TERT promoter mutations are highly recurrent in SHH subgroup medulloblastoma

Telomerase reverse transcriptase (TERT) promoter mutations were recently shown to drive telomerase activity in various cancer types, including medulloblastoma. However, the clinical and biological implications of TERT mutations in medulloblastoma have not been described. Hence, we sought to describe these mutations and their impact in a subgroup-specific manner. We analyzed the TERT promoter by direct sequencing and genotyping in 466 medulloblastomas. The mutational distributions were determined according to subgroup affiliation, demographics, and clinical, prognostic, and molecular features. Integrated genomics approaches were used to identify specific somatic copy number alterations in TERT promoter-mutated and wild-type tumors. Overall, TERT promoter mutations were identified in 21 % of medulloblastomas. Strikingly, the highest frequencies of TERT mutations were observed in SHH (83 %; 55/66) and WNT (31 %; 4/13) medulloblastomas derived from adult patients. Group 3 and Group 4 harbored this alteration in <5 % of cases and showed no association wit

Mitigating risk of exceeding environmental limits requires ambitious food system interventions

Transforming the global food system is necessary to avoid exceeding planetary boundaries. A robust evidence base is crucial to assess the scale and combination of interventions required for a sustainable transformation. We developed a risk assessment framework, underpinned by a meta-regression of 60 global food system modeling studies, to quantify the potential of individual and combined interventions to mitigate the risk of exceeding the boundaries for land-system change, freshwater use, climate change, and biogeochemical flows by 2050. Limiting the risk of exceedance across four key planetary boundaries requires a high but plausible level of ambition in all demand-side (diet, population, waste) and most supply-side interventions. Attaining the required level of ambition for all interventions relies on embracing synergistic actions across the food system

Epidemiology of surgery associated acute kidney injury (EPIS-AKI) : a prospective international observational multi-center clinical study

The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Konzept zur Komfortforschung - Erfassung subjektiver und objektiver Beanspruchungskomponenten

Comfort aspects play an important role in mobility and therefore a decisive role in the car industry. The examinations are based on collection of subjective and objective components of the comfort level having a vehicle seat as an example. For the comfort evaluation the acceptance should be enhanced as a base, like in every psycho-physiologic research based on Fahrenberg's multiple layer concept. This is composed of the parallel registration of behavior and performance data (here driving behavior), psychic condition judgment (here questionnaire process) and objective psychological stress data (here heart rate and its variability parameters)

Mobile augmented reality in industrial applications: approaches for solution of user-related issues

Augmented Reality (AR) uses computer-generated virtual information to enhance the user's information access. While numerous previous studies have demonstrated the large potential of AR to improve industrial processes by enhancing product quality and reducing production times it is still unclear if and how long term usage of such AR technology produces stress and strain. This paper presents an approach to use the analysis of Heart Rate Variability to objectively measure current user strain during different work tasks. Results of a user study comparing strain during an AR supported and a non-AR supported work task in a laboratory setting are presented and discussed