Angst und Depression im Zusammenhang mit Amputationen der unteren Extremität

Thema dieser Studie ist, wie häufig Angst und Depression nach Amputation der unteren Extremität und deren prothetischer Versorgung auftreten und welchen Einfluss diverse Variablen nehmen. Eingesetzt werden HADS/D, IRES-MIN und TAPES. Von 75 Probanden weisen 27% erhöhte Depressions- und 25% erhöhte Angstwerte auf. Sieben Fragestellungen werden analysiert. Es zeigen sich signifikante Korrelationen zwischen krankheits-, behinderungsbezogenen und psychosozialen Variablen und erhöhten Angst- und Depressionswerten. Fehlende psychosoziale Anpassung, häufige und starke Schmerzen, eine große Aktivitätseinschränkung und Unzufriedenheit mit der Prothese begünstigen erhöhte Angst- und Depressionswerte. Angst und Depression nach Amputation der unteren Extremität sind somit von mehreren Faktoren abhängig. Deren zeitige Identifikation hat unter präventiven Gesichtspunkten eine große Bedeutung für Therapie und Rehabilitation

Einfluss von Diäten aus konventioneller und biologischer Erzeugung auf Fruchtbarkeitsparameter bei Kaninchen

In order to test the effect of organic vs. conventional diets on fertility traits, we conducted an on-farm study with female rabbits. Eight groups of seven to eight female rabbits kept in systems with litter were fed ad libitum with either organic or conventional pellets. Offspring was weaned with approx. 28 days. In the first series analysed, the conception rate was higher in the conventional groups. Diet type had no significant influence on that trait. Nevertheless, a significant influence of diet on litter size was found: organically fed female rabbits produced more offspring per litter. The organic groups also showed higher rates of weaned animals, despite of a slightly higher mortality of offspring in these groups, but differences for both traits were not significant compared to conventional animals. Inconsistency of findings in the first series of this study concerning the effect of different diets on fertility traits were also found in literature. Data from the currently running second series will show whether the slightly positive effect of organic diet will become more evident

Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040

Introduction As a population-wide intervention, it has been proposed to raise taxes on unhealthy products to prevent diseases such as type 2 diabetes. In this study, we aimed to estimate the effect of tax policy interventions in 2020 on the projected prevalence and number of people with type 2 diabetes in the German adult population in 2040. Research design and methods We applied an illness-death model and the German Diabetes Risk Score (GDRS) to project the prevalence and number of adults with type 2 diabetes in Germany under a base case scenario and under a tax policy intervention scenario. For the base case scenario, we assumed constant age-specific incidence rates between 2020 and 2040. For the intervention scenario, we assumed a 50% price increase for sugar-sweetened beverages, tobacco and red meat products in the year 2020. Based on price elasticities, we estimated the impact on these risk factors alone and in combination, and calculated subsequent reductions in the age-specific and sex-specific GDRS. These reductions were used to determine reductions in the incidence rate and prevalence using a partial differential equation. Results Compared with the base case scenario, combined tax interventions in 2020 resulted in a 0.95 percentage point decrease in the prevalence of type 2 diabetes (16.2% vs 17.1%), which corresponds to 640 000 fewer prevalent cases of type 2 diabetes and a relative reduction by 6%. Conclusions Taxation of sugar-sweetened beverages, tobacco products and red meat by 50% modestly lowered the projected number and prevalence of adults with type 2 diabetes in Germany in 2040. Raising taxes on unhealthy products as a stand-alone measure may not be enough to attenuate the future rise of type 2 diabetes.Peer Reviewe

Convex Hull of Points Lying on Lines in o(n log n) Time after Preprocessing

Motivated by the desire to cope with data imprecision, we study methods for taking advantage of preliminary information about point sets in order to speed up the computation of certain structures associated with them. In particular, we study the following problem: given a set L of n lines in the plane, we wish to preprocess L such that later, upon receiving a set P of n points, each of which lies on a distinct line of L, we can construct the convex hull of P efficiently. We show that in quadratic time and space it is possible to construct a data structure on L that enables us to compute the convex hull of any such point set P in O(n alpha(n) log* n) expected time. If we further assume that the points are "oblivious" with respect to the data structure, the running time improves to O(n alpha(n)). The analysis applies almost verbatim when L is a set of line-segments, and yields similar asymptotic bounds. We present several extensions, including a trade-off between space and query time and an output-sensitive algorithm. We also study the "dual problem" where we show how to efficiently compute the (<= k)-level of n lines in the plane, each of which lies on a distinct point (given in advance). We complement our results by Omega(n log n) lower bounds under the algebraic computation tree model for several related problems, including sorting a set of points (according to, say, their x-order), each of which lies on a given line known in advance. Therefore, the convex hull problem under our setting is easier than sorting, contrary to the "standard" convex hull and sorting problems, in which the two problems require Theta(n log n) steps in the worst case (under the algebraic computation tree model).Comment: 26 pages, 5 figures, 1 appendix; a preliminary version appeared at SoCG 201

Peripheral serotonin transporter DNA methylation is linked to increased salience network connectivity in females with anorexia nervosa

Background: Epigenetic variation in the serotonin transporter gene (SLC6A4) has been shown to modulate the functioning of brain circuitry associated with the salience network and may heighten the risk for mental illness. This study is, to our knowledge, the first to test this epigenome–brain–behaviour pathway in patients with anorexia nervosa.Methods: We obtained resting-state functional connectivity (rsFC) data and blood samples from 55 acutely underweight female patients with anorexia nervosa and 55 age-matched female healthy controls. We decomposed imaging data using independent component analysis. We used bisulfite pyrosequencing to analyze blood DNA methylation within the promoter region of SLC6A4. We then explored salience network rsFC patterns in the group × methylation interaction.Results: We identified a positive relationship between SLC6A4 methylation levels and rsFC between the dorsolateral prefrontal cortex and the salience network in patients with anorexia nervosa compared to healthy controls. Increased rsFC in the salience network mediated the link between SLC6A4 methylation and eating disorder symptoms in patients with anorexia nervosa. We confirmed findings of rsFC alterations for CpG-specific methylation at a locus with evidence of methylation correspondence between brain and blood tissue.Limitations: This study was cross-sectional in nature, the sample size was modest for the method and methylation levels were measured peripherally, so findings cannot be fully generalized to brain tissue.Conclusion: This study sheds light on the neurobiological process of how epigenetic variation in the SLC6A4 gene may relate to rsFC in the salience network that is linked to psychopathology in anorexia nervosa.</p

Peripheral serotonin transporter DNA methylation is linked to increased salience network connectivity in females with anorexia nervosa

Background: Epigenetic variation in the serotonin transporter gene (SLC6A4) has been shown to modulate the functioning of brain circuitry associated with the salience network and may heighten the risk for mental illness. This study is, to our knowledge, the first to test this epigenome–brain–behaviour pathway in patients with anorexia nervosa.Methods: We obtained resting-state functional connectivity (rsFC) data and blood samples from 55 acutely underweight female patients with anorexia nervosa and 55 age-matched female healthy controls. We decomposed imaging data using independent component analysis. We used bisulfite pyrosequencing to analyze blood DNA methylation within the promoter region of SLC6A4. We then explored salience network rsFC patterns in the group × methylation interaction.Results: We identified a positive relationship between SLC6A4 methylation levels and rsFC between the dorsolateral prefrontal cortex and the salience network in patients with anorexia nervosa compared to healthy controls. Increased rsFC in the salience network mediated the link between SLC6A4 methylation and eating disorder symptoms in patients with anorexia nervosa. We confirmed findings of rsFC alterations for CpG-specific methylation at a locus with evidence of methylation correspondence between brain and blood tissue.Limitations: This study was cross-sectional in nature, the sample size was modest for the method and methylation levels were measured peripherally, so findings cannot be fully generalized to brain tissue.Conclusion: This study sheds light on the neurobiological process of how epigenetic variation in the SLC6A4 gene may relate to rsFC in the salience network that is linked to psychopathology in anorexia nervosa.</p

Curation and expansion of Human Phenotype Ontology for defined groups of inborn errors of immunity.

BACKGROUND: Accurate, detailed, and standardized phenotypic descriptions are essential to support diagnostic interpretation of genetic variants and to discover new diseases. The Human Phenotype Ontology (HPO), extensively used in rare disease research, provides a rich collection of vocabulary with standardized phenotypic descriptions in a hierarchical structure. However, to date, the use of HPO has not yet been widely implemented in the field of inborn errors of immunity (IEIs), mainly due to a lack of comprehensive IEI-related terms. OBJECTIVES: We sought to systematically review available terms in HPO for the depiction of IEIs, to expand HPO, yielding more comprehensive sets of terms, and to reannotate IEIs with HPO terms to provide accurate, standardized phenotypic descriptions. METHODS: We initiated a collaboration involving expert clinicians, geneticists, researchers working on IEIs, and bioinformaticians. Multiple branches of the HPO tree were restructured and extended on the basis of expert review. Our ontology-guided machine learning coupled with a 2-tier expert review was applied to reannotate defined subgroups of IEIs. RESULTS: We revised and expanded 4 main branches of the HPO tree. Here, we reannotated 73 diseases from 4 International Union of Immunological Societies-defined IEI disease subgroups with HPO terms. We achieved a 4.7-fold increase in the number of phenotypic terms per disease. Given the new HPO annotations, we demonstrated improved ability to computationally match selected IEI cases to their known diagnosis, and improved phenotype-driven disease classification. CONCLUSIONS: Our targeted expansion and reannotation presents enhanced precision of disease annotation, will enable superior HPO-based IEI characterization, and hence benefit both IEI diagnostic and research activities

Primary immunodeficiency associated with chromosomal aberration - an ESID survey

Background: Patients with syndromic features frequently suffer from recurrent respiratory infections, but little is known about the spectrum of immunological abnormalities associated with their underlying chromosomal aberrations outside the well-known examples of Down and DiGeorge syndromes. Therefore, we performed this retrospective, observational survey study. Methods: All members of the European Society for Immunodeficiencies (ESID) were invited to participate by reporting their patients with chromosomal aberration (excluding Down and DiGeorge syndromes) in combination with one or more identified immunological abnormalities potentially relating to primary immunodeficiency. An online questionnaire was used to collect the patient data. Results: Forty-six patients were included from 16 centers (24 males, 22 females; median age 10.4 years [range 1.0-69. 2 years]; 36 pediatric, 10 adult patients). A variety of chromosomal aberrations associated with immunological abnormalities potentially relating to primary immune deficiency was reported. The most important clinical presentation prompting the immunological evaluation was 'recurrent ear-nose-throat (ENT) and airway infections'. Immunoglobulin isotype and/or IgG-subclass deficiencies were the most prevalent immunological abnormalities reported. Conclusions: Our survey yielded a wide variety of chromosomal aberrations associated with immunological abnormalities potentially relating to primary immunodeficiency. Although respiratory tract infections can often also be ascribed to other causes (e.g. aspiration or structural abnormalities), we show that a significant proportion of patients also have an antibody deficiency requiring specific treatment (e.g. immunoglobulin replacement, antibiotic prophylaxis). Therefore, it is important to perform immunological investigations in patients with chromosomal aberrations and recurrent ENT or airway infections, to identify potential immunodeficiency that can be specifically treated.Peer reviewe