Technische Universität Dresden: Qucosa
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Die militärischen Erfolge der Athener in der Verteidigung ihrer Demokratie im Zeitraum von der Vertreibung des Kleomenes von der Akropolis 508 v. Chr. bis zum Vorabend des ionischen Aufstandes
No full textEs wird nach den Gründen für die erstaunlichen Erfolge der jungen Demokratie der Athener geforscht, welche prompt nach ihrer Gründung von sämtlichen Nachbarn fast gleichzeitig überraschend angegriffen wurde. Erstaunlich sind diese Erfolge nicht zuletzt deshalb, weil sich Athen unter der Tyrannis bekanntlich auf ausländische Söldner stützte und - so geht man gemeinhin davon aus - die Athener deswegen auf dem militärischen Feld noch völlig unbedarft gewesen sein müssten.:Einleitung 1
I. Kapitel: Der Hergang der Ereignisse 2
II. Kapitel: Die Phylenreform und ihre militärische Bedeutung 9
Zusammenfassung 14
Literaturverzeichnis 16
Internetverzeichnis 18
Quellenverzeichnis 18
Abkürzungsverzeichnis 19
Selbstständigkeitserklärung 2
Alcohol use, dementia risk, and sex: a systematic review and assessment of alcohol‑attributable dementia cases in Europe
No full textBackground:
High-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk. In this systematic review, we take a sex-specific perspective towards the alcohol-dementia link, taking into account the age of dementia onset.
Methods:
We searched electronic databases for original cohort or case–control studies investigating the association between alcohol use and dementia. Two restrictions were considered: First, studies had to report results stratified by sex. Second, given the fact that the age at dementia onset seems to affect the alcohol-dementia link, studies were required to distinguish between early-onset and late-onset dementia (cut-off: 65 years). Additionally, the contribution of alcohol to dementia incidence was quantified for a set of 33 European countries for the year 2019.
Results:
We reviewed 3,157 reports, of which 7 publications were finally included and summarised narratively. A lower dementia risk when drinking alcohol infrequent or at moderate levels was found in men (three studies) and women (four studies). High-risk use and alcohol use disorders increased the risk of mild cognitive impairment and dementia, particularly early-onset dementia. Estimating the alcohol-attributable share of incident dementia cases revealed that 3.2% and 7.8% of incident dementia cases were estimated to be attributable to high-risk alcohol use (at least 24 g of pure alcohol per day) in 45-to-64-year-old women and men, respectively.
Conclusions:
Research to date has paid little attention to the sex-specific link of alcohol and dementia. In the absence of sex-specific research, the established recommendations on high-risk alcohol use should be employed to communicate the alcohol-attributable dementia risk
Glucocorticoid effects in the regenerating fin reflect tissue homeostasis disturbances in zebrafish by affecting Wnt signaling
No full textAs a treatment for various immune-mediated diseases, the use of glucocorticoids as anti-inflammatory and immunosuppressive agents is common practice. However, their use is severely hampered by the risk of the development of adverse effects such as secondary osteoporosis, skin atrophy, and peptic ulcer formation. The exact molecular and cellular mechanisms underlying those adverse effects, which involve most major organ systems, are not yet fully understood. Therefore, their investigation is of great importance to improve treatment regimens for patients. Here, we investigated the effects of the glucocorticoid prednisolone on cell proliferation and Wnt signaling in homeostatic skin and intestinal tissue and compared them to the anti-regenerative effects in zebrafish fin regeneration. We also investigated a potential recovery from the glucocorticoid treatment and the impact of short-term treatment with prednisolone. We identified a dampening effect of prednisolone on Wnt signaling and proliferation in highly proliferative tissues, namely the skin and intestine, as well as reduced fin regenerate length and Wnt reporter activity in the fin. The presence of the Wnt inhibitor Dickkopf1 was enhanced in prednisolone treated skin tissue. A decreased number of mucous producing goblet cells was observed in the intestine of prednisolone treated zebrafish. Unexpectedly, proliferation in bone forming osteoblasts of the skull, homeostatic scales, as well as the brain was not decreased, opposite to the observed effects in the skin, fin, and intestine. Short-term treatment with prednisolone for a few days did not significantly alter fin regenerate length, skin cell proliferation, intestinal leukocyte number and proliferation of intestinal crypt cells. However, it affected the number of mucous-producing goblet cells in the gut. Likewise, discontinuation of prednisolone treatment for a few days saved the skin and intestine from a significant reduction of skin and intestinal cell proliferation, intestinal leukocyte number and regenerate length, but did not rescue goblet cell number. The suppressive effects of glucocorticoids in highly proliferative tissues may be relevant in the context of their therapeutic applications in patients with inflammatory diseases
Case-Based Serious Gaming for Complication Management in Colorectal and Pancreatic Surgery: Prospective Observational Study
No full textBackground: The potential risk and subsequent impact of serious complications after pancreatic and colorectal surgery can be significantly reduced through early recognition, correct assessment, and timely initiation of appropriate therapy. Serious gaming (SG) is an innovative teaching method that combines play with knowledge acquisition, increased concentration, and quick decision-making and could therefore be used for clinically oriented education. - Objective: This study aims to develop a case-based SG platform for complication management in pancreatic and colorectal surgery, validate the application by comparing game courses of various professional groups in the health care sector, and test the acceptance of the developed platform in the context of clinical education by measuring levels of usability and applicability within the framework of a validity and usefulness analysis. - Methods: In this observational trial, a novel SG for management of postoperative complications was developed and prospectively validated in a cohort of 131 human caregivers with varying experience in abdominal surgery. A total of 6 realistic patient cases were implemented, representing common complications after pancreatic and colorectal surgery. Cases were developed and illustrated using anonymized images, data, and histories of postoperative patients. In the prospective section of this study, following a brief case presentation, participants were asked to triage the virtual patient, make an initial suspected diagnosis, and design a 3-step management plan, throughout which the results of selected diagnostic and therapeutic actions were presented. Participants’ proposed case management was compared to ideal case management according to clinical guidelines. Usability, applicability, validity, and acceptance of the application were assessed using the Trier Teaching Evaluation Inventory as part of a noncomparative analysis. In addition, a comparative analysis of conventional teaching and learning formats was carried out. - Results: A total of 131 cases were answered. Physicians selected more appropriate therapeutic measures than nonphysicians. In the Trier Teaching Evaluation Inventory, design, structure, relevance, timeliness, and interest promotion were predominantly rated positively. Most participants perceived the application to be superior to conventional lecture-based formats (training courses, lectures, and seminars) in terms of problem-solving skills (102/131, 77.9%), self-reflection (102/131, 77.9%), and usability and applicability (104/131, 79.4%). - Conclusions: Case-based SG has educational potential for complication management in surgery and could thereby contribute to improvements in postoperative patient care
Young people at risk for developing bipolar disorder: Two-year findings from the multicenter prospective, naturalistic Early-BipoLife study
No full textEarly identification and intervention of individuals with an increased risk for bipolar disorder (BD) may improve the course of illness and prevent long‑term consequences. Early-BipoLife, a multicenter, prospective, naturalistic study, examined risk factors of BD beyond family history in participants aged 15–35 years. At baseline, positively screened help-seeking participants (screenBD at-risk) were recruited at Early Detection Centers and in- and outpatient depression and attention-deficit/hyperactivity disorder (ADHD) settings, references (Ref) drawn from a representative cohort. Participants reported sociodemographics and medical history and were repeatedly examined regarding psychopathology and the course of risk factors. N = 1,083 screenBD at-risk and n = 172 Ref were eligible for baseline assessment. Within the first two years, n = 31 screenBD at-risk (2.9 %) and none of Ref developed a manifest BD. The cumulative transition risk was 0.0028 at the end of multistep assessment, 0.0169 at 12 and 0.0317 at 24 months (p = 0.021). The transition rate with a BD family history was 6.0 %, 4.7 % in the Early Phase Inventory for bipolar disorders (EPIbipolar), 6.6 % in the Bipolar Prodrome Interview and Symptom Scale-Prospective (BPSS-FP) and 3.2 % with extended Bipolar At-Risk - BARS criteria). In comparison to help-seeking young patients from psychosis detection services, transition rates in screenBD at-risk participants were lower. The findings of Early-BipoLife underscore the importance of considering risk factors beyond family history in order to improved early detection and interventions to prevent/ameliorate related impairment in the course of BD. Large long-term cohort studies are crucial to understand the developmental pathways and long-term course of BD, especially in people at- risk
Therapeutic principles and unmet needs in the treatment of cough in pediatric patients: review and expert survey
No full textBackground:
There are evidence gaps in the management of pediatric cough, particularly for acute pediatric cough. This study had two aims: to identify therapeutic principles and unmet needs in the treatment of cough in pediatric patients (internationally), and to consider the evidence required to address these unmet needs.
Methods:
A MEDLINE/PubMed database search was performed to identify articles describing therapeutic principles in the treatment of pediatric cough. An online survey of international pediatric cough experts was conducted, with questions on the definitions, diagnosis, treatment, and unmet needs in pediatric cough management.
Results:
Cough guidelines have differing definitions of pediatric patients (≤12–18 years), acute pediatric cough ( 4–8 weeks). Similarly, among 18 experts surveyed, definitions varied for pediatric patients (≤10–21 years), acute pediatric cough ( 2–8 weeks). Guidelines generally do not recommend over-the-counter or prescription cough medicines in acute pediatric cough, due to lack of evidence. In the expert survey, participants had differing opinions on which medicines were most suitable for treating acute pediatric cough, and noted that effective treatments are lacking for cough-related pain and sleep disruption. Overall, guidelines and experts agreed that chronic pediatric cough requires diagnostic investigations to identify the underlying cough-causing disease and thereby to guide treatment. There are unmet needs for new effective and safe treatments for acute pediatric cough, and for randomized controlled trials of existing treatments. Safety is a particular concern in this vulnerable patient population. There is also a need for better understanding of the causes, phenotypes, and prevalence of pediatric cough, and how this relates to its diagnosis and treatment.
Conclusions:
Whereas pediatric cough guidelines largely align with regard to the diagnosis and treatment of chronic cough, there is limited evidence-based guidance for the management of acute cough. There is a need for harmonization of pediatric cough management, and the development of standard guidelines suitable for all regions and patient circumstances
Examining the Potential of Sentinel Imagery and Ensemble Algorithms for Estimating Aboveground Biomass in a Tropical Dry Forest
No full textAccurate estimations of aboveground biomass (AGB) in tropical forests are crucial for maintaining carbon stocks and ensuring effective forest management. By combining remote sensing (RS) data with ensemble algorithms, reliable AGB estimates in forests can be obtained. In this context, the freely available Sentinel-1 (S-1 SAR) and Sentinel 2 multispectral imagery (S-2 MSI) data have a significant role in enhancing accurate AGB estimations at a lower cost, which is relevant for the tropical dry forest (TDF) regions where AGB estimation is uncertain or there is a lack of comprehensive exploration. This study aims to address this gap by presenting a cost-effective and reliable AGB estimation approach in the TDF region of Colombia. For this purpose, we modeled and compared the performance of two ensemble algorithms, random forest (RF) and extreme gradient boosting (XGBoost), to estimate AGB using three predictor categories (polarizations/textures, spectral bands/vegetation indices, and a combination of both). We then examined the modeling potential of S-1 SAR and S-2 MSI imagery in predicting forest AGB and subsequently identified the most suitable variables. To construct AGB models’ field data, we employed a clustered distributed sampling approach involving 100 subsample plots, each with an area of 400 m². Stepwise multiple linear regression was applied to identify suitable predictors from the original satellite bands, vegetation indices, and texture metrics. To produce a map of AGB, predicted AGB values were calculated for every pixel within a specific satellite subscene using the most effective ensemble algorithm. Our study findings show that the RF model, which employed combined predictor sets, displayed superior performance when evaluated against the independent validation set. The RF model successfully estimated AGB with a high degree of accuracy, achieving an R² value of 0.78 and an RMSE value of 42.25 Mg/ha⁻¹. In contrast, the XGBoost model performed less accurately, obtaining an R² value of only 0.60 and an RMSE value of 48.41 Mg/ha⁻¹. The results also indicate that S-2 vegetation indices data were more appropriate for this purpose than S-1 texture data. Despite this, S-1 cross-polarized textures were necessary during the dry season for the combined datasets. The top predictive variables for S-2 images were cab and cw, as well as red-edge bands during the wet season. As for S-1 images, texture D_VH _Hom during the dry season was the most important variable for explaining performance. Overall, the proposed approach of using freely available Sentinel data seems to improve the accuracy of AGB estimation in heterogeneous forest cover and, as such, they should be recommended as a data source for forest AGB assessment
Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare)
No full textIntroduction:
Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity.
Methods:
We undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation.
Results:
During measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity.
Discussion:
Health-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups
Benign tumours of foot and ankle
No full textMusculoskeletal tumours of foot or ankle make up about 4–5% of all musculoskeletal tumours. Fortunately, about 80% of them are benign. However, due to the rarity and low prevalence of each single tumour entity, diagnosis is often difficult and delayed. - Ultrasonography is an important diagnostic tool to safely recognize ganglion cysts as a frequently encountered ‘bump’ in the foot. - In suspicious lesions, malignancy must be excluded histologically in a tumour center by biopsy after imaging procedures using x-ray, computed tomography (CT) and magnetic resonance imaging (MRI). - Most of the benign tumours do not require any further surgical therapy. Resection should be performed in the case of locally aggressive tumour growth or local symptoms of discomfort. In contrast to malignant tumours, the primary purpose in the resection is the least possible loss of function
Numerical modeling of a cohesively separating soil layer in consideration of locally varying soil distribution
No full textPredicting the cleaning time required to remove a thin layer of soil is a challenging task and subject of current research. One approach to tackle this problem is the decomposition into physical sub-problems which are modelled separately and the subsequent synthesis of these models. In this paper, an existing model for adhesive detachment is extended for the prediction of the cleaning time of cohesively separating soil layers. The extension is based on measurements of the pull-off forces and their correlation to the local water mass fraction. The resulting new model is validated using cleaning experiments with starch in a fully developed channel flow. Furthermore, an inhomogeneous soil distribution and its effect on cleaning results like cleaning time and removal rate is investigated. It is shown that accounting for the local soil distribution in the model leads to a significant improvement of the prediction of the cleaning behaviour