PREDICTING THE INDIVIDUAL MOOD LEVEL BASED ON DIARY DATA

Understanding mood changes of individuals with depressive disorders is crucial in order to guide personalized therapeutic interventions. Based on diary data, in which clients of an online depression treatment report their activities as free text, we categorize these activities and predict the mood level of clients. We apply a bag-of-words text-mining approach for activity categorization and explore recurrent neuronal networks to support this task. Using the identified activities, we develop partial ordered logit models with varying levels of heterogeneity among clients to predict their mood. We estimate the parameters of these models by employing Markov Chain Monte Carlo techniques and compare the models regarding their predictive performance. Therefore, by combining text-mining and Bayesian estimation techniques, we apply a two-stage analysis approach in order to reveal relationships between various activity categories and the individual mood level. Our findings indicate that the mood level is influenced negatively when participants report about sickness or rumination. Social activities have a positive influence on the mood. By understanding the influences of daily activities on the individual mood level, we hope to improve the efficacy of online behavior therapy, provide support in the context of clinical decision-making, and contribute to the development of personalized interventions

Analyzing the Information Search Behavior and Intentions in Visual Information Systems

Visual information search systems support different search approaches such as targeted, exploratory or analytical search. Those visual systems deal with the challenge of composing optimal initial result visualization sets that face the search intention and respond to the search behavior of users. The diversity of these kinds of search tasks require different sets of visual layouts and functionalities, e.g. to filter, thrill-down or even analyze concrete data properties. This paper describes a new approach to calculate the probability towards the three mentioned search intentions, derived from users’ behavior. The implementation is realized as a web-service, which is included in a visual environment that is designed to enable various search strategies based on heterogeneous data sources. In fact, based on an entered search query our developed search intention analysis web-service calculates the most probable search task, and our visualization system initially shows the optimal result set of visualizations to solve the task. The main contribution of this paper is a probability-based approach to derive the users’ search intentions based on the search behavior enhanced by the application to a visual system

Zur Berechnung vielschichtiger Schalen mit orthotropen Schichten

Wirklichkeitsnahe Erfassung und Beschreibung des Trag- und Verformungsverhaltens von Strukturen baulicher Anlagen hat in den letzten Jahrzehnten ständig an Bedeutung gewonnen. Konstruktionen im Hoch- und Industriebau werden zunehmend multifunktional genutzt - die >Grenzen< zwischen Bauwerk und Tragwerk, zwischen Hüll- und Tragkonstruktion lösen sich auf. Werden raumabschließende Elemente (Wände, Decken, Dächer) gleichzeitig als Tragelemente und wärme- und schalldämmende Konstruktionen ausgeführt, so entstehen beispielsweise Sandwichplatten, deren Schichten sehr stark differierende Materialeigenschaften aufweisen. Beim Aufbau des FEM-Modells für vielschichtige Schalen können die Formänderungshypothesen für jede Schicht einzeln als auch für die Schale insgesamt gegeben werden. Im ersten Fall ist der Knotenfreiheitsgrad von der Schichtenzahl abhängig, im zweiten Fall nicht. Im weiteren wird eine Formänderungshypothese für das Schichtenpaket angenommen. Ausgegangen wird von den Gleichungen der 3D-Elastizitätstheorie. Die Berücksichtigung der Querkraftschubverformungen ergibt die Möglichkeit einer adäquaten Beschreibung der Verformungen sowohl dünner Schalen als auch von Schalen mittlerer Dicke; die Berechnung der Krümmungen und der LAMEschen Parameter der Bezugsfläche zu umgehen, was für komplizierte Schalenformen eine selbständige Aufgabe ist; eines natürlichen Übergangs von homogenen zu geschichteten Schalen. Das vielschichtige isoparametrische Schalen-FE wird vorgestellt, seine Implementierung in das in Entwicklung befindliche Programmsystem SLANG wird vorbereitet

MicroRNAs as salivary markers for periodontal diseases

The aim of this review is to discuss current findings regarding the roles of miRNAs in periodontal diseases and the potential use of saliva as a diagnostic medium for corresponding miRNA investigations. For periodontal disease, investigations have been restricted to tissue samples and five miRNAs, that is, miR-142-3p, miR-146a, miR-155, miR-203, and miR-223, were repeatedly validated in vivo and in vitro by different validation methods. Particularly noticeable are the small sample sizes, different internal controls, and different case definitions of periodontitis in in vivo studies. Beside of that, the validated miRNAs are associated with inflammation and therefore with various diseases. Furthermore, several studies successfully explored the use of salivary miRNA species for the diagnosis of oral cancer. Different cancer types were investigated and heterogeneous methodology was used; moreover, no overlap of resultswas found. In conclusion, fivemiRNAs have consistently been reported for periodontitis; however, their disease specificity, detectability, and expression in saliva and their importance as noninvasive markers are questionable. In principle, a salivary miRNA diagnostic method seems feasible.However, standardized criteria and protocols for preanalytics, measurements, and analysis should be established to obtain comparable results across different studies

C-MAC videolaryngoscope compared with direct laryngoscopy for rapid sequence intubation in an emergency department: A randomised clinical trial

BACKGROUND Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting. DESIGN A randomised clinical trial. SETTING Emergency Department of the University Hospital, Zurich, Switzerland. PATIENTS With approval of the local ethics committee, we prospectively enrolled 150 patients between 18 and 99 years of age requiring emergency rapid sequence intubation in the emergency room of the University Hospital Zurich. Patients were randomised (1 : 1) to undergo tracheal intubation using the C-MAC videolaryngoscope or by direct laryngoscopy. INTERVENTIONS Owing to ethical considerations, patients who had sustained maxillo-facial trauma, immobilised cervical spine, known difficult airway or ongoing cardiopulmonary resuscitation were excluded from our study. All intubations were performed by one of three very experienced anaesthesia consultants. MAIN OUTCOME MEASURES First-attempt success rate served as our primary outcome parameter. Secondary outcome parameters were time to intubation; total number of intubation attempts; Cormack and Lehane score; inadvertent oesophageal intubation; ease of intubation; complications including violations of the teeth, injury/bleeding of the larynx/pharynx and aspiration/regurgitation of gastric contents; necessity of using further alternative airway devices for successful intubation; maximum decrease of oxygen saturation and technical problems with the device. RESULTS A total of 150 patients were enrolled, but three patients had to be excluded from the analysis, resulting in 74 patients in the C-MAC videolaryngoscopy group and 73 patients in the direct laryngoscopy group. Tracheal intubation was achieved successfully at the first attempt in 73 of 74 patients in the C-MAC group and all patients in the direct laryngoscopy group (P = 1.0). Time to intubation was similar (32 ± 11 vs. 31 ± 9 s, P = 0.51) in both groups. Visualisation of the vocal cords, represented as the Cormack and Lehane score, was significantly better using the C-MAC videolaryngoscope (P < 0.001). CONCLUSION Our study demonstrates that visualisation of the vocal cords was improved by using the C-MAC videolaryngoscope compared with direct laryngoscopy. Better visualisation did not improve first-attempt success rate, which in turn was probably based on the high level of experience of the participating anaesthesia consultants. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT02297113

Grenzen und Gespinste

Mit Beiträgen von: Mischa Leinkauf, Hans Ulrich Reck, Konstantin Butz, Daniel Burkhardt, Hanns-Josef Ortheil, Dirk Specht, Christina Möser, Karin Lingnau, Elisa Balmaced

Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus:A health economic evaluation

Background: Web-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce. Aims: The aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receiving web-based psychoeducation. Method: We conducted a cost-effectiveness analysis with treatment response as the outcome and a cost-utility analysis with qualityadjusted life-years (QALYs) alongside a randomised controlled trial with 260 participants. Results: At a willingness-to-pay ceiling of €5000 for a treatment response, the intervention has a 97% probability of being regarded as costeffective compared with the active control group. If society is willing to pay €14 000 for an additional QALY, the intervention has a 51% probability of being cost-effective. Conclusions: This web-based intervention for individuals with diabetes and comorbid depression demonstrated a high probability of being cost-effective compared with an active control group

Association of MICA with rheumatoid arthritis independent of known HLA-DRB1 risk alleles in a family-based and a case control study

Introduction The gene MICA encodes the protein major histocompatibility complex class I polypeptide-related sequence A. It is expressed in synovium of patients with rheumatoid arthritis (RA) and its implication in autoimmunity is discussed. We analyzed the association of genetic variants of MICA with susceptibility to RA. Methods Initially, 300 French Caucasian individuals belonging to 100 RA trio families were studied. An additional 100 independent RA trio families and a German Caucasian case-control cohort (90/182 individuals) were available for replication. As MICA is situated in proximity to known risk alleles of the HLA-DRB1 locus, our analysis accounted for linkage disequilibrium either by analyzing the subgroup consisting of parents not carrying HLA-DRB1 risk alleles with transmission disequilibrium test (TDT) or by implementing a regression model including all available data. Analysis included a microsatellite polymorphism (GCT)n and single-nucleotide polymorphisms (SNPs) rs3763288 and rs1051794. Results In contrast to the other investigated polymorphisms, the non-synonymously coding SNP MICA-250 (rs1051794, Lys196Glu) was strongly associated in the first family cohort (TDT: P = 0.014; regression model: odds ratio [OR] 0.46, 95% confidence interval [CI] 0.25 to 0.82, P = 0.007). Although the replication family sample showed only a trend, combined family data remained consistent with the hypothesis of MICA-250 association independent from shared epitope (SE) alleles (TDT: P = 0.027; regression model: OR 0.56, 95% CI 0.38 to 0.83, P = 0.003). We also replicated the protective association of MICA-250A within a German Caucasian cohort (OR 0.31, 95% CI 0.1 to 0.7, P = 0.005; regression model: OR 0.6, 95% CI 0.37 to 0.96, P = 0.032). We showed complete linkage disequilibrium of MICA-250 (D' = 1, r2= 1) with the functional MICA variant rs1051792 (D' = 1, r2= 1). As rs1051792 confers differential allelic affinity of MICA to the receptor NKG2D, this provides a possible functional explanation for the observed association. Conclusions We present evidence for linkage and association of MICA-250 (rs1051794) with RA independent of known HLA-DRB1 risk alleles, suggesting MICA as an RA susceptibility gene. However, more studies within other populations are necessary to prove the general relevance of this polymorphism for RA

Platelets drive fibronectin fibrillogenesis using integrin αIIbβ3

Platelets interact with multiple adhesion proteins during thrombogenesis, yet little is known about their ability to assemble fibronectin matrix. In vitro three-dimensional superresolution microscopy complemented by biophysical and biochemical methods revealed fundamental insights into how platelet contractility drives fibronectin fibrillogenesis. Platelets adhering to thrombus proteins (fibronectin and fibrin) versus basement membrane components (laminin and collagen IV) pull fibronectin fibrils along their apical membrane versus underneath their basal membrane, respectively. In contrast to other cell types, platelets assemble fibronectin nanofibrils using αIIbβ3 rather than α5β1 integrins. Apical fibrillogenesis correlated with a stronger activation of integrin-linked kinase, higher platelet traction forces, and a larger tension in fibrillar-like adhesions compared to basal fibrillogenesis. Our findings have potential implications for how mechanical thrombus integrity might be maintained during remodeling and vascular repair

Antibodies to the endoplasmic reticulum-resident chaperones calnexin, BiP and Grp94 in patients with rheumatoid arthritis and systemic lupus erythematosus

Objectives. To investigate the presence of autoantibodies against mammalian chaperones of the endoplasmic reticulum (ER) in patients with RA and other immune-mediated diseases. Methods. Sera from healthy donors, from early RA patients with two follow-up samples, patients with SLE, SSc and IBD were collected and analysed for anti-ER chaperone antibodies. Detection of serum IgG antibodies against immunoglobulin heavy chain binding protein (BiP), glucose-regulated protein 94 (Grp94) and calnexin was carried out using ELISA. The specificity of sera positive for individual ER chaperones was confirmed by immunoblotting. Statistical analysis was performed using Welch's t-test, Mann-Whitney U-test, partial correlation and Pearson's correlation. Results. In patients with RA and SLE, autoantibody titres against BiP, Grp94 and calnexin were significantly higher than those in healthy controls. These autoantibodies were detectable in patients with early RA and titres remained stable for at least 6-12 months. Also several SSc and IBD patients exhibited autoantibodies against these ER chaperones; however, titres and frequencies were lower than in RA or SLE patients. Furthermore, anti-calnexin antibodies correlated significantly with the presence of BiP and Grp94 autoantibodies in patients with RA and SLE. Conclusion. Calnexin and Grp94 were identified as novel autoantigens in RA and calnexin in SLE. Since calnexin, Grp94 and BiP are ER-resident proteins of eukaryotic cells, our data suggest that autoantibody generation against ER chaperones is independent of initial exposure to the corresponding bacterial chaperones; rather, ER chaperones may represent genuine autoantigen