Additional results on the treatment of arterial hypertension by blood pressure biofeedback

Hintergrund: Auf der Suche nach nebenwirkungsfreien Alternativen zur Behandlung von Bluthochdruck (Arterielle Hypertonie) gelang es Piesbergen et al. (2008), eine verfeinerte Methode für Biofeedback zu entwickeln und in der Anwendung erfolgreich zu evaluieren. Überlegungen zur Ursächlichkeit der gezeigten hohen Effizienz - bereits 2 Sitzungen zeigten signifikante Blutdrucksenkungen - mündeten in der Notwendigkeit, weitere multivariate Analysen zum Datensatz dieser Studie durchzuführen. Patienten und Methoden: Verglichen wurden zwei stationäre Patientengruppen aus der Klinik Höhenried am Starnberger See/Obb, die das normale Heilbehandlungsprogramm der Klinik und zusätzlich zwei (N = 20 Pbn) bzw. drei bis sechs (N = 22 Pbn) jeweils 30minütige Biofeedbackbehandlungen erhielten. Ergebnisse: Zwar zeigte sich ein genereller Wirkeffekt der Heilbehandlung für beide Gruppen (p = .026), allerdings schnitt die Versuchsgruppe mit drei bis sechs Feedbacksitzungen wieder nicht signifikant besser ab als die Gruppe mit nur zwei Sitzungen (p = .255). Eine Trendanalyse zeigte jedoch signifikante, monoton fallende Blutdrucktrends mit steigender Sitzungszahl. Schlussfolgerungen: Insbesondere bei Therapie-Respondern steigt die Wirksamkeit von hochfrequentem Blutdruck-Biofeedback mit der Sitzungsfrequenz.Introduction: In search of alternatives without adverse reactions to treat arterial hypertension Piesbergen et al. (2008) succeeded in developing and evaluating an improved method of biofeedback. The sourcing of the observable high efficiency and above all the very short period of treatment - merely two sessions showed significant blood pressure lowering - lead to a necessity of further multivariate data analyses for this sample. Patients and methods: Two patient groups of the Clinic Höhenried in Bavaria which received the normal treatment program of the clinic and an additional two (N = 20 Ss) or three to six (N = 22 Ss) biofeedback sessions, respectively, were compared on each other. Results: Although clinic treatment showed significant effects (p = .026), subjects treated by three to six feedback sessions did not perform significantly better again than those treated by only two sessions (p = .517), but trend analyses showed significant decreasing trends in blood pressure level with increasing the number of sessions. Conclusions: Especially therapy responders achieve better results by means of higher session frequency

Adjuvante Therapie von arterieller Hypertonie durch hochfrequentes Blutdruckbiofeedback

Introduction: A lack of studies on the effects of continuous blood pressure biofeedback lead to the development of screening and feedback software enabling a “beat-to-beat” representation of arterial blood pressure. With this method patients discover that they are able to influence their own blood pressure. Patients and methods: For evaluation purposes a pilot study was conducted with 84 hypertensive patients of the Clinic Höhenried in Bavaria. Two experimental groups which received the normal treatment program of the clinic and an additional two (N = 20 Ss) or three to six (N = 22 Ss) biofeedback sessions respectively were compared with a control group treated additionally by pseudo biofeedback (N = 20 Ss) and another control group (N = 22 Ss) which only underwent the clinic program without biofeedback. Results: Both experimental groups achieved a significantly higher blood pressure lowering (MAP) than the controls (p = .001), but subjects treated by three to six feedback sessions did not perform significantly better than those treated by only two sessions (p = .517). Conclusions: Even two sessions of feedback treatment can have clinically relevant effects suggesting a great influence of cognitive processes such as self effectiveness and self-control.Hintergrund: Der Mangel an praxisnahen Studien zur Wirksamkeit von kontinuierlichem Blutdruckbiofeedback führte zur Entwicklung und Erprobung einer Aufzeichnungs- und Feedbacksoftware, die eine beat-to-beat Darstellung des arteriellen Blutdrucks auf einem Computermonitor ermöglicht. In Biofeedbacksitzungen mit diesem System machen Hochdruckpatienten die Erfahrung, dass sie über eigene Ressourcen für eine klinisch relevante Blutdrucksenkung verfügen. Patienten und Methoden: Zur Evaluation des Verfahrens wurde an der Klinik Höhenried am Starnberger See/Obb. eine Pilotstudie mit 84 stationären Hypertoniepatienten durchgeführt. Zwei Experimentalgruppen, die das normale Heilbehandlungsprogramm der Klinik und zusätzlich zwei (N = 20 Pbn) bzw. drei bis sechs (N = 22 Pbn) jeweils 30minütige Biofeedbackbehandlungen erhielten, wurden mit zwei Kontrollgruppen verglichen (N = 20 Pbn mit Pseudobiofeedback und N = 22 Pbn, die nur das Klinikprogramm durchliefen). Ergebnisse: Aus den mittels Armmanschette gemessenen RR-Werten wurden bei allen Gruppen die Durchschnittswerte des medizinischen Mitteldrucks (MAP) in der ersten und in der Entlassungswoche berechnet und ein Differenzwert gebildet. Beide Versuchsgruppen erzielten signifikant höhere Senkungen des MAP als die Kontrollgruppen (p = .001), allerdings schnitt die Versuchsgruppe mit drei bis sechs Feedbacksitzungen nicht signifikant besser ab als die Gruppe mit nur zwei Sitzungen (p = .517). Schlussfolgerungen: Schon eine zweimalige Behandlung mit hochfrequentem Biofeedback kann bereits klinisch relevante Effekte haben, was Hinweise auf einen erheblichen Einfluss von kognitiven Prozessen wie Selbstwirksamkeit und Selbstkontrolle liefert

Interorganisationale Zusammenarbeit als Erfolgsfaktor im Innovationsprozess

Die Bedeutung von Forschung und Entwicklung ist in den letzten Jahren aufgrund des steigenden Wettbewerbs und der Komplexität von Produkt- und Prozessentwicklungen, stark gestiegen. Eine Möglichkeit, diese effektiver und effizienter zu betreiben wird durch Kooperationen ermöglicht. Diese Möglichkeit wurde auch von der unternehmerischen Praxis erkannt. So zeigen bisherige Studien, dass knapp die Hälfte der Unternehmen mehr als zehn Prozent ihres F&E-Budgets für Kooperationen ausgibt und sich die interorganisationale Zusammenarbeit positiv auf den Erfolg von Innovationen auswirkt. Gezeigt wurde, dass sich interorganisationale Zusammenarbeit positiv auf den Erfolg von Innovationen auswirkt. Fachliche Qualifikationen alleine sind allerdings nicht ausreichend – eine bedeutende Wirkung wird auch den sozialen Qualifikationen zugesprochen. Das Ziel der vorliegenden Arbeit ist die Betrachtung der Umsetzung von Kooperationsaktivitäten. Schwerpunkte bilden dabei die Initiierung von Kontakten, die Abwicklung von Kooperationen, Konfliktlösungsmechanismen, Evaluationsprozeduren und Auswirkungen auf den Kooperationserfolg. Mithilfe von 17 qualitativen Interviews in der österreichischen Kunststoffindustrie wird gezeigt, dass ein Bewusstsein über Maßnahmen zur Erfolgserreichung vorhanden, deren Umsetzung allerdings nur bedingt festzustellen ist. Offen bleibt, inwiefern sich durch die Einführung solcher Maßnahmen der Erfolg vergrößern lassen würde. In jedem Fall würden sie zur Kontrollierbarkeit und Steuerbarkeit der Innovationsprozesse und des Erfolgs von Kooperationen beitragen

A message emerging from development: the repression of mitochondrial β-F1-ATPase expression in cancer

The original publication is available at www.springerlink.com http://dx.doi.org/10.1007/s10863-007-9087-9Mitochondrial research has experienced a considerable boost during the last decade because organelle malfunctioning is in the genesis and/or progression of a vast array of human pathologies including cancer. The renaissance of mitochondria in the cancer field has been promoted by two main facts: (1) the molecular and functional integration of mitochondrial bioenergetics with the execution of cell death and (2) the implementation of 18FDG-PET for imaging and staging of tumors in clinical practice. The latter, represents the bed-side translational development of the metabolic hallmark that describes the bioenergetic phenotype of most cancer cells as originally predicted at the beginning of previous century by Otto Warburg. In this minireview we will briefly summarize how the study of energy metabolism during liver development forced our encounter with Warburg’s postulates and prompted us to study the mechanisms that regulate the biogenesis of mitochondria in the cancer cellThis review article was written while the research activity in the authors’ laboratory was supported by grants from the Ministerio de Sanidad (PI041255), Educación y Ciencia (SAF2005-4001) and Fundación Mutua Madrileña. The CBMSO is the recipient of an institutional grant from Fundación Ramón ArecesPeer reviewe

Проектирование и реализация чат-бота стриминного сервиса для повышения вовлеченности аудитории

Целью работы является проектирование и разработка клиент-серверного приложения с использованием стека Node.js + React.js на языке TypeScript. Система будет являться генератором контента на трансляции пользователя, что увеличит вовлеченность зрителей, их лояльность и, как следствие, показатель прибыли канала.The goal of research is architecture design and development of client-server application using Node.js + React.js technological stack wrote in TypeScript programming language. The system will be acontent generator on a broadcast media, thus it will increase viewers involvement, loyalty and, сonsequently, monetization rate

Effects of polygenic risk for major mental disorders and cross-disorder on cortical complexity

Background MRI-derived cortical folding measures are an indicator of largely genetically driven early developmental processes. However, the effects of genetic risk for major mental disorders on early brain development are not well understood. Methods We extracted cortical complexity values from structural MRI data of 580 healthy participants using the CAT12 toolbox. Polygenic risk scores (PRS) for schizophrenia, bipolar disorder, major depression, and cross-disorder (incorporating cumulative genetic risk for depression, schizophrenia, bipolar disorder, autism spectrum disorder, and attention-deficit hyperactivity disorder) were computed and used in separate general linear models with cortical complexity as the regressand. In brain regions that showed a significant association between polygenic risk for mental disorders and cortical complexity, volume of interest (VOI)/region of interest (ROI) analyses were conducted to investigate additional changes in their volume and cortical thickness. Results The PRS for depression was associated with cortical complexity in the right orbitofrontal cortex (right hemisphere: p = 0.006). A subsequent VOI/ROI analysis showed no association between polygenic risk for depression and either grey matter volume or cortical thickness. We found no associations between cortical complexity and polygenic risk for either schizophrenia, bipolar disorder or psychiatric cross-disorder when correcting for multiple testing. Conclusions Changes in cortical complexity associated with polygenic risk for depression might facilitate well-established volume changes in orbitofrontal cortices in depression. Despite the absence of psychopathology, changed cortical complexity that parallels polygenic risk for depression might also change reward systems, which are also structurally affected in patients with depressive syndrome

Interaction of developmental factors and ordinary stressful life events on brain structure in adults

An interplay of early environmental and genetic risk factors with recent stressful life events (SLEs) in adulthood increases the risk for adverse mental health outcomes. The interaction of early risk and current SLEs on brain structure has hardly been investigated. Whole brain voxel-based morphometry analysis was performed in N = 786 (64.6% female, mean age = 33.39) healthy subjects to identify correlations of brain clusters with commonplace recent SLEs. Genetic and early environmental risk factors, operationalized as those for severe psychopathology (i.e., polygenic scores for neuroticism, childhood maltreatment, urban upbringing and paternal age) were assessed as modulators of the impact of SLEs on the brain. SLEs were negatively correlated with grey matter volume in the left medial orbitofrontal cortex (mOFC, FWE p = 0.003). This association was present for both, positive and negative, life events. Cognitive-emotional variables, i.e., neuroticism, perceived stress, trait anxiety, intelligence, and current depressive symptoms did not account for the SLE-mOFC association. Further, genetic and environmental risk factors were not correlated with grey matter volume in the left mOFC cluster and did not affect the association between SLEs and left mOFC grey matter volume. The orbitofrontal cortex has been implicated in stress-related psychopathology, particularly major depression in previous studies. We find that SLEs are associated with this area. Important early life risk factors do not interact with current SLEs on brain morphology in healthy subjects

The neural signature of psychomotor disturbance in depression.

Up to 70% of patients with major depressive disorder present with psychomotor disturbance (PmD), but at the present time understanding of its pathophysiology is limited. In this study, we capitalized on a large sample of patients to examine the neural correlates of PmD in depression. This study included 820 healthy participants and 699 patients with remitted (n = 402) or current (n = 297) depression. Patients were further categorized as having psychomotor retardation, agitation, or no PmD. We compared resting-state functional connectivity (ROI-to-ROI) between nodes of the cerebral motor network between the groups, including primary motor cortex, supplementary motor area, sensory cortex, superior parietal lobe, caudate, putamen, pallidum, thalamus, and cerebellum. Additionally, we examined network topology of the motor network using graph theory. Among the currently depressed 55% had PmD (15% agitation, 29% retardation, and 11% concurrent agitation and retardation), while 16% of the remitted patients had PmD (8% retardation and 8% agitation). When compared with controls, currently depressed patients with PmD showed higher thalamo-cortical and pallido-cortical connectivity, but no network topology alterations. Currently depressed patients with retardation only had higher thalamo-cortical connectivity, while those with agitation had predominant higher pallido-cortical connectivity. Currently depressed patients without PmD showed higher thalamo-cortical, pallido-cortical, and cortico-cortical connectivity, as well as altered network topology compared to healthy controls. Remitted patients with PmD showed no differences in single connections but altered network topology, while remitted patients without PmD did not differ from healthy controls in any measure. We found evidence for compensatory increased cortico-cortical resting-state functional connectivity that may prevent psychomotor disturbance in current depression, but may perturb network topology. Agitation and retardation show specific connectivity signatures. Motor network topology is slightly altered in remitted patients arguing for persistent changes in depression. These alterations in functional connectivity may be addressed with non-invasive brain stimulation

Severity of current depression and remission status are associated with structural connectome alterations in major depressive disorder

Major depressive disorder (MDD) is associated to affected brain wiring. Little is known whether these changes are stable over time and hence might represent a biological predisposition, or whether these are state markers of current disease severity and recovery after a depressive episode. Human white matter network ("connectome") analysis via network science is a suitable tool to investigate the association between affected brain connectivity and MDD. This study examines structural connectome topology in 464 MDD patients (mean age: 36.6 years) and 432 healthy controls (35.6 years). MDD patients were stratified categorially by current disease status (acute vs. partial remission vs. full remission) based on DSM-IV criteria. Current symptom severity was assessed continuously via the Hamilton Depression Rating Scale (HAMD). Connectome matrices were created via a combination of T1-weighted magnetic resonance imaging (MRI) and tractography methods based on diffusion-weighted imaging. Global tract-based metrics were not found to show significant differences between disease status groups, suggesting conserved global brain connectivity in MDD. In contrast, reduced global fractional anisotropy (FA) was observed specifically in acute depressed patients compared to fully remitted patients and healthy controls. Within the MDD patients, FA in a subnetwork including frontal, temporal, insular, and parietal nodes was negatively associated with HAMD, an effect remaining when correcting for lifetime disease severity. Therefore, our findings provide new evidence of MDD to be associated with structural, yet dynamic, state-dependent connectome alterations, which covary with current disease severity and remission status after a depressive episode