Pragmatisch-kommunikative Störungen – Herausforderungen für Sprachheilpädagogik und Sprachtherapie in Schule und Berufsbildung

Die Frage nach der Partizipation/Teilhabe von Kindern und Jugendlichen mit sprachlichen Beeinträchtigungen ist häufig auch mit ihren pragmatisch-kommunikativen Fähigkeiten verknüpft. Dabei beinhaltet ein kompetentes Sprachhandeln unterschiedliche Teilfähigkeiten und Kompetenzen, welche sprachliche, aber auch soziale, kognitive, kulturelle und emotionale Aspekte beinhalten. Dieses interdisziplinäre Themenfeld verlangt nach einer multiprofessionellen Unterstützung von Kindern und Jugendlichen mit eingeschränkten pragmatisch-kommunikativen Fähigkeiten. (DIPF/Orig.

Disentangling different moisture transport pathways over the eastern subtropical North Atlantic using multi-platform isotope observations and high-resolution numerical modelling

Due to its dryness, the subtropical free troposphere plays a critical role in the radiative balance of the Earth’s climate system. But the complex interactions of the dynamical and physical processes controlling the variability in the moisture budget of this sensitive region of the subtropical atmosphere are still not fully understood. Stable water isotopes can provide important information about several of the latter processes, namely subsidence drying, turbulent mixing, dry and moist convective moistening. In this study, we use high-resolution simulations of the isotope-enabled version of the regional weather and climate prediction model of the Consortium for Small-Scale Modelling (COSMO$_{iso}$) to investigate predominant moisture transport pathways in the Canary Islands region in the eastern subtropical North Atlantic. Comparison of the simulated isotope signals with multi-platform isotope observations (aircraft-based in situ measurements, ground-based and space-based remote sensing observations) from a field campaign in summer 2013 shows that COSMO$_{iso}$ can reproduce the observed variability of stable water vapour isotopes on time scales of hours to days, and thus allows studying the mechanisms that control the subtropical free-tropospheric humidity. Changes of isotopic signals along backward trajectories from the Canary Islands region reveal the physical processes behind the short-term isotope variability. We identify four predominant moisture transport pathways of mid-tropospheric air, each with distinct isotopic signatures: (1) Air parcels originating from the convective boundary layer of the Saharan heat low (SHL). These are characterised by a homogenous isotopic composition with a particularly high δD (median mid-tropospheric δD = −122 ‰), which results from dry convective mixing of low-level moisture of diverse origin advected into the SHL. (2) Air parcels originating from the free troposphere above the SHL. Although experiencing the largest changes in humidity and δD during their subsidence over West Africa, these air parcels typically have lower δD values (median δD = −148 ‰) than air parcels originating from the boundary layer of the SHL. (3) Air parcels originating from outside the SHL region, typically descending from tropical upper levels south of the SHL, which are often affected by moist convective injections from mesoscale convective systems in the Sahel. Their isotopic composition is much less enriched in heavy isotopes (median δD = −175 ‰) than those from the SHL region. (4) Air parcels subsiding from the upper-level extratropical North Atlantic. This pathway leads to the driest and most depleted conditions (median δD = −255 ‰) in the middle troposphere near the Canary Islands. The alternation of these transport pathways explains to a large degree the observed high variability in humidity and δD on synoptic time scales. We further show that the four different transport pathways are related to specific large scale-flow conditions. In particular, distinct differences in the location of the North African mid-level anticyclone and of extratropical Rossby wave patterns occur between the four transport pathways. Overall, this study demonstrates that the adopted Lagrangian isotope perspective enhances our understanding of air mass transport and mixing and offers a sound interpretation of the free-tropospheric variability of specific humidity and isotope composition on time scales of hours to days in contrasting atmospheric conditions over the eastern subtropical North Atlantic

Soluble Receptor for Advanced Glycation End Products (sRAGE) Is a Sensitive Biomarker in Human Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is a progressive condition with an unmet need for early diagnosis, better monitoring, and risk stratification. The receptor for advanced glycation end products (RAGE) is activated in response to hypoxia and vascular injury, and is associated with inflammation, cell proliferation and migration in PAH. For the adult cohort, we recruited 120 patients with PAH, 83 with idiopathic PAH (IPAH) and 37 with connective tissue disease-associated PAH (CTD-PAH), and 48 controls, and determined potential plasma biomarkers by enzyme-linked immunoassay. The established heart failure marker NTproBNP and IL-6 plasma levels were several-fold higher in both adult IPAH and CTD-PAH patients versus controls. Plasma soluble RAGE (sRAGE) was elevated in IPAH patients (3044 ± 215.2 pg/mL) and was even higher in CTD-PAH patients (3332 ± 321.6 pg/mL) versus controls (1766 ± 121.9 pg/mL; p < 0.01). All three markers were increased in WHO functional class II+III PAH versus controls (p < 0.001). Receiver-operating characteristic analysis revealed that sRAGE has diagnostic accuracy comparable to prognostic NTproBNP, and even outperforms NTproBNP in the distinction of PAH FC I from controls. Lung tissue RAGE expression was increased in IPAH versus controls (mRNA) and was located predominantly in the PA intima, media, and inflammatory cells in the perivascular space (immunohistochemistry). In the pediatric cohort, plasma sRAGE concentrations were higher than in adults, but were similar in PH (n = 10) and non-PH controls (n = 10). Taken together, in the largest adult sRAGE PAH study to date, we identify plasma sRAGE as a sensitive and accurate PAH biomarker with better performance than NTproBNP in the distinction of mild PAH from controls

L-type amino acid transporter (LAT) 1 expression in 18F-FET-negative gliomas

BACKGROUND O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) is a highly sensitive PET tracer for glioma imaging, and its uptake is suggested to be driven by an overexpression of the L-type amino-acid transporter 1 (LAT1). However, 30{\%} of low- and 5{\%} of high-grade gliomas do not present enhanced 18F-FET uptake at primary diagnosis ({\textquotedbl}18F-FET-negative gliomas{\textquotedbl}) and the pathophysiologic basis for this phenomenon remains unclear. The aim of this study was to determine the expression of LAT1 in a homogeneous group of newly diagnosed 18F-FET-negative gliomas and to compare them to a matched group of 18F-FET-positive gliomas. Forty newly diagnosed IDH-mutant astrocytomas without 1p/19q codeletion were evaluated (n = 20 18F-FET-negative (tumour-to-background ratio (TBR) 1.6)). LAT1 immunohistochemistry (IHC) was performed using SLC7A5/LAT1 antibody. The percentage of LAT1-positive tumour cells ({\%}) and the staining intensity (range 0-2) were multiplied to an overall score (H-score; range 0-200) and correlated to PET findings as well as progression-free survival (PFS). RESULTS IHC staining of LAT1 expression was positive in both, 18F-FET-positive as well as 18F-FET-negative gliomas. No differences were found between the 18F-FET-negative and 18F-FET-positive group with regard to percentage of LAT1-positive tumour cells, staining intensity or H-score. Interestingly, the LAT1 expression showed a significant negative correlation with the PFS (p = 0.031), whereas no significant correlation was found for TBRmax, neither in the overall group nor in the 18F-FET-positive group only (p = 0.651 and p = 0.140). CONCLUSION Although LAT1 is reported to mediate the uptake of 18F-FET into tumour cells, the levels of LAT1 expression do not correlate with the levels of 18F-FET uptake in IDH-mutant astrocytomas. In particular, the lack of tracer uptake in 18F-FET-negative gliomas cannot be explained by a reduced LAT1 expression. A higher LAT1 expression in IDH-mutant astrocytomas seems to be associated with a short PFS. Further studies regarding mechanisms influencing the uptake of 18F-FET are necessary

Bilateral lung transplantation for pediatric pulmonary arterial hypertension: perioperative management and one-year follow-up

BackgroundBilateral lung transplantation (LuTx) remains the only established treatment for children with end-stage pulmonary arterial hypertension (PAH). Although PAH is the second most common indication for LuTx, little is known about optimal perioperative management and midterm clinical outcomes.MethodsProspective observational study on consecutive children with PAH who underwent LuTx with scheduled postoperative VA-ECMO support at Hannover Medical School from December 2013 to June 2020.ResultsTwelve patients with PAH underwent LuTx (mean age 11.9 years; age range 1.9–17.8). Underlying diagnoses included idiopathic (n = 4) or heritable PAH (n = 4), PAH associated with congenital heart disease (n = 2), pulmonary veno-occlusive disease (n = 1), and pulmonary capillary hemangiomatosis (n = 1). The mean waiting time was 58.5 days (range 1–220d). Three patients were bridged to LuTx on VA-ECMO. Intraoperative VA-ECMO/cardiopulmonary bypass was applied and VA-ECMO was continued postoperatively in all patients (mean ECMO-duration 185 h; range 73–363 h; early extubation). The median postoperative ventilation time was 28 h (range 17–145 h). Echocardiographic conventional and strain analysis showed that 12 months after LuTx, all patients had normal biventricular systolic function. All PAH patients are alive 2 years after LuTx (median follow-up 53 months, range 26–104 months).ConclusionLuTx in children with end-stage PAH resulted in excellent midterm outcomes (100% survival 2 years post-LuTx). Postoperative VA-ECMO facilitates early extubation with rapid gain of allograft function and sustained biventricular reverse-remodeling and systolic function after RV pressure unloading and LV volume loading

A Lagrangian perspective on stable water isotopes during the West African Monsoon

We present a Lagrangian framework for identifying mechanisms that control the isotopic composition of mid-tropospheric water vapor in the Sahel region during the West African Monsoon 2016. In this region mixing between contrasting air masses, strong convective activity, as well as surface and rain evaporation lead to high variability in the distribution of stable water isotopologues. Using backward trajectories based on high-resolution isotope-enabled model data, we obtain information not only about the source regions of Sahelian air masses, but also about the evolution of H$_{2}$O and its isotopologue HDO (expressed as δD) along the pathways of individual air parcels. We sort the full trajectory ensemble into groups with similar transport pathways and hydro-meteorological properties, such as precipitation and relative humidity, and investigate the evolution of the corresponding paired {H$_{2}$O, δD} distributions. The use of idealized process curves in the {H$_{2}$O, δD} phase space allows us to attribute isotopic changes to contributions from (1) air mass mixing, (2) Rayleigh condensation during convection, and (3) microphysical processes depleting the vapor beyond the Rayleigh prediction, i.e., partial rain evaporation in unsaturated and isotopic equilibration δin saturated conditions. Different combinations of these processes along the trajectory ensembles are found to determine the final isotopic composition in the Sahelian troposphere during the monsoon. The presented Lagrangian framework is a powerful tool for interpreting tropospheric water vapor distributions. In the future, it will be applied to satellite observations of H$_{2}$O, δD} over Africa and other regions in order to better quantify characteristics of the hydrological cycle

An optimized imaging protocol for [99mTc]Tc-DPD scintigraphy and SPECT/CT quantification in cardiac transthyretin (ATTR) amyloidosis

Background: In [(99)mTc]Tc-DPD scintigraphy for myocardial ATTR amyloidosis, planar images 3 hour p.i. and SPECT/CT acquisition in L-mode are recommended. This study investigated if earlier planar images (1 hour p.i.) are beneficial and if SPECT/CT acquisition should be preferred in H-mode (180 degrees detector angle) or L-mode (90 degrees). Methods: In SPECT/CT phantom measurements (NaI cameras, N = 2; CZT, N = 1), peak contrast recovery (CRpeak) was derived from sphere inserts or myocardial insert (cardiac phantom; signal-to-background ratio [SBR], 10:1 or 5:1). In 25 positive and 38 negative patients reference: endomyocardial biopsy or clinical diagnosis), Perugini scores and heart-to-contralateral (H/CL) count ratios were derived from planar images 1 hour and 3 hour p.i. Results: In phantom measurements, accuracy of myocardial CRpeak at SBR 10:1 (H-mode, 0.95-0.99) and reproducibility at 5:1 (H-mode, 1.02-1.14) was comparable for H-mode and L-mode. However, L-mode showed higher variability of background counts and sphere CRpeak throughout the field of view than H-mode. In patients, sensitivity/specificity were >= 95% for H/CL ratios at both time points and visual scoring 3 hour. At 1 hour, visual scores showed specificity of 89% and reduced reader's confidence. Conclusions: Early DPD images provided no additional value for visual scoring or H/CL ratios. In SPECT/CT, H-mode is preferred over L-mode, especially if quantification is applied apart from the myocardium

Evaluating a Novel Class of Biomaterials: Magnesium-Containing Layered Double Hydroxides

Metallic magnesium and compounds such as magnesium hydroxide Mg(OH)2 have been shown to have osteoconductive properties under experimental conditions and are gaining an increasing interest in the field of degradable biomaterials. The application of the compounds as implant coatings could support implant incorporation, resulting in an increased period of use of the implants. A variety of Mg-containing Layered Double Hydroxides (Mg-LDHs) has been synthesized and examined. These materials have been tested in various in vitro and in vivo studies; the latter took place in different sites like in the middle ear or in the condyle of New Zealand White Rabbits. In the latest study newly formed bone could be found around the Mg-Al-CO3-LDH pellets, making it a promising compound for bone-healing applications.DFG/SFB/59

Isotopic measurements in water vapor, precipitation, and seawater during EUREC4^4A

n early 2020, an international team set out to investigate trade-wind cumulus clouds and their coupling to the large-scale circulation through the field campaign EUREC$^4$A: ElUcidating the RolE of Clouds-Circulation Coupling in ClimAte. Focused on the western tropical Atlantic near Barbados, EUREC$^4$A deployed a number of innovative observational strategies, including a large network of water isotopic measurements collectively known as EUREC$^4$A-iso, to study the tropical shallow convective environment. The goal of the isotopic measurements was to elucidate processes that regulate the hydroclimate state – for example, by identifying moisture sources, quantifying mixing between atmospheric layers, characterizing the microphysics that influence the formation and persistence of clouds and precipitation, and providing an extra constraint in the evaluation of numerical simulations. During the field experiment, researchers deployed seven water vapor isotopic analyzers on two aircraft, on three ships, and at the Barbados Cloud Observatory (BCO). Precipitation was collected for isotopic analysis at the BCO and from aboard four ships. In addition, three ships collected seawater for isotopic analysis. All told, the in situ data span the period 5 January–22 February 2020 and cover the approximate area 6 to 16° N and 50 to 60° W, with water vapor isotope ratios measured from a few meters above sea level to the mid-free troposphere and seawater samples spanning the ocean surface to several kilometers depth. This paper describes the full EUREC$^4$A isotopic in situ data collection – providing extensive information about sampling strategies and data uncertainties – and also guides readers to complementary remotely sensed water vapor isotope ratios. All field data have been made publicly available even if they are affected by known biases, as is the case for high-altitude aircraft measurements, one of the two BCO ground-based water vapor time series, and select rain and seawater samples from the ships. Publication of these data reflects a desire to promote dialogue around improving water isotope measurement strategies for the future. The remaining, high-quality data create unprecedented opportunities to close water isotopic budgets and evaluate water fluxes and their influence on cloudiness in the trade-wind environment. The full list of dataset DOIs and notes on data quality flags are provided in Table 3 of Sect. 5 (“Data availability”)

Quartz weathering in freeze–thaw cycles: experiment and application to the El’gygytgyn Crater Lake record for tracing Siberian permafrost history

The object of this study is to test the assumption that cryogenic weathering (here understood as in-situ disintegration of rock under cold-climate conditions including ice as a weathering agent) preferentially breaks up quartz grains. We apply the results of laboratory tests to a Quaternary sediment record. The combination of silt production, relative quartz enrichment in the silt fraction, and quartz grain micro- morphology is traced in a multi-100-kyr lake sediment archive as indicator data for cryogenic weathering. Constant cryogenic weathering conditions are inferred for at least the last 220.000 years from a lake sediment core of El’gygytgyn Crater, northeast Russia. This is the longest continuous terrestrial archive currently known for the continental Arctic. Quartz enrichment in the fines evolves from seasonal freeze–thaw weathering as demonstrated in laboratory testing where over 100 freeze and thaw cycles crack quartz grains preferentially over feldspar. Microscopic grain fea- tures demonstrate that freeze–thaw cycling probably disrupts quartz grains along mineral impurities such as bubble trails, gas–liquid inclusions, or mineralogical sub- grain boundaries. Single-grain micromorphology (e.g. angular outlines, sharp edges, microcracks, brittle surfaces) illustrates how quartz becomes fragmented due to cryogenic cracking of the grains. The single-grain features stemming from the weathering dynamics are preserved even after a grain is transported off site (i.e. in mobile slope material, in seasonal river run-off, into a lake basin) and may serve as first-order proxy data for permafrost conditions in Quaternary records