Softwarearchitektur für den ViKar-Campus

In Karlsruhe wurde 1998 das Projekt Virtueller Hochschulverbund Karlsruhe [ViKar] ins Leben gerufen, in dem die 6 ortsansässigen Hochschulen den Aufbau einer gemeinsamen, virtuellen Hochschule in Karlsruhe vorantreiben. Im Folgenden soll, ausgehend von den angebotenen Diensten des ersten ViKar-Prototyps, die verwendete Softwarearchitektur für den ViKar-Campus aufgezeigt und kritisch untersucht werden. Ein abschließender Ausblick gibt Empfehlungen für den weiteren Ausbau des ViKar-Campus

Lern-Server und elektronischer Studienassistent als virtuelle Dienstleister in der ViKar-Lernumgebung

Der Lern-Server gilt als der entscheidende Kernbereich der virtuellen Lernumgebung für das Projekt "Virtueller Hochschulverbund Karlsruhe" [ViKar]. Er stellt eine Reihe von Diensten und Funktionalitäten zur Verfügung, die bedeutsam für die Akzeptanz des gesamten Projekts durch Studierende und Lehrende gleichermaßen sein werden. In diesem Bericht wird neben einer Ist-Analyse und mehreren Kurzbeschreibungen verfügbarer kommerzieller Produkte darauf eingegangen, welche Anforderungen an den ViKar-Lern-Server zu stellen sind und wie das weitere Konzept auszusehen hat. Ferner wird der persönliche elektronische Studienassistent, der dem Studierenden in der virtuellen Studienwelt ein Begleiter sein soll, in seinen Diensten vorgestellt

Virtualisierung eines wissenschaftlichen Kongresses. Am Beispiel der LEARNTEC 99

Wie ernst muss man die Virtualisierungsbestrebungen im Kongress- und Bildungsbereich nehmen? Rechnet sich der deutliche Mehraufwand, wenn ohnehin die Präsenzveranstaltungen weiter stattfinden sollen? Denn nur noch virtuelle Veranstaltungen zu besuchen da würde etwas im gefühlsmäßigen direkten Erleben fehlen. Als Ergänzung und Erweiterung zu bisherigen Kongressangeboten kann man sich sehr gut eine Virtualisierung vorstellen. Durch die weltweite Vernetzung von Rechnern, die Digitalisierung von Medien und dem strukturellen Wandel der Wirtschaft entsteht eine neue Kommunikationskultur, der wir uns nicht mehr verweigern können. Wie konkret und wie komplex sich diese Tatsache auf den Kongress- und Bildungsbereich auswirkt, kann noch nicht genau eingeschätzt werden. Deshalb bildet der experimentelle Umgang im Rahmen der LEARNTEC eine gewisse Sicherheit, auf künftige Entwicklungen vorbereitet zu sein. Welche virtuelle Dienstestruktur in das Kongresskonzept am Ende eingehen wird, wird durch das Nutzerverhalten der realen und virtuellen Teilnehmer bestimmt

Environmental change during MIS4 and MIS 3 opened corridors in the Horn of Africa for <i>Homo sapiens</i> expansion

Archaeological findings, numerical human dispersal models and genome analyses suggest several time windows in the past 200 kyr (thousands of years ago) when anatomically modern humans (AMH) dispersed out of Africa into the Levant and/or Arabia. From close to the key hominin site of Omo-Kibish, we provide near continuous proxy evidence for environmental changes in lake sediment cores from the Chew Bahir basin, south Ethiopia. The data show highly variable hydroclimate conditions from 116 to 66 kyr BP with rapid shifts from very wet to extreme aridity. The wet phases coincide with the timing of the North African Humid Periods during MIS5, as defined by Nile discharge records from the eastern Mediterranean. The subsequent record at Chew Bahir suggests stable regional hydrological setting between 58 and 32 kyr (MIS4 and 3), which facilitated the development of more habitable ecosystems, albeit in generally dry climatic conditions. This shift, from more to less variable hydroclimate, may help account for the timing of later dispersal events of AMH out of Africa

The clinical course of idiopathic pulmonary fibrosis and its association to quality of life over time: longitudinal data from the INSIGHTS-IPF registry

Background: Quality of life (QoL) is profoundly impaired in patients with idiopathic pulmonary fibrosis (IPF). However, data is limited regarding the course of QoL. We therefore analysed longitudinal data from the German INSIGHTS-IPF registry. Methods: Clinical status and QoL were assessed at enrollment and subsequently at 6- to 12-months intervals. A range of different QoL questionnaires including the St. George’s Respiratory Questionnaire (SGRQ) were used. Results: Data from 424 patients were included; 76.9% male; mean age 68.7 ± 9.1 years, mean FVC% predicted 75.9 ± 19.4, mean DLCO% predicted 36.1 ± 15.9. QoL worsened significantly during follow-up with higher total SGRQ scores (increased by 1.47 per year; 95% CI: 1.17 to 1.76; p &lt; 0.001) and higher UCSD-SOBQ scores and lower EQ-5D VAS and WHO-5 scores. An absolute decline in FVC% predicted of &gt; 10% was associated with a significant deterioration in SGRQ (increasing by 9.08 units; 95% CI: 2.48 to 15.67; p = 0.007), while patients with stable or improved FVC had no significantly change in SGRQ. Patients with a &gt; 10% decrease of DLCO % predicted also had a significant increase in SGRQ (+ 7.79 units; 95% CI: 0.85 to 14.73; p = 0.028), while SQRQ was almost stable in patients with stable or improved DLCO. Patients who died had a significant greater increase in SGRQ total scores (mean 11.8 ± 18.6) at their last follow-up visit prior to death compared to survivors (mean 4.2 ± 18.9; HR = 1.03; 95% CI: 1.01 to 1.04; p &lt; 0.001). All QoL scores across the follow-up period were significantly worse in hospitalised patients compared to non-hospitalised patients, with the worst scores reported in those hospitalised for acute exacerbations. Conclusions: QoL assessments in the INSIGHTS-IPF registry demonstrate a close relationship between QoL and clinically meaningful changes in lung function, comorbidities, disease duration and clinical course of IPF, including hospitalisation and mortality

Health related quality of life in patients with idiopathic pulmonary fibrosis in clinical practice: insights-IPF registry

Background: The INSIGHTS-IPF registry provides one of the largest data sets of clinical data and self-reported patient related outcomes including health related quality of life (QoL) on patients with idiopathic pulmonary fibrosis (IPF). We aimed to describe associations of various QoL instruments between each other and with patient characteristics at baseline. Methods: Six hundred twenty-three IPF patients with available QoL data (St George's Respiratory Questionnaire SGRQ, UCSD Shortness-of-Breath Questionnaire SoB, EuroQol visual analogue scale and index EQ-5D, Well-being Index WHO-5) were analysed. Mean age was 69.6 +/- 8.7 years, 77% were males, mean disease duration 2.0 +/- 3.3 years, FVC pred was 67.5 +/- 17.8%, DLCO pred 35.6 +/- 17%. Results: Mean points were SGRQ total 48.3, UCSD SoB 47.8, EQ-5D VAS 66.8, and WHO-5 13.9. These instruments had a high or very high correlation (exception WHO-5 to EQ-5D VAS with moderate correlation). On bivariate analysis, QoL by SGRQ total was statistically significantly associated with clinical symptoms (NYHA;p < 0.001), number of comorbidities (p < 0.05), hospitalisation rate (p < 0.01) and disease severity (as measured by GAP score, CPI, FVC and 6-min walk test;p < 0.05 each). Multivariate analyses showed a significant association between QoL (by SGRQ total) and IPF duration, FVC, age, NYHA class and indication for long-term oxygen treatment. Conclusions: Overall, IPF patients under real-life conditions have lower QoL compared to those in clinical studies. There is a meaningful relationship between QoL and various patient characteristics

Pulmonary Hypertension in Adults with Congenital Heart Disease: Real-World Data from the International COMPERA-CHD Registry

Introduction: Pulmonary hypertension (PH) is a common complication in patients with congenital heart disease (CHD), aggravating the natural, post-operative, or post-interventional course of the underlying anomaly. The various CHDs differ substantially in characteristics, functionality, and clinical outcomes among each other and compared with other diseases with pulmonary hypertension. Objective: To describe current management strategies and outcomes for adults with PH in relation to different types of CHD based on real-world data. Methods and results: COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension) is a prospective, international PH registry comprising, at the time of data analysis, >8200 patients with various forms of PH. Here, we analyzed a subgroup of 680 patients with PH due to CHD, who were included between 2007 and 2018 in 49 specialized centers for PH and/or CHD located in 11 European countries. At enrollment, the patients’ median age was 44 years (67% female), and patients had either pre-tricuspid shunts, post-tricuspid shunts, complex CHD, congenital left heart or aortic disease, or miscellaneous other types of CHD. Upon inclusion, targeted therapies for pulmonary arterial hypertension (PAH) included endothelin receptor antagonists, PDE-5 inhibitors, prostacyclin analogues, and soluble guanylate cyclase stimulators. Eighty patients with Eisenmenger syndrome were treatment-naïve. While at inclusion the primary PAH treatment for the cohort was monotherapy (70% of patients), with 30% of the patients on combination therapy, after a median observation time of 45.3 months, the number of patients on combination therapy had increased significantly, to 50%. The use of oral anticoagulants or antiplatelets was dependent on the underlying diagnosis or comorbidities. In the entire COMPERA-CHD cohort, after follow-up and receiving targeted PAH therapy (n = 511), 91 patients died over the course of a 5-year follow up. The 5-year Kaplan–Meier survival estimate for CHD associated PH was significantly better than that for idiopathic PAH (76% vs. 54%; p < 0.001). Within the CHD associated PH group, survival estimates differed particularly depending on the underlying diagnosis and treatment status. Conclusions: In COMPERA-CHD, the overall survival of patients with CHD associated PH was dependent on the underlying diagnosis and treatment status, but was significantly better as than that for idiopathic PAH. Nevertheless, overall survival of patients with PAH due to CHD was still markedly reduced compared with survival of patients with other types of CHD, despite an increasing number of patients on PAH-targeted combination therapy

Normal values for cardiovascular magnetic resonance in adults and children

Morphological and functional parameters such as chamber size and function, aortic diameters and distensibility, flow and T1 and T2* relaxation time can be assessed and quantified by cardiovascular magnetic resonance (CMR). Knowledge of normal values for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. In this review, we present normal reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques and sequences