KVD2 – Ein integriertes wissensbasiertes Modul zur Bemessung von Krankenhausverweildauern:Problemstellung, Konzeption und Realisierung

In einem Kooperationsprojekt zwischen dem Institut für Wirtschaftsinformatik der Westfälischen Wilhelms-Universität Münster und der Betriebskrankenkasse der Hoesch AG, Dortmund, wurde ein operationales Expertensystem zur Entscheidungsunterstützung realisiert. Das System hat die Aufgabe, die Sachbearbeiter der Krankenkasse bei der Befristung von Krankenhausverweildauern zu unterstützen. Durch eine angemessene Begrenzung sollen die medizinisch nicht begründbaren Verweildaueranteile reduziert und auf diesem Weg eine Kostensenkung im Krankenhaussektor erzielt werden. Das Expertensystem wurde als Modul in das Informationssystem KINFOSH (KrankenkassenINFOrmationsSystem Hoesch) integriert. Die Systementwicklung erfolgte mit der Shell ESE (Expert System Environment). Zur Ergänzung der Wissensrepräsentationsmechanismen von ESE wurde das relationale Datenbanksystem DB2 eingesetzt. Das Anwendungssystem KINFOSH basiert auf dem hierarchischen Datenbanksystem IMS.<br/

Impact of the metabolic syndrome on severe mental disorders

Background!#!Primary palmar hyperhidrosis is a severely debilitating condition that can affect patients of any age. We report our experience with thoracoscopic sympathicolysis in a large cohort of children less than 14 years of age.!##!Methods!#!All children who underwent thoracoscopic sympathicolysis from April 2005 through January 2017 were evaluated retrospectively. The procedure entailed bilateral bipolar fulguration of the second and third thoracic ganglia with transverse disruption of collateral nerve fibers along the third and fourth rib. Demographic information, as well as postoperative outcome, complications, and satisfaction were analyzed.!##!Results!#!Over the 12 year study interval, a total of 102 children underwent thoracoscopic sympathicolysis for palmar hyperhidrosis. Complete follow-up was available for 98 patients (median age 12 [range 5-14] years; 38 boys [39%]). Median follow-up was 4 [range 2-12] years. Complete palmar dryness was achieved in 93 (95%) cases. One patient suffered postoperative unilateral ptosis, 6 reported gustatory sweating, and 65 experienced compensatory sweating. Average postoperative rating on a 1 (lowest) to 10 (highest) rating scale was 9, with 97 (99%) patients saying that they would undergo the procedure again.!##!Conclusion!#!Our technique of thoracoscopic sympathicolysis in children was associated with very high postoperative satisfaction, despite a high rate of compensatory sweating and occasional autonomic gustatory sweating. Other more severe complications in this age group were rare

Affected neural networks as basis of disturbed motor function in schizophrenia

Objective!#!To investigate diagnostic accuracy of a nerve ultrasound (US) protocol that is individualized to a patient's clinical deficits for the differentiation of amyotrophic lateral sclerosis with predominant lower motoneuron disease (ALS/LMND) and multifocal motor neuropathy (MMN).!##!Methods!#!Single-center, prospective, examiner-blinded, diagnostic study in two cohorts. Cohort I (model development): Convenience sample of subjects with ALS/LMND or MMN according to revised El-Escorial or EFNS guidelines. Cohort II (model validation): Consecutively recruited treatment-naïve subjects with suspected diagnosis of ALS/LMND or MMN. Cutoffs for 28 different US values were determined by Receiver Operating Curve (ROC) in cohort I. Area Under The Curve (AUC) of US was compared to nerve conduction studies (NCS). Diagnostic accuracy of US protocols, individualized according to clinical deficits, was compared to former rigid non-individualized protocols and to random examination site selection in cohort II.!##!Results!#!48 patients were recruited. In cohort I (28 patients), US had higher ROC AUCs than NCS, US 0.82 (0.12) (mean (standard deviation)), NCS (compound muscle action potential (CMAP) 0.60 (0.09), p &amp;lt; .001; two-sided t-test). US models based on the nerve innervating the clinically most affected muscles had higher correct classification rates (CCRs, 93%) in cohort II than former rigid protocols (85% and 80%), or models with random measurement site selection (66% and 80%).!##!Conclusions!#!Clinically guided US protocols for differentiation of ALS/LMND from MMN increase diagnostic accuracy when compared to clinically unguided protocols. They also require less measurements sites to achieve this accuracy

Mutational analysis of the internal membrane proximal domain of the HIV glycoprotein C-terminus

AbstractThis study focuses on the long stretch of highly conserved amino acids in the membrane proximal part of the HIV-1 cytoplasmic tail (Env amino acids (aa) 706–718) upstream of the overlap with the tat and rev second coding exons. Changes in Env aa 713 and 715, although they did not affect Env function, abrogated replicative spread. Other amino acid substitutions, i.e., 706–712, 714 and 716, despite their conservation, did not result in defective replicative phenotypes even in primary peripheral blood lymphocytes. Our results point to their involvement in presently unrecognized essential Env functions pertinent only in in vivo. Interestingly, changes in the codons for residues 717–718 as well as some mutations in residues 714–716 abrogated Gag expression but still allowed expression of functional Env in a rev-independent manner. This could be due to the inactivation of a rev-regulated negative element within the respective nucleotide sequence (8354–8368)

Biochemical and molecular characterisation of Tetrahymena thermophila extracellular cysteine proteases

BACKGROUND: Over the last decades molecular biologic techniques have been developed to alter the genome and proteome of Tetrahymena thermophila thereby providing the basis for recombinant protein expression including functional human enzymes. The biotechnological potential of Tetrahymena has been proved in numerous publications, demonstrating fast growth, high biomass, fermentation in ordinary bacterial/yeast equipment, up-scalability, existence of cheap and chemical defined media. For these reasons Tetrahymena offers promising opportunities for the development of a high expression system. Yet optimised high yield strains with protease deficiency such as commonly used in yeast and bacterial systems are not available. RESULTS: This work presents the molecular identification of predominant proteases secreted into the medium by Tetrahymena thermophila. A one-step purification of the proteolytic enzymes is described. CONCLUSION: The information provided will allow silencing of protease activity by either knock out methods or by Tetrahymena specific antisense-ribosome-techniques. This will facilitate the next step in the advancement of this exciting organism for recombinant protein production

A tudományos kommunikáció története a Journal des Scavans-tól az open access-ig

Background: The foamy viral genome encodes four central purine-rich elements localized in the integrase-coding region of pol. Previously, we have shown that the first two of these RNA elements (A and B) are required for protease dimerization and activation. The D element functions as internal polypurine tract during reverse transcription. Peters et al., described the third element (C) as essential for gag expression suggesting that it might serve as an RNA export element for the unspliced genomic transcript. Results: Here, we analysed env splicing and demonstrate that the described C element composed of three GAA repeats known to bind SR proteins regulates env splicing, thus balancing the amount of gag/pol mRNAs. Deletion of the C element effectively promotes a splice site switch from a newly identified env splice acceptor to the intrinsically strong downstream localised env 3′ splice acceptor permitting complete splicing of almost all LTR derived transcripts. We provide evidence that repression of this env splice acceptor is a prerequisite for gag expression. This repression is achieved by the C element, resulting in impaired branch point recognition and SF1/mBBP binding. Separating the branch point from the overlapping purine-rich C element, by insertion of only 20 nucleotides, liberated repression and fully restored splicing to the intrinsically strong env 3′ splice site. This indicated that the cis-acting element might repress splicing by blocking the recognition of essential splice site signals. Conclusions: The foamy viral purine-rich C element regulates splicing by suppressing the branch point recognition of the strongest env splice acceptor. It is essential for the formation of unspliced gag and singly spliced pol transcripts

El proyecto diccionario español-alemán de locuciones del español de España de Colonia/Hamburgo

Ya han pasado varios años desde que la revista Estudis Romànics tuvo la amabilidad de publicarnos una primera presentación de nuestro proyecto (cf. Torrent-Lenzen 2007), hoy todavía en curso, que consiste en la elaboración de un Diccionario español-alemán de locuciones del español de España. Entre tanto, hemos avanzado considerablemente en nuestro trabajo fraseográfico y también hemos ido modificando nuestros objetivos, con lo cual dicho artículo ha perdido actualidad. Es por esta razón que, estando más o menos “a mitad de camino”, queremos exponer de nuevo, en las páginas que siguen, los rasgos principales de nuestra obra, tal como la concebimos ahora después de que hayan madurado muchas ideas