17-jähriger Mann mit akuten Bauchschmerzen, Hämatochezie und Exanthem

Zusammenfassung: Ein 17-jähriger Patient stellte sich mit kolikartigen abdominellen Schmerzen und Diarrhö vor. Als weitere Symptome traten Petechien, Arthralgien und eine Hämatochezie auf. Sonographisch bestand eine auffällige Ileozökalregion. Endoskopisch fand sich eine Ileitis terminalis, und histologisch zeigte sich hier eine leukozytoklastische Vaskulitis mit IgA-Ablagerungen. Die Kasuistik zeigt exemplarisch die mehrzeitige klinische Manifestation der Purpura Schönlein-Henoch und deren Verlau

Intermittency in the Joint Cascade of Energy and Helicity

The statistics of the energy and helicity fluxes in isotropic turbulence are studied using high resolution direct numerical simulation. The scaling exponents of the energy flux agree with those of the transverse velocity structure functions through refined similarity hypothesis, consistent with Kraichnan's prediction \cite{Kr74}. The helicity flux is even more intermittent than the energy flux and its scaling exponents are closer to those of the passive scalar. Using Waleffe's helical decomposition, we demonstrate that the existence of positive mean helicity flux inhibits the energy transfer in the negative helical modes, a non-passive effect

Lifestyle factors associated with inflammatory bowel disease: data from the Swiss IBD cohort study.

BACKGROUND Various environmental risk factors have been associated with the pathogenesis of inflammatory bowel disease. In this study we aimed to identify lifestyle factors that affect the onset of Crohn's disease and ulcerative colitis. METHODS 2294 patients from the Swiss IBD Cohort Study received a questionnaire regarding physical activity, nutritional habits and status of weight. In addition, a control group was formed comprising patients' childhood friends, who grew up in a similar environment. RESULTS Overall, 1111 questionnaires were returned (response rate: 48.4%). Significantly more patients with inflammatory bowel disease reported no regular practice of sport during childhood and beginning of adulthood compared to the control group (p = 0.0001). No association between intake of refined sugar and onset of inflammatory bowel disease was observed. More patients with Crohn's disease compared to ulcerative colitis and controls suffered from overweight during childhood (12.8% vs. 7.7% and 9.7%, respectively; p = 0.027). CONCLUSIONS Our study underlines the relevance of environmental factors in the development of inflammatory bowel disease. Our results imply a protective effect of physical activity regarding the onset of inflammatory bowel disease

The interplay between helicity and rotation in turbulence: implications for scaling laws and small-scale dynamics

Invariance properties of physical systems govern their behavior: energy conservation in turbulence drives a wide distribution of energy among modes, observed in geophysical or astrophysical flows. In ideal hydrodynamics, the role of helicity conservation (correlation between velocity and its curl, measuring departures from mirror symmetry) remains unclear since it does not alter the energy spectrum. However, with solid body rotation, significant differences emerge between helical and non-helical flows. We first outline several results, like the energy and helicity spectral distribution and the breaking of strict universality for the individual spectra. Using massive numerical simulations, we then show that small-scale structures and their intermittency properties differ according to whether helicity is present or not, in particular with respect to the emergence of Beltrami-core vortices (BCV) that are laminar helical vertical updrafts. These results point to the discovery of a small parameter besides the Rossby number; this could relate the problem of rotating helical turbulence to that of critical phenomena, through renormalization group and weak turbulence theory. This parameter can be associated with the adimensionalized ratio of the energy to helicity flux to small scales, the three-dimensional energy cascade being weak and self-similar

Preferences and Perspectives of Australian General Practitioners Towards a New 'Four-in-One' Risk Assessment Tool for Preventative Health: The LEAD! GP Project

Background: Dementia risk reduction is a public health priority and general practitioners (GPs) play a pivotal role in preventative healthcare. Therefore, risk assessment tools should be designed with GPs' preferences and perspectives in mind. Objective: The LEAD! GP project aimed to investigate Australian GPs' preferences and perspectives relating to design, use and implementation of a new risk assessment tool that simultaneously calculates risk for four outcomes - dementia, diabetes mellitus, myocardial infarct, and stroke. Methods: A mixed methods study using semi-structured interviews of a diverse group of 30 Australian GPs was conducted. Interview transcripts were analyzed thematically. Demographics and questions that elicited categorical answers were analyzed descriptively. Results: Overall, GPs felt that preventative healthcare was important with some finding it rewarding, and others finding it difficult. GPs currently use many risk assessment tools. GPs' perception of the usefulness and negatives/barriers of tools related to clinical practice applicability, patient engagement, and practical aspects. The largest barrier was lack of time. GPs responded positively to the concept of a four-in-one tool and preferred it to be relatively short, supported by practice nurses and some patient involvement, linked to education resources, available in different formats, and integrated into practice software. Conclusion: GPs recognize the importance of preventative healthcare and the potential benefit of a new tool that simultaneously predicts risk for those four outcomes. Findings provide important guidance to inform the final development and piloting of this tool with potential to improve efficiency and practical integration of preventative healthcare for dementia risk reduction

Evaluation of the impact of a school gardening intervention on children's fruit and vegetable intake: a randomised controlled trial.

Background: Current academic literature suggests that school gardening programmes can provide an interactive environment with the potential to change children’s fruit and vegetable intake. This is the first cluster randomised controlled trial (RCT) designed to evaluate whether a school gardening programme can have an effect on children’s fruit and vegetable intake. Methods: The trial included children from 23 schools; these schools were randomised into two groups, one to receive the Royal Horticultural Society (RHS)-led intervention and the other to receive the less involved Teacher-led intervention. A 24-hour food diary (CADET) was used to collect baseline and follow-up dietary intake 18 months apart. Questionnaires were also administered to evaluate the intervention implementation. Results: A total of 641 children completed the trial with a mean age of 8.1 years (95% CI: 8.0, 8.4). The unadjusted results from multilevel regression analysis revealed that for combined daily fruit and vegetable intake the Teacher-led group had a higher daily mean change of 8 g (95% CI: −19, 36) compared to the RHS-led group -32 g (95% CI: −60, −3). However, after adjusting for possible confounders this difference was not significant (intervention effect: −40 g, 95% CI: −88, 1; p = 0.06). The adjusted analysis of process measures identified that if schools improved their gardening score by 3 levels (a measure of school gardening involvement - the scale has 6 levels from 0 ‘no garden’ to 5 ‘community involvement’), irrespective of group allocation, children had, on average, a daily increase of 81 g of fruit and vegetable intake (95% CI: 0, 163; p = 0.05) compared to schools that had no change in gardening score. Conclusions: This study is the first cluster randomised controlled trial designed to evaluate a school gardening intervention. The results have found very little evidence to support the claims that school gardening alone can improve children’s daily fruit and vegetable intake. However, when a gardening intervention is implemented at a high level within the school it may improve children’s daily fruit and vegetable intake by a portion. Improving children’s fruit and vegetable intake remains a challenging task

Lifestyle factors associated with inflammatory bowel disease: data from the Swiss IBD cohort study

BACKGROUND: Various environmental risk factors have been associated with the pathogenesis of inflammatory bowel disease. In this study we aimed to identify lifestyle factors that affect the onset of Crohn's disease and ulcerative colitis. METHODS: 2294 patients from the Swiss IBD Cohort Study received a questionnaire regarding physical activity, nutritional habits and status of weight. In addition, a control group was formed comprising patients' childhood friends, who grew up in a similar environment. RESULTS: Overall, 1111 questionnaires were returned (response rate: 48.4%). Significantly more patients with inflammatory bowel disease reported no regular practice of sport during childhood and beginning of adulthood compared to the control group (p = 0.0001). No association between intake of refined sugar and onset of inflammatory bowel disease was observed. More patients with Crohn's disease compared to ulcerative colitis and controls suffered from overweight during childhood (12.8% vs. 7.7% and 9.7%, respectively; p = 0.027). CONCLUSIONS: Our study underlines the relevance of environmental factors in the development of inflammatory bowel disease. Our results imply a protective effect of physical activity regarding the onset of inflammatory bowel disease

Physical Activity for Cognitive Health: A Model for Intervention Design for People Experiencing Cognitive Concerns and Symptoms of Depression or Anxiety

Background: People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge. Objective: This study (part of a pragmatic physical activity implementation trial) aimed to develop a specified model of physical activity engagement in people experiencing depressive or anxiety symptoms and cognitive concerns, to enable optimized dementia risk reduction intervention tailoring. Methods: We employed a qualitative design, triangulating data from three sources: semi-structured individual interviews with people experiencing cognitive concerns and mild to moderate depressive or anxiety symptoms; review of published evidence; and the Capability, Opportunity and Motivation system of behavior, an existing behavioral science model. Findings were integrated to develop a contextualized model of mechanisms of action for optimizing engagement. Results: Twenty-one participants were interviewed, and 24 relevant papers included. Convergent and complementary themes extended understanding of intervention needs. Findings highlighted emotional regulation, capacities to enact intentions despite barriers, and confidence in existing skills as areas of population-specific need that have not previously been emphasized. The final model provides specificity, directionality, and linked approaches for intervention tailoring. Conclusion: This study demonstrated that people experiencing cognitive concerns and symptoms of depression or anxiety require different interventions to improve physical activity engagement. This novel model can enable more precise intervention tailoring, and, ultimately, benefits for a key at-risk population

Virulence potential of Candida albicans isolated from oral cavity of patients with chronic renal failure on hemodialysis

Objective In patients with chronic renal failure (PCRF), the frequency of colonization of the oral cavity by yeasts of genus Candida spp. is high compared with healthy individuals. These yeasts have virulence factors that may contribute to the persistence of colonization and the development of these infections. The aim of this study was evaluate aspects of virulence from Candida albicans isolated from oral cavity of PCRF on dialysis. Methods This study was initially conducted with 49 clinical samples of C. albicans. The virulence factors assayed were produce of biofilm, germ tube, determination of adherence in oral epithelial cells and evaluation of resistance to the antimicrobial action of neutrophils and mononuclear cells. Results All isolates were highly efficient in forming biofilms on poly- styrene microplates, where 94% of the samples formed 4 + biofilm. Used as a screening test, of which three isolates were selected with different degrees of ability to form biofilm to assess other indicators of virulence. Overall, the isolates exhibited different characteristics regarding the virulence factors analyzed. It was also observed that the hypophosphorous acid (HOCl), production, one of leading inflammatory mediators with fungicidal action, also varied especially when the neutrophils, and not mononuclear cells, were stimulated with different samples. (Figure 1). Conclusion Therefore, our results indicate that C. albicans, is not only the most common species in the oral cavity of CRFP on dialysis, but also it presents the main virulence attributes, which reinforces the importance of monitoring of these patients towards the prevention of fungal infections

The METAFOR project: preserving data through metadata standards for climate models and simulations

Climate modeling is a complex process, requiring accurate and complete metadata in order to identify, assess and use climate data stored in digital repositories. The preservation of such data is increasingly important given the development of ever-increasingly complex models to predict the effects of global climate change. The EU METAFOR project has developed a Common Information Model (CIM) to describe climate data and the models and modelling environments that produce this data. There is a wide degree of variability between different climate models and modelling groups. To accommodate this, the CIM has been designed to be highly generic and flexible, with extensibility built in. METAFOR describes the climate modelling process simply as "an activity undertaken using software on computers to produce data." This process has been described as separate UML packages (and, ultimately, XML schemas). This fairly generic structure canbe paired with more specific "controlled vocabularies" in order to restrict the range of valid CIM instances. The CIM will aid digital preservation of climate models as it will provide an accepted standard structure for the model metadata. Tools to write and manage CIM instances, and to allow convenient and powerful searches of CIM databases,. Are also under development. Community buy-in of the CIM has been achieved through a continual process of consultation with the climate modelling community, and through the METAFOR team’s development of a questionnaire that will be used to collect the metadata for the Intergovernmental Panel on Climate Change’s (IPCC) Coupled Model Intercomparison Project Phase 5 (CMIP5) model runs