Restaurante Park en Neuhausen – Suiza

This restaurant exhibits the characteristic style of the architect-sculptor, Walter Foerderer, with its combinations of concrete and timber and solid and strong outlines. The building has a carefully thought stepped up aspect, which follows the ground outline, and this constitutes one of its most singular appeals. This catering establishment is open all the year round. Its enclosed areas can accommodate 50 clients, and at its outdoor terraces, which are in use most of the year, 200 meals can be served simultaneously. It is a pleasant stopping place for visitors in the course of their excursions, and provides a suitable viewpoint from which to admire the exceptional surrounding panorama.Se observa en este restaurante el sello característico del arquitecto-escultor Walter Foerderer, con sus combinaciones hormigón-madera y sus formas macizas y consistentes. El edificio presenta una estudiada fisonomía escalonada, consecuencia de la perfecta adaptación al terreno, lo que constituye, además, uno de sus más singulares atractivos. Funciona todo el año. Sus locales cubiertos tienen capacidad para servir 50 comidas; y al aire libre, en las terrazas —que se utilizan durante la mayor parte del verano—, pueden ser atendidos, en cada turno, unos 300 comensales. Constituye un lugar de parada agradable para los visitantes, en sus excursiones, ofreciéndoles puntos de vista apropiados desde los que pueden contemplar el excepcional panorama circundante

Restaurante Park en Neuhausen – Suiza

This restaurant exhibits the characteristic style of the architect-sculptor, Walter Foerderer, with its combinations of concrete and timber and solid and strong outlines. The building has a carefully thought stepped up aspect, which follows the ground outline, and this constitutes one of its most singular appeals. This catering establishment is open all the year round. Its enclosed areas can accommodate 50 clients, and at its outdoor terraces, which are in use most of the year, 200 meals can be served simultaneously. It is a pleasant stopping place for visitors in the course of their excursions, and provides a suitable viewpoint from which to admire the exceptional surrounding panorama.<br><br>Se observa en este restaurante el sello característico del arquitecto-escultor Walter Foerderer, con sus combinaciones hormigón-madera y sus formas macizas y consistentes. El edificio presenta una estudiada fisonomía escalonada, consecuencia de la perfecta adaptación al terreno, lo que constituye, además, uno de sus más singulares atractivos. Funciona todo el año. Sus locales cubiertos tienen capacidad para servir 50 comidas; y al aire libre, en las terrazas —que se utilizan durante la mayor parte del verano—, pueden ser atendidos, en cada turno, unos 300 comensales. Constituye un lugar de parada agradable para los visitantes, en sus excursiones, ofreciéndoles puntos de vista apropiados desde los que pueden contemplar el excepcional panorama circundante

The effect of hypophysectomy on pancreatic islet hormone and insulin-like growth factor I content and mRNA expression in rat

The growth arrest after hypophysectomy in rats is mainly due to growth hormone (GH) deficiency because replacement of GH or insulin-like growth factor (IGF) I, the mediator of GH action, leads to resumption of growth despite the lack of other pituitary hormones. Hypophysectomized (hypox) rats have, therefore, often been used to study metabolic consequences of GH deficiency and its effects on tissues concerned with growth. The present study was undertaken to assess the effects of hypophysectomy on the serum and pancreatic levels of the three major islet hormones insulin, glucagon, and somatostatin, as well as on IGF-I. Immunohistochemistry (IHC), in situ hybridization (ISH), radioimmunoassays (RIA), and Northern blot analysis were used to localize and quantify the hormones in the pancreas at the peptide and mRNA levels. IHC showed slightly decreased insulin levels in the β cells of hypox compared with normal, age-matched rats whereas glucagon in α cells and somatostatin in δ cells showed increase. IGF-I, which localized to α cells, showed decrease. ISH detected a slightly higher expression of insulin mRNA and markedly stronger signals for glucagon and somatostatin mRNA in the islets of hypox rats. Serum glucose concentrations did not differ between the two groups although serum insulin and C-peptide were lower and serum glucagon was higher in the hypox animals. These changes were accompanied by a more than tenfold drop in serum IGF-I. The pancreatic insulin content per gram of tissue was not significantly different in hypox and normal rats. Pancreatic glucagon and somatostatin per gram of tissue were higher in the hypox animals. The pancreatic IGF-I content of hypox rats was significantly reduced. Northern blot analysis gave a 2.6-, 4.5-, and 2.2-fold increase in pancreatic insulin, glucagon, and somatostatin mRNA levels, respectively, in hypox rats, and a 2.3-fold decrease in IGF-I mRNA levels. Our results show that the fall of serum IGF-I after hypophysectomy is accompanied by a decrease in pancreatic IGF-I peptide and mRNA but by partly discordant changes in the serum concentrations of insulin and glucagon and the islet peptide and/or mRNA content of the three major islet hormones. It appears that GH deficiency resulting in a "low IGF-I state” affects translational efficiency of these hormones as well as their secretory responses. The maintenance of normoglycemia in the presence of reduced insulin and elevated glucagon serum levels, both of which would be expected to raise blood glucose, may result mainly from the enhanced insulin sensitivity, possibly due to GH deficiency and the subsequent decrease in IGF-I productio

The effect of hypophysectomy on pancreatic islet hormone and insulin-like growth factor I content and mRNA expression in rat

The growth arrest after hypophysectomy in rats is mainly due to growth hormone (GH) deficiency because replacement of GH or insulin-like growth factor (IGF) I, the mediator of GH action, leads to resumption of growth despite the lack of other pituitary hormones. Hypophysectomized (hypox) rats have, therefore, often been used to study metabolic consequences of GH deficiency and its effects on tissues concerned with growth. The present study was undertaken to assess the effects of hypophysectomy on the serum and pancreatic levels of the three major islet hormones insulin, glucagon, and somatostatin, as well as on IGF-I. Immunohistochemistry (IHC), in situ hybridization (ISH), radioimmunoassays (RIA), and Northern blot analysis were used to localize and quantify the hormones in the pancreas at the peptide and mRNA levels. IHC showed slightly decreased insulin levels in the beta cells of hypox compared with normal, age-matched rats whereas glucagon in alpha cells and somatostatin in delta cells showed increase. IGF-I, which localized to alpha cells, showed decrease. ISH detected a slightly higher expression of insulin mRNA and markedly stronger signals for glucagon and somatostatin mRNA in the islets of hypox rats. Serum glucose concentrations did not differ between the two groups although serum insulin and C-peptide were lower and serum glucagon was higher in the hypox animals. These changes were accompanied by a more than tenfold drop in serum IGF-I. The pancreatic insulin content per gram of tissue was not significantly different in hypox and normal rats. Pancreatic glucagon and somatostatin per gram of tissue were higher in the hypox animals. The pancreatic IGF-I content of hypox rats was significantly reduced. Northern blot analysis gave a 2.6-, 4.5-, and 2.2-fold increase in pancreatic insulin, glucagon, and somatostatin mRNA levels, respectively, in hypox rats, and a 2.3-fold decrease in IGF-I mRNA levels. Our results show that the fall of serum IGF-I after hypophysectomy is accompanied by a decrease in pancreatic IGF-I peptide and mRNA but by partly discordant changes in the serum concentrations of insulin and glucagon and the islet peptide and/or mRNA content of the three major islet hormones. It appears that GH deficiency resulting in a "low IGF-I state" affects translational efficiency of these hormones as well as their secretory responses. The maintenance of normoglycemia in the presence of reduced insulin and elevated glucagon serum levels, both of which would be expected to raise blood glucose, may result mainly from the enhanced insulin sensitivity, possibly due to GH deficiency and the subsequent decrease in IGF-I production

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation

BackgroundAtrial fibrillation (AF) is associated with cognitive dysfunction. However, neurocognitive function in AF patients undergoing pulmonary vein isolation (PVI) has not been well studied. The aim of this analysis is to compare neurocognitive function in patients who did or did not undergo PVI.Materials and methodsWe used data from the Swiss Atrial Fibrillation Cohort study (Swiss-AF), a prospective, observational, multicenter study in Switzerland. Patients with documented AF were enrolled and data of 1,576 patients without history of PVI and with complete information on PVI status and neurocognitive function were used. Information on PVI was collected at baseline and during 1 year of follow-up. Neurocognitive testing was performed at baseline and after 1 year of follow-up, using the Montreal Cognitive Assessment (MoCA), trail making test (TMT) A and B, digit symbol substitution test (DSST) and semantic fluency test (SFT). To investigate the association of PVI with neurocognitive function, we use propensity score matching (1:3) and inverse probability of treatment weighting (IPTW).ResultsThe mean age of this population was 74 ± 8 years, 27.1% were women. Overall, 88 (5.5%) patients underwent PVI during 1 year of follow-up. Using ITPW (n = 1576), PVI was weakly associated with the MoCA score after adjusting for time since PVI, baseline MoCA score and other covariates (β (95%CI) 1.19 (0.05; 2.32), p = 0.04). In the propensity matched comparison (n = 352), there was no significant association between PVI and the MoCA score (β (95%CI) 1.04 (−0.19; 2.28), p = 0.1). There were no significant associations between PVI and cognitive function when using the TMT A and B, DSST or SFT independent of the method used.ConclusionIn this population of AF patients, there was no consistent evidence of an association between PVI and neurocognitive function.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT02105844]

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation.

BACKGROUND Atrial fibrillation (AF) is associated with cognitive dysfunction. However, neurocognitive function in AF patients undergoing pulmonary vein isolation (PVI) has not been well studied. The aim of this analysis is to compare neurocognitive function in patients who did or did not undergo PVI. MATERIALS AND METHODS We used data from the Swiss Atrial Fibrillation Cohort study (Swiss-AF), a prospective, observational, multicenter study in Switzerland. Patients with documented AF were enrolled and data of 1,576 patients without history of PVI and with complete information on PVI status and neurocognitive function were used. Information on PVI was collected at baseline and during 1 year of follow-up. Neurocognitive testing was performed at baseline and after 1 year of follow-up, using the Montreal Cognitive Assessment (MoCA), trail making test (TMT) A and B, digit symbol substitution test (DSST) and semantic fluency test (SFT). To investigate the association of PVI with neurocognitive function, we use propensity score matching (1:3) and inverse probability of treatment weighting (IPTW). RESULTS The mean age of this population was 74 ± 8 years, 27.1% were women. Overall, 88 (5.5%) patients underwent PVI during 1 year of follow-up. Using ITPW (n = 1576), PVI was weakly associated with the MoCA score after adjusting for time since PVI, baseline MoCA score and other covariates (β (95%CI) 1.19 (0.05; 2.32), p = 0.04). In the propensity matched comparison (n = 352), there was no significant association between PVI and the MoCA score (β (95%CI) 1.04 (-0.19; 2.28), p = 0.1). There were no significant associations between PVI and cognitive function when using the TMT A and B, DSST or SFT independent of the method used. CONCLUSION In this population of AF patients, there was no consistent evidence of an association between PVI and neurocognitive function. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT02105844]

Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly

Soluble αKlotho (sKl) is a disease-specific biomarker that is elevated in patients with acromegaly and declines after surgery for pituitary adenoma. Approximately 25% of patients do not achieve remission after surgery, therefore a risk stratification for patients early in the course of their disease may allow for the identification of patients requiring adjuvant treatment. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been assessed as biomarker for disease activity, however the value of sKl as a predictive biomarker of surgical success has not been evaluated yet. In this study, we measured serum biomarkers before and after transsphenoidal pituitary surgery in 55 treatment-naïve patients. Based on biochemical findings at follow-up (7-16 years), we divided patients into three groups: (A) long-term cure (defined by normal IGF-1 and random low GH (< 1 μg/l) or a suppressed GH nadir (< 0.4/μg/l) on oral glucose testing); (B) initial remission with later disease activity; (C) persistent clinical and/or biochemical disease activity. sKl levels positively related to GH, IGF-1 levels and tumor volume. Interestingly, there was a statistically significant difference in pre- and postoperative levels of sKl between the long-term cure group and the group with persistent disease activity. This study provides first evidence that sKl may serve as an additional marker for surgical success, decreasing substantially in all patients with initial clinical remission while remaining high after surgery in patients with persistent disease activity

Open PC Server Integration 4.0.1

Imagine a great tool built to make the installation and administration of multiple Windows clients a piece of cake, which is also open source and free of charge. This tool exists for Linux servers and is called Open PC and Server Integration – abbreviated OPSI. The main purpose of this thesis is to describe the installation process and basic functions of OPSI. The core task was to create system documentation on OPSI, which describes several aspects from evaluation, planning, realisation, management and finally to testing. The secondary objective was to create a user documentation that will support the execution of most common OPSI functions. The basic functions of OPSI are vividly depicted and described. To ensure the quality of the OPSI environment, a detailed test plan has been elaborated for this project. The component testing was done with two Windows clients. Additionally this thesis picks up subjects, which deal with OPSI server security, server configuration and monitoring. Currently OPSI is widely used in Germany. Unfortunately it isn’t as wide spread in the rest of the world. The goal is to point out the advantages of OPSI to make it attractive for Finnish companies and overall the globe

Being with Babies: Vocal soothing for preterm infants during painful procedures in the Neonatal Intensive Care Unit

Traditionally infant mental health needs have been attended to in the Neonatal Intensive Care Unit (NICU) by supporting parent-infant relationships. There has been little focus in either the Nursing or the Infant Mental Health literature on the role that non-parental caregivers have in supporting preterm infant social and emotional development. Infants in the NICU experience many painful and stressful procedures yet there is evidence that both pharmacological and non-pharmacological methods of pain relief are under-used in the preterm infant population. This PhD programme of research investigated the NICU nurse-infant relationship, with a focus on vocal soothing. Two observational studies investigated the use of voice by NICU nurses during painful and non-painful procedures. A model of vocal soothing was developed and tested for its ability to provide comfort to preterm infants undergoing painful procedures. Two observational studies recorded the numbers of words spoken to 50 infants in NICU during two procedures; a painful one (heel prick) and a non-painful one (nappy change). Three feasibility studies tested the proposed methods and refined the planning for a study that assessed the effectiveness of the vocal soothing intervention in reducing manifestations of pain and stress in preterm infants during painful procedures. In the first feasibility study the research protocol was tested with twenty infants and their nurses. The remaining two feasibility studies further refined the methods for collecting enough saliva from preterm infants for salivary cortisol analysis. In the main study for this PhD research programme, fifty-one infants received both the intervention condition (vocal soothing) and the control condition (silence) during two routine heel prick blood tests in their first 10 days of life. Measures of stress included cortisol, heart rate and oxygen saturation. Pain was measured using the Premature Infant Pain Profile Revised (PIPP-R). Nurses were found to speak infrequently to infants during both painful and non-painful procedures, but were less likely to speak to infants during painful procedures than during non-painful procedures. The feasibility studies led to changes in methods that included the researcher providing the intervention rather than the nurses, the use of a polygraphic system for recording the physiological data and the administration of a 5% aqueous solution of citric acid to increase saliva volume. The results of the main study found no statistically significant differences in cortisol response or physiological data between the vocal soothing and control conditions, although there was some indication that the vocal soothing intervention is unlikely to have an adverse effect on preterm infant cortisol levels. In bringing together the results of these studies, this thesis argues that vocal soothing is an important aspect of emotional care in the NICU. A case is made for ‘companionship’ as a concept that promotes attuned emotionally sensitive care by non-parental caregivers. The international problem of the under-use of pain management interventions is viewed through a psychoanalytic lens and it is proposed that the psychological defence of denial may be a contributing factor. Future directions for research are suggested, including the emotional experience of NICU nurses and the efficacy of a ‘psyche-education’ for improving pain management practices in the NICU