University of Münster
Münstersches Informations und Archivsystem für Multimediale InhalteNot a member yet
10543 research outputs found
Sort by
Caseload per Year in Robotic-Assisted Minimally Invasive Esophagectomy: A Narrative Review
No full textEsophageal surgery is deemed one of the most complex visceral operations. There is a well-documented correlation between higher caseload and better outcomes, with hospitals that perform more surgeries experiencing significantly lower mortality rates. The approach to caseload per year varies across different countries within Europe. Germany increased the minimum annual required caseload of complex esophageal surgeries from 10 to 26 starting in 2023. Furthermore, the new regulations present challenges for surgical training and staff recruitment, risking the further fragmentation of training programs. Enhanced regional cooperation is proposed as a solution to ensure comprehensive training. This review explores the benefits of robotic-assisted minimally invasive esophagectomy (RAMIE) in improving surgical precision and patient outcomes and aims to evaluate how the caseload per year influences the quality of patient care and the efficacy of surgical training, especially with the integration of advanced robotic techniques
Concerto C-Dur für Viola, Streicher und Basso continuo (D-RH Ms 165)
No full textDas Musikleben in den Residenzen Hohenlimburg und Rheda unter Graf Moritz Casimir I. von Bentheim-Tecklenburg (1701-1768) wurde maßgeblich von Johann Martin Doemming (geb. 1703 in Milz/Thüringen, gest. um 1760) geprägt. Über die musikalische Ausbildung des Verwaltungsangestellten Doemming ist nichts bekannt, jedoch muss sie so fundiert gewesen sein, dass er 1731 zum "Directore musices" bestellt wurde. Doemming hat zahlreiche Kompositionen für den Gebrauch der Hofmusik hinterlassen, insbesondere konzertante Musik für Bläser, Streicher und Basso continuo. Unter seiner Leitung wurde 1750 ein thematischer "Catalogus musicus" angelegt, der das Repertoire der Hofkapelle während der Regierungszeit von Moritz Casimir I. widerspiegelt. Die erhaltenen Werke von Johann Martin Doemming sind - vielfach als Autograph - ausschließlich in der Fürstlich zu Bentheim-Tecklenburgischen Musikbibliothek Rheda überliefert
DOG1 controls dormancy independently of ABA core signaling kinases regulation by preventing AFP dephosphorylation through AHG1
No full textSeed dormancy determines germination timing, influencing seed plant adaptation and overall fitness. DELAY OF GERMINATION 1 (DOG1) is a conserved central regulator of dormancy cooperating with the phytohormone abscisic acid (ABA) through negative regulation of ABA HYPERSENSITIVE GERMINATION (AHG) 1 and AHG3 phosphatases. The current molecular mechanism of DOG1 signaling proposes it regulates the activation of central ABA-related SnRK2 kinases. Here, we unveil DOG1's functional autonomy from the regulation of ABA core signaling components and unravel its pivotal control over the activation of ABSCISIC ACID INSENSITIVE FIVE BINDING PROTEINs (AFPs). Our data revealed a molecular relay in which AFPs' genuine activation by AHG1 is contained by DOG1 to prevent the breakdown of maturation-imposed ABA responses independently of ABA-related kinase activation status. This work offers a molecular understanding of how plants fine-tune germination timing, while preserving seed responsiveness to adverse environmental cues, and thus represents a milestone in the realm of conservation and breeding programs
Don Quijote y la filosofía del idealismo alemán
No full textDer Text analysiert die Verbindungen zwischen Cervantes' Don Quijote und der deutschen idealistischen Philosophie, insbesondere in den Werken von Hegel, Schelling und Schlegel. Es wird gezeigt, wie Don Quijote als Paradigma für den idealistischen Subjektivismus dient, bei dem das Individuum seine Realität aus sich selbst heraus erschafft. Hegel und andere Philosophen nutzen den Charakter von Don Quijote, um den Konflikt zwischen Idealität und Realität zu veranschaulichen. Die satirische und ironische Darstellung von Don Quijote wird als Spiegel der inneren Spannungen der idealistischen Philosophie interpretiert, wobei der Ritter die äußere Welt umformt, um sie seinen inneren Idealen anzupassen.El documento analiza las conexiones entre Don Quijote de Cervantes y la filosofía idealista alemana, especialmente en las obras de Hegel, Schelling y Schlegel. Se muestra cómo Don Quijote sirve como un paradigma para el subjetivismo idealista, donde el individuo crea su realidad desde sí mismo. Hegel y otros filósofos utilizan el personaje de Don Quijote para ilustrar el conflicto entre la idealidad y la realidad. La representación satírica e irónica de Don Quijote se interpreta como un reflejo de las tensiones internas de la filosofía idealista, en la que el caballero transforma el mundo exterior para que se ajuste a sus ideales internos
Effects of a short-term fasting period as a model for excitation manipulation on brain volume and cognitive performance
No full textDie für eine gesunde Gehirnfunktion notwendige Balance aus exzitatorischen und inhibitorischen Signalen und ihre Regulationsmechanismen bieten die Grundlage zur Erklärung multipler assoziierter Erkrankungen, sowie für Interventions- und Behandlungsmaßnahmen. Eine 72-stündige Fastenperiode, als möglicher Modulator neuronaler Exzitabilität in Form erhöhter synaptischer Lipidsignalisierung, bewirkte in unserer longitudinalen, klinisch experimentellen Studie mit 30 gesunden, männlichen Probanden zwischen 18 und 49 eine Abnahme der neurokognitiven Performanz im d2-Attention-Test, sowie eine Zunahme depressiver Symptome, negativer Emotionen, Ängstlichkeit und Nahrungsverlangen, sowie eine Zunahme des Gehirnvolumens im gefasteten Zustand in multiplen Clustern in einer ROI- und Whole-Brain-Analyse. Zusätzlich zeigte sich eine möglicherweise durch osmotische Neuronenschwellung bedingte, negative Korrelation zwischen kognitiver Leistung und fasteninduzierter Volumenzunahme
Fitness, functions, and exaptation:a study in philosophical methodology and theoretical and applied philosophy of biology
No full textDiese Arbeit widmet sich einem Thema aus dem Bereich der Philosophie der Biologie. Zwei zentrale Begriffe der Biologie werden untersucht: der Begriff der biologischen Fitness und der Funktionsbegriff. Über die Fragen aus diesem speziellen Gebiet hinaus stellt sie methodologische Überlegungen zur philosophischen Reflexion wissenschaftlicher Grundbegriffe an. Insbesondere beschäftigt sich die Arbeit mit der Frage, ob Wissenschaftsphilosophie bei der Erklärung der zu verstehenden Phänomene in Einzelwissenschaften bzw. der Klärung einzelwissenschaftlicher Begriffe dem Ansatz der Begriffsanalyse oder einer anderen Methode folgen sollte. Zum Schluss wird anhand einer Fallstudie aus der Verhaltensbiologie gezeigt, wie die Wissenschaftsphilosophie auch für die experimentelle Biologie fruchtbar gemacht werden kann.This book comprises various areas in the philosophy of science. It begins with a general consideration of philosophical methodology and its significance for the philosophy of science. Applying the methodological framework developed in the first part, it continues to work on some conceptual issues within the philosophy of biology, namely issues concerning the notions of biological fitness and functions. Subsequently, it ends with a case study of the applied philosophy of science suggesting new experiments based on theoretical considerations
Functionality and Scar Evaluation of the Donor Site in Extended Radial Forearm Flap Phalloplasty: How Affected Is the Arm in Day-to-Day Life?
No full textBackground: The radial forearm flap remains the gold standard in phalloplasty in gender-affirming surgery due to its versatility and functional outcome, but the significant donor site morbidity and its impact on daily functioning and aesthetic perception remains understudied. This study provides valuable insights into the mid-term functional and aesthetic outcomes of the forearm in transgender individuals following radial forearm flap phalloplasty using widespread instruments for assessment scoring systems and for the evaluation of postoperative wound healing of surgical interventions in general. Methods: Between January 2013 and March 2018, a total of 47 patients underwent radial phalloplasty at AGAPLESION Markus Hospital, and 20 consented to participate in this cross-sectional, retrospective study evaluating functional and aesthetic outcomes post-radial forearm flap phalloplasty using standardized questionnaires (DASH, POSAS, and SBSES). A univariate median regression of each score was performed to determine the associations with selected variables, and correlation analyses between scores was performed using a nonparametric Spearman rank correlation. Results: Among the 20 participants, the median Quick DASH, DASH functionality, DASH sport and music, and DASH work scores indicated minimal to no functional impairment. Scar evaluations using the PSAS, OSAS, and SBSES scales showed overall patient satisfaction with minimal concerns regarding pigmentation and scar texture. Notably, an increase of 0.27 cm2 in wound surface area added one point to the DASH sport and music score (p = 0.037). Statistical analysis also demonstrated a significant correlation between functional and aesthetic assessment scores. Conclusions: The radial forearm phalloplasty donor site, evaluated by the PSAS, OSAS, and SBSES scales, leads to minimal or no functional impairment; however, the worsening of the DASH sport and music score with increasing wound surface reflects a direct relation between wound size and functional impairment
Impact of intensified contact precautions while treating hematopoietic stem cell transplantation recipients during aplasia
No full textBackground: Bacterial infections are a major complication for patients undergoing allogeneic hematopoietic stem cell transplantation (HCT). Therefore, protective isolation is considered crucial to prevent nosocomial infections in this population. Here, the impact of intensified contact precautions on environmental contamination and the occurrence of bloodstream infections (BSI) in patients on a HCT unit were compared between two contact precaution measures. Methods: A 2-year retrospective observational study was performed. In the first year, strict contact precaution measures were applied (i.e., protective isolation, the use of sterile personal protective equipment (PPE) by healthcare workers and visitors and sterilization of linen and objects that entered the patient’s room). After one year, contact precautions were reduced (i.e., no use of sterile PPE, no sterilization of linen and objects that entered the patient’s room). Environmental contamination in randomly selected patient rooms was monitored by sampling six standardized environmental sites in the respective patient treatment units. In a before-and-after study, the number of BSI episodes of those patients, who were accommodated in the monitored rooms was compared. Results: In total, 181 treatment units were monitored. No significant difference in the contamination of anterooms and patient’s rooms between both groups was found. A total of 168 patients were followed for the occurrence of BSI during the entire study period (before: 84 patients, after: 84 patients). The total count of patients with BSI episodes showed a higher incidence in the period with reduced contact precautions (30/84 vs. 17/84, p = 0.039). The cause of this increasing number of BSI can be traced back to BSI episodes with common commensal bacteria (17/84 vs. 5/84, p = 0.011). Conclusions: The implementation of maximal barrier measures did not reduce the bacterial contamination of the patients’ environment. The impact on the patients' outcomes remain controversial. Further research is needed to investigate the impact of infection prevention measures on the clinical outcome of patients undergoing HCT
Impact of NPSR1 gene variation on the neural correlates of phasic and sustained fear in spider phobia—an imaging genetics and independent replication approach
No full textThe functional neuropeptide S receptor 1 (NPSR1) gene A/T variant (rs324981) is associated with fear processing. We investigated the impact of NPSR1 genotype on fear processing and on symptom reduction following treatment in individuals with spider phobia. A replication approach was applied [discovery sample: Münster (MS) nMS = 104; replication sample Würzburg (WZ) nWZ = 81]. Participants were genotyped for NPSR1 rs324981 [T-allele carriers (risk) versus AA homozygotes (no-risk)]. A sustained and phasic fear paradigm was applied during functional magnetic resonance imaging. A one-session virtual reality exposure treatment was conducted. Change of symptom severity from pre to post treatment and within session fear reduction were assessed. T-allele carriers in the discovery sample displayed lower anterior cingulate cortex (ACC) activation compared to AA homozygotes independent of condition. For sustained fear, this effect was replicated within a small cluster and medium effect size. No association with symptom reduction was found. Within-session fear reduction was negatively associated with ACC activation in T-allele carriers in the discovery sample. NPSR1 rs324981 genotype might be associated with fear processing in the ACC in spider phobia. Interpretation as potential risk-increasing function of the NPSR1 rs324981 T-allele via impaired top-down control of limbic structures remains speculative. Potential association with symptom reduction warrants further research