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Die Entstehungsgeschichte des kasachischen Zivilgesetzbuches
No full textDas rechtshistorische Thema "Die Entstehungsgeschichte des kasachischen Zivilgesetzbuches" knüpft an die jüngste politische, wirtschaftliche und gesellschaftliche Entwicklung in Kasachstan an und befasst sich mit den Rechtsreformprozessen nach den Systemveränderungen Anfang der 90er Jahre. Vor den kasachischen Juristen, die während der Sowjetzeit ausgebildet worden waren, stand die enorme Aufgabe, eine eigene, marktwirtschaftlich ausgerichtete Zivilrechtskodifikation zu erarbeiten. Die kasachische ZGB-Kommission hat sich bewusst für die Übernahme eines von Russland ausgearbeiteten Entwurfs des ZGB entschieden, ohne nach anderen Lösungen zu suchen. Die Arbeit beleuchtet, wie und von wem entsprechende Entscheidungen getroffen wurden, wie der konkrete Regierungsauftrag lautete und welche Arbeitspläne dem Prozess zugrunde lagen
Gender differences in acute myocardial infarction—A nationwide German real-life analysis from 2014 to 2017
No full textBackground: Female sex was reported to be associated with an unfavorable outcome in acute myocardial infarction (AMI). In this nationwide analysis we assessed sex differences in acute outcomes of AMI and recent trends in patient healthcare. Methods: We analyzed 875 735 German cases hospitalized with a main diagnosis of ST- (STEMI) and non ST-elevation myocardial infarction (NSTEMI) between January 01 2014 and December 31 2017 regarding morbidity, in-hospital mortality and treatments. A multivariable logistic regression model was designed to evaluate the use of interventions and their impact on in-hospital mortality. Results: STEMI cases decreased from 72 894 in 2014 to 68 213 in 2017, with 70% assignable to men. Female sex was associated with older age (74 vs. 62 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (19.2% vs. 12.5%), hypertension (69.0% vs. 65.0%) and left ventricular heart failure (36.0% vs. 32.1%). In NSTEMI, female sex was also associated with older age (78 vs. 71 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (29.7% vs. 23.9%), hypertension (77.4% vs. 74.5%) and left ventricular heart failure (40.5% vs. 36.4%). Overall, 74.3% of female and 81.3% of male STEMI cases received percutaneous coronary intervention (PCI, p < 0.001). In NSTEMI, PCI was performed in 40.8% of female and 52.0% of male cases (p < 0.001). In-hospital mortality was notably increased in female patients with STEMI (15.0% vs. 9.6%; p < 0.001; OR 1.07; 95% CI 1.03–1.10) and NSTEMI (8.3% vs. 6.3%; p < 0.001; OR 0.91; 95% CI 0.89–0.93) compared to males. Conclusions: Our nationwide real-world data document that in-patient STEMI cases continue to decrease in women and men. The observed higher in-hospital mortality in women was largely attributed to a more unfavorable risk and age distribution rather than to female-intrinsic factors. Women with AMI continue to be less likely to receive revascularization therapies
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No full textHyperspectral Imaging for Viability Assessment of Human Liver Allografts During Normothermic Machine Perfusion
No full textBackground. Normothermic machine perfusion (NMP) is nowadays frequently utilized in liver transplantation. Despite commonly accepted viability assessment criteria, such as perfusate lactate and perfusate pH, there is a lack of predictive organ evaluation strategies to ensure graft viability. Hyperspectral imaging (HSI)—as an optical imaging modality increasingly applied in the biomedical field—might provide additional useful data regarding allograft viability and performance of liver grafts during NMP. Methods. Twenty-five deceased donor liver allografts were included in the study. During NMP, graft viability was assessed conventionally and by means of HSI. Images of liver parenchyma were acquired at 1, 2, and 4 h of NMP, and subsequently analyzed using a specialized HSI acquisition software to compute oxygen saturation, tissue hemoglobin index, near-infrared perfusion index, and tissue water index. To analyze the association between HSI parameters and perfusate lactate as well as perfusate pH, we performed simple linear regression analysis. Results. Perfusate lactate at 1, 2, and 4 h NMP was 1.5 [0.3–8.1], 0.9 [0.3–2.8], and 0.9 [0.1–2.2] mmol/L. Perfusate pH at 1, 2, and 4 h NMP was 7.329 [7.013–7.510], 7.318 [7.081–7.472], and 7.265 [6.967–7.462], respectively. Oxygen saturation predicted perfusate lactate at 1 and 2 h NMP (R2 = 0.1577, P = 0.0493; R2 = 0.1831, P = 0.0329; respectively). Tissue hemoglobin index predicted perfusate lactate at 1, 2, and 4 h NMP (R2 = 0.1916, P = 0.0286; R2 = 0.2900, P = 0.0055; R2 = 0.2453, P = 0.0139; respectively). Conclusions. HSI may serve as a noninvasive tool for viability assessment during NMP. Further evaluation and validation of HSI parameters are warranted in larger sample sizes
Expansion microscopy of neutrophil nuclear structure and extracellular traps
No full textNeutrophils are key players of the immune system and possess an arsenal of effector functions, including the ability to form and expel neutrophil extracellular traps (NETs) in a process termed NETosis. During NETosis, the nuclear DNA/chromatin expands until it fills the whole cell and is released into the extracellular space. NETs are composed of DNA decorated with histones, proteins, or peptides, and NETosis is implicated in many diseases. Resolving the structure of the nucleus in great detail is essential to understand the underlying processes, but so far, superresolution methods have not been applied. Here, we developed an expansion-microscopy-based method and determined the spatial distribution of chromatin/DNA, histone H1, and nucleophosmin with an over fourfold improved resolution (<40–50 nm) and increased information content. It allowed us to identify the punctate localization of nucleophosmin in the nucleus and histone-rich domains in NETotic cells with a size of 54–66 nm. The technique could also be applied to components of the nuclear envelope (lamins B1 and B2) and myeloperoxidase, providing a complete picture of nuclear composition and structure. In conclusion, expansion microscopy enables superresolved imaging of the highly dynamic structure of nuclei in immune cells
Expression of CXCR4 on CD4+ T cells predicts body composition parameters in female adolescents with anorexia nervosa
No full textAnorexia nervosa (AN) is a severe eating disorder characterized by excessive weight loss and lack of recognition of the seriousness of the current low body weight. Individuals with AN frequently exhibit an enhanced inflammatory state and altered blood levels of cytokines and chemokines. However, the expression of chemokine receptors in AN and the association with body composition parameters and treatment effects are still unknown. In this study, we examined the expression of CCR4, CCR6, CXCR3, and CXCR4 on peripheral blood T cells in female adolescents with AN before (T0, n = 24) and after 6 weeks of multimodal therapy (T1, n = 20). We also investigated their value to predict body mass index (BMI) and fat mass index (FMI) at baseline. Using multi-parameter flow cytometry, we found increased expression of CCR4, CXCR3, and CXCR4, but not CCR6, on CD4+ T cells in AN at T0 when compared to healthy controls (HC, n = 20). At T1, CXCR3 and CXCR4 expression decreased in AN. We found a close link between CCR4, CCR6 and CXCR4 expression and the adolescent mental health status in the study cohort as determined by the Strengths and Difficulties Questionnaire (SDQ). Specifically, CXCR4 expression correlated positively with emotional symptoms and peer relationship problems, as well as with the total sum score of the SDQ. In addition, CXCR4 expression on CD4+ T cells was a significant predictor of BMI and FMI in female adolescents. Our findings that CXCR4 expression on T cells is altered in adolescents with AN and predicts body composition parameters in adolescents suggest an impact of this chemokine receptor in the pathogenesis of AN
FFP: Indication for minimally invasive navigation technique
No full textAn 85-year-old female patient was transferred to our clinic for surgical treatment of a complex FFP IIc. She had suffered a ground level fall 10 days ago and was still living independently. The patient was initially treated conservatively with pain medication and immobilization in an outward hospital. Due to the clinical symptoms and complex fracture pattern a physiotherapeutic assisted mobilization was not possible. The clinical examination revealed severe bilateral pain at the anterior and posterior pelvic ring. We performed a minimally invasive and an image-guided surgical stabilization. After surgical treatment the patient was mobilized with crutches for short distances. On the third day after surgical intervention the patient was discharged from our hospital into rehabilitation. This case shows the successful use of minimally invasive and modern navigation technique for treatment of a complex FFP
Inefficient frontal and parietal brain activation during dual-task walking in a virtual environment in older adults
No full textWalking while performing an additional cognitive task (dual-task walking; DT walking) is a common yet highly demanding behavior in daily life. Previous neuroimaging studies have shown that performance declines from single-task (ST) to DT conditions are accompanied by increased prefrontal cortex (PFC) activity. This increment is particularly pronounced in older adults and has been explained either by compensation, dedifferentiation, or inefficient task processing in fronto-parietal circuits. However, there is only limited evidence for the hypothesized fronto-parietal activity changes measured under real-life conditions such as walking. In this study, we therefore assessed brain activity in PFC and parietal lobe (PL), to investigate whether higher PFC activation during DT walking in older adults is related to compensation, dedifferentiation, or neural inefficiency. Fifty-six healthy older adults (69.11 ± 4.19 years, 30 female) completed three tasks (treadmill walking at 1 m/s, Stroop task, Serial 3′s task) under ST and DT conditions (Walking + Stroop, Walking + Serial 3′s), and a baseline standing task. Behavioral outcomes were step time variability (Walking), Balance Integration Score BIS (Stroop), and number of correct calculations S3corr (Serial 3′s). Brain activity was measured using functional near-infrared spectroscopy (fNIRS) over ventrolateral and dorsolateral PFC (vlPFC, dlPFC) and inferior and superior PL (iPL, sPL). Neurophysiological outcome measures were oxygenated (HbO2) and deoxygenated hemoglobin (HbR). Linear mixed models with follow-up estimated marginal means contrasts were applied to investigate region-specific upregulations of brain activation from ST to DT conditions. Furthermore, the relationships of DT-specific activations across all brain regions was analyzed as well as the relationship between changes in brain activation and changes in behavioral performance from ST to DT. Data indicated the expected upregulation from ST to DT and that DT-related upregulation was more pronounced in PFC (particularly in vlPFC) than in PL regions. Activation increases from ST to DT were positively correlated between all brain regions, and higher brain activation changes predicted higher declines in behavioral performance from ST to DT. Results were largely consistent for both DTs (Stroop and Serial 3′s). These findings more likely suggest neural inefficiency and dedifferentiation in PFC and PL rather than fronto-parietal compensation during DT walking in older adults. Findings have implications for interpreting and promoting efficacy of long-term interventions to improve DT walking in older persons
Learning to Teach English in the Multilingual Classroom Utilizing the Framework of Reference for Pluralistic Approaches to Languages and Cultures
No full textPositioned in a specific curriculum context, yet universal in its rationale, this paper illustrates how over the course of one term, student teachers experiment with designing and teaching language learning activities that foster plurilingual competence of young learners of English, while following the 'Framework of Reference for Pluralistic Approaches to Languages and Cultures'. It presents two practical teaching examples (one for primary and one for secondary school level) not only to showcase the great learning and motivational potential of pluralistic tasks employed in L3 English classrooms but also to bear testimony to the creativity and plentiful resources today’s pre-service language teachers themselves bring into their multilingual classrooms if encouraged and opened up to such a practice. Based on the FREPA descriptors, the paper evaluates the developed teaching material to discuss implications for pre- and in-service training of teachers working with young learners of diverse linguistic and cultural backgrounds
