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Background and Purpose— On the basis of phase II trials, we considered that transcranial laser therapy could have neuroprotective effects in patients with acute ischemic stroke. Methods— We studied transcranial laser therapy in a double-blind, sham-controlled randomized clinical trial intended to enroll 1000 patients with acute ischemic stroke treated ≤24 hours after stroke onset and who did not undergo thrombolytic therapy. The primary efficacy measure was the 90-day functional outcome as assessed by the modified Rankin Scale, with hierarchical Bayesian analysis incorporating relevant previous data. Interim analyses were planned after 300 and 600 patients included. Results— The study was terminated on recommendation by the Data Monitoring Committee after a futility analysis of 566 completed patients found no difference in the primary end point (transcranial laser therapy 140/282 [49.6%] versus sham 140/284 [49.3%] for good functional outcome; modified Rankin Scale, 0–2). The results remained stable after inclusion of all 630 randomized patients (adjusted odds ratio, 1.024; 95% confidence interval, 0.705–1.488). Conclusions— Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01120301.

Background Increased physical activity may be advantageous for weight loss. Objective We investigated the effects of an energy-restricted diet with and without moderate walking on body weight, body composition, resting energy expenditure (REE), and endocrine and cardiometabolic risk variables in overweight and obese participants. Methods A 12-wk, randomized, 2-arm, parallel, controlled, energy-restricted (500-800 kcal/d) dietary intervention study was conducted in 82 men and women [mean baseline characteristics: age, 39.4 y; weight, 99.3 kg; body mass index (in kg/m2), 31.9]. Participants were divided into 2 groups. One group received a hypoenergetic diet (DI) only (n = 44). The second group received the same DI and participated in a regular walking program of 2.5 h/wk (DI + walking; n = 38). Results After the 12-wk intervention, body weight was significantly decreased in the DI + walking group and the DI group (-8.8 compared with -7.0 kg, P = 0.064 for intergroup differences). The decrease in body weight was accompanied by a significant reduction in total fat mass, which was significantly more pronounced in the DI + walking group than in the DI group (-6.4 ± 3.1 compared with -4.8 ± 3.0 kg; P = 0.020). REE after 12 wk was not significantly different compared with the baseline REE. Diastolic blood pressure, mean arterial pressure, LDL cholesterol, and non-HDL cholesterol were similarly significantly improved by both interventions. In the DI + walking group, insulin and the homeostasis model assessment of insulin resistance index were also significantly reduced. Serum free triiodothyronine was significantly decreased and serum cortisol was significantly increased in both groups. Conclusions Participation in a 12-wk weight-loss study resulted in significant reductions in body weight and fat mass and was associated with significant improvements in biomarkers for cardiovascular disease risk. Moderate weight loss was not accompanied by a reduction in REE. Additional moderate walking enhanced the effects of a DI on fat loss and serum insulin. This trial was registered at www.germanctr.de/ and http://apps.who.int/trialsearch/ as DRKS00006827.

Schwellen sind in der Spiroergometrie fur die Leistungsbemessung bei schwierig zu beurteilender Kooperation bzw. Motivation im Rahmen einer Belastungsuntersuchung, zur Trainingssteuerung, in der Transplantationsplanung, der Operabilitatsbeurteilung und der Begutachtung erforderlich. In der Literatur besteht eine kaum ubersehbare Vielfalt von Schwellenterminologien, die einen Vergleich von Protokollen und Studien nur schwer moglich machen und auch im Alltag der Spiroergometrieinterpretation bzw. –auswertung zu terminologischen Unsicherheiten fuhren. Daraus ergibt sich die Notwendigkeit einer klaren Terminologie. Anhand der Literatur wurde eine Festlegung der Schwellendefinitionen vorgenommen. Danach ist zwischen einer konzeptionellen und operationalen (methodischen) Schwellenbetrachtung zu unterscheiden. Das konzeptionelle Schwellenkonzept bedeutet, dass es zwei ventilatorische (VT1 und VT2) und zwei metabolische Schwellen (Laktatschwelle [LT] 1 und 2) gibt. Diese Schwellen sind pathophysiologisch erklarbar. Beide Schwellenkonzepte kennzeichnen den Beginn und das Ende des aerob-anaeroben Ubergangs. Wahrend die Laktatschwellen 1 und 2 direkt die metabolischen Anderungen anzeigen, beschreiben die ventilatorischen Schwellen 1 und 2 die respiratorische Antwort auf diese metabolischen Anderungen. So kennzeichnet VT1 die infolge des Laktatanstiegs und der erforderlichen Laktatpufferung notwendige Steigerung der Ventilation und CO2-Abgabe im Verhaltnis zur Sauerstoffaufnahme. Der VT2 liegt ein Uberschreiten des Laktat-Steady-State mit konsekutivem Laktatexzess, Auftreten einer metabolischen Azidose und daraus resultierender uberproportionaler Steigerung der Ventilation zugrunde. Demgegenuber bezeichnet das operationale Schwellenkonzept die Methode, mit der die jeweilige Laktat- und ventilatorische Schwelle bestimmt werden. Dies kann in einem weiteren Schritt noch erganzt werden durch die Angabe der Belastungsform, die zur Schwellenbestimmung herangezogen wurde.

Complexes of formula [UO2S2P(iPr)22∗dH2O have been isolated either unsolvated (I) or as acetonitrile solvates (II and III). They have been characterized by X-ray crystallography and NMR spectroscopy. The UO3S4 core deformation from ideal geometry varies widely in the solid state and is shown to become stereochemically rigid at moderately low temperature in solution. Crystal data for complex I: [UO22P(iPr)22∗dH2O], C12H30O3P2S4U, Mr = 650.61, monoclinic, P2 1 /c, a = 8.685(1), b = 12.445(1), c = 21.536(3) A , β = 94.78(1)°, V = 2320(1) A 3 , Z = 4, D x = 1.86 g cm −3 , R = 0.028 ; complex II: [UO2S2P(IPr)22∗dMeCN, C14H33NO3P2S4U, Mr = 691.66, orthorhmobic, Pbca, a = 28.831(3), b = 16.536(2), c = 10.801(1) A , V = 5149(2) A 3 , Z = 8, D x = 1.78 g cm −3 , R = 0.042 ; complex III: [UO2S2P(iPr)22∗dH2O]∗dMeCN, C14H33NO3P2S4U, Mr = 691.66, monoclinic, P2 1 /c, a = 14.626(2), b = 16.468(2), c = 10.873(2) A , β = 100.29(1)°, V = 2577(1) A 3 , Z = 4, D x = 1.78 g cm −3 , R = 0.054 .

Thresholds in cardiopulmonary exercise testing are necessary for the evaluation of motivation and cooperation in exercise, for training programs, in transplant medicine, preoperative evaluation and medical assessments. There is a hardly comprehensible number of terminologies concerning these thresholds and their definitions. This hampers the comparison of protocols and studies and leads to incertainties in terminologies and interpretations of cardiopulmonary exercise tests. Based on literature a definition of thresholds was undertaken. Thresholds should be regarded from a conceptional and an operational (methodological) point of view. The conceptional model means, that there are two ventilatory thresholds (VT1 and VT2) and two metabolic thresholds (lactate threshold [LT] 1 and 2 ). These thresholds are pathophysiologically based. Both threshold concepts determinate the beginning and the end of the aerobic-anaerobic transition. The lactate thresholds determine the metabolic changes, whereas the ventilator thresholds 1 and 2 represent the ventilatory response to the metabolic changes. VT1 represents the subsequent increase of ventilation and CO2-output relative to oxygen uptake as a consequence of an increase of lactate and a necessary lactate buffering. VT2 is characterized by an exceeding of lactate-steady-state, resulting in excess lactate, metabolic acidosis and overproportional rise of ventilation. The operational concept describes the method, which is used for determination of the different lactate and ventilatory thresholds. In a further step this can be completed by indicating the exercise protocol which was applied.

The isolation and structural characterization of the dimeric uranium(IV) species [U{S2PMe2}2{O(S)PMe2} {μ-O2PMe2}]2 starting from UO2Cl2·3H2O and NaS2PMe2 is reported. Crystal data: C26H48O6P8S10U2, Mr = 1381.05, monoclinic, P2 1 /c, a = 13.754(2), b = 15.103(1), c = 11.798(1) A , β = 101.13(1)°, V = 2405(1) A 3 , Z = 2 λ( Mo K α) = 0.70930 A , R = 0.036 for 3224 unique observed reflections. The geometry at uranium is pentagonal bipyramidal.

Die neue ternare Phase Tl3Al7S12 konnte aus den binaren Komponenten Tl2S und Al2S3 bei 700 °C im Vakuum dargestellt werden. Die hellgelbe Verbindung kristallisiert in der monoklinen, polaren Raumgruppe P21 (No. 4) mit a = 9,040(2), b = 12,381(2), c = 9,569(2) A und β = 95,91(2)°. Der polymere, anionische Teil der Kristallstruktur wird aus ausschlieslich eckenverknupften [AlS4]-Tetraedern so aufgebaut, das eine gewellte, schichtartige Anordnung etwa parallel zu (001) resultiert. Zwischen den Schichten, die uber einzelne Schwefelatome miteinander verbunden werden, sind die sterisch anspruchsvollen Tl+ -Kationen eingelagert. Die mittleren AlS-Bindungslangen betragen fur μ2-SAl 2,227 A und fur μ3-SAl 2,298 A. Die TlSBindungslangen variieren von 3,009(9) bis 3,907(9) A mit vier einseitig orientierten kurzen und zwei bis drei langeren Abstanden. Zwischen zwei der drei kristallographisch unabhangigen Thalliumatome wird ein kurzer Abstand von 3,619(3) A beobachtet, so das schwach bindende Wechselwirkungen diskutiert werden mussen. Die schwingungsspektroskopischen Daten der neuen Phase werden diskutiert. Tl3Al7S12 — a Novel Al-rich Thioaluminate: Preparation, Crystal Structure, and Properties The new ternary phase Tl3Al7S12 was prepared from the binary compounds Tl2S and Al2S3 at 700 °C under vacuum. The structure of a yellow plateshaped single crystal was determined at room temperature. The compound crystallizes in the monoclinic polar space group P21 (No. 4) with a = 9.040(2), b = 12.381(2), c = 9.569(2) A and β = 95.91(2)°. The polymeric anionic part of the structure can be described as a puckered layer-like arrangement of cornersharing [AlS4]-tetrahedra parallel to (001). The aluminium-sulfur layers are connected via single sulfur atoms. The voluminous monovalent thallium atoms bridge the layers of the anionic framework. The mean AlS bond lengths are 2.227 A for μ2-SAl and 2.298 A for μ2-SAl. In the strongly asymmetric coordination sphere of thallium the TlS bond lengths vary from 3.009(9) to 3.907(9) A and contain four short and two or three longer distances. A rather short Tl…Tl distance of 3.619(3) A is observed between two of the three crystallographically independent Tl atoms, so that a weak bonding interaction has to be discussed. Vibrational spectroscopic data for the new phase are reported and discussed.

The crystal structure of NaAlCl{sub 4} was determined in the orthorhomic space group P2{sub 1}2{sub 1}2{sub 1} (D{sub 2}{sup 4}, No. 19; z = 4) at temperatures 138, 150, and 154 {plus minus} 0.2C, resulting in the lattice parameters a = 10.442 (4), 10.449 (3), 10.455 (2) {Angstrom}, b = 9.973 (3), 9.993 (2), 10.002 (2) {Angstrom}, and c = 6.202 (2), 6.206 (2), 6.204 (2) {Angstrom}, respectively. Samples of the compound were investigated by differential scanning calorimetry. {sup 27}Al NMR spectra were obtained on NaAlCl{sub 4} and LiAlCl{sub 4} solids as a function of temperature up to and above the melting points, at 157 and 146C, respectively. In accordance with the enhanced premelting heat contents, the observed phenomena indicate the existence of a specific dynamical behavior of the components in the two crystals, involving reorientational noncontinuous movements of the AlCl{sub 4}{sup {minus}} ions and translational jumps of the alkali-metal cations.

Krafttraining ist eine effektive Methode zur Vergrößerung der Muskelmasse und der Kraftfähigkeiten des Menschen. Die Belastungsnormative (Belastungsintensität, Belastungsdauer, Belastungsumfang, Belastungsdichte, Belastungsfrequenz) sind die Beschreibungsgrößen des Krafttrainings. Die unterschiedlichen Kombinationen dieser Belastungsnormative ermöglichen eine nahezu unbegrenzte Anzahl von Krafttrainingsmethoden. Obwohl eine Vielzahl von Trainingsmethoden im Fitness-, und Leistungssport eingesetzt werden, besteht nach wie vor ein erhebliches Forschungsdefizit bezüglich der Effektivität dieser Verfahren. Daher war das Ziel dieser Arbeit die Überprüfung der Effektivität dreier populärer Krafttrainingsmethoden: Dem Mehrsatz-Training, dem Einsatz-Training und dem High Intensity Training (HIT). Die Effekte dieser Trainingsmethoden auf Maximalkraft, Kraftausdauer und Muskeldicke des M. quadrizeps femoris wurden im Rahmen einer Zeitreihenanalyse verglichen. Insgesamt 22 krafttrainingserfahrene Männer (n=11) und Frauen (n=11) wurden auf drei Trainingsgruppen und eine Kontrollgruppe aufgeteilt. Die Trainingsgruppen absolvierten nach einer einwöchigen Gewöhnungsphase über einen Zeitraum von 12 Wochen dreimal pro Woche ein Ganzkörper-Krafttraining. Die Parameter Maximalkraft, Kraftausdauer sowie Muskeldicke des M. quadrizeps femoris wurden in einwöchigen Abständen vor, nach, sowie während des Trainingszeitraums gemessen. Die Ergebnisse zeigen eine Überlegenheit des Mehrsatz-Trainings gegenüber dem Einsatz-Training und dem HIT. Allerdings ist hierbei zu bedenken, dass beispielsweise unter zeitökonomischen Gesichtspunkten die Einsatz-Trainingsmethode oder auch das HIT empfehlenswerte Alternativen zum zeitaufwendigen Mehrsatz-Training darstellen können. It is well known that resistance training is an effective method for improving muscle strength and lean body mass. The program variables (training intensity, time under tension, training volume, rest periods and training frequency) are the descriptors of resistance training. By variation of the program variables an almost indefinite number of strength training programs can be created. Even though a vast number of training methods are used in fitness and athletic training there is still a lack of evidence based research regarding the effectiveness oh these methods. Therefore, it was the purpose of this study to evaluate the effectiveness of three popular resistance training methods: the multiple-set training, the single-set training and the high intensity training (HIT). A time series design was employed to compare the effects of these training methods on maximal strength, strength endurance and muscle thickness of the m. quadriceps femoris. Altogether 22 men (n=11) and women (n=11) with resistance training experience were divided into three training groups and one control group. The training groups conducted a whole body resistance training program over a period of 12 weeks three times a week. All training groups completed a one week familiarization period prior to the training period. Maximal strength, strength endurance and muscle thickness of the m. quadriceps femoris were measured in weekly intervals before, after and within the training period. The results show a superiority of the multiple-set training compared to the single-set training and the HIT. However, it ought to be considered that the single-set training method or the HIT represent reasonable alternatives to a time consuming multiple-set training if, for instance, time economic aspects are of special interest.

Kardiovaskuläre Erkrankungen spielen eine immer dominanter werdende Rolle als Ursachen von Morbidität und Mortalität. Endotheliale Dysfunktion, Arteriosklerose und ischämische Herzerkrankungen sind unangefochten die häufigsten Todesursachen in hochentwickelten Ländern. Die Krankheitslast kardiovaskulärer Erkrankungen wird durch die globale Zunahme von Risikofaktoren wie Übergewicht, metabolischem Syndrom und Diabetes mellitus Typ 2 in Zukunft wohl weiter steigen. Keines der in der heutigen Form existierenden Gesundheitssysteme ist den gesundheitlichen Folgen dieser bedenklichen epidemiologischen Entwicklung gewachsen, ohne dafür beträchtliche Einschnitte in Qualität oder Quantität hinnehmen zu müssen. Präventivmedizinische Strategien haben im Vergleich zur Akutmedizin bisher eine wesentlich geringere Aufmerksamkeit erfahren. Aufgrund der weiterhin steigenden Krankheitslast werden gerade präventivmedizinische Strategien immer wichtiger. Die Ermittlung der individuellen kardiovaskulären Gesundheit beinhalten neben einer Untersuchung wichtiger physiologsicher Kernsysteme, einen besonderen Fokus auf die Stärkung der gesundheitlichen Eigenverantwortung durch Vermittlung entsprechender medizinischer Zusammenhänge. Dies kann durch geeignete und prognostisch wertvolle Untersuchungsmethoden und laienverständliche Interpretationen der komplexen kardiovaskulären Zusammenhänge realisiert werden. Mithilfe eines besseren Verständnisses für die eigene kardiovaskuläre Gesundheit und gezielter konkreter Hilfestellungen von ärztlicher Seite, können grundlegende Strukturen für einen achtsameren Umgang mit der eigenen Gesundheit geschaffen werden. Alltägliche körperliche Aktivität, Körperzusammensetzung, Gefäßsteifigkeit und die maximale Leistungsfähigkeit bilden aktuellen Studien zufolge vier relativ einfach zu erhebend Hauptdeterminanten kardiovaskulärer Gesundheit mit großer prädiktiver Vorhersagekraft für kardiovaskulärer Ereignisse. Die Einordnung der Untersuchungsbefunde unter Berücksichtigung altersentsprechender Referenzdaten bietet zusätzlich die Möglichkeit, chronologisches und biologisches Alter zu differenzieren. Darüber hinaus könnte das hier vorgestellte Untersuchungskonzept ebenso dafür eingesetzt werden, die Effektivität von zuvor eingeleiteten therapeutischen Strategien zu überprüfen und eine Übermedikation zu vermeiden. Ein stärkerer Fokus auf nachhaltige kardiovaskuläre präventivmedizinische Strategien birgt das Potential Morbidität und Mortalität zu Reduzieren und die Lebensqualität und Selbstbestimmung der Klienten zu steigern. Nowadays endothelial dysfunction, arteriosclerosis and ischaemic heart disease depict major issues in most developed countries. Chronic diseases cause an increasing number of deaths worldwide. Responsible for approximately 30% of all deaths, this number is shocking despite the knowledge that these lives could be saved in a realistic point of view. However, disturbing global tendencies and the increase in epidemic overweight, obesity, glucose intolerance and diabetes mellitus type 2 seem to amplify cardiovascular diseases and deaths. No existing medical care system could ever sufficiently match these emergent burdens of global chronic diseases if these tendencies will continue to grow. Due to fatal epidemiological changes general practitioners will not only have to treat more diseases of elderly people, but also be the first contact person for enquiries about their health concerning the cardiovascular systems of younger and older generations. Strengthening prevention concerning cardiovascular diseases is probably the most efficient and only way to escape the vicious circle of pathophysiological processes. To implement cardiovascular prevention it is essential to focus on cardiovascular health rather than on cardiovascular disease. In order to master this challenge sufficiently a deliberate concept of preventive examinations for cardiovascular health is required to quantify cardiovascular wellness and sharpen the awareness of one’s health. Therefore, it is to establish precise, predictive and cost-efficient examination methods to quantify cardiovascular health and subclinical changes at early stages of a disease. Broader acceptance of the preventive potential and the use of modern technological advances could therefore be a powerful instrument to solve the growing global problem of chronic diseases. In this context the routine evaluation of daily physical activity, body composition, arterial stiffness and the maximum physical performance could be a starting point for a preventive diagnostic approach. They can serve as future parameters reflecting health, detecting subclinical diseases and encouraging people’s responsibility for their own health. Detailed information about the major cardiovascular parameters opens specific and efficient course of action to create multiple strategies for gaining or rehabilitating cardiovascular wellbeing