Incidence and risk factors for community-acquired acute gastroenteritis in north-west Germany in 2004

In developed countries, acute gastroenteritis (AGE) is a major source of morbidity. However, only a few studies have estimated its incidence and the associated medical burden. This population-based study determined the incidence of community-acquired AGE patients seeking medical care and the relative role of various pathogens. Stool samples from patients with AGE presenting to a general practitioner (GP), pediatrician, or specialist in internal medicine for that reason were screened for various bacterial and viral enteropathogens. A control group was established as well. Incidences were calculated by the number of positive patients divided by the general population. The study was performed in north-west Germany in 2004. The incidence of AGE patients requiring medical consultation was 4,020/100,000 inhabitants. Children (<5 years of age) were at the highest risk (13,810/100,000 inhabitants). Of the patients, 6.6% were tested positive for an enteropathogenic bacteria and 17.7% for a viral agent. The predominant pathogens were norovirus (626/100,000) and rotavirus (270/100,000). Salmonella was the most frequently detected bacteria (162/100,000). The results presented confirm AGE and, specifically, AGE of viral origin as a major public health burden in developed countries

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP

Optimal tobramycin dosage in patients with cystic fibrosis : evidence for predictability based on previous drug monitoring

A retrospective analysis of files of patients with cystic fibrosis and pulmonary exacerbations was performed to investigate whether an individual dosage of tobramycin once established by serum level determination allows a reliable prediction of the adequate dosage in a consecutive exacerbation. All patients hospitalized 2 microg/ml (median: 0.6) and the peak levels were 7.1-16.9 microg/ml (median: 11.9). In four patients the peak level was < 12 microg/ml. In 28 consecutive episodes the dosage of tobra myci n was chosen based on optimal results of previous drug level monitoring and in 27 instances (96%) the previously established optimal dose was confirmed. In five consecutive episodes the tobramycin dosage had been increased erroneously and this resulted in abnormally high peak levels in three cases. These findings suggest that a safe and therapeutic tobramycin dosage in an individual patient with cystic fibrosis is predictable based on a previously established optimal dosage

Identification of nnp and npp Auger recombination as significant contributor to the efficiency droop in (GaIn)N quantum wells by visualization of hot carriers in photoluminescence

We report the direct observation of hot carriers generated by Auger recombination via photoluminescence spectroscopy on tailored (AlGaIn)N multiple quantum well (QW) structures containing alternating green and ultra-violet (UV) emitting (GaIn)N QWs. Optically pumping solely the green QWs using a blue emitting high power laser diode, carrier densities similar to electrical light-emitting diode (LED) operation were achieved, circumventing possible leakage and injection effects. This way, luminescence from the UV QWs could be observed for excitation where the emission from the green QWs showed significant droop, giving direct evidence for Auger generated hot electrons and holes being injected into the UV QWs. An examination of the quantitative relation between the intensity of the UV luminescence and the amount of charge carriers lost due to drooping of the QWs supports the conclusion that Auger processes contribute significantly to the droop phenomenon in (AlGaIn)N based light-emitting diodes

Improving Accuracy in Coronary Lumen Segmentation via Explicit Calcium Exclusion, Learning-based Ray Detection and Surface Optimization

Invasive cardiac angiography (catheterization) is still the standard in clinical practice for diagnosing coronary artery disease (CAD) but it involves a high amount of risk and cost. New generations of CT scanners can acquire high-quality images of coronary arteries which allow for an accurate identification and delineation of stenoses. Recently, computational flow dynamics (CFD) simulation has been applied to coronary blood flow using geometric lumen models extracted from CT angiography (CTA). The computed pressure drop at stenoses proved to be indicative for ischemia-causing lesions, leading to non-invasive Fractional Flow Reserve derived from CTA (FFRCT). Since the diagnostic value of non-invasive procedures for diagnosing CAD relies on an accurate extraction of the lumen, a precise segmentation of the coronary arteries is crucial. As manual segmentation is tedious, time-consuming and subjective, automatic procedures are desirable. We present a novel fully-automatic method to accurately segment the lumen of coronary arteries in the presence of calcified and noncalcified plaque. Our segmentation framework is based on three main steps: boundary detection, calcium exclusion and surface optimization. A learning-based boundary detector enables a robust lumen contour detection via dense ray-casting. The exclusion of calcified plaque is assured through a novel calcium exclusion technique which allows us to accurately capture stenoses of diseased arteries. The boundary detection results are incorporated into a closed set formulation whose minimization yields an optimized lumen surface. On standardized tests with clinical data, a segmentation accuracy i

Trap-assisted tunneling in InGaN/GaN single-quantum-well light-emitting diodes

Based on numerical simulation and comparison with measured current characteristics, we show that the current in InGaN/GaN single-quantum-well light-emitting diodes at low forward bias can be accurately described by a standard trap-assisted tunneling model. The qualitative and quantitative differences in the current characteristics of devices with different emission wavelengths are demonstrated to be correlated in a physically consistent way with the tunneling model parameters

Characterization of Glucocorticoid Binding Capacity in Human Mononuclear Lymphocytes: Increase by Metyrapone is Prevented by Dexamethasone Pretreatment

Autoregulation of receptor systems by their own ligands is a well established biological phenomenon. While down-regulation of the glucocorticoid binding capacity by glucocorticoids has been shown in animals and humans, data on up-regulation processes in humans are lacking. To further explore glucocorticoid receptor plasticity in relation to endogenous ligands, glucocorticoid binding parameters were assessed in 15 healthy controls before and after oral administration of 1.5 g metyrapone with and without dexamethasone pretreatment. Administration of metyrapone resulted in blockade of the feedback of the hypothalamic-pituitary-adrenal system as shown by the rise in adrenocorticotropin levels, while pretreatment with 1 mg dexamethasone completely suppressed adrenocorticotropin concentrations. Glucocorticoid binding sites per lymphocyte exhibited an increase of 63% following metyrapone administration, which was prevented by dexamethasone pretreatment. Comparison of morning and afternoon glucocorticoid binding sites per cell in 11 healthy volunteers further revealed a diurnal rhythm of glucocorticoid receptor sites. These data suggest that human lymphocyte glucocorticoid receptors are under autoregulatory control

Transport and capture properties of Auger-generated high-energy carriers in (AllnGa)N Quantum well structures

Recent photoluminescence experiments presented by M. Binder et al. [Appl. Phys. Lett. 103, 071108 (2013)] demonstrated the visualization of high-energy carriers generated by Auger recombination in (AlInGa)N multi quantum wells. Two fundamental limitations were deduced which reduce the detection efficiency of Auger processes contributing to the reduction in internal quantum efficiency: the transfer probability of these hot electrons and holes in a detection well and the asymmetry in type of Auger recombination. We investigate the transport and capture properties of these high-energy carriers regarding polarization fields, the transfer distance to the generating well, and the number of detection wells. All three factors are shown to have a noticeable impact on the detection of these hot particles. Furthermore, the investigations support the finding that electron-electron-hole exceeds electron-hole-hole Auger recombination if the densities of both carrier types are similar. Overall, the results add to the evidence that Auger processes play an important role in the reduction of efficiency in (AlInGa)N based LEDs