Seniorenläufer werden schneller und gewinnen Ultramarathons

Quintessenz • Seniorensportler (Läufer über 35 Jahre) dominieren Ultramarathons, also Läufe, die länger sind als die klassische Marathondistanz von 42,195 km. • Aus physiologischer Sicht wird mit ca. 35 Jahren der Leistungszenit im Langstrecken-Laufsport überschritten. • Das Alter der Spitzenleistung im Ultralaufen steigt mit zunehmender Distanz und/oder der Dauer eines Ultramarathons. • Lebenslanger Ausdauersport vermindert die altersbedingte Abnahme der maximalen Sauerstoffaufnahme um ca. 50%. • Eine Abnahme der Muskelmasse ist kein unabwendbares Schicksal, denn regelmässiges Training lässt den altersbedingten jährlichen Abbau auf bis zu 0,5% schrumpfen

The anterior center edge angle in Lequesne's false profile view: interrater correlation, dependence on pelvic tilt and correlation to anterior acetabular coverage in the sagital plane. A cadaver study

Introduction: Lequesne's vertical-center-anterior margin (VCA) angle measured on the false profile view of the pelvis aims at quantifying the anterior acetabular coverage of the femoral head. The anterior delimitation of the acetabular roof is often defined on the false profile view but there are no data on its interrater reliability. Additionally, it is not known how pelvic tilt may influence this angle. Finally, the plane in which this angle is measured lies at an angle of 65° to the sagittal plane and we wondered if this angle would be transposable to the anterior acetabular coverage measured in the sagittal plane. Methods: Eight hips from four cadaver pelvises were investigated by means of a total of 72 false profile views, each taken in defined pelvic inclinations at 5° increments ranging from −20° to +20°, and the VCA angle measured by three independent raters. A computed tomography (CT) of each hip was performed in a neutral pelvic tilt position and a sagittal 2D reconstruction calculated in order to measure anterior coverage in the sagittal plane. The interrater reliability of the VCA angles was assessed using the intra-class correlation coefficient (ICC). The dependence of the VCA angle on pelvic tilt was assessed by regression analysis. The Correlation between the VCA angle and anterior coverage in the sagittal plane of the CT was analyzed using a simple linear regression model. Results: The interrater reliability for measurements of the VCA angle was almost perfect (ICC:0.97). Regression analysis showed that each degree of pelvic tilt was accompanied by a change of the VCA angle by a value of 0.63° (P<0.001). A low correlation between the VCA angle measured in the false profile view and the anterior coverage in the sagittal plane was statistically not significant (r=0.667, P=0.06). Conclusions: Lequesne's VCA angle has an excellent interrater reliability and represents a reliable measure of acetabular dysplasia for comparisons with published data. Lequesne's VCA angle is influenced by pelvic tilt in a linear manner. Performing the false profile view in a standing position may reduce the clinical relevance of this dependency on pelvic tilt. The correlation of Lequesne's VCA angle to anterior acetabular coverage in the sagittal plane is low and therefore unsuitable to be transposed into the sagittal plan

Rapidly Destructive Staphylococcus epidermidis Endocarditis

Abstract : A 29-year-old man with rapidly destructive Staphylococcus epidermidis endocarditis after mitral valve reconstruction is presented. Resistance to rifampin and teicoplanin occurred during antibiotic treatment resulting in clinical failure and valve destruction. Subsequently, the patient was successfully treated, by combining valve replacement with antibiotic therapy including quinupristin/dalfopristin, levofloxacin, and vancomycin. In conclusion, S. epidermidis can cause rapid valve destruction with large vegetations, and combination of surgery and antibiotic therapy may be necessar

The evolution of pebble size and shape in space and time

We propose a mathematical model which suggests that the two main geological observations about shingle beaches, i.e. the emergence of predominant pebble size ratios and strong segregation by size are interrelated. Our model is a based on a system of ODEs called the box equations, describing the evolution of pebble ratios. We derive these ODEs as a heuristic approximation of Bloore's PDE describing collisional abrasion. While representing a radical simplification of the latter, our system admits the inclusion of additional terms related to frictional abrasion. We show that nontrivial attractors (corresponding to predominant pebble size ratios) only exist in the presence of friction. By interpreting our equations as a Markov process, we illustrate by direct simulation that these attractors may only stabilized by the ongoing segregation process.Comment: 22 pages, 8 figure

Risk Prediction Scores for Postoperative Mortality After Esophagectomy: Validation of Different Models

Background: Different prediction models for operative mortality after esophagectomy have been developed. The aim of this study is to independently validate prediction models from Philadelphia, Rotterdam, Munich, and the ASA. Methods: The scores were validated using logistic regression models in two cohorts of patients undergoing esophagectomy for cancer from Switzerland (n = 170) and Australia (n = 176). Results: All scores except ASA were significantly higher in the Australian cohort. There was no significant difference in 30-day mortality or in-hospital death between groups. The Philadelphia and Rotterdam scores had a significant predictive value for 30-day mortality (p = 0.001) and in-hospital death (p = 0.003) in the pooled cohort, but only the Philadelphia score had a significant prediction value for 30-day mortality in both cohorts. Neither score showed any predictive value for in-hospital death in Australians but were highly significant in the Swiss cohort. ASA showed only a significant predictive value for 30-day mortality in the Swiss. For in-hospital death, ASA was a significant predictor in the pooled and Swiss cohorts. The Munich score did not have any significant predictive value whatsoever. Conclusion: None of the scores can be applied generally. A better overall predictive score or specific prediction scores for each country should be develope

Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)

Background Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation. Methods In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR. Results Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research. Conclusions Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective

Spatial modelling of soil water holding capacity improves models of plant distributions in mountain landscapes

Aims The aims of this study were: 1) to test a new methodology to overcome the issue of the predictive capacity of soil water availability in geographic space due to measurement scarcity, 2) to model and generalize soil water availability spatially to a whole region, and 3) to test its predictive capacity in plant SDMs. Methods First, we modelled the measured Soil Water Holding Capacity (SWHC at different pFs) of 24 soils in a focal research area, using a weighted ensemble of small bivariate models (ESM). We then used these models to predict 256 locations of a larger region and used the differences in these pF predictions to calculate three different indices of soil water availability for plants (SWAP. These SWAP variables were added one by one to a set of conventional topo-climatic predictors to model 104 plant species distributions. Results We showed that adding SWAP to the SDMs could improve our ability to predict plant species distributions, and more specifically, pF1.8–pF4.2 became the third most important predictor across all plant models. Conclusions Soil water availability can contribute a significant increase in the predictive power of plant distribution models, by identifying important additional abiotic information to describe plant ecological niches

Holographic Superconductors with Lifshitz Scaling

Black holes in asymptotically Lifshitz spacetime provide a window onto finite temperature effects in strongly coupled Lifshitz models. We add a Maxwell gauge field and charged matter to a recently proposed gravity dual of 2+1 dimensional Lifshitz theory. This gives rise to charged black holes with scalar hair, which correspond to the superconducting phase of holographic superconductors with z > 1 Lifshitz scaling. Along the way we analyze the global geometry of static, asymptotically Lifshitz black holes at arbitrary critical exponent z > 1. In all known exact solutions there is a null curvature singularity in the black hole region, and, by a general argument, the same applies to generic Lifshitz black holes.Comment: 23 pages, 4 figures; v2: added references; v3: matches published versio

Fourier-transform infrared spectroscopy for typing of vancomycin-resistant Enterococcus faecium: performance analysis and outbreak investigation.

Vancomycin-resistant Enterococci, mainly Enterococcus faecium (VREfm), are causing nosocomial infections and outbreaks. Bacterial typing methods are used to assist in outbreak investigations. Most of them, especially genotypic methods like multi-locus sequence typing (MLST), whole genome sequencing (WGS), or pulsed-field gel electrophoresis, are quite expensive and time-consuming. Fourier-transform infrared (FT-IR) spectroscopy assesses the biochemical composition of bacteria, such as carboxyl groups in polysaccharides. It is an affordable technique and has a faster turnaround time. Thus, the aim of this study was to evaluate FT-IR spectroscopy for VREfm outbreak investigations. Basic performance requirements like reproducibility and the effects of incubation time were assessed in distinct sample sets. After determining a FT-IR spectroscopy cut-off range, the clustering agreement between FT-IR and WGS within a retrospective (n: 92 isolates) and a prospective outbreak (n: 15 isolates) was investigated. For WGS an average nucleotide identity (ANI) cut-off score of 0.999 was used. Basic performance analysis showed reproducible results. Moreover, FT-IR spectroscopy readouts showed a high agreement with WGS-ANI analysis in clinical outbreak investigations (V-measure 0.772 for the retrospective and 1.000 for the prospective outbreak). FT-IR spectroscopy had a higher discriminatory power than MLST in the outbreak investigations. After determining cut-off values to achieve optimal resolution, FT-IR spectroscopy is a promising technique to assist in outbreak investigation as an affordable, easy-to-use tool with a turnaround time of less than one day. IMPORTANCE Vancomycin-resistant Enterococci, mainly Enterococcus faecium (VREfm), are a frequent cause of nosocomial outbreaks. Several bacterial typing methods are used to track transmissions and investigate outbreaks, whereby genome-based techniques are used as a gold standard. Current methods are either expensive, time-consuming, or both. Additionally, often, specifically trained staff needs to be available. This study provides insight into the use of Fourier-transform infrared (FT-IR) spectroscopy, an affordable, easy-to-use tool with a short turnaround time as a typing method for VREfm. By assessing clinical samples, this work demonstrates promising results for species discrimination and reproducibility. FT-IR spectrosopy shows a high level of agreement in the analysis of VREfm outbreaks in comparison with whole genome sequencing-based methods