In Patients Undergoing Cochlear Implantation, Psychological Burden Affects Tinnitus and the Overall Outcome of Auditory Rehabilitation

Cochlear implantation (CI) is increasingly being used in the auditory rehabilitation of deaf patients. Here, we investigated whether the auditory rehabilitation can be influenced by the psychological burden caused by mental conditions. Our sample included 47 patients who underwent implantation. All patients were monitored before and 6 months after CI. Auditory performance was assessed using the Oldenburg Inventory (OI) and Freiburg monosyllable (FB MS) speech discrimination test. The health-related quality of life was measured with Nijmegen Cochlear implantation Questionnaire (NCIQ) whereas tinnitus- related distress was measured with the German version of Tinnitus Questionnaire (TQ). We additionally assessed the general perceived quality of life, the perceived stress, coping abilities, anxiety levels and the depressive symptoms. Finally, a structured interview to detect mental conditions (CIDI) was performed before and after surgery. We found that CI led to an overall improvement in auditory performance as well as the anxiety and depression, quality of life, tinnitus distress and coping strategies. CIDI revealed that 81% of patients in our sample had affective, anxiety, and/or somatoform disorders before or after CI. The affective disorders included dysthymia and depression, while anxiety disorders included agoraphobias and unspecified phobias. We also diagnosed cases of somatoform pain disorders and unrecognizable figure somatoform disorders. We found a positive correlation between the auditory performance and the decrease of anxiety and depression, tinnitus-related distress and perceived stress. There was no association between the presence of a mental condition itself and the outcome of auditory rehabilitation. We conclude that the CI candidates exhibit high rates of psychological disorders, and there is a particularly strong association between somatoform disorders and tinnitus. The presence of mental disorders remained unaffected by CI but the degree of psychological burden decreased significantly post-CI. The implants benefitted patients in a number of psychosocial areas, improving the symptoms of depression and anxiety, tinnitus, and their quality of life and coping strategies. The prevalence of mental disorders in patients who are candidates for CI suggests the need for a comprehensive psychological and psychosomatic management of their treatment

ESTIMATING LUMBAR SPINE LOADING DURING VOLLEYBALL SPECIFIC MOVEMENTS USING 3D MODELING

Volleyball has a high prevalence of back pain resulting from degenerated intervertebral discs in the lumbar spine. Therefore knowledge about volleyball specific spine loading and its direction is very important. In this study a method is introduced to calculate spine forces in volleyball specific situations also accounting for muscle forces. Two players performed volleyball specific movements in a laboratory environment. Kinematic data were captured by an infrared camera system. An inverse dynamic model was used to calculate spine forces in all three movement planes. Results indicate that the spike has the highest loading. However, peak loading was recognized in phases of takeoff and landing. The presented method was found to be adequate and might be used for further research to get a more comprehensive insight into the topic

Responses to iron deficiency in Arabidopsis thaliana : The Turbo iron reductase does not depend on the formation of root hairs and transfer cells

Arabidopsis thaliana (L.) Heynh. Columbia wild type and a root hair-less mutant RM57 were grown on iron-containing and iron-deficient nutrient solutions. In both genotypes, ferric chelate reductase (FCR) of intact roots was induced upon iron deficiency and followed a Michaelis-Menten kinetic with a K m of 45 and 54 μM Fe III -EDTA and a V max of 42 and 33 nmol Fe 2+ ·(g FW) −1 ·min −1 for the wild type and the mutant, respectively. The pH optimum for the reaction was around pH 5.5. The approximately four fold stimulation of FCR activity was independent of formation of root hairs and/or transfer cells induced by iron deficiency. Iron-deficiency-induced chlorosis and the development of a rigid root habit disappeared when ferric chelate was applied to the leaves, while FCR activity remained unchanged. The time course of the responses to iron deficiency showed that morphological and physiological responses were controlled separately.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47479/1/425_2004_Article_BF00195707.pd

Unterstützung kommunalplanerischer Prozesse mit CityGLM-basierter Anbindung Modelica-getriebener Quartierssimulationen

Eine integrale Planung städtischer (Energie-)Systeme bedarf einer planungsbegleitenden Unterstützung durch IT-basierte Planungs- und Simulationswerkzeuge. Die durchgängige Anwendung dieser digitalen Planungshilfsmittel wird allerdings bislang insbesondere durch den sehr hohen Aufwand bei der Spezifizierung und Erfassung benötigter Datengrundlagen sowie eine mangelhafte Interoperabilität zwischen den Systemen gehemmt. Im Rahmen eines Forschungsverbundprojektes wird dieses Problemfeld mittels praxisbezogener Prozessanalysen genauer spezifiziert und die technische und fachliche Integration durch die prozessbezogene Spezifikation relevanter Informationsbedarfe sowie die Entwicklung einer darauf aufbauenden, bidirektionalen Schnittstelle auf Basis des etablierten virtuellen Stadtmodellstandards CityGML verbessert. Als exemplarisches Anwendungsszenario innerhalb kommunaler Planungsprozesse wurde die Ausweisung von Vorranggebieten der Fernwärmenutzung basierend auf einer räumlichen Analyse des Wärmebedarfs für verschiedene Entwicklungsszenarien mittels einer bidirektionalen standard-basierten Koppelung von CityGML und Modelica ausgearbeitet

Wenn Kopf, Bauch und Hand zusammenpassen

Nicht jeder Mitarbeiter im Controlling ist begeistert, dass sich Aufgabeninhalte und Arbeitsabläufe derzeit massiv verändern. Motivationsdefizite können die Folge sein. Durch eine Fokussierung auf die intrinsische Motivation von Mitarbeitern lassen sich diese Defizite reduzieren

The Influence of Depression, Anxiety and Cognition on the Treatment Effects of Ginkgo biloba Extract EGb 761® in Patients with Tinnitus and Dementia: A Mediation Analysis

Background: Comorbid occurrence of tinnitus and emotional symptoms of anxiety and depression is highly prevalent. The Ginkgo biloba extract EGb 761® has been shown to be effective in reducing neuropsychiatric symptoms in patients with dementia and tinnitus. Methods: We performed a mediation analysis to evaluate direct effects of EGb 761® on tinnitus severity, as well as indirect effects mediated by symptoms of depression and anxiety and by changed cognition. We pooled data from subsets of patients suffering from tinnitus that were enrolled in three double-blind, randomized, placebo-controlled clinical trials, which investigated the efficacy of EGb 761® (240 mg/day for 22–24 weeks) in dementia with concomitant neuropsychiatric symptoms. Results: In total, 594 patients suffered from tinnitus (EGb 761®, 289; placebo, 305). Direct effects of EGb 761® on tinnitus severity (p < 0.001) in patients with mild to moderate dementia were found to represent about 60% of the total effect, whereas the indirect effects (p < 0.001) mediated by improvement of anxiety, depression and cognition represented about 40% of the total effect. Conclusions: EGb 761® could be considered as a supporting treatment for tinnitus in elderly patients suffering from dementia, with added benefit in those with symptoms of depression or anxiety

The HEPHAISTOS study: compliance and adherence with a novel orthotic device for calf muscle unloading

The present manuscript seeks to discuss methodological aspects regarding the application of the novel unloading orthosis 'HEPHAISTOS' that has been specifically developed to study physiological effects of muscular unloading without altering the impact of gravitational loading. The 'HEPHAISTOS' has been applied in an ambulatory clinical interventional study. During gait, the 'HEPHAISTOS' significantly reduces activation and force production of calf muscles while it completely retains body mass-related force on the tibia. Eleven healthy male subjects participated in the study and followed their normal everyday lives while wearing the orthosis. Several measurement sessions have been performed to investigate the time course of structural and functional adaptations during intervention and recovery. Follow-up measurements were performed for one year after the intervention. In consideration of the experiences of a unique ambulant unloading study, organizational and methodological recommendations are discussed in this manuscript. Activity monitoring data obtained with portable accelerometers reveal unchanged gait activities and good subject compliance throughout the intervention. Moreover, electromyography (EMG) and motion data investigating gait properties on reambulation day are illustrated. These data show that during the initial steps following removal of 'HEPHAISTOS', gait was significantly asynchronous indicating an acutely altered motor control in the unloaded lower leg muscles

Prävalenz von Rückenschmerzen bei Elitesportlern

$\bf Objectives:$ The primary objectives of this investigation were to provide an overview of data about back pain prevalence in athletes, to analyse the prevalence in the German elite athletic population, and to compare it with physically-active individuals. $\bf Methods:$ 1. A comprehensive analysis of the literature was undertaken, using specifically developed search strategies for relevant epidemiological research on back pain. 2. An online back pain questionnaire was sent to approximately 4,000 German elite athletes and a control group of 253 physically-activeindividuals. $\bf Results:$ Lifetime and point prevalence were the most commonly researched episodes and the lower back was the most common location of pain. Lifetime prevalence of low back pain in athletes was 1-94%, and point prevalence was 18-65%. In German elite athletes,prevalence rates were 77% and 34%, respectively, and were slightly higher in athletes than inactive controls (71% and 29%, respectively) and the general population (11-84% and 7-33%, respectively). Prevalence of back pain varied between athletes of different disciplines. $\bf Conclusion:$ Back pain is a common complaint in athletes and in the general population. A high training volume in athletes and a low training volume in the general population might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity to prevent back pain.$\bf Ziele:$ Hauptziel dieser Untersuchung war es, eine Übersicht zur Rückenschmerzprävalenz von Sportler*innen zu erstellen, die Prävalenz in der deutschen Leistungssportelite zu analysieren und diese mit körperlich aktiven Personen zu vergleichen. $\bf Methodik:$ 1. Es wurde eine umfassende Literaturanalyse mit speziell entwickelten Suchstrategien für relevante epidemiologische Rückenschmerzforschung durchgeführt. 2. Ein Online-Rückenschmerzfragebogen wurde an ca. 4000 deutsche Leistungssportler*innen und eine Kontrollgruppe von 253 körperlich aktiven Personen verschickt. $\bf Ergebnisse:$ In der internationalen Literatur waren Lebenszeit- und Punktprävalenz die am häufigsten untersuchten Episoden und der untere Rücken war die häufigste Lokalisation für Schmerzen. Die Lebenszeitprävalenz von Rückenschmerzen bei Sportler*innen betrug 1-94% und die Punktprävalenz betrug 18-65%. Bei deutschen Spitzensportler*innen lagen die Prävalenzen bei 77% bzw. 34% und waren höher im Vergleich zur aktiven Kontrollgruppe (71% bzw. 29%) und der Allgemeinbevölkerung (11-84% und 7-33%). Die Prävalenz von Rückenschmerzen variierte zwischen Sportler*innen verschiedener Disziplinen. $\bf Schlussfolgerung:$ Rückenschmerzen sind ein häufiges gesundheitliches Problem bei Sportler*innen und in der Allgemeinbevölkerung. Ein hohes Trainingsvolumen bei Sportler*innen und ein niedriges Trainingsvolumen in der Allgemeinbevölkerung könnten die Prävalenzraten erhöhen. Die vorliegenden Ergebnisse weisen auf die Notwendigkeit spezifischer Präventionsprogramme hin, insbesondere in risikoreichen Sportarten. Weitere Forschung sollte die optimale Dosis-Wirkungs-Beziehung sportlicher Aktivität untersuchen, um Rückenschmerzen zu verhindern

The mechanical loading of the spine in physical activities

Purpose To summarize the mechanical loading of the spine in different activities of daily living and sports. Methods Since the direct measurement is not feasible in sports activities, a mathematical model was applied to quantify spinal loading of more than 600 physical tasks in more than 200 athletes from several sports disciplines. The outcome is compression and torque (normalized to body weight/mass) at L4/L5. Results The data demonstrate high compressive forces on the lumbar spine in sport-related activities, which are much higher than forces reported in normal daily activities and work tasks. Especially ballistic jumping and landing skills yield high estimated compression at L4/L5 of more than ten times body weight. Jumping, landing, heavy lifting and weight training in sports demonstrate compression forces significantly higher than guideline recommendations for working tasks. Conclusion These results may help to identify acute and long-term risks of low back pain and, thus, may guide the development of preventive interventions for low back pain or injury in athletes