Novel concept to guide systolic heart failure medication by repeated biomarker testing-results from TIME-CHF in context of predictive, preventive, and personalized medicine

Background It is uncertain whether repeated measurements of a multi-target biomarker panel may help to personalize medical heart failure (HF) therapy to improve outcome in chronic HF. Methods This analysis included 499 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF), aged >= 60 years, LVEF = II, who had repeated clinical visits within 19 months follow-up. The interaction between repeated measurements of biomarkers and treatment effects of loop diuretics, spironolactone, beta-blockers, and renin-angiotensin system (RAS) inhibitors on risk of HF hospitalization or death was investigated in a hypothesis-generating analysis. Generalized estimating equation (GEE) models were used to account for the correlation between recurrences of events in a patient. Results One hundred patients (20%) had just one event (HF hospitalization or death) and 87 (17.4%) had at least two events. Loop diuretic up-titration had a beneficial effect for patients with high interleukin-6 (IL6) or high high-sensitivity C-reactive protein (hsCRP) (interaction, P = 0.013 and P = 0.001), whereas the opposite was the case with low hsCRP (interaction, P = 0.013). Higher dosage of loop diuretics was associated with poor outcome in patients with high blood urea nitrogen (BUN) or prealbumin (interaction, P = 0.006 and P = 0.001), but not in those with low levels of these biomarkers. Spironolactone up-titration was associated with lower risk of HF hospitalization or death in patients with high cystatin C (CysC) (interaction, P = 0.021). beta-Blockers up-titration might have a beneficial effect in patients with low soluble fms-like tyrosine kinase-1 (sFlt) (interaction, P = 0.021). No treatment biomarker interactions were found for RAS inhibition. Conclusion The data of this post hoc analysis suggest that decision-making using repeated biomarker measurements may be very promising in bringing treatment of heart failure to a new level in the context of predictive, preventive, and personalized medicine. Clearly, prospective testing is needed before this novel concept can be adopted

EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy. Based on published clinical studies and employing efficacy criteria adapted by the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback and Research, alpha theta training—either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious. Considerations of further research design taking these factors into account are discussed and descriptions of contemporary research are given

Psychometric Properties and Correlates of Precarious Manhood Beliefs in 62 Nations

Precarious manhood beliefs portray manhood, relative to womanhood, as a social status that is hard to earn, easy to lose, and proven via public action. Here, we present cross-cultural data on a brief measure of precarious manhood beliefs (the Precarious Manhood Beliefs scale [PMB]) that covaries meaningfully with other cross-culturally validated gender ideologies and with country-level indices of gender equality and human development. Using data from university samples in 62 countries across 13 world regions (N = 33,417), we demonstrate: (1) the psychometric isomorphism of the PMB (i.e., its comparability in meaning and statistical properties across the individual and country levels); (2) the PMB’s distinctness from, and associations with, ambivalent sexism and ambivalence toward men; and (3) associations of the PMB with nation-level gender equality and human development. Findings are discussed in terms of their statistical and theoretical implications for understanding widely-held beliefs about the precariousness of the male gender role

Entwicklung eines Multitouch-Konferenztisches

Die Gestaltung ergonomischer Multitouch-Interaktion ist mit Anforderungen verbunden, die bei klassischen Interaktionsformen nicht von Bedeutung waren. Die unterschiedlichen Gerätegrößen und User-Interfaces spielen dabei eine wichtige Rolle. Die Gestaltung von Multi-User-Interaktion an Multitouch-Surfaces ist mit besonderen Herausforderungen verbunden. Bei der Entwicklung von GADjet, einer Software für Multitouch-Konferenztische, wurden Lösungen für diese Probleme erarbeitet. Sie behandeln die Orientierung von Steuerelementen, das kollaborative Arbeiten mit verteilten Daten und die Identifikation von Benutzern

Nutzergenerierte Inhalte für ältere Menschen aufbereiten: Eine Informationsarchitektur für Social Best Practices

Eine Herausforderung des demografischen Wandels ist, Menschen bis ins hohe Alter ein selbstbestimmtes Leben zu ermöglichen. Eine Grundvoraussetzung hierfür bildet die Fähigkeit älterer Menschen, selbstständig Alltagsprobleme zu bewältigen, die beispielsweise durch altersbedingte Krankheiten, eingeschränkte Mobilität und schwindende Sozialkontakte hervorgerufen werden. Während jüngere Generationen sich aus dem reichhaltigen Angebot an Diensten im Internet bedienen, ist dieser Zugang älteren Menschen - aufgrund der Komplexität der Inhalte, sowie der Schwierigkeit deren Qualität und Integrität beurteilen zu können - oftmals verbaut. Eine Best Practice Analyse thematisch verwandter Angebote im Internet hat gezeigt: Dienste mit nutzergenerierten Inhalten weisen häufig eine unzureichende Strukturierung auf und sind für diese Zielgruppe zu komplex - Dienste ohne Nutzerpartizipation bieten hingegen wenig Potenzial Alltagsprobleme zu lösen. Gesucht ist deshalb ein Aufbereitungsmechanismus und eine Darstellungsform nutzergenerierter Informationsquellen, die in der Zielgruppe die gewünschte Wirkung des selbstbestimmten Lebens und eines lebendigen Sozialverhaltens entfalten. Dieser Beitrag stellt eine Informationsarchitektur vor, die es erlaubt, Alltagsprobleme und deren Lösungen strukturiert und verständlich darzustellen, und diese Inhalte qualitativ zu sichern. Zudem wird eine aktive Nutzerpartizipation durch das Einstellen eigener Erfahrungen motiviert und technisch unterstützt

Linear conversion of pressure into concentration, rapid switching of concentration, and generation of linear ramps of concentration in a microfluidic device

Mixing of liquids to produce solutions with different concentrations is one of the basic functionalities of microfluidic devices. Generation of specific temporal patterns of concentration in microfluidic devices is an important technique to study responses of cells and model organisms to variations in the chemical composition of their environment. Here, we present a simple microfluidic network that linearly converts pressure at an inlet into concentration of a soluble reagent in an observation region and also enables independent concurrent linear control of concentrations of two reagents. The microfluidic device has an integrated mixer channel with chaotic three-dimensional flow that facilitates rapid switching of concentrations in a continuous range. A simple pneumatic setup generating linear ramps of pressure is used to produce smooth linear ramps and triangular waves of concentration with different slopes. The use of chaotic vs. laminar mixers is discussed in the context of microfluidic devices providing rapid switching and generating temporal waves of concentration