Identifizierung von Steigungen als Barrieren für mobilitätseingeschränkte Personen

Nicht erst durch den demographischen Wandel verändern sich die Anforderungen an den öffentlichen Straßenraum. Die Forderung und Nachfrage nach barrierefreier Mobilität, besonders für Menschen mit körperlichen Einschränkungen, bilden die Grundlage für viele Planungen. Der öffentliche Straßenraum weist neben Behinderungen durch Verkehrsinfrastrukturen, wie Schilder und Treppen, auch grundlegende Hindernisse auf. Gerade Steigungen sind insbesondere für ältere und mobilitätseingeschränkte Menschen sowie Rollstuhlfahrer eine enorme Erschwernis. Ein realistisches Bild von der Barrierefreiheit des Straßenraumes stellt daher eine wichtige Grundlage für eine effektive Verkehrsplanung dar. Barrieren im Straßenraum werden allerdings aktuell aufgrund des hohen Erfassungsaufwands nur für ausgewählte Gebiete erfasst, Steigungen lassen sich dabei in der Örtlichkeit nur mit einem speziellen Neigungsmesser aufwändig ermitteln. In dieser Studie sollten speziell Steigungen in einer flächendeckenden Karte für die Stadt Wetter in Nordrhein-Westfalen (NRW) dargestellt werden. Das Ziel war es, ein Werkzeug zu erstellen, welches es ermöglicht, Straßen anhand ihrer Steigungen zu klassifizieren und diese dementsprechend auf einer Karte darzustellen. Voraussetzung war, dass die Analyse in einem freien Geoinformationssystem durchgeführt wird und ausschließlich amtliche Geodaten verwendet werden. Durch das vorgestellte Werkzeug, welches in einer Kombination aus QGIS und R umgesetzt wurde, kann die Analyse von Steigungen im Straßenraum mit Geobasisdaten für gesamte Städte und Kreise flächendeckend durchgeführt werden. Anschließend ist eine zielgruppenspezifische Einteilung in Klassen möglich, um die Daten der Öffentlichkeit als Karte oder Dienst bereitzustellen. Im Hinblick auf den demographischen Wandel und die Veränderung des Bevölkerungsalters bietet dieses Werkzeug großes Potenzial, als direkte Hilfestellung für Menschen mit körperlichen Einschränkungen zur Sicherung der barrierefreien Mobilität zu dienen und eröffnet gleichzeitig für die nachhaltige Mobilitätsplanung eine Methodik zur Visualisierung der Potentiale für einen ausgewogenen Modal Split

Characteristics of lapsed German whole blood donors and barriers to return four years after the initial donation

Background: The aim of the study was to identify characteristics of lapsed donors 4 years after the initial donation as well as self-reported barriers to return for further blood donations. Methods: A random number of 8,000 blood donors, donating for the German Red Cross Blood Service Baden-Wurttemberg - Hessen, were asked to fill in a self-administered questionnaire. The response rate was 38.5%. Donors were categorized as ”lapsed’ if they had not donated within the last 24 months. The odds of being a lapsed donor were determined in a multivariate logistic regression. Results: Multivariate analysis showed that lapsed donors were more likely to be female, between 26 and 33 years old, not employed, have moved, and were dissatisfied with the last donation experience. Furthermore, lapsed donors were less likely to have family members or friends who also donate blood. Medical reasons and having moved to another city were the most frequently named reasons preventing lapsed donors from continuing to donate blood. Conclusion: The importance of medical reasons and having moved was rated much higher than in previous studies. We conclude that barriers to return may vary considerably between countries and blood services. Therefore, donor surveys are required to guide reactivation campaigns

Cyanotic nephropathy and use of non-ionic contrast agents during cardiac catherization in patients with cyanotic congenital heart disease

Background: Chronic cyanosis with its associated rheologic changes is a known risk factor for glomerular nephropathy. Therefore, contrast-induced nephrotoxicity should be an important consideration for angiographers comparable to diabetics. On the other hand, progressions in diagnostic and interventional techniques have led to expanded indications and a more widespread use of x-ray contrast agents. The aim of this study was to investigate the risk of contrast-induced nephropathy in the small group of patients with cyanotic heart disease prior to surgical repair. Methods: We investigated 23 cyanotic patients with an oxygen saturation of 82 (50–92)%, age 25 (5–63) years, and 13 control subjects with atrial septal defect, age 37 (20–66) years. Blood viscosity was measured before and after cardiac catherization. Renal damage was evaluatated by selective analysis of urinary proteins and enzymes. Results: Before cardiac catheterization, 48% of the cyanotic patients had a moderate glomerulopathy. Cardiac catherization was performed with 3.0 (1.2 – 6.8) mls/kg non ionic contrast medium. Only one of the 23 patients (4.3%) with normal urinary analysis before cardiac catheterization showed renal damage, which involved tubular and glomerular function. Elevated blood viscosity in cyanotic patients was slightly reduced by the contrast. None of the acyanotic controls had contrast-induced nephropathy. Conclusions: The use of non-ionic contrast medium does not worsen cyanotic glomerulopathy. This finding may be due to the reduction of blood viscosity by the application of the contrast medium. The finding of contrast-induced nephropathy in one patient underlines the importance of monitoring renal function after cardiac catheterization

Technical Report for Research Unit FOR-1511

This technical report presents the interim results of the DFG research unit FOR1511 "Protection and Control Systems for Reliable and Secure Operation of Electrical Transmission Systems"

Induction of Bim and Bid gene expression during accelerated apoptosis in severe sepsis

ABSTRACT: INTRODUCTION: In transgenic animal models of sepsis, members of the Bcl-2-family of proteins regulate lymphocyte apoptosis and survival of sepsis. This study investigates the gene regulation of pro- and anti-apoptotic members of the Bcl-2-family of proteins in patients with early stage severe sepsis. METHODS: In this prospective case-control study patients were recruited from three intensive care units in a university hospital. Sixteen patients were enrolled as soon as they fulfilled the criteria of severe sepsis. Ten critically ill but non-septic patients and eleven healthy volunteers served as controls. Blood samples were immediately obtained at inclusion. To confirm the presence of accelerated apoptosis in the patient groups, caspase-3 activation and phosphatidylserine (PS) externalization in CD4+, CD8+ and CD19+ lymphocyte subsets were assessed by flow cytometry. Specific mRNA's of Bcl-2 family members were quantified from whole blood by real-time polymerase chain reaction. To test for statistical significance, Kruskal-Wallis testing with Dunn's multiple comparison test for post hoc testing was performed. RESULTS: In all lymphocyte populations caspase-3 (p<0.05) was activated, which was reflected in an increased PS externalization (p<0.05). Accordingly, lymphocyte counts were decreased in early severe sepsis. In CD4+ T-cells (p<005) and in B-cells (p<0.001) the Bcl-2 protein was decreased in severe sepsis. Gene expression of the BH3-only Bim was massively upregulated as compared to critically ill patients (p<0.001) and 51.6 fold as compared to healthy controls (p<0.05). Bid was increased 12.9 fold compared to critically ill (p<0.001). In the group of the mitochondrial apoptosis-inducers, Bak was upregulated 5.6 fold, while the expression of Bax showed no significant variations. By contrast, the pro-survival members Bcl-2 and Bcl-xl were both downregulated in severe sepsis (p<0.001, p<0.05). CONCLUSIONS: In early severe sepsis a gene expression pattern with induction of the pro-apoptotic Bcl-2 family members Bim, Bid and Bak and a downregulation of the anti-apoptotic Bcl-2 and Bcl-xl was observed in peripheral blood. This constellation may affect cellular susceptibility to apoptosis and complex immune dysfunction in sepsis

Cavity-enhanced simultaneous dressing of quantum dot exciton and biexciton states

The authors acknowledge financial support of the Deutsche Forschungsgemeinschaft (DFG) within the SFB/TRR21 and the projects MI500/23-1 and Ka2318/4-1, and the Natural Sciences and Engineering Research Council of Canada.We demonstrate the simultaneous dressing of both vacuum-to-exciton and exciton-to-biexciton transitions of a single semiconductor quantum dot in a high-Q micropillar cavity, using photoluminescence spectroscopy. Resonant two-photon excitation of the biexciton is achieved by spectrally tuning the quantum dot emission with respect to the cavity mode. The cavity couples to both transitions and amplifies the Rabi-frequency of the likewise resonant cw laser, driving the transitions. We observe strong-field splitting of the emission lines, which depend on the driving Rabi field amplitude and the cavity-laser detuning. A dressed state theory of a driven 4-level atom correctly predicts the distinct spectral transitions observed in the emission spectrum, and a detailed description of the emission spectra is further provided through a polaron master equation approach which accounts for cavity coupling and acoustic phonon interactions of the semiconductor medium.PostprintPeer reviewe

Neural distinctiveness of fatigue and low sleep quality in multiple sclerosis

Background and purpose Fatigue and low sleep quality in multiple sclerosis (MS) are closely related symptoms. Here, the associations between the brain's functional connectivity (FC) and fatigue and low sleep quality were investigated to determine the degree of neural distinctiveness of these symptoms. Method A hundred and four patients with relapsing–remitting MS (age 38.9 ± 10.2 years, 66 females) completed the Modified Fatigue Impact Scale and the Pittsburgh Sleep Quality Index and underwent resting-state functional magnetic resonance imaging. FC was analyzed using independent-component analysis in sensorimotor, default-mode, fronto-parietal and basal-ganglia networks. Multiple linear regression models allowed us to test the association between FC and fatigue and sleep quality whilst controlling for one another as well as for demographic, disease-related and imaging variables. Results Higher fatigue correlated with lower sleep quality (r = 0.54, p < 0.0001). Higher fatigue was associated with lower FC of the precentral gyrus in the sensorimotor network, the precuneus in the posterior default-mode network and the superior frontal gyrus in the left fronto-parietal network, independently of sleep quality. Lower sleep quality was associated with lower FC of the left intraparietal sulcus in the left fronto-parietal network, independently of fatigue. Specific associations were found between fatigue and the sensorimotor network's global FC and between low sleep quality and the left fronto-parietal network's global FC. Conclusion Despite the high correlation between fatigue and low sleep quality in the clinical picture, our findings clearly indicate that, on the neural level, fatigue and low sleep quality in MS are associated with decreased FC in distinct functional brain networks

A functional network driven by microRNA-125a regulates monocyte trafficking in acute inflammation

During the onset of acute inflammation, rapid trafficking of leukocytes is essential to mount appropriate immune responses towards an inflammatory insult. Monocytes are especially indispensable for counteracting the inflammatory stimulus, neutralising the noxa and reconstituting tissue homeostasis. Thus, monocyte trafficking to the inflammatory sites needs to be precisely orchestrated. In this study, we identify a regulatory network driven by miR-125a that affects monocyte adhesion and chemotaxis by the direct targeting of two adhesion molecules, i.e., junction adhesion molecule A (JAM-A), junction adhesion molecule-like (JAM-L) and the chemotaxis-mediating chemokine receptor CCR2. By investigating monocytes isolated from patients undergoing cardiac surgery, we found that acute yet sterile inflammation reduces miR-125a levels, concomitantly enhancing the expression of JAM-A, JAM-L and CCR2. In contrast, TLR-4-specific stimulation with the pathogen-associated molecular pattern (PAMP) LPS, usually present within the perivascular inflamed area, resulted in dramatically induced levels of miR-125a with concomitant repression of JAM-A, JAM-L and CCR2 as early as 3.5 h. Our study identifies miR-125a as an important regulator of monocyte trafficking and shows that the phenotype of human monocytes is strongly influenced by this miRNA, depending on the type of inflammatory stimulus

Survival outcomes in a prospective randomized multicenter Phase III trial comparing patients undergoing anatomical segmentectomy versus standard lobectomy for non-small cell lung cancer up to 2 cm

OBJECTIVES The oncological equivalence of anatomical segmentectomy for early stage non-small cell lung cancer (NSCLC) is still controversial. Primary aim of this study was survival outcomes in combination with improved quality of life after segmentectomy compared with lobectomy in patients with pathological stage Ia NSCLC (up to 2 cm, 7th edition) MATERIALS AND METHODS: We conducted a prospective, randomized, multicenter phase III trial to confirm the non-inferiority of segmentectomy to lobectomy in regard to prognosis (trial No. DRKS00004897). Patients were randomized to undergo either segmentectomy or lobectomy and followed up for 5-years survival and tumor recurrence. The 5-year hazard ratio comparing lobectomy with segmentectomy was required to remain above 0.5. RESULTS Between October 2013 and June 2016, 108 patients with verified or suspected NSCLC up to 2 cm diameter were enrolled; 54 were assigned to lobectomy and 54 (1 drop-out) to segmentectomy. In-hospital and 90 days mortality was 0% in both groups. Overall survival at 5 years was 86.52% in the lobectomy compared to 78.21% in the segmentectomy group (HR = 0.61, (95% CI 0.23-1.66), p-value of non-inferiority test, p-ni = 0.687). Disease free survival was 77.29% for the lobectomy and 77.96% for the segmentectomy patients (HR = 1.50, (95% CI 0.60-3.76), p-ni = 0.019). At a median follow-up of 5 years, no differences were noted in either the locoregional or distant recurrent disease in both groups (9.4% vs 7.4%, p-ni = 0.506). CONCLUSION Overall survival, locoregional and distant recurrences was not significantly difference for patients undergoing either segmentectomy or lobectomy for stage Ia NSCLC. The targeted non-inferiority of segmentectomy to lobectomy could not be proven for primary endpoint overall survival, but was significant for the secondary endpoint of disease free survival