Analyse zeitveraenderlicher Kovariablen und rekurrenter Ereignisse am Beispiel einer Studie zur prophylaktischen Behandlung von Oesophagusvarizen

To assess the effect of prophylactic sclerotherapy on variceal hemorrhage and survival of patients with liver cirrhosis and esophageal varices, a randomized study had been carried out. We analysed the data from different points of view. The time-dependent Cox model and the linear counting process of Aalen are applied allowing for the time-dependent covariate ``variceal bleeding`` -- that switches up to three times -- in a multivariate analysis of the remaining life time. A model for the times to and between the recurrent events of bleeding including unobserved heterogeneity is estimated by a distribution-free and by a parametric method where the latter also admits time-dependent covariates such as repeated measurements of laboratory data. We find that high age, high Child-Pugh score and especially the first occurence of variceal bleeding have a statistically significant negative effect on survival whereas patients with fundic varices and/or alcoholic cirrhosis have a significant higher risk of bleeding. In both analyses, inclusion of time-dependent covariates does not change the estimation substantially. In particular, prophylactic sclerotherapy is not shown to reduce the risk of bleeding nor dying significantly

Quality of life (QoL) as predictive mediator variable for survival in patients with intracerebral neoplasma during radiotherapy

Background: The prognosis for patients with malignant astrocytoma or brain metastases is often fatal despite intensive therapy. Therefore we wished to elucidate whether the quality of life (QoL) is a determinant of overall survival (OAS). Patients and Methods: From 1997 to 2000 153 patients with brain tumours were screened; 39 patients (26%) refused to participate and further 47 patients were excluded (cerebral impairment 14%, amaurosis/language problems 3%, Karnofsky performance score < 50% 7%, death 8%, non-compliance 7%). Thus, 57 patients were analysed (33 with primary brain tumours, 24 with brain metastases). With the FACT-G questionnaire cancer-specific aspects of health-related QoL were assessed. Results: Patients with metastases showed a lower QoL in the physical sphere than patients with astrocytoma, but there were no significant differences in OAS. Median survival of patients with good QoL was 31.3 months versus 14.2 months in patients with bad QoL. Only the two variables `living with a spouse' and FACT-G sum score had a statistically significant influence on survival (p = 0.033 and p = 0.003) modelled by the Cox-PH regression. Patients who did not live with a spouse had shorter survival times than the other patients. Conclusion: Health-related QoL can serve to identify a patient group with higher risks of death

Radiotherapy: Impact of quality of life and need for psychological care: Results of a longitudinal study

Background: In the framework of a prospective longitudinal study, the quality of life (QoL) and support requirements of patients from a university hospital department of radiotherapy were evaluated for the first time by means of established psychodiagnostic questionnaires. Patients and Methods: At first, 732 patients were screened, of whom 446 (60.9%) fulfilled the criteria for inclusion; 39.1% did not (refusals 21.0%, low Karnofsky performance status 6.6%, management problems 3.4%, language barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease-specific aspects of QoL (Functional Assessment of Cancer Treatment - General, FACT-G) and moderating variables {[}Social Support Scale (SSS), Disease Coping (FKV), Self-Assessment Depression Scale (SDS), and Self-Defined Care Requirements (BB)] were self-rated by patients with different tumor types before radiotherapy (T1), after radiotherapy (T2), and 6 weeks after the end of radiotherapy (T3). We studied 265 patients (157 male, 108 female; median age 58.6 years) with complete data of three time points. Results: In general, QoL of patients decreased significantly over all time points in all subscales. Social support was rated high and remained constant throughout the treatment. Apparent coping mechanisms were active problem-oriented coping, leisure activities, and self-support. The patients' depression proved to be an important and constant factor without significant changes. The support requirement is characterized by the need for more medical information and dialogue with a physician. Conclusions: Early specific support from personnel with radiotherapeutic skills, during the disease-coping process as well as during rehabilitation, should be a permanent component of an integrated radiooncological treatment schedule

Coping of cancer patients during and after radiotherapy - a follow-up of 2 years

Aim: We wanted to understand coping strategies specific to different phases up to two years after radiotherapy, to identify patients who are at higher risk of mood disturbances and to characterise the association between coping strategies and psychosocial adaptation. Patients and Methods: From 1997 to 2001, 2,169 patients with different diagnoses were screened (27.8% refused to participate). Data of 276 patients from the beginning of radiotherapy (ti1) and 5 follow-up investigations (ti6/2 years) could be analysed. With the FKV ( Freiburg Questionnaire Coping with Disease) cancer-specific coping aspects were assessed. The association between coping styles and psychosocial adaptation was evaluated using the Questionnaire on Stress in Cancer Patients (QSC) and the questionnaire on Functional Assessment of Cancer Treatment (FACT-G). Results: `Active problem-orientated' coping and `distractions' are the most important coping strategies. Only `active problem-orientated' and `depressive' coping showed a significant decrease. We observed higher means on the scales of the FKV in women. Marital status ( single, married, divorced/widowed) had a significant influence on active problem-orientated coping and spirituality. Age, children, education, T/M status and curative/ palliative intention of treatment had no influence on coping styles. Breast cancer patients and lymphoma patients demonstrated the highest use of coping strategies after radiotherapy with a significant decrease of `active problem-orientated coping'. Depressive coping and minimizing importance at ti1 were associated with high psychosocial distress and low quality of life (QoL) at ti6. Conclusion: The correlation of coping mechanisms at the beginning of radiotherapy with low QoL and high psychosocial stress at 2 years could help to identify patients at risk for low psychosocial adaptation. Psychooncologically trained teams of physicians would best correspond to this profile of needs and would contribute significantly to an ameliorated adaptation of patients to cancer which could lead to higher life satisfaction

First-principles calculations and experimental studies of: XYZ 2 thermoelectric compounds: Detailed analysis of van der Waals interactions

First-principles calculations can accelerate the search for novel high-performance thermoelectric materials. However, the prediction of the thermoelectric properties is strongly dependent on the approximations used for the calculations. Here, thermoelectric properties were calculated with different computational approximations (i.e., PBE-GGA, HSE06, spin-orbit coupling and DFT-D3) for three layered XYZ2 compounds (TmAgTe2, YAgTe2, and YCuTe2). In addition to the computations, the structural, electrical and thermal properties of these compounds were measured experimentally and compared to the computations. An enhanced prediction of the crystal structure and heat capacity was achieved with the inclusion of van der Waals interactions due to more accurate modeling of the interatomic forces. In particular, a large shift of the acoustic phonons and low-frequency optical phonons to lower frequencies was observed from the dispersion-optimized structure. From the phonon dispersion curves of these compounds, the ultralow thermal conductivity in the investigated XYZ2 compounds could be described by a recent developed minimum thermal conductivity model. For the prediction of the electrical conductivity, a temperature-dependent relaxation time was used, and it was limited by acoustic phonons. While HSE06 has only a small influence on the electrical properties due to a computed band gap energy of &gt;0.25 eV, the inclusion of both van der Waals interactions and spin-orbit coupling leads to a more accurate band structure, resulting in better prediction of electrical properties. Furthermore, the experimental thermoelectric properties of YAgTe2, TmAg0.95Zn0.05Te2 and TmAg0.95Mg0.05Te2 were measured, showing an increase in zT of TmAg0.95Zn0.05Te2 by more than 35% (zT = 0.47 ± 0.12) compared to TmAgTe2

Temperature-dependent profile of the surface states and series resistance in (Ni/Au)/ AIGaN/AIN/GaN heterostructures

The profile of the interface state densities(N ss) and series resistances (R s) effect on capacitance-voltage (C-V) and conductancevoltage (G/ω-V) of (Ni/Au)/Al xGa 1-xN/AIN/ GaN heterostructures as a function of the temperature have been investigated at 1 MHz. The admittance method allows us to obtain the parameters characterizing the metal/semiconductor interface phenomena as well as the bulk phenomena. The method revealed that the density of interface states decreases with increasing temperature. Such a behavior of N ss can be attributed to reordering and restructure of surface charges. The value of series R s decreases with decreasing temperature. This behavior of R s is in obvious disagreement with that reported in the literature. It is found that the N ss and R s of the structure are important parameters that strongly influence the electrical parameters of (Ni/Au)/Al xGa 1-XN/AlN/GaN(x = 0.22) heterostructures. In addition, in the forward bias region a negative contribution to the capacitance C has been observed, that decreases with the increasing temperature. Copyright © 2010 John Wiley &amp; Sons, Ltd

Non-locality in quantum field theory due to general relativity

We show that general relativity coupled to a quantum field theory generically leads to non-local effects in the matter sector. These non-local effects can be described by non-local higher dimensional operators which remarkably have an approximate shift symmetry. When applied to inflationary models, our results imply that small non-Gaussianities are a generic feature of models based on general relativity coupled to matter fields. However, these effects are too small to be observable in the cosmic microwave background

Bounds on the dipole moments of the tau-neutrino via the process e+e−→ννˉγe^{+}e^{-}\rightarrow \nu \bar \nu \gamma in a 331 model

We obtain limits on the anomalous magnetic and electric dipole moments of the $\nu_{\tau}$ through the reaction $e^{+}e^{-}\rightarrow \nu \bar \nu \gamma$ and in the framework of a 331 model. We consider initial-state radiation, and neglect $W$ and photon exchange diagrams. The results are based on the data reported by the L3 Collaboration at LEP, and compare favorably with the limits obtained in other models, complementing previous studies on the dipole moments.Comment: 13 pages, 4 figures, to be published in The European Physical J C. arXiv admin note: substantial text overlap with arXiv:hep-ph/060527

Common variable immunodeficiency syndrome with right aortic arch: a case report

BACKGROUND: Common variable immunodificiency syndrome predominantly affects adults. It is characterized by low production of all the major classes of immunoglobulins. We report a case of common variable immunodeficiency syndrome with right aortic arch. An association of right-sided arch and common variable immunodificiency syndrome has not been previously reported. CASE PRESENTATION: A 41-year-old female patient presented with a history of recurrent pneumonia, sinusitis, otitis media, diarrhoea, cystitis since childhood. Biochemical and immunocytochemical analysis revealed common variable immunodeficiency syndrome and radiological evaluation confirmed right aortic arch and aberrant left subclavian artery. CONCLUSION: Common variable immunodeficiency syndrome syndrome is a clinical entity that should be kept in mind in patients with recurrent infections of different sites