Lernpfade − Ein Weg zur selbständigen und sinnvollen Nutzung von digitalen Werkzeugen durch Schüler/innen

Pointiert formuliert geht es beim Einsatz von Computerwerkzeugen im Mathematikunterricht darum, die Selbsttätigkeit der Schüler/innen zu unterstützen und digitale Werkzeuge sinnvoll zu nutzen, um die Ziele des Mathematikunterrichts zu erreichen. Probleme die dabei in der Praxis auftreten, drehen sich um den Umgang mit digitalen Werkzeugen. „Umgang“ umfasst hier drei Aspekte, nämlich die Handhabung (Werkzeugkompetenz), die methodische Unterrichtseinbindung (Methodenkompetenz) und die technisch-organisatorische Verfügbarkeit. Ein Weg zur konstruktiven Auseinandersetzung mit diesen Problemen ist der Einsatz von Lernpfaden

Postnatal cardiovascular risk after hypertensive disorder of pregnancy: Identifying knowledge needs and education recommendations for women and healthcare providers

University of Technology Sydney. Faculty of Health.Women with a history of hypertensive disorder of pregnancy (HDP) are at significantly increased risk of future cardiovascular disease compared to women with no HDP pregnancies. Recent findings suggest this information is not transferred sufficiently to women, and how best to do this, including how to equip healthcare providers (HCP) for the knowledge transfer process, is not known. The aim of this study was to (i) identify knowledge and knowledge gaps of Australian women and HCPs regarding health risks after HDP and (ii) to explore their education preferences. A sequential explanatory mixed method design was undertaken. After a scoping review of relevant literature, data were collected from two cohorts: women and HCPs. Quantitative data on knowledge related to health after HDP were collected using online surveys. Qualitative data were collected through interviews and analysed using framework analysis. The scoping review identified that published literature reflected a lack of, or insufficient knowledge amongst HCP and women regarding CVD risks after HDP. The surveys (266 women and 492 HCPs) found that women’s and HCP level of knowledge about health post-HDP was similar. Knowledge was highest in both groups regarding risk of recurrent hypertensive disorders in future pregnancies and future chronic hypertension, and lowest/greatest knowledge gaps regarding risks after gestational hypertension versus preeclampsia, and increased risk of Type 2 diabetes. Only one-third of participants in each cohort were aware that risks start within 10 years after the HDP affected pregnancy. In the qualitative component (13 women and 20 HCPs), women’s preference included early post-HDP birth risk counselling about long-term and modifiable risk factors from their HCPs accompanied with evidence-based, print or web-based information. HCPs wanted access to similar material to assist in their risk discussions with women. HCPs expressed a preference for multi-disciplinary education, preferably endorsed or facilitated by professional colleges and health organisations. Both groups were in favour of structured long-term follow-up, including reminder systems, to facilitate the transition from hospital to community health and align with international and local societies’ hypertension guidelines. Important knowledge gaps in women and healthcare providers were found regarding health after HDP in the Australian context. Women and healthcare providers want more information about long-term and modifiable risk factors post-HDP. Recommendations are made to enable a more structured transition from hospital to community health post-HDP, including automated alerts to remind women about key points of follow-up

Anyone up for helping the Fisherman's wife? More solidarity with accidental misery than with man-made misery

We examine the willingness to donate depending on whether “misery” is random generated or self-inflicted by too high demands in bilateral negotiations. We find that randomness has a positive influence on the total amount of donation. In case of self-inflicted “misery” we observe that the subject who may have caused the unfavourable situation receives significantly less than the perceived innocent subject.altruism, bargaining experiment

Enhanced at puberty 1 (EAP1) is a new transcriptional regulator of the female neuroendocrine reproductive axis

The initiation of mammalian puberty and the maintenance of female reproductive cycles are events controlled by hypothalamic neurons that secrete the decapeptide gonadotropin-releasing hormone (GnRH). GnRH secretion is, in turn, controlled by changes in neuronal and glial inputs to GnRH-producing neurons. The hierarchical control of the process is unknown, but it requires coordinated regulation of these cell-cell interactions. Here we report the functional characterization of a gene (termed enhanced at puberty 1 [EAP1]) that appears to act as an upstream transcriptional regulator of neuronal networks controlling female reproductive function. EAP1 expression increased selectively at puberty in both the nonhuman primate and rodent hypothalamus. EAP1 encoded a nuclear protein expressed in neurons involved in the inhibitory and facilitatory control of reproduction. EAP1 transactivated genes required for reproductive function, such as GNRH1, and repressed inhibitory genes, such as preproenkephalin. It contained a RING finger domain of the C3HC4 subclass required for this dual transcriptional activity. Inhibition of EAP1 expression, targeted to the rodent hypothalamus via lentivirus-mediated delivery of EAP1 siRNAs, delayed puberty, disrupted estrous cyclicity, and resulted in ovarian abnormalities. These results suggest that EAP1 is a transcriptional regulator that, acting within the neuroendocrine brain, contributes to controlling female reproductive function.This work was supported by grants from the NIH, the National Institute of Child Health and Human Development/NIH (to S.R. Ojeda), the European Society for Paediatric Endocrinology (to H. Jung), the German Research Foundation (to S. Heger), and the European Commission (PIONEER to S. Heger)

Optical properties of the human round window membrane

Optical techniques are effective tools for diagnostic applications in medicine and are particularly attractive for the noninvasive analysis of biological tissues and fluids in vivo. Noninvasive examinations of substances via a fiber optic probe need to consider the optical properties of biological tissues obstructing the optical path. This applies to the analysis of the human perilymph, which is located behind the round window membrane. The composition of this inner ear liquid is directly correlated to inner ear hearing loss. In this work, experimental methods for studying the optical properties of the human round window membrane ex vivo are presented. For the first time, a comprehensive investigation of this tissue is performed, including optical transmission, forward scattering, and Raman scattering. The results obtained suggest the application of visible wavelengths (>400nm) for investigating the perilymph behind the round window membrane in future. © 2017 Society of Photo-Optical Instrumentation Engineers (SPIE)

Extratubular Polymerized Uromodulin Induces Leukocyte Recruitment and Inflammation In Vivo

Uromodulin (UMOD) is produced and secreted by tubular epithelial cells. Secreted UMOD polymerizes (pUMOD) in the tubular lumen, where it regulates salt transport and protects the kidney from bacteria and stone formation. Under various pathological conditions, pUMOD accumulates within the tubular lumen and reaches extratubular sites where it may interact with renal interstitial cells. Here, we investigated the potential of extratubular pUMOD to act as a damage associated molecular pattern (DAMP) molecule thereby creating local inflammation. We found that intrascrotal and intraperitoneal injection of pUMOD induced leukocyte recruitment in vivo and led to TNF-alpha secretion by F4/80 positive macrophages. Additionally, pUMOD directly affected vascular permeability and increased neutrophil extravasation independent of macrophage-released TNF-alpha. Interestingly, pUMOD displayed no chemotactic properties on neutrophils, did not directly activate beta 2 integrins and did not upregulate adhesion molecules on endothelial cells. In obstructed neonatal murine kidneys, we observed extratubular UMOD accumulation in the renal interstitium with tubular atrophy and leukocyte infiltrates. Finally, we found extratubular UMOD deposits associated with peritubular leukocyte infiltration in kidneys from patients with inflammatory kidney diseases. Taken together, we identified extratubular pUMOD as a strong inducer of leukocyte recruitment, underlining its critical role in mounting an inflammatory response in various kidneys pathologies

Neoadjuvant cisplatin and fluorouracil versus epirubicin, cisplatin, and capecitabine followed by resection in patients with oesophageal adenocarcinoma (UK MRC OE05): an open-label, randomised phase 3 trial.

BACKGROUND: Neoadjuvant chemotherapy before surgery improves survival compared with surgery alone for patients with oesophageal cancer. The OE05 trial assessed whether increasing the duration and intensity of neoadjuvant chemotherapy further improved survival compared with the current standard regimen. METHODS: OE05 was an open-label, phase 3, randomised clinical trial. Patients with surgically resectable oesophageal adenocarcinoma classified as stage cT1N1, cT2N1, cT3N0/N1, or cT4N0/N1 were recruited from 72 UK hospitals. Eligibility criteria included WHO performance status 0 or 1, adequate respiratory, cardiac, and liver function, white blood cell count at least 3 × 10(9) cells per L, platelet count at least 100 × 10(9) platelets per L, and a glomerular filtration rate at least 60 mL/min. Participants were randomly allocated (1:1) using a computerised minimisation program with a random element and stratified by centre and tumour stage, to receive two cycles of cisplatin and fluorouracil (CF; two 3-weekly cycles of cisplatin [80 mg/m(2) intravenously on day 1] and fluorouracil [1 g/m(2) per day intravenously on days 1-4]) or four cycles of epirubicin, cisplatin, and capecitabine (ECX; four 3-weekly cycles of epirubicin [50 mg/m(2)] and cisplatin [60 mg/m(2)] intravenously on day 1, and capecitabine [1250 mg/m(2)] daily throughout the four cycles) before surgery, stratified according to centre and clinical disease stage. Neither patients nor study staff were masked to treatment allocation. Two-phase oesophagectomy with two-field (abdomen and thorax) lymphadenectomy was done within 4-6 weeks of completion of chemotherapy. The primary outcome measure was overall survival, and primary and safety analyses were done in the intention-to-treat population. This trial is registered with the ISRCTN registry (number 01852072) and ClinicalTrials.gov (NCT00041262), and is completed. FINDINGS: Between Jan 13, 2005, and Oct 31, 2011, 897 patients were recruited and 451 were assigned to the CF group and 446 to the ECX group. By Nov 14, 2016, 327 (73%) of 451 patients in the CF group and 302 (68%) of 446 in the ECX group had died. Median survival was 23·4 months (95% CI 20·6-26·3) with CF and 26·1 months (22·5-29·7) with ECX (hazard ratio 0·90 (95% CI 0·77-1·05, p=0·19). No unexpected chemotherapy toxicity was seen, and neutropenia was the most commonly reported event (grade 3 or 4 neutropenia: 74 [17%] of 446 patients in the CF group vs 101 [23%] of 441 people in the ECX group). The proportions of patients with postoperative complications (224 [56%] of 398 people for whom data were available in the CF group and 233 [62%] of 374 in the ECX group; p=0·089) were similar between the two groups. One patient in the ECX group died of suspected treatment-related neutropenic sepsis. INTERPRETATION: Four cycles of neoadjuvant ECX compared with two cycles of CF did not increase survival, and cannot be considered standard of care. Our study involved a large number of centres and detailed protocol with comprehensive prospective assessment of health-related quality of life in a patient population confined to people with adenocarcinomas of the oesophagus and gastro-oesophageal junction (Siewert types 1 and 2). Alternative chemotherapy regimens and neoadjuvant chemoradiation are being investigated to improve outcomes for patients with oesophageal carcinoma. FUNDING: Cancer Research UK and Medical Research Council Clinical Trials Unit at University College London