Zur Situation der Kinder in der Welt

Das 20. Jahrhundert begann mit einem Traum. Es sollte ein \u27\u27Jahrhundert des Kindes" werden. So wünschte es sich die schwedische Frauenrechtlerin Ellen Key in ihrem 1900 veröffentlichten gleichnamigen Buch. Kindheit hat sich seither radikal verändert. In den Industrieländern haben Kinder heute Möglichkeiten und Freiheiten, die für ihre Altersgenossen um 1900 noch unvorstellbar waren. Doch dies ist nur die eine Seite der Medaille. Denn während sich bei uns die Computer Kids zunehmend Wohlstandsproblemen gegenüber sehen, kämpfen viele Kinder in den Entwicklungsländern um das tägliche Überleben. (DIPF/Orig.

Finanzwirkung von Gesundheitsreformen auf gesetzliche Krankenkassen - Modellanalyse unter besonderer Berücksichtigung des Risikostrukturausgleichs -

The thesis is about the impact of health care reforms on the competition and budget planning of insurers. The focus are state insurers and there especially the Risikostrukturausgleich. Macro- as well as microeconomic elements are analyzed from a theoretical and practical point of view. The main outcome is a statistical model that simulates the impact on payment in and out of the Risikostrukturausgleich.Die Dissertation beschäftigt sich mit der Bedeutung von gesundheitspolitischen Maßnahmen für die Wettbewerbsfähigkeit und die Finanzplanung von Krankenkassen. Fokus der Arbeit sind die gesetzlichen Krankenkassen und dort im Speziellen der Risikostrukturausgleich. Die Arbeit berührt sowohl gesundheitssystembedingte makroökonomische als auch kassenspezifische mikroökonomische Elemente. Sie werden jeweils von theoretischer und praktischer Seite betrachtet, wobei der Schwerpunkt in etwa gleich verteilt ist. Wesentliches Element der Arbeit ist ein mathematisches Modell, mit dem die Auswirkungen auf die Ausgleichszahlungen des Risikostrukturausgleichs simuliert werden

Biomechanical comparison of a new expandable intramedullary nail and conventional intramedullary nails for femoral osteosynthesis in dogs

Intramedullary nailing of diaphyseal femoral fractures is a commonly used treatment method in dogs because of its biological and biomechanical advantages compared to bone plating. To achieve adequate resistance of the intramedullary nail against torsional and axial compressive forces, additional application of transcortical screws is needed. As these interlocking screws represent a frequent cause of post-operative complications, a new expandable intramedullary nail (EXPN) was developed, which was designed to provide adequate fracture stabilisation without the need for transcortical fixation. The evaluation of the biomechanical properties of the new EXPN with regard to torsional, compressive and bending stability as well as direct comparison to the biomechanical properties of conventional Steinmann (STMN)- and interlocking (ILN) nails was carried out with different biomechanical test arrangements. No significant statistical differences regarding the torsional and bending resistance between the EXPN and ILN group were seen, which indicates that rotatory as well as bending stability of the innovative EXPN is similar to the conventional ILN. Nevertheless, the percentage deviation between the attempted and successfully reached physiological compressive forces was significantly higher (p = 0.045) in the EXPN group compared to the ILN group, which indicates that the compressive stability of the innovative EXPN might be weaker compared to the ILN. In summary, the new EXPN represents an interesting alternative to conventional intramedullary nails. However, in direct comparison to conventional interlocking nails, the EXPN has shown weaknesses in the neutralization of axial compressive forces, which indicates that at least biomechanically the interlocking nail seems advantageous. Further in-vitro and in-vivo investigations are required before clinical use can be recommended. © 2020 Plenert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

The Toarcian Posidonia Shale at Salem (North Alpine Foreland Basin; South Germany): hydrocarbon potential and paleogeography

The Posidonia Shale in the basement of the North Alpine Foreland Basin of southwestern Germany represents an important archive for environmental changes during the Toarcian oceanic anoxic event and the associated carbon isotope excursion (T-CIE). It is also an important hydrocarbon source rock. In the Salem borehole, the Posidonia Shale is ~ 10 m thick. The lower 7.5 m (1763.5–1756.0 m) of the Posidonian Shale and the uppermost part of the underlying Amaltheenton Formation were cored and studied using a total of 62 samples. Rock–Eval, palynological, maceral, biomarker and carbon isotope data were collected to assess variations in environmental conditions and to quantify the source rock potential. In contrast to most other Toarcian sections in southwest Germany, TOC contents are high in sediments deposited during the T-CIE, but reach a peak in post-CIE sediments. Biomarker ratios suggest that this reflects strong oxygen-depletion during the T-CIE (elegantulum to lower elegans subzones), but also during the falciferum Subzone, which is also reflected by a prolonged dinoflagellate cyst blackout. While sediments of the tenuicostatum Zone to the elegans Subzone are thinner than in neighbouring sections (e.g., Dotternhausen), sediments of the falciferum Subzone are unusually thick, suggesting that increased subsidence might have contributed to anoxia. The T-CIE interval is very thin (0.75 m). δ$^{13}$C values of n-alkanes show that the maximum negative isotope shift predates the strongest basin restriction during the T-CIE and that the carbon isotope shift is recorded earlier for aquatic than for terrigenous organisms. In Salem, the Posidonia Shale is thermally mature and highly oil-prone. The residual source petroleum potential is about 0.8 tHC/m$^{2}$. Graphical Abstrac

(23)Na magnetic resonance imaging of the lower leg of acute heart failure patients during diuretic treatment

OBJECTIVE: Na+ can be stored in muscle and skin without commensurate water accumulation. The aim of this study was to assess Na+ and H2O in muscle and skin with MRI in acute heart failure patients before and after diuretic treatment and in a healthy cohort. METHODS: Nine patients (mean age 78 years; range 58-87) and nine age and gender-matched controls were studied. They underwent 23Na/1H-MRI at the calf with a custom-made knee coil. Patients were studied before and after diuretic therapy. 23Na-MRI gray-scale measurements of Na+-phantoms served to quantify Na+-concentrations. A fat-suppressed inversion recovery sequence was used to quantify H2O content. RESULTS: Plasma Na+-levels did not change during therapy. Mean Na+-concentrations in muscle and skin decreased after furosemide therapy (before therapy: 30.7+/-6.4 and 43.5+/-14.5 mmol/L; after therapy: 24.2+/-6.1 and 32.2+/-12.0 mmol/L; p<0.05 and p<0.01). Water content measurements did not differ significantly before and after furosemide therapy in muscle (p = 0.17) and only tended to be reduced in skin (p = 0.06). Na+-concentrations in calf muscle and skin of patients before and after diuretic therapy were significantly higher than in healthy subjects (18.3+/-2.5 and 21.1+/-2.3 mmol/L). CONCLUSIONS: 23Na-MRI shows accumulation of Na+ in muscle and skin in patients with acute heart failure. Diuretic treatment can mobilize this Na+-deposition; however, contrary to expectations, water and Na+-mobilization are poorly correlated

The hidden identity of faces. A case of lifelong prosopagnosia

Wegrzyn M, Garlichs A, Heß RWK, Woermann FG, Labudda K. The hidden identity of faces. A case of lifelong prosopagnosia. BMC Psychology. 2019;7(1): 4.Background Not being able to recognize a person’s face is a highly debilitating condition from which people with developmental prosopagnosia (DP) suffer their entire life. Here we describe the case of J, a 30 year old woman who reports being unable to recognize her parents, her husband, or herself in the mirror. Case presentation We set out to assess the severity of J’s prosopagnosia using tests with unfamiliar as well as familiar faces and investigated whether impaired configural processing explains her deficit. To assess the specificity of the impairment, we tested J’s performance when evaluating emotions, intentions, and the attractiveness and likability of faces. Detailed testing revealed typical brain activity patterns for faces and normal object recognition skills, and no evidence of any brain injury. However, compared to a group of matched controls, J showed severe deficits in learning new faces, and in recognizing familiar faces when only inner features were available. Her recognition of uncropped faces with blurred features was within the normal range, indicating preserved configural processing when peripheral features are available. J was also unimpaired when evaluating intentions and emotions in faces. In line with healthy controls, J rated more average faces as more attractive. However, she was the only one to rate them as less likable, indicating a preference for more distinctive and easier to recognize faces. Conclusions Taken together, the results illustrate both the severity and the specificity of DP in a single case. While DP is a heterogeneous disorder, an inability to integrate the inner features of the face into a whole might be the best explanation for the difficulties many individuals with prosopagnosia experience

Case report: C-reactive protein apheresis in cardiogenic shock: case series from the C-reactive protein apheresis in acute myocardial infarction-registry

C-reactive protein (CRP) apheresis may preserve myocardial tissue after acute myocardial infarction with delayed revascularization. Ten consecutive patients with cardiogenic shock were graded using the Society of Cardiovascular Angiography and Interventions shock classification and treated with CRP apheresis. All patients tolerated CRP apheresis well and were discharged in good clinical condition

Association Between Plasma Monocyte Chemoattractant Protein-1 Concentration and Cardiovascular Disease Mortality in Middle-Aged Diabetic and Nondiabetic Individuals

OBJECTIVE Monocyte chemoattractant protein-1 (MCP-1/CCL2) is a chemokine involved into the pathogenesis of atherosclerosis and has prognostic value in the acute and chronic phases in patients with acute coronary syndromes. RESEARCH DESIGN AND METHODS MCP-1/CCL2 concentration was measured in plasma fractions of 363 middle-aged overweight/obese individuals (aged 61 \ub1 12 years, BMI 30.1 \ub1 6.6 kg/m2, 15% with type 2 diabetes, and 12% with impaired glucose tolerance) of a population survey carried out in 1990\u20131991 in Lombardy, Italy (Cremona Study), and cardiovascular disease (CVD) mortality was assessed in 2006 through Regional Health Registry files. RESULTS At baseline MCP-1/CCL2 was increased in individuals with type 2 diabetes (P < 0.05) and showed significant correlations with biochemical risk markers of atherosclerosis. After 15 years, among the 363 subjects, there were 82 deaths due to CVD. In univariate analysis age, sex, fasting glucose and insulin, fibrinogen, glucose tolerance status, smoking habit, and MCP-1/CCL2 were associated with CVD mortality. Age, sex, fasting serum glucose, MCP-1/CCL2, and smoking habit maintained an independent association with CVD mortality in multiple regression analysis. In a subgroup of 113 subjects in whom data for C-reactive protein (CRP) were available, its level was not predictive of CVD mortality. CONCLUSIONS In middle-aged overweight/obese individuals MCP-1/CCL2 was independently associated with CVD mortality. Further studies will be necessary to establish its role as a surrogate biomarker and as a potential therapeutic target