diagnosed between 2009 and 2013—90% located to the pleura. On average, 1,198 men and 312 women were affected each year. We estimated AIR40+ of 4.77 in 100,000 German men and 0.98 in 100,000 German women. Regional clusters were predominantly located to the seaports of West Germany. The highest regional AIR40+ was 20 per 100,000 men. Corresponding rates in northeast Germany were between 2 and 4 per 100,000 men. Regional clusters of high incidence indicate districts with former shipyards and steel industry, but predominantly in the western part of Germany. The West-to-East difference corresponds to patterns of mortality. Twenty years after banning asbestos in Germany, Bremen and Hamburg are presenting the highest mesothelioma incidence but show steadily decreasing trends.

Welders have an increased susceptibility to airway infections with non-typeable Haemophilus influenzae (NTHi), which implicates immune defects and might promote pneumonia and chronic obstructive pulmonary disease (COPD). We hypothesized that welding-fume exposure suppresses Th1-lymphocyte activity. Non-effector CD4+ T-cells from blood of 45 welders (n = 23 gas metal arc welders, GMAW; n = 16 tungsten inert gas welders, TIG; n = 6 others) and 25 non-welders were ex vivo activated towards Th1 via polyclonal T-cell receptor stimulation and IL-12 (first activation step) and then stimulated with NTHi extract or lipopolysaccharide (LPS) (second activation step). IFNγ and IL-2 were measured by ELISA. In the first activation step, IFNγ was reduced in welders compared to non-welders and in the GMAW welders with higher concentrations of respirable particles compared to the lower exposed TIG welders. IFNγ was not influenced by tobacco smoking and correlated negatively with welding-fume exposure, respirable manganese, and iron. In the second activation step, NTHi and LPS induced additional IFNγ, which was reduced in current smokers compared to never smokers in welders as well as in non-welders. Analyzing both activation steps together, IFNγ production was lowest in smoking welders and highest in never smoking non-welders. IL-2 was not associated with any of these parameters. Welding-fume exposure might suppress Th1-based immune responses due to effects of particulate matter, which mainly consists of iron and manganese. For responses to NTHi this is strongest in smoking welders because welding fume suppresses T-cell activation towards Th1 and cigarette smoke suppresses the subsequent Th1-response to NTHi via LPS. Both effects are independent from IL-2-regulated T-cell proliferation. This might explain the increased susceptibility to infections and might promote COPD development.

Due to a potential exposure to several definite or probable carcinogens, the IARC classified manufacturing of art glass, glass containers, and pressed ware as probably carcinogenic to humans in 1993 (Group 2A). Purpose of this study was to update the evidence from recently published scientific reports. We searched for peer-reviewed articles published between 1993 and 2018 and combined result in terms of a meta-analysis. Overall, we considered twelve articles for a meta-analytic approach published after 1992. From a meta-analysis we derived a standardized incidence ratio (mSIR) and a standardized mortality ratio (mSMR) for lung cancer in men of 1.25 (95% CI 0.97–1.59) and 1.41 (95% CI 1.11–1.77), respectively. The estimated odds ratio (mOR) from five case–control studies was 1.25 (95% CI 0.90–1.73). Associated with an employment in glass factories, the estimated mSMR for larynx cancer was 2.38 (95% CI 1.23–4.16) based on two cohort studies; the mOR from four case–control studies was 1.35 (95% CI 0.73–2.52). Reports on elevated cancer risks at other sites were not consistent. Only few studies assessed cancer risk solely in glass workers. Gained evidence from more recent reports supports the IARC rating from 1993. Our combined results add limited evidence to a moderately elevated risk for cancer of the airways.

Although both communities share a common object of research, the Business and Information Systems Engineering (BISE) community from the German-speaking countries and the Information Systems (IS) community centered in North America have developed quite differently. The BISE community features promote connections with industry, attractive topics to students and practical relevance of publications. But due to various reasons numerous BISE researchers struggle with publications in top-ranked journals. While this weakness obviously is a strength of the IS community, we observe that the IS community struggles with its industry connections and enrollment numbers. What the global IS/BISE community needs is a more intense discourse that increases mutual understanding, creates awareness for the need for complementation, and ensures that the opportunity for complementation is seized. This paper offers insights on how by complementation both communities could mitigate some of their weaknesses and the global IS/BISE community could increase its success as a whole.

We studied determinants of Vitamin D in serum of 67 female health care workers (aged 25-60 years), including age, body mass index, physical activity, and shift work. Overall, vitamin D levels were low, ranging from 6 to 51 ng/mL (median: 20 ng/mL). Lower serum levels were found in samples drawn in winter and spring and in obese subjects. Shift work had only small effects on vitamin D levels. The high prevalence of vitamin D undersupply is in line with observations from the German general population. Vitamin D supply particularly in winter and spring should be ensured to avoid health problems.

Malignant mesothelioma (MM) is a fatal disease mostly associated with asbestos exposure and difficult to detect by non-invasive methods. This study aimed to use recombinant fragments of the megakaryocyte potentiating factor (MPF) for the development of cost-effective MPF ELISAs. Three polypeptides spanning the MPF region (MPF1-148, MPF 34-288, MPF/MSLN254-400) were produced in E.coli as maltose-binding protein hybrids. After isolation, Factor Xa digest, and purification, the polypeptides were used for the generation of rabbit antibodies and development of ELISAs. Forty-one MM patients with known histological subtype before tumor-specific treatment and 70 asbestos-exposed individuals free of any cancer were matched according to age, gender, and smoking. Plasma of all subjects was tested with the three newly developed polyclonal antibody-based ELISAs and a commercial mesothelin assay (MESOMARK™). The latter differentiated patients (median concentration 1.95 nM) from controls (median 1.07 nM, p < 0.0001) and showed an area under curve (AUC) of 0.77 in receiver operating characteristics (ROC) analysis. Of the MPF variants, exclusively the ELISA based on antibodies against the MPF34-288 fragment displayed significantly (p = 0.0002) higher values in patients than in controls (median 1.61 nM versus 0.88 nM; AUC = 0.72). The combination of the MPF34-288 and mesothelin displayed an improved ROC performance (AUC = 0.80). The MPF34-288 ELISA could be a cost-effective and minimal-invasive contribution to support a diagnosis of mesothelioma, especially in regions with a limited medical care.

Welding fumes may produce adverse health effects in the respiratory tract. To assess the relationship between exposure to welding fumes and inflammation in the upper airways, 190 male welders were examined from the WELDOX study (median age 40 yr, 54.7% smokers, and 32.9% atopics). Inhalable welding fumes were collected in the breathing zone of welders during a single shift. Chromium (Cr), nickel (Ni), manganese (Mn), and iron (Fe) were measured in the welding-fume samples and in postshift nasal lavage fluid (NALF). In addition, the numbers of particles and inflammatory biomarkers, including total and differential cell counts, interleukin (IL)-8, leukotriene (LT) B4, 8-isoprostane (8-iso-PGF2α), tissue inhibitor of metalloproteinase-1 (TIMP-1), and immunoreactive matrix metalloproteinase (MMP)-9, were determined. Metal concentrations in NALF correlated with airborne concentrations. No significant association was found between airborne metal concentrations and biomarkers of inflammation in NALF, whe...

We took advantage of magnetic resonance imaging (MRI) and spectroscopy (MRS) as non-invasive methods to quantify brain iron and neurometabolites, which were analyzed along with other predictors of motor dysfunction in Parkinson’s disease (PD). Tapping hits, tremor amplitude, and the scores derived from part III of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS3 scores) were determined in 35 male PD patients and 35 controls. The iron-sensitive MRI relaxation rate R2* was measured in the globus pallidus and substantia nigra. γ-aminobutyric acid (GABA)-edited and short echo-time MRS was used for the quantification of neurometabolites in the striatum and thalamus. Associations of R2*, neurometabolites, and other factors with motor function were estimated with Spearman correlations and mixed regression models to account for repeated measurements (hands, hemispheres). In PD patients, R2* and striatal GABA correlated with MDS-UPDRS3 scores if not adjusted for age. Patients with akinetic-rigid PD subtype (N = 19) presented with lower creatine and striatal glutamate and glutamine (Glx) but elevated thalamic GABA compared to controls or mixed PD subtype. In PD patients, Glx correlated with an impaired dexterity when adjusted for covariates. Elevated myo-inositol was associated with more tapping hits and lower MDS-UPDRS3 scores. Our neuroimaging study provides evidence that motor dysfunction in PD correlates with alterations in brain iron and neurometabolites.

Manganese (Mn) is an essential trace element with well characterized neurotoxic effects in high concentrations. Neurochemically, the initial neurotoxic effect of Mn is the perturbation of striatal γ-aminobutyric acid levels. Specific tasks for the assessment of cognitive functions subserved by fronto-striatal loops are available as the stop-change task (SCT) assessing control of multi-component behavior and action cascading. In a cross-sectional study, fifty male welders and 28 age-matched controls completed the SCT during a whole day examination. Reaction times, responses accuracy, and event-related potentials (ERPs) from electroencephalogram (EEG) recordings were analyzed. The shift exposure of the welders to respirable Mn was stratified by 20 µg/m3 in 23 low-exposed (median = 4.7 µg/m3) and 27 high-exposed welders (median = 86.0 µg/m3). Welders graduation was lower and was therefore included in the analyses. The task-related factor (stop-change delay, SCD) modified the responses as expected; however, the lack of an interaction “SCD × group” revealed no differences between welders and controls. EEG data showed that the “SCD” modulated the amplitude of the P3 ERP in controls stronger than in welders. There was no difference between the two groups of welders and no association between airborne or systemic Mn and the P3 ERP. Moreover, the P3 amplitude was smaller in subjects with lower education. These results showed that multitasking performance and cognitive flexibility are not impaired in welders. The electrophysiological results gave a weak hint that relevant neurobiological processes were different in welders as compared to controls but this may be related to lower education.

Business process management (BPM) is an important area of organizational design and an acknowledged source of corporate performance. Over the last decades, many approaches, methods, and tools have been proposed to discover, design, analyze, enact, and improve individual processes. At the same time, BPM research has been and still is paying ever more attention to BPM itself and the development of organizations’ BPM capability. Little, however, is known about how to develop an organization’s BPM capability and improve individual processes in an integrated manner. To address this research gap, we developed a planning model. This planning model intends to assist organizations in determining which BPM- and process-level projects they should implement in which sequence to maximize their firm value, catering for the projects’ effects on process performance and for interactions among projects. We adopt the design science research (DSR) paradigm and draw from project portfolio selection as well as value-based management as justificatory knowledge. For this reason, we refer to our approach as value-based process project portfolio management. To evaluate the planning model, we validated its design specification by discussing it against theory-backed design objectives and with BPM experts from different organizations. We also compared the planning model with competing artifacts. Having instantiated the planning model as a software prototype, we validated its applicability and usefulness by conducting a case based on real-world data and by challenging the planning model against accepted evaluation criteria from the DSR literature.

Summary Humoral rejection processes may lead to allograft injury and subsequent dysfunction. Today, only one B-cell-specific agent is in clinical use and the effects of standard and new immunosuppressant substances on B-cell activation and function are not fully clarified. The impact of sotrastaurin, mycophenolic acid and everolimus on human B-lymphocyte function was assessed by analysing proliferation, apoptosis, CD80/CD86 expression and immunoglobulin and IL-10 production in primary stimulated B cells. In addition, B-cell co-cultures with pre-activated T cells were performed to evaluate the effect of the different immunosuppressive agents on T-cell-dependent immunoglobulin production. Sotrastaurin did not inhibit B-cell proliferation, CD80/CD86 expression, and IgG production and had only minor effects on IgM levels at the highest concentration administered. In contrast, mycophenolic acid and everolimus had strong effects on all B-cell functions in a dose-dependent manner. All immunosuppressive agents caused decreased immunoglobulin levels in T-cell-dependent B-cell cultures. The data provided here suggest that mycophenolic acid and everolimus, but not sotrastaurin, are potent inhibitors of human B-lymphocyte function and activation.

LEHNERT M., KRAYWINKEL K., PESCH B., HOLLECZEK B. & BRUNING T. (2012) European Journal of Cancer Care21, 398–402 New malignancies following cancer of the urinary bladder: analysis of German cancer registry data This analysis aimed at occurrence and distribution patterns of new malignancies following bladder cancer. Standardised incidence ratios (SIRs) were calculated for two German population-based cancer registries of North Rhine-Westphalia (NRW) and Saarland to access risks for subsequent primaries. An elevated risk for secondary cancer of any site but urothelium was observed in NRW men [SIR 1.35, 95% confidence interval (CI) 1.22–1.49]. The corresponding risk in Saarland was not significantly elevated (SIR 1.06, 95% CI 0.97–1.15). In data of both registries excess risks were observed for cancer of the respiratory tract (SIR 1.54, CI 1.23–1.89 in NRW men) and the prostate (SIR 1.91, 95% CI 1.61–2.24 in NRW; SIR 1.25, 95% CI 1.07–1.45 in Saarland). Common risk factors and incidental findings during follow-up care of bladder cancer patients might explain most of the observed patterns. In addition SIRs were throughout particular high for subsequent cancer of the renal pelvis and the ureter due to pathological characteristics of urothelial neoplasms.

The efficiency of energy management strategies for hybrid electric vehicles depends significantly on the accuracy of the prediction of the load power which has to be provided by the hybrid drive. For vehicles in fixed-route service, measurements gained during vehicle operation can be used for the design of a predictor for the online calculation of the expected speed profile which is directly related to the load power profile. The paper describes, how the relevant information contained in measurements of the vehicle speed and position is processed and compressed in order to obtain a prediction algorithm that can cope with the limited memory space and computing power of a vehicle controller. The characteristics of the resulting algorithm are illustrated with real-life data.

We aimed to prospectively evaluate the efficacy of a multi-modal surveillance programme for the early detection of familial breast cancer. Ultrasound, mammography and breast magnetic resonance imaging were evaluated in 413 women who participated in a prospective study with a median follow-up of 2.2 years (range 1-6.75 years). Of these, 49 women carried a BRCA mutation, 203 were at high and 161 at moderate risk. Breast carcinomas diagnosed within the programme were compared with 297 carcinomas previously observed in the risk group and 7894 carcinomas documented in the regional cancer registry within the same time period. Overall, 41 breast carcinomas and no interval carcinoma were detected. The detection rates averaged 107.2/1000 for mutation carriers with highest rates between 20 and 39 years of age, 45.8/1000 for high-risk women with highest rates between 40 and 49 years of age and 23.9/1000 for moderate-risk women with highest rates between 50 and 74 years of age. Overall, 82.8% of the breast carcinomas were node negative and 85.4% pre-invasive or smaller than 2 cm. In comparison, of breast carcinomas detected outside the programme only 47.8% were node negative (P=0.0005) and 43.8% pre-invasive or smaller than 2 cm (P0.000 01). Of those gathered in the local cancer registry 55.7% were node negative (P=0.004) and 47.6% pre-invasive or smaller than 2 cm (P0.000 01). Our data indicate that (1) there is a strong correlation between breast cancer detection rates, risk status and age at disease onset and (2) a multi-modal surveillance programme can detect early-stage hereditary breast carcinomas.

Valid incidence rates of uveal melanoma (UM) from German population-based cancer registries are currently not available due to under-reporting. We conducted two case-control studies on UM at a reference centre for eye tumours and show the influence on population-based incidences of UM when data from case-control studies are linked with a cancer registry. The first case-control study (1996-1998) recruited 13 UM cases aged 35-74 years and the second case-control study (2002-2003) recruited 20 UM cases aged 20-74 residing within the population covered by the Münster Cancer Registry. After record linkage, age-truncated and standardized (World Standard Population) incidences with and without the record linkage were compared. Incidence rates based on routine cancer registration increased by a factor of 1.7 (1996-1998, age group 35-74 years) and 3.7 (2002-2003, age group 20-74 years) after record linkage with the case-control data. The supplemented age-standardized incidence of UM is 8.6 per million (20-74 years, 2002-2003) compared with the unsupplemented incidence of 2.3 per million. UM unknown to the registry were less often morphologically verified than those known to the registry. Cancer registries relying on pathology reports underestimate UM incidences if eye-preserving treatments are introduced. Close co-operation between cancer referral centres and cancer registries can substantially improve the completeness of registration.

The association between exposure to welding fume and chronic obstructive pulmonary disease (COPD) has been insufficiently clarified. In this study we assessed the influence of exposure to welding fume on lung function parameters. We investigated forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and expiratory flow rates in 219 welders. We measured current exposure to respirable particles and estimated a worker’s lifetime exposure considering welding techniques, working conditions and protective measures at current and former workplaces. Multiple regression models were applied to estimate the influence of exposure to welding fume, age, and smoking on lung function. We additionally investigated the duration of working as a welder and the predominant welding technique. The findings were that age- and smoking-adjusted lung function parameters showed no decline with increasing duration, current exposure level, and lifetime exposure to welding fume. However, 15 % of the welders had FEV1/FVC below the lower limit of normal, but we could not substantiate the presence of an association with the measures of exposure. Adverse effects of cigarette smoking were confirmed. In conclusion, the study did not support the notion of a possible detrimental effect of exposure to welding fume on lung function in welders.

The management and improvement of business processes is an evergreen topic of organizational design. With many techniques and tools for process modeling, execution, and improvement being available, research pays progressively more attention to the organizational impact of business process management (BPM) and the development of BPM capabilities. Despite knowledge about the capabilities required for successful BPM, there is a lack of guidance on how these BPM capabilities should be developed and balanced with the improvement of individual business processes. As a first step to address this research gap, we propose a decision model that enables valuating and selecting BPM roadmaps, i.e., portfolios of scheduled projects with different effects on business processes and BPM capabilities. The decision model is grounded in the literature related to project portfolio selection, process performance measurement, and value-based management. We also provide an extensive demonstration example to illustrate how the decision model can be applied.

Amoghavajra was born in Samarkand; his father was an Indian merchant or brahmin, and his mother was of Sogdian origin. At the age of twenty, Amoghavajra was fully ordained but he was denied access to the advanced ritual knowledge of yoga covered in the STTS . Beginning in 756 Amoghavajra resided at Daxingshan Monastery where he remained during the rebellion of General An Lushan. Amoghavajra's influence on Buddhism can be understood in political terms as counteracting the imminent decline of Buddhist institutions following the An Lushan Rebellion. In 767, Amoghavajra initiated the ordination of thirty-seven monks for repeated rituals, referring to the Vajradhātu Mandala and its thirty-seven basic deities. Amoghavajra's emphasis on ritual expertise can be qualified as an "expertocratic instrumentalism" based on generic relations between the warring state, social disorder, and occult pragmatics. Amoghavajra's extensive and eclectic body of scriptures superseded traditional standards of textual transmission, translation, and exegesis. Keywords: Amoghavajra's translations; Buddhism

Purpose Population-based analyses of the incidence of skin lymphoma in Europe are very sparse. We analyzed German population-based incidence data on skin lymphoma to study the descriptive epidemiology of these tumors. Methods We extracted skin lymphoma cases from the registry files of the East German National Cancer Registry (1976–1989) and registries of three new federal states (1998–2002) (Sachsen, Brandenburg, Mecklenburg-Vorpommern), the Cancer Registry Schleswig-Holstein, Lubeck (1998–2002), and the Epidemiological Cancer Registry Munster (1998–2002). We calculated age-standardized incidence rates (world standard population) and compared these figures with international data. Results From 1976 through 1989, 619 cases of skin lymphoma were registered in the former German Democratic Republic. During this period, the incidence among men increased from 2.0 to 2.5 per million and decreased among women from 1.5 to 0.8 per million. Current age-standardized incidence rates of skin lymphoma (1998–2002) varied by sex and registry and were about 3.2–6.0 per million among men and 1.6–2.6 per million among women. Conclusions The current incidence rates among the registries of Germany are fairly similar but are considerably lower than incidence rates from the United States and Israel. Several methodological issues hamper the analysis of population-based incidence data of skin lymphoma.

Summary Background Ewing tumor treatment involves high cumulative doses of alkylating agents and topoisomerase inhibitors, drugs capable of inducing second cancers We analyzed the second cancer risk in a large cohort of consistently treated patients Patients and methods Six hundred ninety Ewing tumor patients were treated between 1992 and 1999 with local therapy and vincristine, doxorubicin, ifosfamide and/or cyclophosphamide, and antinomycin D, with or without etoposide as a randomized question Second cancer incidences were estimated by competing risk analyses, standardized incidence ratios (SIR) in comparison to registry data were compiled Results After a median observation time of 56 months (32 months for survivors), 6 of 690 patients had developed second cancers MDS/AML, two, ALL/NHL, two, squamous cell carcinoma, one, liposarcoma, one SIR were increased 20–30 fold in comparison to the general population The cumulative second cancer risk five years after diagnosis of the Ewing tumor was 0 0093 for the total group, zero for patients without etoposide, and 0.0118 with etoposide. Additional phase II high-dose therapy increased the risk to 0 0398 after five years Conclusions The second cancder risk observed was in the range to be expected in cancer survivors High-dose therapy, and less markedly, etoposide, may contribute to the overall second cancer risk

Objectives Siderosis due to excessive iron exposure is a rare disease in welders. Less is known about the effect of inhaled iron on systemic iron status in welders. Here we present the association between exposure to iron as major constituent of the welding fume and the iron status in German welders. Method In this analysis we included 192 welders from the German WELDOX study not wearing respirators. Respirable welding fume was measured during one shift and analysed for its metal content. Iron status was assessed with different measures, including serum iron, serum ferritin (SF), transferrin, and prohepcidin. High iron stores were classified according to international standards. The influence of exposure to iron and other factors on the iron status was analysed with multiple regression models. Results Median shift exposure to respirable iron was 88 µg/m³ (interquartile range 13–690 µg/m³). For the overall study population the prevalence of high iron stores (SF > 200 µg/L) was 31.3%. A lower prevalence was found for tungsten inert gas (TIG) welders (16.9%). For all other welders using welding techniques with higher emission rates it was 38.6%. The regression models revealed a significant association of respirable iron and prohepcidin (exp (β)=1.08, 95% CI 1.05; 1.11) and a weaker association between respirable iron and serum ferritin (exp (β)=1.06, 95% CI 1.00; 1.12). Conclusions Although the iron status is biologically well regulated we found positive associations of respirable iron in welding fumes on prohepcidin and ferritin. We observed more welders with high iron stores in comparison to male persons from the general population.

In this study we evaluate the suitability of two methods of RNA conservation in blood samples, PAXgene and RNAlater, in combination with variable shipping conditions for their application in multicenter studies and biobanking. RNA yield, integrity, and purity as well as levels of selected mRNA and microRNA species were analyzed in peripheral human blood samples stabilized by PAXgene or RNAlater and shipped on dry ice or at ambient temperatures from the study centers to the central analysis laboratory. Both examined systems were clearly appropriate for RNA stabilization in human blood independently of the shipping conditions. The isolated RNA is characterized by good quantity and quality and well suited for downstream applications like quantitative RT-PCR analysis of mRNA and microRNA. Superior yield and integrity values were received using RNAlater. It would be reasonable to consider the production and approval of blood collection tubes prefilled with RNAlater to facilitate the use of this excellent RNA stabilization system in large studies.