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The stringency and potential impact of climate laws and policies in the European Union and the 21OECD countries
Get PDFIn this paper, I offer a way to measure the stringency of climate change legislation for macro-comparative studies using publicly available data. The paper is innovative in that it examines the complex interrelationship between national, subnational, and supranational legislation using data from the FaoLex database on environmental laws and policies. It is also novel in that it conducts a contextualized comparison that takes into account different national conditions for climate change policies. The resulting index is the Gross Potential Impact (GPI), which is a measure of the stimulus of legislation before taking into account implementation issues. To demonstrate the validity of the index, findings from case study research on the European Union’s 2020 and 2030 climate and energy frameworks are used. The rest of the paper presents the GPI for 21 OECD countries for the period between 1990 and 2020
Assoziation von Sphingosin-1-phosphat mit linksventrikulärer und linksatrialer Morphologie und Funktion
Get PDFHintergrund und Zielsetzung:
Sphingosin-1-phosphat (S1P) ist ein bioaktives Sphingolipid, das an zentralen zellulären Prozessen wie Wachstum, Proliferation, Migration und Apoptose beteiligt ist. Es könnte physiologische Funktionen aufweisen, die das kardiale Remodeling beeinflussen. Frühere Studien deuten auf einen Zusammenhang niedrigerer S1P-Konzentrationen mit ungünstigen kardiovaskulären Outcomes hin. Ziel der vorliegenden Analyse war es, die Assoziationen zwischen S1P-Serumkonzentrationen und linksventrikulärer sowie linksatrialer Morphologie und Funktion in einer bevölkerungsbasierten Stichprobe zu untersuchen.
Methoden:
Es wurden Daten von 858 Teilnehmenden (467 Männer) im Alter von 22 bis 81 Jahren aus der bevölkerungsbasierten „Study of Health in Pomerania“ (SHIP) analysiert. Die S1P-Serumkonzentrationen wurden mittels Flüssigkeitschromatographie in Kombination mit Tandem-Massenspektrometrie bestimmt. Morphologische und systolische Funktionsparameter des linken Ventrikels und des linken Atriums wurden durch kardiale Magnetresonanztomographie (MRT) erfasst. Die statistische Auswertung erfolgte anhand geschlechtsstratifizierter, multivariabel adjustierter linearer Regressionsmodelle.
Ergebnisse:
Bei Männern waren niedrigere S1P-Konzentrationen signifikant mit einer größeren Wanddicke und Masse des linken Ventrikels, einem erhöhten enddiastolischen Volumen des linken Ventrikels und des linken Atriums sowie mit einem größeren Schlagvolumen und einer höheren Schlagarbeit des linken Ventrikels assoziiert. Bei Frauen zeigten sich hingegen keine signifikanten Zusammenhänge.
Schlussfolgerung:
Die Ergebnisse deuten darauf hin, dass S1P bei Männern mit Parametern assoziiert ist, die auf Veränderungen im Sinne eines kardialen Remodelings hinweisen könnten. Um die Zusammenhänge zwischen S1P und kardialer Morphologie und Funktion sowie den beobachteten Geschlechtsunterschied weiterführend zu untersuchen, sind zukünftig prospektive Studien erforderlich
Case report: Aortobiiliac bypass with autotransplantation of the horseshoe kidney and renal vascular reconstruction
Get PDFIntroduction and importance
This case report describes the rare encounter of a large infrarenal abdominal aortic aneurysm (AAA) and a horseshoe kidney (HEN), which was managed through comprehensive preoperative planning and effective multidisciplinary collaboration, with the patient being fully informed and consenting to the publication of data and images.
Case presentation
The patient was referred to the Department of Vascular Surgery with increasing abdominal pain. Computed tomography angiography showed that the aneurysm was significantly advanced. For surgical correction of the aortic aneurysm, the horseshoe kidney was autotransplanted intraoperatively to ensure renal vascular reconstruction for further renal perfusion after treatment of the aneurysm.
Discussion
Abdominal aortic aneurysm carries a significant risk of rupture, with more than half of ruptures being fatal before reaching the hospital. When the AAA occurs concomitantly with a HEN, detailed imaging is critical for planning the procedure, as the unusual arterial supply to the HEN complicates the procedure and requires careful strategies to protect renal function while treating the aneurysm.
Conclusion
The treatment of complex cases with severe disease manifestations and difficult anatomy requires careful planning to ensure effective treatment and optimise patient survival and quality of life
Colloid cyst of the third ventricle: a rare case of spontaneous regression. Illustrative case
Get PDFBACKGROUND
Colloid cysts (CCs) are benign lesions commonly located in the third ventricle, near the foramen of Monro. They constitute about 0.5%–1% of all intracranial tumors. As benign lesions, CCs can be found incidentally, but they can also present with neurological deterioration and are even associated with sudden death, which might be explained as a result of obstructive hydrocephalus. Thus, larger and symptomatic CCs are often considered for surgery.
OBSERVATIONS
The following case presents a rare and curious instance of a spontaneously regressing CC. This represents the 11th case ever reported about an extremely rare occurrence: the spontaneous regression of a previously diagnosed CC in the third ventricle.
LESSONS
Carefully selected asymptomatic CCs can be monitored through regular imaging studies and neurological examinations. If regression of the cyst is observed, physicians should not be surprised, as this event, although rare, has been documented and published in 11 cases, including this one
Music Listening as a Non-Pharmacological Intervention for People with Dementia in the Community
Get PDFHintergrund & Ziel: Nicht-pharmakologische, musikbasierte Interventionen (MBI) für Menschen mit Demenz (MmD) stehen zunehmend im Fokus. Allerdings besteht ein Mangel an Studien, die MBI gezielt einsetzen, um Kognition bei MmD zu stärken. Ziel dieser Dissertation war es, eine solche MBI speziell für zu Hause lebende MmD zu entwickeln. Methoden: Der Forschungsstand wurde in einer systematischen Literatur- übersicht ausgewertet. Daraufhin wurde in einer Online-Befragung (n = 102, intraindividuelles Design) Musik hinsichtlich emotionaler Valenz validiert. In einem Experiment (n = 40, intraindividuelles Design) wurden die Assoziationen zwischen Tempo und Valenz von Hintergrundmusik mit Kognition untersucht. Basierend auf diesen Studien wurde eine MBI mit schnell-positiver Musik entwickelt. Diese wurde in einer intraindividuellen crossover Pilotstudie mit einer alternativen MBI (langsam-positiv) und Regelversorgung verglichen. Interventionsdauer war je 6 Wochen. Sechszehn zu Hause lebende MmD und ihre Angehörigen nahmen teil. Quantitative Endpunkte waren Kognition, Wohlbefinden und Lebensqualität, sowie behaviorale und psychologische Symptome der MmD. Ergebnisse: Die Literaturübersicht zeigte die Notwendigkeit, musikalische Stimuli vor ihrer Nutzung zu validieren. Im Zuge der Online-Befragung wurden 19 beziehungsweise 16 Stimuli mit positiver beziehungsweise negativer Valenz für die weitere Nutzung identifiziert. Im Experiment war Hintergrundmusik mit schnellem (vs. langsamem) Tempo und positiver (vs. negativer) emotionaler Valenz insgesamt mit besserer kognitiver Leistung verbunden. Die schnell-positive (vs. langsam-positive) MBI war mit einer besseren Merkfähigkeit bei MmD verbunden (p = 0,028; Hedges’s gav = 0,70). Nach 6 Wochen Musikhören stieg die Lebensqualität im Vergleich zur Regelversorgung (p = 0,04; Hedges’s gav = 0,51). Darüber hinaus berichteten Dyaden von unterschiedlichen Wirkungen der schnell- und langsam-positiven Musik im Moment des Hörens. Schlussfolgerungen: Eine evidenzbasierte, durchführbare MBI wurde erfolgreich entwickelt. Schnell-positive Musik war mit verbesserten Gedächtnisabruf verbunden. Die Berichte der Dyaden unterstreichen, dass das Musikhören Momente des Wohlbefindens für MmD schuf. Die MBI könnte, sofern Folgestudien die Ergebnisse bestätigen, als niedrigschwellige Unterstützung von Merkfähigkeit und Lebensqualität im Alltag von zu Hause lebenden MmD eingesetzt werden.Background & Aim: Non-pharmacological, music-based interventions (MBIs) for people with dementia (PwD) are gaining attention. However, there is a lack of studies using MBIs to enhance cognition in PWD. The aim of this dissertation was to develop such an MBI targeting cognition in community-dwelling PwD. Methods: First, a systematic literature review was conducted to evaluate the state of research. Subsequently, music was pre-validated in terms of emotional valence in an online survey (n = 102, within- participants). In an experiment (n = 40, within-participants), the associations between tempo and valence of background music with cognition were investigated. Based on these preliminary studies a MBI with fast-positive music was developed. This fast- positive MBI was compared with an alternative, slow-positive MBI and care-as-usual in a within-participants crossover pilot study. Each intervention lasted 6 weeks. Sixteen community-dwelling PwD and their informal caregivers participated. Quantitative endpoints were cognition, well-being and quality of life, as well as behavioural and psychological symptoms of the PwD. Results: The systematic review highlighted the need to validate musical stimuli prior to their use. In the course of the online survey, 19 and 16 stimuli with positive and negative valence, respectively, were identified for further use. In the experiment, background music with fast (vs. slow) tempo and positive (vs. negative) emotional valence was associated with better overall cognitive performance. The fast-positive (vs. slow-positive) MBI was associated with better recall in PwD (p = 0.028; Hedges’s gav = 0.70). After 6 weeks of listening to music, quality of life increased compared to care-as-usual (p = 0.04; Hedges’s gav = 0.51). In addition, dyads reported different effects of fast- and slow-positive music in the moment of listening. Conclusions: An evidence-based, feasible MBI was successfully developed. Fast-positive music was associated with improved memory retrieval. The dyads' reports emphasise that listening to music provided moments of well-being for PwD. If follow-up studies confirm these results, the MBI could be used as a low-threshold means to support memory function and quality of life in community-dwelling PwD
Antileukaemic rescue by dose-dense donor-lymphocyte infusions in T-PLL after allogeneic stem cell transplantation – a case report
Get PDFT-Cell Prolymphocytic Leukaemia (T-PLL) is an aggressive disease with a poor prognosis and only curable by allogeneic stem cell transplantation. We describe the case of a male suffering from T-PLL. Therapy was alemtuzumab followed by an allograft from an unrelated donor. T-PLL relapsed after allogeneic stem cell transplantation. Discontinuation of immunosuppression had no effected and three increasing doses of donor lymphocytes were given within one month. The patient developed acute GvHD of the lover (grade III). GvHD was successfully treated by steroids and ruxolitinib and graft-versus-leukaemia effects induced a complete remission of T-PLL. 18,5 months after transplantation the patient is well and alive without GvHD under immunosuppression with ruxolitinib. Flow cytometry of peripheral blood was negative for residual leukemic cells
Emerging drought sensitivity for large Norway spruce trees at high elevation in the High Tatras, Slovakia
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Climate-growth correlations are non-stationary among all size classes, and large trees are becoming sensitive to August and September drought conditions in the year preceding growth during the last decades.
Abstract
Understanding tree growth and forest dynamics under climate change is paramount to predict changes in carbon cycling, forest development, and ecosystem services. At temperature limited sites, such as alpine treelines, tree growth is often assumed to benefit from rising temperatures, while increased drought may offset potential benefits. Tree size is known to be related to climate sensitivity and drought induced mortality, with large trees generally suffering the most from drought. To assess the relationship of tree size and climate sensitivity for Norway spruce trees at treeline, we collected 158 tree cores at treeline and the adjacent closed canopy forest in the High Tatra Mountains in Slovakia. Size classes were established based on size class isolation of the total sample set, yielding artificial tree ring chronologies with a constant size over time. We ran moving-window correlation analyses to assess the temporal development of climate sensitivity. We found climate-growth correlations to be non-stationary and with similar trends among size classes. In general, trees are temperature limited during the growing season, but correlations have shifted from June to July in recent decades. Additionally, the largest trees show an increased and significant sensitivity to August and September drought conditions in the year preceding growth. These findings emphasize the increasing influence of drought constraints on tree growth, even at supposedly temperature limited treeline sites
Influence of clinical expertise and practical experience on transfer accuracy in guided dental implant placement - an in vitro study
Get PDFPurpose
To investigate whether inexperienced users applying a static navigation system can perform in-vitro a fully guided implant placement protocol and achieve similar results in terms of accuracy compared to experienced clinicians.
Methods
Based on 36 identical resin models, a computer-assisted implant planning was performed and a surgical guide was produced accordingly. Three study groups were composed with 12 operators, each: control group with experienced surgeons (DOC), test group 1 with dental technicians (TEC) and test group 2 with non-specialists (OFC). Using a fully guided drilling protocol, two implants were placed into each of the 36 models. Subsequently, the differences between the virtually planned and final implant positions were determined and the transfer accuracy was evaluated.
Results
For the control group DOC, the mean value of axial deviation was 1.90 ± 1.15 degrees, for 3-dimensional deviation at the implant base 0.52 ± 0.33 mm, for 3-dimensional deviation at the implant tip 0.76 ± 0.39 mm and for vertical deviation at the implant tip − 0.11 ± 0.51 mm. For corresponding parameters, the mean values of test group TEC were 1.99 ± 0.87 degrees, 0.42 ± 0.21 mm, 0.68 ± 0.30 mm and − 0.03 ± 0.33 mm and for test group OFC 2.29 ± 1.17 degrees, 0.63 ± 0.35 mm, 0.89 ± 0.43 mm and − 0.24 ± 0.57 mm, respectively. The results did not reveal any statistically significant differences between the control and the 2 test groups (p˃0.05).
Conclusion
The results of the present in-vitro study demonstrated that inexperienced users applying a static navigation system can perform a fully guided implant placement protocol and achieve similar results in terms of accuracy compared to experienced clinicians in this specific in vitro setup
ST and TS as Product and Sum
Get PDFThe set of ST-valid inferences is neither the intersection, nor the union of the sets of K3-valid and LP-valid inferences, but despite the proximity to both systems, an extensional characterization of STin terms of a natural set-theoretic operation on the sets of K3-valid and LP-valid inferences is still wanting. In this paper, we show that it is their relational product . Similarly, we prove that the set of TS-valid inferences can be identified using a dual notion, namely as the relational sum of the sets of LP-valid and K3-valid inferences. We discuss links between these results and the interpolation property of classical logic. We also use those results to revisit the duality between STand TS. We present a notion of duality on which STand TSare dual in exactly the same sense in which LPand K3are dual to each other
Understanding the Interaction of Thermal, Rheological, and Mechanical Parameters Critical for the Processability of Polyvinyl Alcohol-Based Systems during Hot Melt Extrusion
Get PDFHot melt extrusion (HME) is a common manufacturing process used in the pharmaceutical industry to improve the solubility of poorly soluble active pharmaceutical ingredients (API). The goal is to create an amorphous solid dispersion (ASD) where the amorphous form of the API is stabilized within a polymer matrix. Traditionally, the development of pharmaceutically approved polymers has focused on requirements such as thermal properties, solubility, drug–polymer interactions, and biocompatibility. The mechanical properties of the material have often been neglected in the design of new polymers. However, new downstream methods require more flexible polymers or suitable plasticizer polymer combinations. In this study, two grades of the polymer polyvinyl alcohol (PVA), which is already established for HME, are investigated in terms of their mechanical, rheological, and thermal properties. The mechanical properties of the extruded filaments were tested by the three-point bending test. The rheological behavior was analyzed by oscillating plate measurements. Thermal analysis was performed by differential scanning calorimetry (DSC). In addition, the solid and liquid plasticizers mannitol, sorbitol, triacetin, triethyl citrate, polyethylene glycol, and glycerol were evaluated for use with PVA and their impact on the polymer properties was elaborated. Finally, the effects of the plasticizers are compared to each other, and the correlations are analyzed statistically using principal component analysis (PCA). Thereby, a clear ranking of the plasticizer effects was established, and a deeper understanding of the polymer–plasticizer interactions was created