Vergleich internationaler Konsensus-Empfehlungen zur Erkennung des präsymptomatischen Hochrisikopatienten für den Herzinfarkt in Deutschland

Summary : The recommendations of the International Task Force for the Prevention of Coronary Heart Disease/International Atherosclerosis Society (ITF/IAS), the US-American Adult Treatment Panel III of the National Cholesterol Education Programs (ATP III) and the 3rd Joint European Guidelines (3JE) for the prevention coronary heart disease (CHD) show good agreement in tertiary prevention. All three guidelines recommend that patients with manifest CHD should have a blood pressure below 140/90 mm Hg and LDL-cholesterol below 2.6 mmol/l (100 mg/dl). By contrast, the three recommendations differ with respect to the prevention of cardiovascular events in asymptomatic high risk patients (secondary prevention), notably in the strategy to be used for risk assessment. Both the ITF/IAS guidelines and the 3JE guidelines can be adapted and realized in the various European countries. We therefore compared the prognostic values of the three recommendations by applying them to the data of male participants of the Prospective Cardiovascular Münster (PROCAM) Study. The ITF/IAS recommendations show the highest specificity (94.5%), positive predictive value (32.0%) and diagnostic efficacy (90.5%); the 3JE guidelines have the highest sensitivity (64.6%) but lowest specificity (77.9%), positive predictive value (17.5%) and diagnostic efficacy (77.0%). The application of the 3JE recommendations would target 25% of German men aged 35-65 years as cardiovascular high risk patients, by contrast to 7.5% through application of the ITF/IAS guidelines. In view of the limited resources in the public health systemthe application of the ITF/IAS guidelines in Germany appears more appropriat

Relative CC"-Numerical Ranges for Applications in Quantum Control and Quantum Information

Motivated by applications in quantum information and quantum control, a new type of $C$"-numerical range, the relative $C$"-numerical range denoted $W_K(C,A)$, is introduced. It arises upon replacing the unitary group U(N) in the definition of the classical $C$"-numerical range by any of its compact and connected subgroups $K \subset U(N)$. The geometric properties of the relative $C$"-numerical range are analysed in detail. Counterexamples prove its geometry is more intricate than in the classical case: e.g. $W_K(C,A)$ is neither star-shaped nor simply-connected. Yet, a well-known result on the rotational symmetry of the classical $C$"-numerical range extends to $W_K(C,A)$, as shown by a new approach based on Lie theory. Furthermore, we concentrate on the subgroup $SU_{\rm loc}(2^n) := SU(2)\otimes ... \otimes SU(2)$, i.e. the $n$-fold tensor product of SU(2), which is of particular interest in applications. In this case, sufficient conditions are derived for $W_{K}(C,A)$ being a circular disc centered at origin of the complex plane. Finally, the previous results are illustrated in detail for $SU(2) \otimes SU(2)$.Comment: accompanying paper to math-ph/070103

The Significance of the CC-Numerical Range and the Local CC-Numerical Range in Quantum Control and Quantum Information

This paper shows how C-numerical-range related new strucures may arise from practical problems in quantum control--and vice versa, how an understanding of these structures helps to tackle hot topics in quantum information. We start out with an overview on the role of C-numerical ranges in current research problems in quantum theory: the quantum mechanical task of maximising the projection of a point on the unitary orbit of an initial state onto a target state C relates to the C-numerical radius of A via maximising the trace function |\tr \{C^\dagger UAU^\dagger\}|. In quantum control of n qubits one may be interested (i) in having U\in SU(2^n) for the entire dynamics, or (ii) in restricting the dynamics to {\em local} operations on each qubit, i.e. to the n-fold tensor product SU(2)\otimes SU(2)\otimes >...\otimes SU(2). Interestingly, the latter then leads to a novel entity, the {\em local} C-numerical range W_{\rm loc}(C,A), whose intricate geometry is neither star-shaped nor simply connected in contrast to the conventional C-numerical range. This is shown in the accompanying paper (math-ph/0702005). We present novel applications of the C-numerical range in quantum control assisted by gradient flows on the local unitary group: (1) they serve as powerful tools for deciding whether a quantum interaction can be inverted in time (in a sense generalising Hahn's famous spin echo); (2) they allow for optimising witnesses of quantum entanglement. We conclude by relating the relative C-numerical range to problems of constrained quantum optimisation, for which we also give Lagrange-type gradient flow algorithms.Comment: update relating to math-ph/070200

The effect of cognition on the visually-induced illusion of self-motion (vection)

INTRODUCTION: The illusion of self-motion induced by moving visual stimuli has typically been attributed to bottom-up perceptual processes. Here, we investigated whether a cognitive factor such as spatial presence can contribute to the illusion. Spatial presence was indirectly manipulated by presenting either a photorealistic image of a natural scene or modified versions of the same stimulus. Those were created by either scrambling image parts in a mosaic-like manner or by slicing the original image horizontally and randomly reassembling it. We expected scene modifications to decrease spatial presence and thus impair vection. METHODS: Twelve observers viewed stimuli projected onto a curved projection screen (FOV: 54 ×40.5 ). Dependent measures included vection onset time, vection intensity, and convincingness of the illusion (0–100 ratings). Spatial presence was assessed with presence questionnaires. RESULTS: Scene modification led to both reduced presence scores and impaired vection: Modified stimuli yielded significantly longer vection onset times, lower perceived intensity, and lower convincingness ratings than the intact market scene. No clear difference was found between the sliced and scrambled stimuli or among the number of slices or mosaics (2, 8, or 32). Results suggest that high level information (consistent reference frame for the intact market scene) dominated over the low-level information (more contrast edges in the scrambled stimulus, which are known to facilitate vection). CONCLUSIONS: Results suggest a direct relation between spatial presence and self-motion perception. We posit that stimuli depicting naturalistic scenes provide observers with a convincing reference frame for the simulated environment which enables them to feel “spatially present”. This, in turn, facilitates the self-motion illusion. This work has important implications for both self-motion perception and motion simulator design and applications

Distribution of enteric glia and GDNF during gut inflammation

<p>Abstract</p> <p>Background</p> <p>The enteric glia network may be involved in the pathogenesis of inflammatory bowel disease (IBD). Enteric glia cells (EGCs) are the major source of glial-derived neurotrophic factor (GDNF), which regulates apoptosis of enterocytes. The aim of the study was to determine the distribution of EGCs and GDNF during gut inflammation and to elucidate a possible diminished enteric glia network in IBD.</p> <p>Methods</p> <p>The expression of glial fibrillary acidic protein (GFAP) in colonic biopsies of patients with IBD, controls and patients with infectious colitis was detected by immunohistochemistry and Western blot. Tissue GDNF levels were measured by ELISA.</p> <p>Results</p> <p>The expression of GFAP and GDNF in the mucosal plexus is highly increased in the inflamed colon of patients with ulcerative colitis (UC) and infectious colitis. Although the GDNF and GFAP content are increased in Crohn's disease (CD), it is significantly less. Additionally the non-inflamed colon of CD patients showed a reduced GFAP and no GDNF expression compared to controls and the non-inflamed colon of UC patients.</p> <p>Conclusions</p> <p>GFAP and GDNF as signs of activated EGCs are increased in the inflamed mucosa of patients with UC and infectious colitis, which underline an unspecific role of EGC in the regulation of intestinal inflammation. The reduced GFAP and GDNF content in the colon of CD patients suggest a diminished EGC network in this disease. This might be a part of the pathophysiological puzzle of CD.</p

Case report: HLA-haploidentical HSCT rescued with donor lymphocytes infusions in a patient with X-linked chronic granulomatous disease

Chronic granulomatous disease is an inborn error of immunity due to disrupted function of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. This results in impaired respiratory burst of phagocytes and insufficient killing of bacteria and fungi. Patients with chronic granulomatous disease are at increased risk for infections, autoinflammation and autoimmunity. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only widely available curative therapy. While HSCT from human leukocyte antigen (HLA) matched siblings or unrelated donors are standard of care, transplantation from HLA-haploidentical donors or gene therapy are considered alternative options. We describe a 14-month-old male with X-linked chronic granulomatous disease who underwent a paternal HLA-haploidentical HSCT using T-cell receptor (TCR) alpha/beta(+)/CD19(+) depleted peripheral blood stem cells followed by mycophenolate graft versus host disease prophylaxis. Decreasing donor fraction of CD3(+) T cells was overcome by repeated infusions of donor lymphocytes from the paternal HLA-haploidentical donor. The patient achieved normalized respiratory burst and full donor chimerism. He remained disease-free off any antibiotic prophylaxis for more than three years after HLA-haploidentical HSCT. In patients with x-linked chronic granulomatous disease without a matched donor paternal HLA-haploidentical HSCT is a treatment option worth to consider. Administration of donor lymphocytes can prevent imminent graft failure

Process Modules for GeSn Nanoelectronics with high Sn-contents

This paper systematically studies GeSn n-FETs, from individual process modules to a complete device. High-k gate stacks and NiGeSn metallic contacts for source and drain are characterized in independent experiments. To study both direct and indirect bandgap semiconductors, a range of 0 at.% to 14.5 at.% Sn-content GeSn alloys are investigated. Special emphasis is placed on capacitance-voltage (C-V) characteristics and Schottky-barrier optimization. GeSn n-FET devices are presented including temperature dependent I-V characteristics. Finally, as an important step towards implementing GeSn in tunnel-FETs, negative differential resistance in Ge0.87Sn0.13 tunnel-diodes is demonstrated at cryogenic temperatures. The present work provides a base for further optimization of GeSn FETs and novel tunnel FET devices

Iron Chelation in Patients with Myelodysplastic Syndromes and Myeloproliferative Neoplasms—Real-World Data from the German Noninterventional Study EXCALIBUR

Myelodysplastic syndromes and myeloproliferative neoplasms both represent hematologic diseases associated with bone marrow failure often resulting in anemia. For those patients, transfusion of red blood cell (RBC) units is essential but results in iron overload (IOL) that may affect various organ functions. Therefore, iron chelation therapy plays a major role in anemic patients, not only because it reduces IOL, but also because it may improve hematopoietic function by increasing hemoglobin or diminishing the requirement for RBC transfusions. To assess the utility, efficacy, and safety of the different iron chelation medications approved in Germany, as well as to examine the effect of chelation on hematopoietic insufficiency, a prospective, multicenter, noninterventional study named EXCALIBUR was designed. In total, 502 patients from 106 German hospitals and medical practices were enrolled. A large proportion of patients switched from a deferasirox dispersible tablet to a deferasirox-film-coated tablet, mainly because of more convenient application, which was reflected in the treatment satisfaction questionnaire for medication scores. Iron chelation was effective in lowering serum ferritin levels, with the observed adverse drug reactions being in line with the known safety profile. Hematologic response occurred in a few patients, comparable to other studies that examined hematologic improvement in patients with MDS