Einflussfaktoren auf die postoperative Genesung und gesundheitsbezogene Lebensqualität bei gynäkologisch operierten Frauen mit und ohne Migrationshintergrund

Zielsetzung: Diese Studie soll aufzeigen, ob sich bestimmte medizinische, psychische oder sozio-demographische Faktoren, wie die Invasivität des operativen Eingriffs, das präoperative psychische Wohlbefinden oder ein Migrationshintergrund, auf die Rekonvaleszenz von Frauen nach einer gynäkologischen Operation aufgrund einer benignen Indikation auswirken. Hat der Grad der Akkulturation bei Patientinnen mit Migrationshintergrund einen Einfluss auf die Genesung? Weiterhin soll geklärt werden, ob sich die gesundheitsbezogene Lebensqualität sieben Monate nach dem operativen Eingriff verbessert und wie lange die Patientinnen postoperativ krankgeschrieben werden bzw. wie sie ihre Arbeitsfähigkeit einschätzen. Methodik: Wir führten vier standardisierte Patientinnenbefragungen mit evaluierten Fragebögen zur Erfassung der Lebensqualität, der Genesung und der Akkulturation durch; weiterhin wurden medizinische und soziodemographische Daten erfasst. Die erste Befragung fand während des stationären Aufenthaltes und anschließend je 1 Woche, 6 Wochen und 7-8 Monate nach Entlassung per Telefoninterview statt. Befragt wurden in einem 7-monatigen Zeitraum alle Frauen in einem Alter von 18 bis 67 Jahren, die aufgrund einer benignen Indikation am Campus Virchow Klinikum der Charité gynäkologisch operiert wurden. Die durchgeführten operativen Eingriffe wurden in drei Invasivitätsklassen eingeteilt. Anschließend wurden die gewonnenen Daten in lineare Modelle eingeschlossen. Ergebnisse: 182 Patientinnen konnten primär einbezogen werden (Rücklaufquote: 70 %), davon 27 % mit Migrationshintergrund. Sowohl medizinische, wie postoperative Komplikationen oder relevante Voroperationen, als auch psychische Faktoren, wie das präoperative psychische Wohlbefinden oder ein postoperativ bestehendes Gefühl der Angst, hatten einen signifikanten Einfluss auf die Genesung (p < 0,05). Diese besserte sich auch im zeitlichen Verlauf. Die Variable Invasivität der durchgeführten Operation oder soziodemographische Parameter hatten hingegen keinen signifikanten Einfluss, wie auch der Grad der Akkulturation bei Patientinnen mit Migrationshintergrund ohne signifikanten Einfluss war. Eine steigende Invasivität des operativen Eingriffs ging jedoch mit steigender Krankschreibungsdauer einher. Weiterhin besserte sich die gesundheitsbezogene Lebensqualität postoperativ und auch die Einschätzung der Arbeitsfähigkeit durch die Patientinnen. Schlussfolgerung: Im untersuchten Kollektiv beeinflussten sowohl medizinische als auch psychische Kriterien die Genesung unabhängig von der durchgeführten Operation. Soziodemographische Faktoren wiesen keinen signifikanten Einfluss auf; die Rekonvaleszenz von Patientinnen mit und ohne Migrationshintergrund unterschied sich demnach nicht. Unabhängig von diesen Faktoren besserte sich allgemein die Lebensqualität durch den operativen Eingriff. Die Genesung einer Patientin nach einer gynäkologischen Operation bei benigner Indikation ist demnach ein multifaktorielles Geschehen.Aims: To determine if there are medical, mental or socio-demographic factors, such as the invasiveness of the operation, the preoperative emotional well-being or a migration background, that affect the convalescence of women after a gynecological operation due to benign indication. Does the degree of acculturation of women with a migration background influence on the recovery? Furthermore, we examined if health-related quality of life is improving seven months after the operation and how long women will be on sick leave, respectively how they self-assess their abilitiy to work. Methods: We conducted four standardized interviews with evaluated questionnaires to record quality-of-life, recovery and acculturation; furthermore, we registered medical and socio-demographic data. The first interview took place during hospitalisation, the remaining ones were conducted subsequently 1 week, 6 weeks and 7-8 months after discharge by telephone. Within a 7 month period, we consulted all women aged 18 to 67, who had a gynecological operation due to benign indication at the Charité, Campus Virchow Klinikum. The performed operations were classified in three different categories of invasiveness. Afterwards we calculated the obtained data in linear models. Results: Primarily we were able to include 182 women (return rate: 70 %), 27 % of them represented a migration background. Medical factors, such as postoperative complications or relevant previous diseases, as well as mental criteria, like preoperative emotional well-being or postoperative anxiety, had a significant influence on recovery (p < 0,05). In addition, recovery was improving over time. In contrast, neither the variable invasiveness of the operation, nor socio-demographic criteria were significant. The degree of acculturation of women with migration background did not show any significant differences, either. However, an increased level of invasiveness of the surgery led to prolonged sick leave. Moreover, the health-related quality of life was improving over time after operation, as did the self-assessment of the ability to work. Conclusion: In this analyzed collective both the medical and mental criteria affect recovery irrespective of the performed operation. Socio-demographic factors had no significant influence; there was no difference in convalescence of women with and without migration background. Regardless of all these factors, quality of life was improving due to the performed operation. According to these results, the recovery of a woman after a gynecological operation is a multifaceted process

Reconstruction of retreating mass wasting in response to progressive slope steepening of the northeastern Gretan margin, eastern Mediterranean

In this study we aim on a reconstruction of mechanisms and kinematics of slope-failure and mass-movement processes along the northeastern slope of Crete in the Hellenic forearc, eastern Mediterranean. Here, subsidence of the forearc basin and the uplift of the island of Crete cause ongoing steepening of the slope in-between. The high level of neotectonic activity in this region is expected to exert a key role in slope-failure development. Newly acquired reflection seismic data from the upper slope region reveal an intact sediment cover while the lower slope is devoid of both intact strata and mass-transport deposits (MTDs). In a mid-slope position, however, we found evidence for a ∼ 4-km³-sized landslide complex that comprises several MTDs from translational transport of coherent sediment bodies over short distances. Morphometric analysis of these MTDs and their source scars indicates that this part of the northeast Cretan slope can be characterized as a cohesive slope. Furthermore, we reconstruct retrogressive development for this complex and determine a critical slope angle for both pre-conditioning of failure and subsequent landslide deposition near source scars. Consequently, data imply that the investigated shallower slope is stable due to low angles in the order of 3°, whereas 5°-inclined mid-slope portions favour both slope destabilization and landslide deposition. The failed mid-slope parts are dominated by sediment truncations from faults almost correlating with the orientation of head- and sidewalls of scars. We suggest that cohesive landslides and MTDs are generated and preserved, respectively, in such critical slope regions. If once generated, cohesive landslides reach the lower slope further downslope that exceeds the threshold gradient for MTD deposition (∼ 5°), they are transported all the way down to the foot of the slope and disintegrate to mass flows. From these observations we suggest that the mass-wasting history of the investigated Cretan slope area over a longer period of time is characterized by repeated sediment erosion and transport into the deeper Cretan Sea basin. The relocation of the critical slope portion in upslope direction and therefore recurrence of mass-wasting events is thereby likely controlled by the progressive steepening of the slope. This mechanism and restriction of sediment failure to narrow, critically-inclined and relocating slope portions likely explains how such an active margin setting can exhibit only scarce findings of MTDs on the slope despite an expected, extensive and widespread mass wasting

The effects of conflict strength and ageing on cognitive control

Electronic version excludes material for which permission has not been granted by the rights holderIn this thesis, I investigated effects of conflict strength and ageing on cognitive control. Conflict strength was manipulated in the Eriksen flanker task using two different approaches: 1. independent variation of flanker and target contrast; 2. manipulation of stimulus onset asynchrony (SOA). Reducing flanker contrast relative to target contrast decreased conflict strength, as shown by a reduction in compatibility effects, when contrast conditions were presented in a randomized fashion but not when they were presented block-wise. An SOA of 100 ms did lead to increased compatibility effects compared to SOAs of 0 ms and 200 ms. Effects of conflict appear to be reflected in the N2 component of the ERP. Although priming played a crucial role in the emergence of the sequential adjustment effect, conflict strength also influenced this effect to a certain degree, supporting the claim that sequential adjustments represent an adaptation of cognitive control. Post-error slowing and error-related ERP components, on the other hand, were not affected by the conflict manipulations, suggesting that errors cannot be explained in terms of conflict processing. Effects of ageing on cognitive control were investigated in a group of middle-aged participants. Although physiological indicators of conflict and error processing were compromised in this age group and overall response times were increased, compatibility, sequential adjustment, and post-error slowing effects were of comparable size as in young adults. These findings suggest that participants could successfully compensate for age-related physiological changes at this early stage of ageing. In conclusion, the research presented in this thesis provided important information to extend our knowledge of factors influencing cognitive control processes

Forms and methods of training system for electrical engineers in national higher technical education institutions

Розглянуто визначальні ознаки формування системи вищої електротехнічної освіти України в ХХ ст. Досліджено структурні зміни підготовки фахівців-електриків в провідних вищих технічних навчальних закладах України. На залученні нормативно-правових документів показано етапи формування технічної освіти, підкреслено позитивні та негативні ознаки кожного етапу. Висвітлено особливості організації навчального процесу, виробничої практики, науково-дослідної роботи, створення нових спеціальностей, кафедр, факультетів, філій.The article is shown main features of formation of higher electrotechnical education in Ukraine in the twentieth century. The structural changes in training electricians in the leading higher technical educational institutions of Ukraine are research. The analysis of the technical documents show stages in the formation of technical education, emphasized the positive and negative features of each stage. In the article noted features of the organization of educational process, production practice, research work, creating new disciplines, departments, faculties, branches

Development of a pilot site for high temperature heat pumps, with high temperature mine thermal energy storage as heat source

A pilot plant for high temperature heat pumps (HTHP’s) combined with high temperature mine thermal energy storage (HT-MTES) is developed at the Fraunhofer IEG location of Bochum. The aim of the plant is to inject renewable heat into the district heating (DH) grid. The HT-MTES is a seasonal thermal storage: heat is injected during the summer and successively extracted during the cold season. A HTHP, hydraulically connected to the storage, transfers heat to the DH gri

Enhanced electrocaloric efficiency via energy recovery.

Materials that show large and reversible electrically driven thermal changes near phase transitions have been proposed for cooling applications, but energy efficiency has barely been explored. Here we reveal that most of the work done to drive representative electrocaloric cycles does not pump heat and may therefore be recovered. Initially, we recover 75-80% of the work done each time BaTiO3-based multilayer capacitors drive electrocaloric effects in each other via an inductor (diodes prevent electrical resonance while heat flows after each charge transfer). For a prototype refrigerator with 24 such capacitors, recovering 65% of the work done to drive electrocaloric effects increases the coefficient of performance by a factor of 2.9. The coefficient of performance is subsequently increased by reducing the pumped heat and recovering more work. Our strategy mitigates the advantage held by magnetocaloric prototypes that exploit automatic energy recovery, and should be mandatory in future electrocaloric cooling devices

Emerging methods in therapeutics using multifunctional nanoparticles

Clinical translation of nanoparticle‐based drug delivery systems is hindered by an array of challenges including poor circulation time and limited targeting. Novel approaches including designing multifunctional particles, cell‐mediated delivery systems, and fabrications of protein‐based nanoparticles have gained attention to provide new perspectives to current drug delivery obstacles in the interdisciplinary field of nanomedicine. Collectively, these nanoparticle devices are currently being investigated for applications spanning from drug delivery and cancer therapy to medical imaging and immunotherapy. Here, we review the current state of the field, highlight opportunities, identify challenges, and present the future directions of the next generation of multifunctional nanoparticle drug delivery platforms.This article is categorized under:Biology‐Inspired Nanomaterials > Protein and Virus‐Based StructuresNanotechnology Approaches to Biology > Nanoscale Systems in BiologyNovel approaches in designing nanoparticles to overcome challenges faced by traditional nanoparticle‐based drug delivery systems.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155963/1/wnan1625.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155963/2/wnan1625_am.pd

Spatial Analysis of Metal-PLGA Hybrid Microstructures Using 3D SERS Imaging

The incorporation of gold nanoparticles in biodegradable polymeric nanostructures with controlled shape and size is of interest toward different applications in nanomedicine. Properties of the polymer such as drug loading and antibody functionalization can be combined with the plasmonic properties of gold nanoparticles, to yield advanced hybrid materials. This study presents a new way to synthesize multicompartmental microgels, fibers, or cylinders, with embedded anisotropic gold nanoparticles. Gold nanoparticles dispersed in an organic solvent can be embedded within the poly(lactic‐co‐glycolic acid) (PLGA) matrix of polymeric microstructures, when prepared via electrohydrodynamic co‐jetting. Prior functionalization of the plasmonic nanoparticles with Raman active molecules allows for imaging of the nanocomposites by surface‐enhanced Raman scattering (SERS) microscopy, thereby revealing nanoparticle distribution and photostability. These exceptionally stable hybrid materials, when used in combination with 3D SERS microscopy, offer new opportunities for bioimaging, in particular when long‐term monitoring is required