Optical cleaning of lithium niobate crystals

An all-optical method for the removal of photoexcitable electrons from photorefractive centers to get rid of optical damage in lithium niobate crystals is presented, the so-called "optical cleaning". The method combines the photovoltaic drift of electrons with ionic charge compensation at sufficiently high temperatures of about 180 °C. Optimum choice of the light pattern plus heat dramatically decreases the concentration of photoexcitable electrons in the exposed region leading to a suppression of optical damage. Experiments with slightly iron-doped lithium niobate crystals have shown an increase of the threshold for optical damage of more than 1000 compared to those of untreated crystals

Holography in commercially available photoetchable glasses

Volume holographic gratings are recorded and retrieved in two commercially available glasses: Schott Foturan and Hoya PEG3. These materials are photoetchable, which describes their major application, but they also allow storage of volume holograms without any chemical etching. The samples are illuminated with ultraviolet light at a wavelength of 325 nm and thermally processed to achieve a maximum diffraction efficiency of approximately 9% for a 1-mm-thick sample. The two glasses show similar behavior; the diffraction efficiencies in Foturan tend to be slightly larger, whereas PEG3 tends to have weaker light scattering

RECOVERY OF DAILY ACTIVITY PATTERNS IN PATIENTS AFTER ACL RECONSTRUCTION

Injuries of the anterior cruciate ligament are one of the most often occurring injuries during sports activities. For young active patients, surgical treatment with repair, augmentation or replacement of the involved structure(s) is advised. The present study compared the outcome after Ligamys repair and Semitendinosus reconstruction during the first six postoperative weeks with objective measurements of the activity/inactivity behavior in daily life

Der aktuelle Stand der Forschung zur Homöopathie

In diesem Bericht zum Stand der Homöopathie-Forschung werden die Forschungsbereiche Versorgungsforschung, randomisierte kontrollierte klinische Studien, Meta-Analysen und Grundlagenforschung zusammenfassend dargestellt. Dies soll einen Beitrag leisten zur Diskussion innerhalb der Homöopathie, über die Notwendigkeit von Forschung, über die Bedeutung einzelner Forschungsfelder und -methoden und deren Rolle für die künftige Forschungsstrategie. Aber auch für die Diskussion innerhalb der gesamten Medizin und für die Öffentlichkeit stellen wir diesen aktuellen Stand der wissenschaftlichen Forschung zur Verfügung. Während die konventionelle Entwicklung von Medikamenten auf Forschung beruht, die sich dann der medizinischen Praxis stellen muss, ist die Homöopathie in erster Linie eine erfolgreiche medizinische Praxis, die sich der wissenschaftlichen Forschung stellen muss. Studien aus der Versorgungsforschung zur Homöopathie unter Praxis-Bedingungen zeigen klinisch relevante Verbesserungen von Symptomen und Lebensqualität, häufig vergleichbar mit denen konventioneller Therapien; jedoch werden weniger Nebenwirkungen berichtet. In der Hälfte aller gesundheitsökonomischen Evaluationen geht die Homöopathie mit geringeren Kosten einher. Eine Kausalbeziehung zwischen Arzneitherapie und Therapieergebnis lässt sich aus methodischen Gründen allerdings aus diesen Studien nicht ableiten. Die hier untersuchten randomisierten kontrollierten klinischen Studien (ausschließlich methodisch hochwertige Studien zur individualisierten Homöopathie mit Hochpotenzen) ergeben, in Übereinstimmung mit früheren Untersuchungen, Hinweise für eine Überlegenheit der klassischen Homöopathie im Vergleich zu Placebo, mithin für einen spezifischen Effekt von Hochpotenzen. Eine endgültige wissenschaftliche Aussage ist aufgrund der heterogenen Studienlage und der geringen Anzahl qualitativ hochstehender Studien aber derzeit nicht möglich. Eine Betrachtung der Meta-Analysen zur Homöopathie zeigt überwiegend statistisch signifikante Ergebnisse gegenüber Placebo, die auf eine spezifische Wirksamkeit potenzierter Arzneien hinweisen. Je nach den verwendeten Selektionskriterien werden hierbei unterschiedliche Studien in die Auswertung eingeschlossen. Die Mehrzahl der Studien, auch der methodisch hochwertigen, weist in allen untersuchten Übersichtsarbeiten (inkl. Shang et al.) auf die Überlegenheit der homöopathischen Therapie gegenüber Placebo hin. Diese Befunde werden von den Autoren der jeweiligen Meta-Analysen zum Teil stark relativiert. Die angeführten Vorbehalte, z. B. hinsichtlich der Studienqualität, entsprechen hierbei nicht immer den üblichen wissenschaftlichen Standards, oder sie berufen sich sogar ausdrücklich auf eine postulierte Implausibilität der Wirksamkeit hochpotenzierter Arzneimittel. In der Grundlagenforschung finden sich viele qualitativ hochwertige Studien, die spezifische Wirkungen auch für Hochpotenzen beobachteten, darunter mittlerweile auch unabhängig replizierte experimentelle Modelle. Zum physikochemisch-pharmazeutischen sowie zum biologischen Wirkprinzip gibt es erste empirische Hinweise, aber noch keine ausgereifte Theorie. Eine zusammenfassende Betrachtung klinischer Forschungsdaten belegt hinreichend einen therapeutischen Nutzen (effectiveness) der homöopathischen Behandlung

The Current State of Homeopathic Research

This report on the current state of homeopathic research provides a summary on the research areas of healthcare research, randomised controlled clinical trials, meta-analyses and basic research. It aims to contribute to the discussion within the field of homeopathy concerning the need for research, the relevance of individual research fields and methods, and their role in future research strategies. We are also publishing this report on the current status of scientific research, moreover, for the benefit of medical science as a whole and the public. Whilst the conventional development of medicinal products is based on research which must then stand up to medical practice, homeopathy is primarily a successful medical practice that must stand up to scientific research. Outcome studies investigating homeopathic treatment under routine conditions have reported clinically relevant improvements in symptoms and quality of life, often comparable with those under conventional treatments, but with fewer adverse effects. In half of all health economic evaluations homeopathic treatment showed less costs. Methodologically, a causal relationship between drug therapy and therapeutic outcome cannot be deduced from those studies. The randomised controlled clinical trials investigated here, studies with good methodology into individualised homeopathy with high potencies only, have indicated, like earlier studies, that classical homeopathy is superior to placebo, and that remedies in high potencies have a specific effect. A definitive scientific statement cannot be made at present given the heterogeneous nature of the data and the small number of studies of good quality. A review of the meta-analyses of homeopathy reveals results which mostly are statistically significant compared to placebo, suggesting specific efficacy from potentised remedies. Depending on the selection criteria applied, different studies are thereby included in the analysis. The majority of the studies reported in all the examined reviews (also Shang et al.), including those with good methodology, suggest that homeopathic treatment is superior to placebo. These findings are in part markedly qualified by the authors of the respective meta-analyses in their (comment/discussion and) conclusion. The stated caveats, e.g. with respect to study quality, thereby do not always reflect the usual scientific standards, or they actually refer explicitly to the postulated implausibility of the efficacy of high-potency medicines. There are a number of high-quality basic research studies that report specific effects also for high potencies, inclusive also of independently replicated experimental models. There are initial empirical results pointing to the physicochemical and pharmaceutical, as well as biological ways homeopathic remedies work, but no theory is fully developed yet. A summary analysis of the clinical research data offers sufficient evidence of the therapeutic effectiveness of homeopathic treatment. The results from numerous placebo-controlled trials and basic research experiments suggest, moreover, that potentised medicines offer a specific efficacy. Put in perspective, there are many important open research areas – notably: • Basic research into the optimisation of laboratory models and the understanding of the mode of action • Independent replications of studies in clinical and basic research • Exploration of the provision of homeopathic care in reality, also combined with conventional medicine • Health economic analyses to evaluate the costs and benefits (cost effectiveness

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

BACKGROUND: Employment is of great importance as it is associated with various positive effects. Individuals with severe mental illness (SMI) are often excluded from competitive employment. Current data on employment of individuals with mental illness are rare, and influencing factors are under-researched. The present study examines possible predictors of competitive employment among individuals with SMI. METHODS: This was a cross-sectional and multicentered study of 300 individuals with SMI aged 18 to 65 years. The following inclusion criteria were used: (I) diagnosis of schizophrenia, schizotypal and delusional disorders (ICD-10 F2x), or affective disorders (ICD-10 F3x), (II) duration of psychiatric illness ≥ 2 years, and (III) substantial impact of illness on social functioning. Participants were interviewed by trained staff using standardised instruments. The relationship between potential predictors (age, sex, education, marital status, living situation, migration background, psychosocial functioning, age at first mental problem, physical illness, work ability) and employment was analysed using a hierarchic binary logistic regression model. RESULTS: Only one-third (34%) of participants were competitively employed. Almost one-third were unemployed (30%), and 28% reported early retirement due to mental illness. Psychosocial functioning was positively associated with competitive employment (OR = 1.09, 95% CI: 1.05 – 1.13, p < 0.001); concurrent chronic physical illness was negatively associated with competitive employment (OR = 0.38, 95% CI: 0.21 – 0.71, p = 0.002). CONCLUSIONS: Findings confirm a high risk of exclusion from competitive employment among individuals with SMI. Nonetheless, a substantial proportion of individuals are employed. Findings call for efforts to maintain or enhance workforce participation among individuals with SMI. A special focus should be placed on improving physical health and strengthening psychosocial functioning. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Register (DRKS) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019)

The role of migration in mental healthcare: treatment satisfaction and utilization

Migration rates increase globally and require an adaption of national mental health services to the needs of persons with migration background. Therefore, we aimed to identify differences between persons with and without migratory background regarding (1) treatment satisfaction, (2) needed and received mental healthcare and (3) utilization of mental healthcare. In the context of a cross-sectional multicenter study, inpatients and day hospital patients of psychiatric settings in Southern Germany with severe affective and non-affective psychoses were included. Patients’ satisfaction with and their use of mental healthcare services were assessed by VSSS-54 and CSSRI-EU; patients’ needs were measured via CAN-EU. In total, 387 participants (migratory background: n = 72; 19%) provided sufficient responses for analyses. Migrant patients were more satisfied with the overall treatment in the past year compared to non-migrant patients. No differences between both groups were identified in met and unmet treatment needs and use of supply services (psychiatric, psychotherapeutic, and psychosocial treatment). Despite a comparable degree of met and unmet treatment needs and mental health service use among migrants and non-migrants, patients with migration background showed higher overall treatment satisfaction compared to non-migrants. The role of sociocultural and migrant-related factors may explain our findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-022-03722-8

Employment status and desire for work in severe mental illness: results from an observational, cross-sectional study

PURPOSE: People with a severe mental illness (SMI) are at particular risk of occupational exclusion. Among the approaches to occupational rehabilitation, supported employment (SE) has been proven to be the most effective. A requirement to enter SE-programs is that individuals must want to seek competitive employment. The aim of this work is to investigate the relationship between serious mental illness and the desire to work including potential predictors. METHODS: This is a cross-sectional observational study of patients with SMI aged 18–65 years (n = 397). Patients were interviewed by trained staff using standardised instruments. The relationship between potential predictors and a strong preference for employment were analysed using a hierarchic binary logistic regression model. RESULTS: Only about one-quarter (27.9%) of SMI patients is in competitive employment. Another quarter is unemployed (25.9%). Results show that the desire for competitive employment is strong among more than half of the SMI patients. Among the unemployed, two-thirds express a strong desire for work. These individuals are an ideal target group for SE interventions. Comorbid chronic physical illness, diagnosis, and the subjectively judged ability to work are associated with the desire for work. CONCLUSION: Our data confirm a substantial exclusion of individuals with SMI from the workforce. In general, care needs for workplace interventions are not being met and leave much room for improvement. In addition to employment status, the desire for work should be routinely assessed. STUDY REGISTRATION: The study was registered in the German Clinical Trials Register (DRKS) (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015801) and under the WHO-Platform “International Clinical Trials Registry Platform” (ICTRP) (https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00015801) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019)

Balancing scientific interests and the rights of participants in designing a recall by genotype study

Recall by genotype (RbG) studies aim to better understand the phenotypes that correspond to genetic variants of interest, by recruiting carriers of such variants for further phenotyping. RbG approaches pose major ethical and legal challenges related to the disclosure of possibly unwanted genetic information. The Cooperative Health Research in South Tyrol (CHRIS) study is a longitudinal cohort study based in South Tyrol, Italy. Demand has grown for CHRIS study participants to be enrolled in RbG studies, thus making the design of a suitable ethical framework a pressing need. We here report upon the design of a pilot RbG study conducted with CHRIS study participants. By reviewing the literature and by consulting relevant stakeholders (CHRIS participants, clinical geneticists, ethics board, GPs), we identified key ethical issues in RbG approaches (e.g. complexity of the context, communication of genetic results, measures to further protect participants). The design of the pilot was based on a feasibility assessment, the selection of a suitable test case within the ProtectMove Research Unit on reduced penetrance of hereditary movement disorders, and the development of appropriate recruitment and communication strategies. An empirical study was embedded in the pilot study with the aim of understanding participants’ views on RbG. Our experience with the pilot study in CHRIS allowed us to contribute to the development of best practices and policies for RbG studies by drawing recommendations: addressing the possibility of RbG in the original consent, implementing tailored communication strategies, engaging stakeholders, designing embedded empirical studies, and sharing research experiences and methodology

Patellar tendon properties distinguish elite from non-elite soccer players and are related to peak horizontal but not vertical power

Purpose: The aims of our study were to investigate differences in tendon properties between elite and non-elite soccer players, and to establish whether tendon properties were related to power assessed during unilateral jumps in different directions. Methods: Elite (n=16; age, 18.1 ± 1.0yrs) and non-elite (n=13; age, 22.3 ± 2.7yrs) soccer players performed three repetitions of each type (unilateral vertical, unilateral horizontal-forward and unilateral medial) of countermovement jump (CMJ) on a force plate. Patellar tendon (PT) cross-sectional area (CSA), elongation, stiffness and Young’s modulus (measured at the highest common force interval) were assessed with ultrasonography and isokinetic dynamometry. Results: Elite soccer players demonstrated greater PT elongation (6.83±1.87 vs. 4.92±1.88 mm, P=0.011) and strain (11.73±3.25 vs. 8.38±3.06 %, P=0.009) than non-elite. Projectile range and peak horizontal power during unilateral horizontal-forward CMJ correlated positively with tendon elongation (r=0.657 and 0.693, P<0.001) but inversely with Young’s modulus (r=-0.376 and -0.402, P=0.044 and 0.031). Peak medial power during unilateral medial CMJ correlated positively with tendon elongation (r=0.658, P=<0.001) but inversely with tendon stiffness (r=-0.368, P=0.050). No tendon property correlated with unilateral vertical CMJ performance (r≤0.168; P≥0.204). Conclusions: Patellar tendon strain was greater in elite vs. non-elite soccer players and can therefore be considered an indicator of elite soccer playing status. Moreover, a more compliant patellar tendon appears to facilitate unilateral horizontal-forward and medial, but not vertical CMJ performance in soccer players. These findings should be considered when prescribing the detail of talent selection and development protocols related to direction-specific power in elite soccer players