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Background The rapid and safe exclusion of functionally relevant coronary artery disease (CAD) is a crucial, yet unmet clinical need. High-sensitivity cardiac troponin (hs-cTn) may be an attractive strategy, particularly in patients without previously known CAD. Purpose To derive and internally validate optimal rule-out cutoffs for an early and safe exclusion of functionally relevant CAD in symptomatic patients without previously known CAD. Methods In an ongoing single-center, prospective, cohort study, we enrolled consecutive patients without previously known CAD that were referred with symptoms possibly related to functionally relevant CAD. Cardiac troponin concentrations were measured at presentation using two high-sensitivity assays (Elecsys hs-cTnT and Architect hs-cTnI). Presence of functionally relevant CAD was adjudicated by 2 independent cardiologists, blinded to hs-cTn measurements, using MPI-SPECT/CT in all patients, as well as coronary angiography and fractional flow reserve measurements, whenever available. The primary diagnostic outcome was safety for early rule-out of functionally relevant CAD, quantified by sensitivity and the negative predictive value (NPV). The co-primary prognostic outcomes were cumulative incidences of cardiovascular death and all-cause death after 5 years. A NPV ≥90% and sensitivity ≥90% were predefined as acceptable performance criteria. The derived cutoffs were further evaluated in pre-specified subgroups. Internal validity was assessed with a bootstrapping procedure for a realistic estimate in similar future patients. Cumulative incidence curves stratified by the presence of functionally relevant CAD and hs-cTn concentrations below and above the derived cutoffs were constructed. Results Among 2111 eligible patients, 498 (23.6%) had a final diagnosis of functionally relevant CAD. Median age was 68 years and 938 (44.4%) were female. For ruling out functionally relevant CAD, a hs-cTnT concentration Conclusion In symptomatic patients without previously known CAD, very low hs-cTn concentrations may generally allow to safely and effectively exclude functionally relevant CAD. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss National Science FoundationSwiss Heart Foundation

Participation is a key strategy in municipal health promotion and health equity. Short-term trainings for professionals and activists are missing in Germany. Therefore, a curriculum was developed together with experienced health promotion professionals and Public Health scientists. The course aims at the development of competencies as well as at practical training. Essentials to the curriculum are main principles of participatory approaches, academic and practice-based knowledge on methods of community-based research. The evaluation asked: -Which amount of in-class time and field training is needed? How can elements of ‘participatory training' be implemented? What support is given to transfer the course contents into practice? Two pilot series with in sum 25 participants were conducted. This led after evaluation to a five days' curriculum of training, divided on two workshops plus a midterm online-meeting. Training material on participatory approaches and step-by-step-descriptions on six methods were developed. An own practice project is embedded in the program. Experienced trainers introduced the methods and led seminar sessions. Elements of ‘participatory training' were implemented as follows: in the application as teams of two, in telling project stories to introduce new methods, supporting peer-to-peer-reflection and learning from each other. Support was provided through a virtual course platform for the group exchange and individual consulting. After evaluation informal meet-ups and monthly tasks were added to the course. In the pre-pandemic series all teams designed and started own projects. There is a high need in the field of municipal health promotion to implement community-based participation in Germany. Thus, classes were quickly booked out and evaluation showed a high motivation in working more participatory after the course. The curriculum is going to be published open access. Several health promotion associations are interested in offering the program. Key messages There is a high need in the field of municipal health promotion to implement community-based participation in Germany. The curriculum is going to be published open access. Several health promotion associations are interested in offering the program.

Can fractal analysis enable us to classify a lava flow to a morphologic type (e.g., ‘a‘ā vs. pāhoehoe) solely by examining the geometry of the flow’s margin? If so, these classifications would prov...

Following the planet-encircling dust event (PEDE) of Mars Year (MY) 34, MRO/HiRISE has seen many more candidate RSL than in typical Mars years. They were imaged at more than 285 unique locations fr...

Background The study of substance use disorder among communities affected by mass violence has not received equal attention as other health concerns. This has led to the majority of psychosocial interventions in post-conflict zones being unresponsive to substance use-related problems among refugees. This study focused on gaining an in-depth understanding of the lay discourses and cultural concepts around substance use among male Syrian refugees in Germany. Methods Purposive and convenience sampling strategies were used for the recruitment of participants. The interview schedule was piloted among experts prior to conducting fieldwork. Inclusion criteria were a recent arrival from Syria. The study utilized a qualitative methodology, consisting of semi-structured group interviews with a native-speaking professional translator. The interviews were audio-recorded, transcribed and analyzed using an inductive thematic approach. Results Participants were refugees aged between 18 - 60 years (n = 19). The narratives revealed three themes. Firstly, the characteristics of Syrian society featured particularly in the participants' narratives. Society's rejection of substance use, generally enforced through taboos (e.g. halal/haram) was described and placed in contrast to a more liberal German society. Easier access and an open attitude to drug use in Europe were seen as problematic by some. The social stigma attached to mental health issues was discussed in participant narratives. Stigma was interpreted as both a cause for the development of a disorder as well as an exacerbating factor. Family was perceived as a protective force against substance use and the development of disorders. Thirdly, substance use was understood as one strategy of coping with stress, experience of violence and displacement. Conclusions Substance use may be seen as both an expression and a product of social suffering caused by the experience of war and displacement.

The origin or origins of recurring slope lineae (RSL) on Mars are enigmatic. These seasonally dark, linear features correlate with temperatures appropriate for liquid water or brine. They also progress slowly downslope and fade (disappear) when inactive, similar to shallow subsurface groundwater flows that wick moisture to the surface. If liquid water or brine does indeed flow so near the surface and is sufficiently dilute, it could have profound implications for the modern habitability of Mars. We present the results of a case study at Tivat crater in the southern midlatitudes that provide new insights into RSL, including their potential origins at Tivat. These results include comprehensive maps of RSL extents in four Mars years, detailed RSL evolution across one growth season, rockfall markings, and dust devil tracks. In two well-constrained years, RSL and rockfall markings—which are more widely distributed than RSL—fade at the same time, suggesting a fading mechanism that acts across Tivat. Based on relative albedo analyses, RSL and rockfall markings at Tivat fade because their host slopes darken, which is most easily explained by the widespread removal of dust. Such a dry fading mechanism would favor a dry origin for RSL. We also present a wide range of other RSL observations, including highly variable growth, pooling-like behavior where slopes shallow to roughly 30°, and total areal extents that decrease each year across a span of five years. We discuss the implications of these observations for various RSL formation models, including a new conceptual model that primarily mobilizes dust. Taken together, our observations seem to favor a dry mass movement origin for RSL at Tivat, but significant challenges remain for each examined model.

Background Metabolic syndrome clusters the main risk factors for cardiovascular diseases and endocrine dysfunction. Novel studies show that the important underlying mechanism is a long term inflammation of adipose tissue with a gradual shift from the anti-inflammatory M2 towards the pro-inflammatory M1 macrophages (pathognomonic). Massive hypertrophy induces adipocyte death, which releases DAMPs like nucleotides recognized by purinergic receptors orchestrating ongoing inflammatory process. Interestingly, we found Gi coupled P2Y13R only expressed on M1 macrophages, not in M0 (unstimulated) and M2 macrophages. Nevertheless, the role of P2Y13R in the immune system and especially macrophages is currently unknown. Given its pivotal role in central metabolic processes (P2Y13R has been described in insulin secretory signalling) together with its unique expression in its pathognomonic inflammatory macrophage subtype makes it an interesting candidate to investigate its role in metabolic syndrome. Purpose Due to the unique expression of P2Y13R on M1 macrophages we hypothesise an improved outcome in a high-fat diet induced metabolic syndrome by interfering with the P2Y13 signalling cascade. Methods BMDM differentiation to macrophages using M-CSF and subsequent stimulation with medium (M0), LPS and IFNγ (M1) or IL4 (M2); Expression of P2Rs quantified using Taqman qPCR. Male C57Bl6/J wild-type (WT) and P2Y13-deficient (KO) mice were fed with a high-fat diet (HFD) for 20 weeks; On week 15 we performed the ITT, on week 16 the GTT. Metabolic performance was monitored by metabolic caging. Results We observed a unique expression of P2Y13R on M1 macrophages. Adult P2Y13-deficient mice showed a higher O2 consumption compared to adult C57Bl6/J wild-type mice (AUC of O2 consumption 2nd day= KO: 61620±2261mL/kg vs WT: 53830±916.1mL/kg, p=0.0331). Although both P2Y13−/− mice and WT littermates consumed comparable amount of food (daily food intake per mouse → KO: 3.97±0.25g vs WT: 3.76±0.18g), P2Y13 deficient animals showed significantly decelerated weight gain (e.g. on week 15 → KO: 142±2% (n=10) vs WT: 198±5% (n=10), p Conclusion Global P2Y13 deficiency leads to an improved outcome in metabolic syndrome with an increased protection against developing an insulin resistance as shown through an improved glucose tolerance and basal glucose levels, a decelerated weight gain despite comparable food consumption and a better metabolic turnover. Observing these beneficial metabolic improvements, we hypothesise that antagonization of P2Y13R could be a promising therapeutic target in the field of metabolic syndrome.

Lunar impact melt deposits have unique physical properties. They have among the highest observed radar returns at S-Band (12.6 cm wavelength), implying that they are rough at the decimeter scale. However, they are also observed in high-resolution optical imagery to be quite smooth at the meter scale. These characteristics distinguish them from well-studied terrestrial analogues, such as Hawaiian pāhoehoe and ʻaʻā lava flows. The morphology of impact melt deposits can be related to their emplacement conditions, so understanding the origin of these unique surface properties will help to inform us as to the circumstances under which they were formed. In this work, we seek to find a terrestrial analogue for well-preserved lunar impact melt flows by examining fresh lava flows on Earth. We compare the radar return and high-resolution topographic variations of impact melt flows to terrestrial lava flows with a range of surface textures. The lava flows examined in this work range from smooth Hawaiian pāhoehoe to transitional basaltic flows at Craters of the Moon (COTM) National Monument and Preserve in Idaho to rubbly and spiny pāhoehoe-like flows at the recent eruption at Holuhraun in Iceland. The physical properties of lunar impact melt flows appear to differ from those of all the terrestrial lava flows studied in this work. This may be due to (a) differences in post-emplacement modification processes or (b) fundamental differences in the surface texture of the melt flows due to the melts’ unique emplacement and/or cooling environment. Information about the surface properties of lunar impact melt deposits will be critical for future landed missions that wish to sample these materials.

Hintergrund: In Deutschland gibt es bisher zu wenig Evidenz fur regionale Unterschiede in der Versorgung der Psoriasis bei Kindern, um daraus Verbesserungsmoglichkeiten abzuleiten. Zielsetzung: Ziel war die Analyse der Pravalenz und Versorgungssituation der juvenilen Psoriasis in Deutschland unter regionalen Gesichtspunkten. Methoden: Die Daten wurden auf Grundlage der ICD-10-Kodierung fur Psoriasis vulgaris mit dem L40-Schlussel aus der Datenbank einer gesetzlichen Krankenkasse (Gmunder Ersatzkasse) in Deutschland extrahiert und nach KV (Kassenarztliche Vereinigungen)-Regionen klassifiziert. Ergebnisse: Im Jahr 2009 waren unter den n = 1 642 852 Versicherten n = 293 181 Kinder und Jugendliche bis 18 Jahre vertreten.. Bei 1313 Kindern 0,45 % (95 % CI 0,42 – 0,47) wurde eine Psoriasis diagnostiziert. Mit 0,63 % (95 % CI 0,42 – 0,90) wurde in Sachsen-Anhalt die hochste Pravalenz der juvenilen Psoriasis festgestellt. Regionale Unterschiede in der Versorgung der juvenilen Psoriasis waren vorhanden. So wurden die meisten UV-Behandlungen in Niedersachsen (n = 86, neun Patienten) verordnet, gefolgt vom Saarland (n = 74, drei Patienten), im Gegensatz zu den anderen KV-Regionen. Insgesamt stammten die meisten Arzneimittelverordnungen zur Therapie der juvenilen Psoriasis von Hautarzten. Systemische Kortikosteroide wurden haufiger von Kinderarzten oder Allgemeinmedizinern als von Dermatologen verordnet. Schlussfolgerung: Bundesweit gibt es ein Verbesserungspotenzial in der Versorgung von Kindern mit Psoriasis, auch auf Facharztebene.

Recurring Slope Lineae (RSL) are active features on Mars that might require flowing water. Most examples observed through 2011 formed on steep, equator-facing slopes in the southern mid-latitudes. They form and grow during warm seasons and fade and often completely disappear during colder seasons, but recur over multiple Mars years. They are recognizable by their incremental growth, relatively low albedo and downhill orientation. We examined all images acquired by HiRISE during L s 250–10° (slightly longer than southern summer, L s 270–360°) of Mars years 30–31 (03/2011–10/2011), and supplemented our results with data from previous studies to better understand the geologic context and characteristics of RSL. We also confirmed candidate and likely sites from previous studies and discovered new RSL sites. We report 13 confirmed RSL sites, including the 7 in McEwen et al. (McEwen et al. [2011]. Science 333(6043), 740–743]. The observed seasonality, latitudinal and slope orientation preferences, and THEMIS brightness temperatures indicate that RSL require warm temperatures to form. We conclude that RSL are a unique phenomenon on Mars, clearly distinct from other slope processes that occur at high latitudes associated with seasonal CO 2 frost, and episodic mass wasting on equatorial slopes. However, only 41% (82 out of 200) of the sites that present apparently suitable conditions for RSL formation (steep, equator-facing rocky slopes with bedrock exposure) in the southern mid-latitudes (28–60°S) contain any candidate RSL, with confirmed RSL present only in 7% (13 sites) of those locations. Significant variability in abundance, size and exact location of RSL is also observed at most sites, indicating additional controls such as availability of water or salts that might be playing a crucial role.

In order to visualize and quantify the direction and extent of morphological upper-jaw changes in infants with unilateral cleft lip and palate (UCLP) during early orthodontic treatment, a three-dimensional method of cast analysis for routine application was developed. In the present investigation, this method was used to identify reaction patterns associated with specific cleft forms. The study included a cast series reflecting the upper-jaw situations of 46 infants with complete (n=27) or incomplete (n=19) UCLP during week 1 and months 3, 6, and 12 of life. Three-dimensional datasets were acquired and visualized with scanning software (DigiModel®; OrthoProof, The Netherlands). Following interactive identification of landmarks on the digitized surface relief, a defined set of representative linear parameters were three-dimensionally measured. At the same time, the three-dimensional surfaces of one patient series were superimposed based on a defined reference plane. Morphometric differences were statistically analyzed. Thanks to the user-friendly software, all landmarks could be identified quickly and reproducibly, thus, allowing for simultaneous three-dimensional measurement of all defined parameters. The measured values revealed that significant morphometric differences were present in all three planes of space between the two patient groups. Patients with complete UCLP underwent significantly larger reductions in cleft width (p

To achieve sustainable effects of health promotion interventions, first of all, long-term implementation is needed. However, there are just a few studies that explore how to maintain health-promoting structures and activities after external funding comes to an end. Using a mixed-methods approach, the evaluation study of the Bielefeld University analysed long-term implementation of government-funded projects. Our results show that maintenance of project structures and activities is a multiplex and contextual process. Apart from conceptual factors that can be influenced by project activities, interviewees reported on contextual factors (e. g., political support) that particularly affect successful long-term implementation. Thus, strategies need to be planned and initiated in the early stages of a project.Die Verstetigung gesundheitsförderlicher Interventionen als Voraussetzung für langfristige Wirkungen gewinnt zunehmend an Bedeutung. Es liegen jedoch nur vereinzelt Kenntnisse darüber vor, wie es gelingen kann, Projekte in dauerhafte Strukturen und Regelangebote zu überführen. Die Evaluationsstudie der Universität Bielefeld analysierte mit einem Mixed-methods-Ansatz die erreichte Verstetigung ausgewählter Initiativen, die im Rahmen des Nationalen Aktionsplans IN FORM gefördert wurden, und ermittelte Faktoren, die den Verstetigungsprozess beeinflusst haben. Es hat sich gezeigt, dass Verstetigung ein vielgestaltiger und kontextabhängiger Prozess ist, der bereits in der Planungsphase eines Projektes mitgedacht werden sollte. Neben konzeptionellen Einflussfaktoren, die durch Projektaktivitäten beeinflusst werden können, sind insbesondere Kontextfaktoren entscheidend für eine gelingende Verstetigung gesundheitsförderlicher Interventionen.

Although the transfer of an existing project can be a resource-efficient form of implementation of successful interventions, project transfers are rarely carried out in practice. The aim of this article is to pool the experience of 3 projects about the transfer of their prevention approaches to other municipalities and regions, as well as to make recommendations for future trans-regional transfer processes in the field of disease prevention and health promotion. To achieve this, documentation sheets were used and interviews were conducted with team members of the transfer projects. The results show that the ability to adapt intervention to context is an essential condition of successful implementation. In addition, there has to be a need for the intervention in the transfer region and a benefit to the participant organizations as well as to the team members. Furthermore, constructive and personal communication and cooperation between the participants of the original and the transferred project are required for successful transfer.Obgleich die Weitergabe eines bereits bestehenden Projekts eine ressourcensparende Form der Implementation bewährter Interventionen darstellen kann, finden in der Alltagspraxis bislang nur wenige Projekte Nachahmer und Anwender. Ziel des vorliegenden Artikels ist die Bündelung der Erfahrungen dreier Modellvorhaben mit der Übertragung ihrer Präventionsansätze in andere Kommunen und Regionen sowie die Ableitung von Empfehlungen für die Gestaltung zukünftiger überregionaler Transferprozesse im Bereich der Prävention und Gesundheitsförderung. Dazu wurden qualitative Interviews mit Verantwortlichen der Modellvorhaben sowie der Transferregionen geführt und Dokumentationsbögen eingesetzt. Die Ergebnisse zeigen, dass die Möglichkeit, die Intervention an die spezifischen Gegebenheiten der Transferregion anzupassen, eine bedeutsame Gelingensbedingung für einen Projekttransfer darstellt. Daneben tragen ein bestehender Bedarf für die Intervention in der Transferregion, ein erkennbarer Nutzen für die projektnehmende Organisation, eine konstruktive und persönliche Kommunikation sowie eine partizipative Zusammenarbeit zwischen den projektgebenden und projektnehmenden Organisationen wesentlich zu einem erfolgreichen Projekttransfer bei.

Bis zu 75 % der onkologischen Patienten leiden trotz wirksamer Therapiemöglichkeiten unter Schmerzen. Gründe dafür sind unter anderem Barrieren auf Patientenseite. Unklar bleiben jedoch die Entscheidungsprozesse von Patienten bezüglich ihrer Analgetikaeinnahme. In dieser qualitativen Arbeit wurden Wege von vier Frauen und vier Männern mit verschiedenen Krebserkrankungen erkundet, die zu Entscheidungen bezüglich der Analgetika führten. Dazu boten die Protokolle der zehnwöchigen Intervention und Interviews aus der PEINCA-Pilotstudie Daten für eine Sekundäranalyse. Mit der Pilotstudie wurde ein Edukationsprogramm zur Unterstützung onkologischer Patienten in ihrem Schmerzmanagement erstmals in der deutschen Version an einem Tumorzentrum in Deutschland getestet. Die Daten von zielgerichtet ausgewählten Patienten wurden mittels Inhaltsanalyse ausgewertet. Ergebnisse zeigten, dass diese Patienten in ihren Entscheidungen bezüglich der Analgetika zwischen dem Wunsch nach Schmerzlinderung und dem Vermeiden von Medikamenten zerrissen waren. Zweifel ließen sie getroffene Entscheidungen trotz guter Erfahrungen wiederholt umstoßen. Nach unserem Wissen beschreibt diese Studie erstmals solche Prozesse über zehn Wochen während einer Selbstmanagementedukation. Dank individuell angepasster Intervention verhalf das Edukationsprogramm den meisten Patienten zum Umdenken und zu einer verbesserten Schmerzsituation. Erfahrungen von Patienten und die mögliche Ambivalenz gegenüber Analgetika sollten in die Schmerztherapie einbezogen und Betroffene von Fachpersonen begleitet werden.

Einleitung Trotz verbesserter operativer und klinischer Versorgung des Bauchaortenaneurysmas sind die Mortalitatszahlen der Erkrankung in Deutschland in den letzten Jahren gestiegen. Diese werden nach wie vor durch die spontane Aneurysmaruptur bestimmt, die noch immer uberwiegend letal verlauft. Die in internationalen Studien erwiesene, mogliche Absenkung der aneurysmabedingten Mortalitatsraten durch ein Ultraschall-Screening-Programm hat im Gegensatz zu anderen Landern in Deutschland noch nicht zur Einfuhrung eines solchen Programms gefuhrt. Es wurde anhand einer Befragung deutscher Hausarzte die Moglichkeit untersucht, ein entsprechendes Ultraschallscreening in den Hausarztpraxen einzufuhren.

Unrelieved pain affects up to 75 % of cancer patients. Possible reasons for the undertreatment of pain are, amongst others, patient-related barriers towards cancer pain management. However the way patients decide on the use of analgesics remains unclear. The purpose of this qualitative study was to explore decision-making processes of four women and four men with diverse cancers concerning their pain medications. Audiotaped protocols of the 10-week-intervention and interviews of the PEINCA-pilot study provided data for a secondary analysis. This pilot study was conducted at a comprehensive cancer centre in Germany to test the German version of a cancer pain self-management intervention to enhance oncology patients' pain self-management for the first time. The data of purposively selected patients were analysed using content analysis. The results showed that these patients were very ambivalent about their analgesic use. The need to relieve severe pain conflicted with the desire to avoid opioids at any price. Decisions were reconsidered and overturned even after good experiences with analgesics. This study seems to provide a first look into decision-making processes over 10 weeks during a self-management education. Individually tailored counselling by a professional within the education programme helped the patients adopt new attitudes towards analgesics and gradually reduce their pain levels. Previous experiences of the patients and their possible ambivalence towards analgesics should be considered in a pain therapy, and patients should be coached by professionals.

In line with the National Action Plan "IN FORM" the German Federal Ministry of Health funds the establishment of 11 regional community health promotion networks (alliances). To meet quality development standards, an external evaluation project has been established in addition to the alliances' internal evaluation. Scientific monitoring focuses on alliance-spanning investigation of quality of planning, structures and processes and uses different methods and instruments (e.g., guided interviews, analytical framework, Goal Attainment Scaling). Regional networks also receive support for their efforts to quality development. Up to now concluding analysis can be done on aspects of planning quality based on findings of the analytical framework developed within the project. 5 selected results presented in the article reveal a heterogeneous picture: on one hand the standard on which the alliances' rationales on demands justifying the project's strategy are written at is very encouraging. The situation is similar with the descriptions of the work planning and statements concerning the sustainability at which the implemented activities are aimed. On the other hand, in explaination criteria like consideration of target group's needs or definition of goals the possibilities are not exhausted yet considering the state of the debate. Hence in similar future projects there is a clear necessity of assistance in approaching these aspects, provided preferably in an early stage of the planning phase.

[1] A fresh, 1.85 km diameter impact crater in the midlatitudes of Mars (38°N) named Vaduz exhibits distinctive crater‐related geological subunits (facies) extending up to ∼15 radii from the rim crest and perched >10 m above the adjacent plains. Knobby terrain fringing and underlying the facies is interpreted as degraded thermal contraction crack polygons, consistent with an ice‐rich mantle buried by ejecta. The almost complete regional disappearance of this ice‐rich unit, and consequent lowering of regional topography by over ten meters, is interpreted to mean that the ice‐rich mantle was formed by climate‐related deposition of snow, ice, and dust during recent periods of high obliquity. Transition to lower obliquity, and the attendant poleward retreat of the mantling unit, is the most likely cause of the regional loss of the ice‐rich layer. The depth of this crater, relative to the thickness of the ice‐rich unit, indicates that the impact event excavated bedrock and that Vaduz can be classified as an excess ejecta crater. Excavated silicate regolith and fragmented target debris appear to have been an important factor in the armoring mechanism. Citation: Schaefer, E. I., J. W. Head, and S. J. Kadish (2011), Vaduz, an unusual fresh crater onMars:Evidenceforimpactintoarecentice‐richmantle,Geophys.

Background and objectives: The International Pediatric Peritonitis Registry (IPPR) was established to collect prospective data regarding peritoneal dialysis (PD)-associated peritonitis in children. In this report, we present the IPPR results that pertain to relapsing peritonitis (RP). Design, setting, participants, & measurements: This was an online, prospective entry into the IPPR of data that pertain to peritonitis cases by participating centers. Results: Of 490 episodes of nonfungal peritonitis, 52 (11%) were followed by a relapse. There was no significant difference between RP and non-RP in distribution of causative organisms and antibiotic sensitivities. Initial empiric therapy - ceftazidime with either first-generation cephalosporin or glycopeptide (vancomycin or teicoplanin) - was not associated with relapse. Switching to monotherapy with a first-generation cephalosporin on the basis of culture results was associated with higher relapse rate (23%) than other final antibiotic therapies (0 to 9%). Culture-negative RP was less likely to have a satisfactory early treatment response than non-RP (82 versus 98%). Young age, single-cuff catheter, downward-pointing exit site, and chronic systemic antibiotic prophylaxis were additional independent risk factors for RP in the multivariate analysis. Compared with non-RP, RP was associated with a lower rate of full functional recovery (73 versus 91%), higher ultrafiltration problems (14 versus 2%), and higher rate of permanent PD discontinuation (17 versus 7%). Conclusions: This is the largest multicenter, prospective study to date to examine RP in children. In addition, this is the first report in the literature to examine specifically the relationship of postempiric antibiotic treatment regimens to the subsequent risk for relapse. Copyright © 2010 by the American Society of Nephrology.

The keynote lecture describes recent design and development efforts in DLR’s robotics lab towards a new generation of ultra-light weight robots with articulated hands (Fig.1). The design of fully sensorized joints with complete state feedback and the underlying mechanisms are outlined. The second joint torque-controlled light-weight arm generation is available now [1], as well as the second generation of a highly integrated 4 finger-hand with 13 actuators and more than 100 sensors [2]. Thus we hope that important steps towards a new generation of service and personal robots have been achieved, with space robotics becoming a major driver due to the need for advanced “robonaut” technologies.

The concept of canonical restricted mixed polarity (CRMP) exclusive sum of products (ESOP) forms is introduced. It includes the inconsistent canonical Reed-Muller and generalized Reed-Muller forms as special cases. The set of CRMP forms is included in the set of ESOP expressions. An attempt to characterize minimal CRMP forms for completely specified Boolean functions is presented, as well as an attempt to gain insight into the complexity of computation needed to find such a form. Some fundamental properties unique to CRMPs are proved. It is also proved that the upper bound on the number of terms in the CRMP form is smaller than that in the conventional normal forms and is equal to that of the ESOPs. A theorem providing a lower bound on the number of CRMP terms is also given. These results prove the validity of the CRMP concept. An efficient generic heuristic algorithm to find the CRMP form is presented. >

The paper describes the recent design and development efforts in DLR Robotics Lab towards the second generation of light-weight robots. The design of the light weight mechanics, integrated sensors and electronics is outlined. The fully sensory joint, with motor and link position sensors as well as joint torque sensors enables the implementation of effective vibration damping and advanced control strategies for compliant manipulation. The mechatronic approach incorporates a tight collaboration between mechanics, electronics and controller design. The authors hope that important steps towards a new generation of service and personal robots have been achieved.

Describes design and development efforts in DLR's robotics lab towards a new generation of ultra-light weight robots with articulated hands. The design of fully sensorized joints with complete state feedback and the underlying mechanisms are outlined. The second light-weight arm generation is available now, as well as the second generation of a worldwide most highly integrated 4 finger-hand is available now. Thus we hope that important steps towards a new generation of service and personal robots have been achieved.

We present a system for catching a flying ball with a robot arm using off-the-shelf components (PC based system) for visual tracking. The ball is observed by a large baseline stereo camera, comparing each image to a slowly adapting reference image. We track and predict the target position using an extended Kalman filter, also taking into account the air drag. The calibration is achieved by simply performing a few throws and observing their trajectories, as well as moving the robot to some predefined positions.

Practically all municipal health authorities, including the Bremen health authorities, now offer advice with regard to healthy environmental protection, i. e. environmental-medical consulting activities. The majority of the consultantcy services deal with individual inquiries made by citizens. This is supplemented by counselling and discussions with groups in various contexts. It is frequent for extremely difficult counselling contents, situations and deficits in the conducting of the discussions by the consultants who are specialised in natural science subjects to coincide. Within the framework of a further training course designed for these specific needs, the staff of the Bremen health authorities, with specialist instruction, were successful in acquitting skill in the communication of risks, which is a qualification that should become self-evident also in this sphere.

Frostegård et al. (J Lipid Res 1990;31:37-44) demonstrated that the proliferation of the human monocyte cell line U937 is critically dependent on the uptake of low-density lipoprotein (LDL) via the apo B, E (LDL) receptor, a characteristic that was used to detect patients with familial defective apolipoprotein B-100 (FDB). Here we applied this principle to develop a simple and reproducible assay for the detection of patients with functionally defective LDL. We added serum to U937 cells in cholesterol-free incubation medium and determined the increase in cell number after a 72-h incubation at 37 degrees C by using an electronic cell counter. Sera from 10 normolipidemic individuals and from 34 patients with type IIa hyperlipoproteinemia stimulated the growth of U937 cells in proportion to the exogenous cholesterol concentration (r = 0.83, P0.001) and the LDL-cholesterol concentration (r = 0.81, P0.001). However, sera from 16 patients with FDB stimulated less cell proliferation than did sera from patients with type IIa hyperlipoproteinemia with equal LDL-cholesterol concentrations. With a 15% reduction in growth as the cutoff value, this test had a sensitivity and specificity for diagnosis of FDB of 87.5% and 100%, respectively. The improved U937 monocyte proliferation assay can be used for screening hypercholesterolemic patients to detect individuals with functionally defective LDL.

Normal and SV40-infected human fibroblasts were grown in the presence of the drug N-(phosphonoacetyl)-L-aspartate (PALA) and examined for evidence of genetic instability. Both cell populations were precrisis and showed a normal, diploid karyotype at early passage. In contrast to the normal IMR-90 cells, which showed growth arrest and did not form colonies in PALA, the SV40-infected IMR-90 cells formed colonies at a very high frequency and continued to cycle in the drug. The drug-resistant colonies senesced after continued growth in culture, indicating that this change in ability to amplify preceded immortalization. This is the first observation of mortal human cells overcoming the drug-induced growth arrest. Although all previously isolated PALA-resistant colonies demonstrated CAD gene amplification as the mechanism of the drug-resistant phenotype, these SV40-infected human cells also showed alternative mechanisms, including increases in gene copy number by aneuploidy and formation of an isochromosome 2p.

The establishment of medical environmental centres at public health offices is hardly questioned any longer even though it means a crucial shift regarding the points of emphasis in human ecology in general as well as the extension of the fields of activity in public health services. It is doubtful whether the individual-orientated approach of environmental medicine can meet the complexity of medical problems due to environmental factors or which rating preventive medicine can have in this context. Environmental medicine could well not only overtax the personnel resources of public health offices, as previous experience shows, but also change the fields of activity of public health services qualitatively. At present the lack of knowledge and experience in environmental medicine enables only research-orientated institutions to perform appropriate work in this field.

New legal provisions set a limiting value of 0.1 mg TCE/m3 air in flats. Follow-up examinations by the Public Health Office Bremen show again that so far this limit can not be complied with in flats adjacent to dry cleaners. Interviews with affected residents give no hint for a change in utilisation habits. The Upper House of the German Federal Parliament has taken the legislative initiative for a complete prohibition of TCE in consequence of the fundamental problem of limiting values.