Sleeping Sickness in Travelers - Do They Really Sleep?

The number of imported Human African Trypanosomiasis (HAT) cases in non-endemic countries has increased over the last years. The objective of this analysis is to describe the clinical presentation of HAT in Caucasian travelers. Literature was screened (MEDLINE, Pubmed) using the terms “Human African Trypanosomiasis”, “travelers” and “expatriates”; all European languages except Slavic ones were included. Publications without clinical description of patients were only included in the epidemiological analysis. Forty-five reports on Caucasians with T.b. rhodesiense and 15 with T.b. gambiense infections were included in the analysis of the clinical parameters. Both species have presented with fever (T.b. rhodesiense 97.8% and T.b. gambiense 93.3%), headache (50% each) and a trypanosomal chancre (T.b. rhodesiense 84.4%, T.b. gambiense 46.7%). While sleeping disorders dominate the clinical presentation of HAT in endemic regions, there have been only rare reports in travelers: insomnia (T.b. rhodesiense 7.1%, T.b. gambiense 21.4%), diurnal somnolence (T.b. rhodesiense 4.8%, T.b. gambiense none). Surprisingly, jaundice has been seen in 24.2% of the Caucasian T.b. rhodesiense patients, but has never been described in HAT patients in endemic regions. These results contrast to the clinical presentation of T.b. gambiense and T.b. rhodesiense HAT in Africans in endemic regions, where the presentation of chronic T.b. gambiense and acute T.b. rhodesiense HAT is different. The analysis of 14 reports on T.b. gambiense HAT in Africans living in a non-endemic country shows that neurological symptoms such as somnolence (46.2%), motor deficit (64.3%) and reflex anomalies (14.3%) as well as psychiatric symptoms such as hallucinations (21.4%) or depression (21.4%) may dominate the clinical picture. Often, the diagnosis has been missed initially: some patients have even been hospitalized in psychiatric clinics. In travelers T.b. rhodesiense and gambiense present as acute illnesses and chancres are frequently seen. The diagnosis of HAT in Africans living outside the endemic region is often missed or delayed, leading to presentation with advanced stages of the disease

Gauge-invariant Green's functions for the bosonic sector of the standard model

There are many applications in gauge theories where the usually employed framework involving gauge-dependent Green's functions leads to considerable problems. In order to overcome the difficulties invariably tied to gauge dependence, we present a manifestly gauge-invariant approach. We propose a generating functional of appropriately chosen gauge-invariant Green's functions for the bosonic sector of the standard model. Since the corresponding external sources emit one-particle states, these functions yield the same S-matrix elements as those obtained in the usual framework. We evaluate the generating functional for the bosonic sector of the standard model up to the one-loop level and carry out its renormalization in the on-shell scheme. Explicit results for some two-point functions are given. Gauge invariance is manifest at any step of our calculation.Comment: 29 pages, Revtex. v2: Discussions improved, conclusions unchanged. Some references added. v3: Published versio

The electroweak chiral Lagrangian reanalyzed

In this paper we reanalyze the electroweak chiral Lagrangian with particular focus on two issues related to gauge invariance. Our analysis is based on a manifestly gauge-invariant approach that we introduced recently. It deals with gauge-invariant Green's functions and provides a method to evaluate the corresponding generating functional without fixing the gauge. First we show, for the case where no fermions are included in the effective Lagrangian, that the set of low-energy constants currently used in the literature is redundant. In particular, by employing the equations of motion for the gauge fields one can choose to remove two low-energy constants which contribute to the self-energies of the gauge bosons. If fermions are included in the effective field theory analysis the situation is more involved. Even in this case, however, these contributions to the self-energies of the gauge bosons can be removed. The relation of this result to the experimentally determined values for the oblique parameters S, T, and U is discussed. In the second part of the paper we consider the matching relation between a full and an effective theory. We show how the low-energy constants of the effective Lagrangian can be determined by matching gauge-invariant Green's functions in both theories. As an application we explicitly evaluate the low-energy constants for the standard model with a heavy Higgs boson. The matching at the one-loop level and at next-to-leading order in the low-energy expansion is performed employing functional methods.Comment: 44 pages, Revtex. v2: Sections II and III interchanged. New section II now self-contained. Discussions improved in sections I, II, V.C and VI. Conclusions unchanged. Published versio

Soziale Roboter, Empathie und Emotionen : eine Untersuchung aus interdisziplinärer Perspektive

Bericht: «Soziale Roboter, Empathie und Emotionen»Robots, empathy, emotions, technology assessmen

Older Adults’ Engagement and Mood During Robot-Assisted Group Activities in Nursing Homes: Development and Observational Pilot Study

BackgroundPromoting the well-being of older adults in an aging society requires new solutions. One resource might be the use of social robots for group activities that promote physical and cognitive stimulation. Engaging in a robot-assisted group activity may help in the slowdown of physical and cognitive decline in older adults. Currently, our knowledge is limited on whether older adults engage in group activities with humanlike social robots and whether they experience a positive affect while doing so. Both are necessary preconditions to achieve the intended effects of a group activity. ObjectiveOur pilot study has 2 aims. First, we aimed to develop and pilot an observational coding scheme for robot-assisted group activities because self-report data on engagement and mood of nursing home residents are often difficult to obtain, and the existing observation instruments do have limitations. Second, we aimed to investigate older adults’ engagement and mood during robot-assisted group activities in 4 different nursing care homes in the German-speaking part of Switzerland. MethodsWe developed an observation system, inspired by existing tools, for a structured observation of engagement and mood of older adults during a robot-assisted group activity. In this study, 85 older adult residents from 4 different care homes in Switzerland participated in 5 robot-assisted group activity sessions, and they were observed using our developed system. The data were collected in the form of video clips that were assessed by 2 raters regarding engagement (direction of gaze, posture as well as body expression, and activity) and mood (positive and negative affects). Both variables were rated on a 5-point rating scale. ResultsOur pilot study findings show that the engagement and mood of older adults can be assessed reliably by using the proposed observational coding scheme. Most participants actively engaged in robot-assisted group activities (mean 4.19, SD 0.47; median 4.0). The variables used to measure engagement were direction of gaze (mean 4.65, SD 0.49; median 5.0), posture and body expression (mean 4.03, SD 0.71; median 4.0), and activity (mean 3.90, SD 0.65; median 4.0). Further, we observed mainly positive affects in this group. Almost no negative affect was observed (mean 1.13, SD 0.20; median 1.0), while the positive affect (mean 3.22, SD 0.55; median 3.2) was high. ConclusionsThe developed observational coding system can be used and further developed in future studies on robot-assisted group activities in the nursing home context and potentially in other settings. Additionally, our pilot study indicates that cognitive and physical stimulation of older adults can be promoted by social robots in a group setting. This finding encourages future technological development and improvement of social robots and points to the potential of observational research to systematically evaluate such developments

Evaluating an e-mental health program (“deprexis”) as adjunctive treatment tool in psychotherapy for depression: design of a pragmatic randomized controlled trial

Background Major depressive disorder (MDD) places a significant disease burden on individuals as well as on societies. Several web-based interventions for MDD have shown to be effective in reducing depressive symptoms. However, it is not known whether web-based interventions, when used as adjunctive treatment tools to regular psychotherapy, have an additional effect compared to regular psychotherapy for depression. Methods/design This study is a currently recruiting pragmatic randomized controlled trial (RCT) that compares regular psychotherapy plus a web-based depression program (¿deprexis¿) with a control condition exclusively receiving regular psychotherapy. Adults with a depressive disorder (N?=?800) will be recruited in routine secondary care from therapists over the course of their initial sessions and will then be randomized within therapists to one of the two conditions. The primary outcome is depressive symptoms measured with the Beck Depression Inventory (BDI-II) at three months post randomization. Secondary outcomes include changes on various indicators such as anxiety, somatic symptoms and quality of life. All outcomes are again assessed at the secondary endpoint six months post randomization. In addition, the working alliance and feasibility/acceptability of the treatment condition will be explored. Discussion This is the first randomized controlled trial to examine the feasibility/acceptability and the effectiveness of a combination of traditional face-to-face psychotherapy and web-based depression program compared to regular psychotherapeutic treatment in depressed outpatients in routine care