Multi-modales Biofeedback System zur Vorbeugung von Stürzen Multi-modal Biofeedback System for the Prevention of Falls

Das Biofeedback des Körperschwankens stellt eine Möglichkeit dar, Patienten mit statischen und dynamischen Gleichgewichtsproblemen alternative Sinnesreize zur Erlangung eines stabilen Gleichgewichts zur Verfügung zu stellen, was zu einer Verbesserung ihrer Lebensqualität führt. Das Biofeedback-System erzeugt mittels am Kopf befestigter Signalwandler auditive, vibro-taktile und vibro-vestibuläre Sinneseindrücke. Die Ergebnisse sowohl an jungen als auch an älteren Probanden ergaben, dass mit Hilfe des Biofeedbacks eine bemerkenswerte 40-60%ige Reduktion des Körperschwankens erzielt werden konnt

Automated identification of diagnostic labelling errors in medicine

Objectives: Identification of diagnostic error is complex and mostly relies on expert ratings, a severely limited procedure. We developed a system that allows to automatically identify diagnostic labelling error from diagnoses coded according to the international classification of diseases (ICD), often available as routine health care data. Methods: The system developed (index test) was validated against rater based classifications taken from three previous studies of diagnostic labeling error (reference standard). The system compares pairs of diagnoses through calculation of their distance within the ICD taxonomy. Calculation is based on four different algorithms. To assess the concordance between index test and reference standard, we calculated the area under the receiver operating characteristics curve (AUROC) and corresponding confidence intervals. Analysis were conducted overall and separately per algorithm and type of available dataset. Results: Diagnoses of 1,127 cases were analyzed. Raters previously classified 24.58% of cases as diagnostic labelling errors (ranging from 12.3 to 87.2% in the three datasets). AUROC ranged between 0.821 and 0.837 overall, depending on the algorithm used to calculate the index test (95% CIs ranging from 0.8 to 0.86). Analyzed per type of dataset separately, the highest AUROC was 0.924 (95% CI 0.887-0.962). Conclusions: The trigger system to automatically identify diagnostic labeling error from routine health care data performs excellent, and is unaffected by the reference standards' limitations. It is however only applicable to cases with pairs of diagnoses, of which one must be more accurate or otherwise superior than the other, reflecting a prevalent definition of a diagnostic labeling error

Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease

We identified rare coding variants associated with Alzheimer’s disease (AD) in a 3-stage case-control study of 85,133 subjects. In stage 1, 34,174 samples were genotyped using a whole-exome microarray. In stage 2, we tested associated variants (P<1×10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, an additional 14,997 samples were used to test the most significant stage 2 associations (P<5×10-8) using imputed genotypes. We observed 3 novel genome-wide significant (GWS) AD associated non-synonymous variants; a protective variant in PLCG2 (rs72824905/p.P522R, P=5.38×10-10, OR=0.68, MAFcases=0.0059, MAFcontrols=0.0093), a risk variant in ABI3 (rs616338/p.S209F, P=4.56×10-10, OR=1.43, MAFcases=0.011, MAFcontrols=0.008), and a novel GWS variant in TREM2 (rs143332484/p.R62H, P=1.55×10-14, OR=1.67, MAFcases=0.0143, MAFcontrols=0.0089), a known AD susceptibility gene. These protein-coding changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified AD risk genes. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to AD development

Roger Boltshauser 1996-2021

Mit Beiträgen von Martin Tschanz, Roger Boltshauser, Jonathan Sergison, Jules Petit und Jan de Vylder.Eine umfassende Monographie über die architektonischen und künstlerischen Arbeiten von Roger Boltshauser

Stampflehm fordert die Reflexion, das Denken heraus

Das Potenzial des Stampflehmbaus ist bei Weitem noch nicht ausgeschöpft. Doch wie bringt man das Studierenden bei, welche Möglichkeiten bringen Verbindungen mit anderen Materialien, und was lernen Architekten vom Umgang mit Lehm? Fünf Experten unterhalten sich

Trunk sway reductions in young and older adults using multi-modal biofeedback

This study investigated whether real-time biofeedback of angular trunk displacement could alter balance performance among healthy older and young adults. Healthy community-dwelling older adults (n=32) and healthy young adults (n=32) were included in the randomized control trial study. The intervention group received combined vibrotactile, auditory and visual biofeedback of angular trunk displacement in real-time during training on a battery of static and dynamic balance tasks and during the subsequent post-training balance re-assessment. The control group received balance training and were re-assessed in the absence of real-time biofeedback of their trunk displacement. The 90% range of angular trunk displacement was calculated for each balance task pre- and post-training. Significant age-related differences were observed independent of the intervention. Biofeedback intervention significantly changed the angular displacement of the trunk for both young and older participants on a number of balance tasks compared to control treatment (40-60% reduction in angular displacement). In some cases, biofeedback influenced balance in older adults, but not younger adults

Lactic acidosis following heart transplantation: a common phenomenon?

BACKGROUND Lactic acidosis (LAc) is a common form of metabolic acidosis early after heart transplantation (HTX). The mechanism remains unclear. This study analyzed 13 patients who developed severe LAc after HTX. METHODS From a series of 60 consecutive heart transplant patients, we identified 13 patients with LAc in the first hours following HTX. Nine patients with normal or mildly elevated lactate levels (<5.0 mmol/l) were investigated as controls. RESULTS Thirteen patients developed a moderate or severe LAc (up to 14.6 mmol/l) after HTX. Serum lactate levels increased immediately following surgery with a peak after 6.3+/-1.4 h, spontaneously returning to normal values within 24 h. In contrast to the control group, a significant correlation was found between the maximal serum lactate level and the maximal dosage of inotropic drugs (r=0.93, P<0.02), administered during the reperfusion phase and continued for 12-24 h postoperatively. No correlation was found between LAc and blood gas analysis during extracorporeal perfusion period. CONCLUSION LAc can occur after HTX and seems to be related to the inotropic support of the graft. In contrast to other forms, LAc after HTX has an excellent prognosis and resolves rapidly and spontaneously without treatment. The fact that inotropic support during and immediately after cardiac transplantation can enhance preexisting severe peripheral metabolic cellular dysfunction remains hypothetical