Berufssegmente: Eine empirisch fundierte Neuabgrenzung vergleichbarer beruflicher Einheiten

"Der Mangel an wissenschaftlichen Analysen über die horizontale berufliche Mobilität ist vor allem das Ergebnis der Definitions- und Interpretationsprobleme, die mit der Operationalisierung dieses Sachverhaltes verbunden sind. Operationalisiert man berufliche Mobilität über Wechsel der Berufsordnungen der Klassifizierung der Berufe der Bundesanstalt für Arbeit 1988 (Dreisteller), bezieht sich die wichtigste Kritik auf den unterschiedlichen Homogenitätsgrad der in den verschiedenen Dreistellern zusammengefassten Berufe (Berufsordnungen). Um eine verbesserte Grundlage für die empirische Analyse beruflicher Mobilität zu legen, fassen wir deshalb die Dreisteller (Berufsordnungen) in der Arbeit nach einem empirisch fundierten, transparenten und nachvollziehbaren Verfahren anhand eines einheitlichen Homogenitätskriteriums zu empirisch analysefähigen beruflichen Einheiten - wir nennen diese Berufssegmente - neu zusammen. Analysen zur Intra-Homogenität und Inter-Heterogenität belegen, dass es sich bei den Berufssegmenten um besser vergleichbare und trennschärfere berufliche Einheiten handelt als bei den Berufsgruppen (Zweistellern), so dass die mit Berufssegmenten durchgeführten Berufsmobilitätsanalysen zu konsistenteren Ergebnissen führen müssen." (Autorenreferat, IAB-Doku)Berufsklassifikation, Berufsgruppe, Berufsbereiche, berufliche Mobilität - Messung, Berufswechsel

Pronounced social inequality in health-related factors and quality of life in women and men from Austria who are overweight or obese

Background The burden of social inequalities in health as well as the association between obesity with morbidity and mortality is a worldwide problem. Therefore, the aim of our study was to investigate health-related factors, health, and quality of life in Austrian women and men with normal weight, overweight, and obesity with a different socioeconomic status (SES) based on actual data from 2015. Methods This representative population-based study was based on self-reported data of 15,338 Austrian adults (8,425 women and 6,933 men) in 2014/2015. Data of the Austrian Health Interview Survey was analyzed stratified by sex and adjusted for age concerning health-related behavior, health, and quality of life. Results The results have shown that people with a low SES differ significantly from those of high SES concerning health-related factors (e.g., eating behavior, physical activity), health and impairment due to chronic conditions, as well as quality of life. Obesity in women and men was associated with poorer health-related factors and more chronic conditions as well as unfavorable psychological aspects. In women, the results showed a significant body mass index*SES interaction for impairment due to disorders, the number of chronic conditions and quality of life in the domain of physical health. In men, the interaction was significant regarding alcohol consumption, as well as health impairment. The SES has a strong negative impact on health which implies that people of low SES have more health problems which especially concerns individuals who are obese. Therefore, a continuous target group-oriented, non-discriminatory, interdisciplinary public health program is required, prioritizing women, and men with obesity with a low SES

Berufssegmente: eine empirisch fundierte Neuabgrenzung vergleichbarer beruflicher Einheiten

"Der Mangel an wissenschaftlichen Analysen über die horizontale berufliche Mobilität ist vor allem das Ergebnis der Definitions- und Interpretationsprobleme, die mit der Operationalisierung dieses Sachverhaltes verbunden sind. Operationalisiert man berufliche Mobilität über Wechsel der Berufsordnungen der Klassifizierung der Berufe der Bundesanstalt für Arbeit 1988 (Dreisteller), bezieht sich die wichtigste Kritik auf den unterschiedlichen Homogenitätsgrad der in den verschiedenen Dreistellern zusammengefassten Berufe (Berufsordnungen). Um eine verbesserte Grundlage für die empirische Analyse beruflicher Mobilität zu legen, fassen wir deshalb die Dreisteller (Berufsordnungen) in der Arbeit nach einem empirisch fundierten, transparenten und nachvollziehbaren Verfahren anhand eines einheitlichen Homogenitätskriteriums zu empirisch analysefähigen beruflichen Einheiten - wir nennen diese Berufssegmente - neu zusammen. Analysen zur Intra-Homogenität und Inter-Heterogenität belegen, dass es sich bei den Berufssegmenten um besser vergleichbare und trennschärfere berufliche Einheiten handelt als bei den Berufsgruppen (Zweistellern), so dass die mit Berufssegmenten durchgeführten Berufsmobilitätsanalysen zu konsistenteren Ergebnissen führen müssen." (Autorenreferat

Re-testing the JET-X Flight Module No. 2 at the PANTER facility

The Joint European X-ray Telescope (JET-X) was the core instrument of the Russian Spectrum-X-gamma space observatory. It consisted of two identical soft X-ray (0.3 - 10 keV) telescopes with focusing optical modules having a measured angular resolution of nearly 15 arcsec. Soon after the payload completion, the mission was cancelled and the two optical flight modules (FM) were brought to the Brera Astronomical Observatory where they had been manufactured. After 16 years of storage, we have utilized the JET-X FM2 to test at the PANTER X-ray facility a prototype of a novel X-ray polarimetric telescope, using a Gas Pixel Detector (GPD) with polarimetric capabilities in the focal plane of the FM2. The GPD was developed by a collaboration between INFN-Pisa and INAF-IAPS. In the first phase of the test campaign, we have re-tested the FM2 at PANTER to have an up-to-date characterization in terms of angular resolution and effective area, while in the second part of the test the GPD has been placed in the focal plane of the FM2. In this paper we report the results of the tests of the sole FM2, using an unpolarized X-ray source, comparing the results with the calibration done in 1996.Comment: Author's accepted manuscript posted to arXiv.org as permitted by Springer's Self-Archiving Policy. The final publication is available at http://rd.springer.com/article/10.1007%2Fs10686-013-9365-

Evaluation of high-sensitivity C-reactive protein and uric acid in vericiguat-treated patients with heart failure with reduced ejection fraction

Aims: The effects of vericiguat vs. placebo on high-sensitivity C-reactive protein (hsCRP) and serum uric acid (SUA) were assessed in patients with heart failure with reduced ejection fraction (HFrEF) in the Phase 2 SOCRATES-REDUCED study (NCT01951625). Methods and results: Changes from baseline hsCRP and SUA values at 12 weeks with placebo and vericiguat (1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg, respectively) were assessed. The probability of achieving an hsCRP value of ≤3.0 mg/L or SUA value of <7.0 mg/dL at week 12 was tested. Median baseline hsCRP and SUA levels were 3.68 mg/L [interquartile range (IQR) 1.41–8.41; n = 335] and 7.80 mg/dL (IQR 6.40–9.33; n = 348), respectively. Baseline-adjusted mean percentage changes in hsCRP were 0.2%, −19.5%, −24.3%, −25.7% and −31.9% in the placebo and vericiguat 1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg groups, respectively; significance vs. placebo was observed in the vericiguat 10.0 mg group (P = 0.035). Baseline-adjusted mean percentage changes in SUA were 5.0%, −1.3%, −1.1%, −3.5% and −5.3% in the placebo, and vericiguat 1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg groups, respectively; significance vs. placebo was observed in the 5.0 mg and 10.0 mg groups (P = 0.0202 and P = 0.004, respectively). Estimated probability for an end-of-treatment hsCRP value of ≤3.0 mg/L and SUA value of <7.0 mg/dL was higher with vericiguat compared with placebo. The effect was dose-dependent, with the greatest effect observed in the 10.0 mg group. Conclusions: Vericiguat treatment for 12 weeks was associated with reductions in hsCRP and SUA, and a higher likelihood of achieving an hsCRP value of ≤3.0 mg/L and SUA value of <7.0 mg/dL

Left ventricular dysfunction in heart failure with preserved ejection fraction-molecular mechanisms and impact on right ventricular function

The current classification of heart failure (HF) based on left ventricular (LV) ejection fraction (EF) identifies a large group of patients with preserved ejection fraction (HFpEF) with significant morbidity and mortality but without prognostic benefit from current HF therapy. Co-morbidities and conditions such as arterial hypertension, diabetes mellitus, chronic kidney disease, adiposity and aging shape the clinical phenotype and contribute to mortality. LV diastolic dysfunction and LV structural remodeling are hallmarks of HFpEF, and are linked to remodeling of the cardiomyocyte and extracellular matrix. Pulmonary hypertension (PH) and right ventricular dysfunction (RVD) are particularly common in HFpEF, and mortality is up to 10-fold higher in HFpEF patients with vs. without RV dysfunction. Here, we review alterations in cardiomyocyte function (i.e., ion homeostasis, sarcomere function and cellular metabolism) associated with diastolic dysfunction and summarize the main underlying cellular pathways. The contribution and interaction of systemic and regional upstream signaling such as chronic inflammation, neurohumoral activation, and NO-cGMP-related pathways are outlined in detail, and their diagnostic and therapeutic potential is discussed in the context of preclinical and clinical studies. In addition, we summarize prevalence and pathomechanisms of RV dysfunction in the context of HFpEF and discuss mechanisms connecting LV and RV dysfunction in HFpEF. Dissecting the molecular mechanisms of LV and RV dysfunction in HFpEF may provide a basis for an improved classification of HFpEF and for therapeutic approaches tailored to the molecular phenotype

Right‐ventricular dysfunction in HFpEF is linked to altered cardiomyocyte Ca2+ homeostasis and myofilament sensitivity

Aim Heart failure with preserved ejection fraction (HFpEF) is frequently (30%) associated with right ventricular (RV) dysfunction, which increases morbidity and mortality in these patients. Yet cellular mechanisms of RV remodelling and RV dysfunction in HFpEF are not well understood. Here, we evaluated RV cardiomyocyte function in a rat model of metabolically induced HFpEF. Methods: and results Heart failure with preserved ejection fraction-prone animals (ZSF-1 obese) and control rats (Wistar Kyoto) were fed a high-caloric diet for 13 weeks. Haemodynamic characterization by echocardiography and invasive catheterization was performed at 22 and 23 weeks of age, respectively. After sacrifice, organ morphometry, RV histology, isolated RV cardiomyocyte function, and calcium (Ca2+) transients were assessed. ZSF-1 obese rats showed a HFpEF phenotype with left ventricular (LV) hypertrophy, LV diastolic dysfunction (including increased LV end-diastolic pressures and E/e ' ratio), and preserved LV ejection fraction. ZSF-1 obese animals developed RV dilatation (50% increased end-diastolic area) and mildly impaired RV ejection fraction (42%) with evidence of RV hypertrophy. In isolated RV cardiomyocytes from ZSF-1 obese rats, cell shortening amplitude was preserved, but cytosolic Ca2+ transient amplitude was reduced. In addition, augmentation of cytosolic Ca2+ release with increased stimulation frequency was lost in ZSF-1 obese rats. Myofilament sensitivity was increased, while contractile kinetics were largely unaffected in intact isolated RV cardiomyocytes from ZSF-1 obese rats. Western blot analysis revealed significantly increased phosphorylation of cardiac myosin-binding protein C (Ser282 cMyBP-C) but no change in phosphorylation of troponin I (Ser23, 24 TnI) in RV myocardium from ZSF-1 obese rats. Conclusions: Right ventricular dysfunction in obese ZSF-1 rats with HFpEF is associated with intrinsic RV cardiomyocyte remodelling including reduced cytosolic Ca2+ amplitudes, loss of frequency-dependent augmentation of Ca2+ release, and increased myofilament Ca2+ sensitivity

Association of Leptin Gene DNA Methylation With Diagnosis and Treatment Outcome of Anorexia Nervosa

Epigenetic alterations are increasingly implicated in the pathophysiology of anorexia nervosa (AN) but are as yet poorly understood. We investigated possible associations between the leptin gene (LEP) and the leptin receptor gene (LEPR) DNA promoter methylation and (1) a diagnosis of AN and (2) outcome after a 10 months psychotherapeutic outpatient treatment. 129 (LEPR: n = 135) patients with AN were investigated during the large scale psychotherapeutic Anorexia Nervosa Treatment Outpatient Study (ANTOP) trial, compared to 117 (LEPR: n = 119) age and height matched, normal-weight healthy controls. Blood samples were taken at baseline, the end of therapy (40 weeks) and the 12-months follow-up and compared to controls. Methylation was measured in whole blood via bisulfite sequencing. Within the promoter region 32 (LEP) and 39 CpG sites (LEPR) were analyzed. Two key findings were observed. First, LEP and LEPR methylation at baseline were lower in patients compared to controls (LEP: [%] AN: 30.94 ± 13.2 vs. controls: 34.53 ± 14.6); LEPR ([%] AN: 3.73 ± 5.4 vs. controls: 5.22 ± 8.3, mixed linear models: both P &lt; 0.001). Second, lower DNA methylation of the LEP promoter, with a dynamic upregulation during treatment, was associated with a full recovery in AN patients (% change from baseline to follow-up in full recovery patients: +35.13% (SD: 47.56); mixed linear model: P &lt; 0.0001). To test for potential predictive properties of mean LEP DNA methylation a LEP DNA methylation cut-off (31.25% DNA methylation) was calculated, which significantly discriminated full recovery vs. full syndrome AN patients. This cut-off was then tested in a group of previously unclassified patients (missing follow-up data of the Structured Interview for Anorexic and Bulimic disorders; n = 33). Patients below the cut-off (31.25% LEP DNA methylation) showed an increase in BMI over time, while those above the cut-off had a decrease in BMI (ANOVA at the 12-months follow-up: P = 0.0142). To our knowledge, this is the first study investigating epigenetic alterations in AN over time. Our findings indicate that LEP DNA methylation might be involved in the disease course of AN

Treatments targeting inotropy

Acute heart failure (HF) and in particular, cardiogenic shock are associated with high morbidity and mortality. A therapeutic dilemma is that the use of positive inotropic agents, such as catecholamines or phosphodiesterase-inhibitors, is associated with increased mortality. Newer drugs, such as levosimendan or omecamtiv mecarbil, target sarcomeres to improve systolic function putatively without elevating intracellular Ca2+. Although meta-analyses of smaller trials suggested that levosimendan is associated with a better outcome than dobutamine, larger comparative trials failed to confirm this observation. For omecamtiv mecarbil, Phase II clinical trials suggest a favourable haemodynamic profile in patients with acute and chronic HF, and a Phase III morbidity/mortality trial in patients with chronic HF has recently begun. Here, we review the pathophysiological basis of systolic dysfunction in patients with HF and the mechanisms through which different inotropic agents improve cardiac function. Since adenosine triphosphate and reactive oxygen species production in mitochondria are intimately linked to the processes of excitation-contraction coupling, we also discuss the impact of inotropic agents on mitochondrial bioenergetics and redox regulation. Therefore, this position paper should help identify novel targets for treatments that could not only safely improve systolic and diastolic function acutely, but potentially also myocardial structure and function over a longer-term.Peer reviewe