510 research outputs found

    Untersuchungen der Einsetzbarkeit von Smartphone-Applikationen zur Messung von Arbeitsumweltfaktoren am Beispiel Klima

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    Der Einsatz von Smartphones hat nicht nur im Alltag, sondern auch im industriellen Kontext in den letzten Jahren stark zugenommen. Die eingebaute Sensorik in Smartphones bietet Potential für vielfältige Anwendungen. Ein mögliches Einsatzgebiet stellt die Messung von Arbeitsumweltfaktoren wie Lärm, Klima und Beleuchtung dar. Hierzu wurde sich u.a. mit der Fragestellung beschäftigt, inwiefern mit Applikationen auf Smartphones arbeitswissenschaftliche Messungen des Arbeitsumweltfaktors Klima möglich sind. Im Ergebnis kann festgehalten werden, dass einzelne Applikationen für orientierende Messungen herangezogen werden können. Zwischen verschiedenen Applikationen sind jedoch größere Messabweichungen feststellbar. Dies bedingt eine geeignete Vorauswahl. Der nachfolgende Beitrag stellt ausgewählte Ergebnisse der durchgeführten Klimamessungen mittels Smartphones vor

    Selbstbestimmung am Lebensende: Nachdenken über assistierten Suizid und aktive Sterbehilfe

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    Sterben und Tod gehören zum Leben. Das gilt nicht nur für jeden Einzelnen, sondern auch für unsere Gesellschaft. Auch sie muss immer wieder prüfen, wie sie mit den Sterbenden und dem Sterben umgeht. Gestorben wird nicht im rechtsfreien Raum. Gesetze können menschliche Zuwendung weder verordnen noch sie ersetzen. Aber jeder, der Angehörige oder Freunde beim Sterben begleiten oder ihnen beim Sterben helfen will, sollte vorab wissen (können), wie weit seine Hilfe gehen darf und an welche Regeln er sich zu halten hat. In einer demokratischen Gesellschaft sind das vor allem die Selbstbestimmung des Sterbenden und dessen Würde - eingebettet in ein mehr oder weniger gutes Vertrauensverhältnis zu Angehörigen sowie Pfleger/innen und Ärzt/innen. Wie weit sterbende Menschen ihr Lebensende selbstbestimmt gestalten können, ist auch ein bürgerrechtliches Anliegen, das offenkundig immer deutlicher artikuliert wird. Denn Sterben wird heute nicht tabuisiert, es ist kein Schicksal mehr, dem Männer und Frauen sich einfach zu unterwerfen hätten. Viele Menschen machen für ihr Sterben selbstbewusst Freiheits- und Selbst-bestimmungsrechte geltend, die sich zunehmend auch auf die Umstände und den Zeitpunkt des Todes und das Bild erstrecken, das sie in der Erinnerung ihrer Angehörigen hinterlassen möchten. Sie wollen das Bild eines würdevollen Menschen hinterlassen und nicht das einer Mensch/Maschine-Chimäre. Dabei ist zu bedenken, dass die meisten Todesfälle heute nicht unversehens, sondern absehbar und erwartet auftreten. Viele von ihnen setzen die bewusste Entscheidung voraus, das Leben eines Menschen enden, ihn sterben zu lassen. In dieser Publikation wird nach den rechtlichen Rahmenbedingungen des Sterbens und nach sinnvollen Zielen rechtlicher Regelungen für ein Sterben in Würde gefragt

    Stage II/III rectal cancer with intermediate response to preoperative radiochemotherapy: Do we have indications for individual risk stratification?

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    <p>Abstract</p> <p>Background</p> <p>Response to preoperative radiochemotherapy (RCT) in patients with locally advanced rectal cancer is very heterogeneous. Pathologic complete response (pCR) is accompanied by a favorable outcome. However, most patients show incomplete response. The aim of this investigation was to find indications for risk stratification in the group of intermediate responders to RCT.</p> <p>Methods</p> <p>From a prospective database of 496 patients with rectal adenocarcinoma, 107 patients with stage II/III cancers and intermediate response to preoperative 5-FU based RCT (ypT2/3 and TRG 2/3), treated within the German Rectal Cancer Trials were studied. Surgical treatment comprised curative (R0) total mesorectal excision (TME) in all cases. In 95 patients available for statistical analyses, residual transmural infiltration of the mesorectal compartment, nodal involvement and histolologic tumor grading were investigated for their prognostic impact on disease-free (DFS) and overall survival (OS).</p> <p>Results</p> <p>Residual tumor transgression into the mesorectal compartment (ypT3) did not influence DFS and OS rates (p = 0.619, p = 0.602, respectively). Nodal involvement after preoperative RCT (ypN1/2) turned out to be a valid prognostic factor with decreased DFS and OS (p = 0.0463, p = 0.0236, respectively). Persistent tumor infiltration of the mesorectum (ypT3) and histologic tumor grading of residual tumor cell clusters were strongly correlated with lymph node metastases after neoadjuvant treatment (p < 0.001).</p> <p>Conclusions</p> <p>Advanced transmural tumor invasion after RCT does not affect prognosis when curative (R0) resection is achievable. Residual nodal status is the most important predictor of individual outcome in intermediate responders to preoperative RCT. Furthermore, ypT stage and tumor grading turn out to be additional auxiliary factors. Future clinical trials for risk-adapted adjuvant therapy should be based on a synopsis of clinicopathologic parameters.</p

    Outcome Prediction in Pneumonia Induced ALI/ARDS by Clinical Features and Peptide Patterns of BALF Determined by Mass Spectrometry

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    BACKGROUND: Peptide patterns of bronchoalveolar lavage fluid (BALF) were assumed to reflect the complex pathology of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) better than clinical and inflammatory parameters and may be superior for outcome prediction. METHODOLOGY/PRINCIPAL FINDINGS: A training group of patients suffering from ALI/ARDS was compiled from equal numbers of survivors and nonsurvivors. Clinical history, ventilation parameters, Murray's lung injury severity score (Murray's LISS) and interleukins in BALF were gathered. In addition, samples of bronchoalveolar lavage fluid were analyzed by means of hydrophobic chromatography and MALDI-ToF mass spectrometry (MALDI-ToF MS). Receiver operating characteristic (ROC) analysis for each clinical and cytokine parameter revealed interleukin-6>interleukin-8>diabetes mellitus>Murray's LISS as the best outcome predictors. Outcome predicted on the basis of BALF levels of interleukin-6 resulted in 79.4% accuracy, 82.7% sensitivity and 76.1% specificity (area under the ROC curve, AUC, 0.853). Both clinical parameters and cytokines as well as peptide patterns determined by MALDI-ToF MS were analyzed by classification and regression tree (CART) analysis and support vector machine (SVM) algorithms. CART analysis including Murray's LISS, interleukin-6 and interleukin-8 in combination was correct in 78.0%. MALDI-ToF MS of BALF peptides did not reveal a single identifiable biomarker for ARDS. However, classification of patients was successfully achieved based on the entire peptide pattern analyzed using SVM. This method resulted in 90% accuracy, 93.3% sensitivity and 86.7% specificity following a 10-fold cross validation (AUC = 0.953). Subsequent validation of the optimized SVM algorithm with a test group of patients with unknown prognosis yielded 87.5% accuracy, 83.3% sensitivity and 90.0% specificity. CONCLUSIONS/SIGNIFICANCE: MALDI-ToF MS peptide patterns of BALF, evaluated by appropriate mathematical methods can be of value in predicting outcome in pneumonia induced ALI/ARDS

    A genome-wide association study identifies risk alleles in plasminogen and P4HA2 associated with giant cell arteritis

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    Giant cell arteritis (GCA) is the most common form of vasculitis in individuals older than 50 years in Western countries. To shed light onto the genetic background influencing susceptibility for GCA, we performed a genome-wide association screening in a well-powered study cohort. After imputation, 1,844,133 genetic variants were analysed in 2,134 cases and 9,125 unaffected controls from ten independent populations of European ancestry. Our data confirmed HLA class II as the strongest associated region (independent signals: rs9268905, P = 1.94E-54, per-allele OR = 1.79; and rs9275592, P = 1.14E-40, OR = 2.08). Additionally, PLG and P4HA2 were identified as GCA risk genes at the genome-wide level of significance (rs4252134, P = 1.23E-10, OR = 1.28; and rs128738, P = 4.60E-09, OR = 1.32, respectively). Interestingly, we observed that the association peaks overlapped with different regulatory elements related to cell types and tissues involved in the pathophysiology of GCA. PLG and P4HA2 are involved in vascular remodelling and angiogenesis, suggesting a high relevance of these processes for the pathogenic mechanisms underlying this type of vasculitis

    Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

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    Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

    Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

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    One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

    Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

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    This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good
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