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Predictors of malignant swelling in space-occupying cerebellar infarction
Get PDFBackground : Malignant swelling is a fatal complication that can occur abruptly in space-occupying cerebellar infarction. We aimed to establish markers that predict malignant swelling in cerebellar infarction. Methods : We retrospectively analysed data of stroke patients who were treated in our hospital between 2014 and 2020. Malignant swelling was defined as a mass effect in the posterior cranial fossa, accompanied by a decrease in consciousness due to compression of the brainstem and/or the development of obstructive hydrocephalus. Statistical analyses were performed on multiple variables to identify predictors of malignant swelling. Results : Among 7284 stroke patients, we identified 487 patients with an infarct in the cerebellum. 93 patients were suitable for analysis having space-occupying cerebellar infarction. 33 of 93 (35.5%) patients developed malignant swelling. Multivariable analysis revealed infarct volume as the main predictor being independently associated with the development of malignant swelling with a cut-off infarct volume of 38 cm3 being associated with a swelling rate of >50% (OR 32.0, p<0.001). Higher NIHSS (National Institutes of Health Stroke Scale) score on admission (median NIHSS 12 vs 4, OR 1.078; p=0.008) and the presence of additional brainstem infarction (51.5% vs 16.7%, OR 5.312; p=0.013) were associated with the development of malignant swelling in univariate analyses. 13 of 33 (39.4%) cases of malignant swellings occurred after more than 3 days. Conclusions : Infarct volume was the key significant predictor of malignant swelling in space-occupying cerebellar infarction. With many cases of malignant swelling occurring after more than 72 hours, we advocate prolonged neurological monitoring
Dynamic programming and dimensionality in convex stochastic optimization and control
Get PDFThis paper studies stochastic optimization problems and associated Bellman equations in formats that allow for reduced dimensionality of the cost-to-go functions. In particular, we study stochastic control problems in the ``decision-hazard-decision'' form where at each stage, the system state is controlled both by predictable as well as adapted controls. Such an information structure may result in a lower dimensional system state than what is required in more traditional ``decision-hazard'' or ``hazard-decision'' formulations. The dimension is critical for the complexity of numerical dynamic programming algorithms and, in particular, for cutting plane schemes such as the stochastic dual dynamic programming algorithm. Our main result characterizes optimal solutions and optimum values in terms of solutions to generalized Bellman equations. Existence of solutions to the Bellman equations is established under general conditions that do not require compactness. We allow for general randomness but show that, in the Markovian case, the dimensionality of the Bellman equations reduces with respect to randomness just like in more traditional control formulations
Monoprotonated species of 2-aminomalonyl difluoride, [C3H4F2NO2][H2F3]
Get PDFThe monoprotonated species of 2-aminomalonyl difluoride, namely, 1,3-difluoro-1,3-dioxopropan-2-aminium dihydrogen trifluoride, [C3H4F2NO2][H2F3],was synthesized from sulfur tetrafluoride in anhydrous hydrogen fluoride (aHF) with [NH4][C3H5NO4] as the starting material. The solvent was removed and the salt was dissolved in aHF and crystallized. In the solid state, the three-dimensional network is built by medium–strong N—H...F hydrogen bonds and C...F contacts. This is the first structure determination of an aminoacyl difluoride and the second of an aminoacyl fluoride
Working from home as an adaptation strategy to heat: Comparing temperatures and workers’ assessments for 203 offices and 107 homes
Get PDFThis contribution considers whether working from home (WFH) can be an effective adaptation to increasing summer heat for office workers. The mixed-method study presents temperature data from 203 offices and 107 home workspaces in Southern Germany, along with survey data from >100 workers at both locations during a hot period in June 2023. Home workplaces had both lower mean temperatures and less occurrence of elevated temperatures or overheating (operationalised as degree hours above 26 °C and 30 °C) than passive offices. A comparison with mechanically cooled offices is offered, but should be interpreted cautiously due to the small N and energy saving measures being in place at the time. Measured temperatures had significant effects on workers’ perceived heat stress and productivity in a mixed-effects regression model. Individual variables age, gender, general activity level and general thermal preference were also explored. Barriers for WFH were explored through stakeholder interviews. We conclude that flexible WFH can be a means to protect workers’ health depending on the specific office and work situation, and could offer workers better adaptive options and potentially a slight psychological benefit
Urinary diversion and quality of life: A six-year follow-up study of bladder cancer surgery
Get PDFObjectives
To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.
Patients and methods
This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.
Results
Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS > 70) were observed between ONB and IC at six years (IC: 60 ± 22; ONB: 69 ± 23, p = 0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p = 0.01; 6 years: p = 0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p = 0.04).
Conclusion
Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.Objetivos
Evaluar la calidad de vida relacionada con la salud (CVRS) a los seis años de la cistectomía radical en pacientes con cáncer de vejiga músculo-invasor, comparando la neovejiga ileal ortotópica (NIO) y el conducto ileal (CI). El objetivo del estudio fue analizar los efectos a largo plazo (y poco estudiados) de los tratamientos estándar para el cáncer de vejiga en la CVRS y proporcionar información sobre las diferencias en la CVRS asociadas con estos dos métodos comunes de derivación urinaria.
Pacientes y métodos
Este estudio prospectivo incluyó a 39 pacientes con carcinoma urotelial tratados con NIO o CI en nuestro centro entre 03/2013 y 01/2023. Se excluyeron pacientes con histología variante, metástasis, quimioterapia neoadyuvante o enfermedades benignas como indicación para la cistectomía. La CVRS se evaluó mediante el cuestionario QLQ-C30 de la European Organization for Research and Treatment of Cancer (EORTC) en el preoperatorio y a los cuatro y seis años del postoperatorio. Los análisis estadísticos incluyeron pruebas de Chi-cuadrado, pruebas T y modelos de regresión logística.
Resultados
Del total de pacientes, el 64% (25/39) fue sometido a NIO, y el 76,9% (30/39) eran varones, con una edad media de 69 años. No se observaron diferencias significativas en cuanto a buena CVRS global (ESG > 70) entre la NIO y el CI a los seis años (CI: 60 ± 22; NIO: 69 ± 23, p = 0,2). Los pacientes con CI refirieron mayor insomnio en los dos controles de seguimiento (4 años: p = 0,01; 6 años: p = 0,03). El estado emocional se mantuvo estable en los pacientes con NIO, pero disminuyó en los pacientes con CI del cuarto al sexto año (p = 0,04).
Conclusiones
La CVRS a largo plazo no mostró diferencias significativas entre la NIO y el CI durante los primeros seis años tras la cistectomía radical. Ambos métodos de derivación urinaria pueden ser opciones viables para los pacientes, con un asesoramiento personalizado basado en la CVRS de cada caso
How variants in inflammatory mediator genes influence symptom severity of psychiatric disorders: Findings from the PsyCourse study
Get PDFAlterations in glial cell function and cytokine levels in the central nervous system may be influenced by neuroinflammatory processes, which have a pathogenic role in psychiatric disorders. Variability in genes that encode inflammatory mediators is associated with risk of developing mental disorders. Therefore, by analyzing data from the transdiagnostic PsyCourse Study, we aimed to investigate whether variations in inflammatory mediator genes are associated with current symptom severity.
We used cross-sectional data from 1320 individuals with a psychiatric disorder and 466 neurotypical individuals. Outcome variables were the psychopathological data from various rating scales and questionnaires that measured depressive, psychotic, and manic symptoms. Furthermore, from a whole-genome SNP array dataset, we extracted single nucleotide polymorphisms (SNPs) in the loci of genes related to inflammatory mediators, and we performed an association analysis by considering covariates. False discovery rate (FDR) was used to adjust the results for multiple comparisons.
A total of 1594 individuals and 1336 SNPs were included in the analyses. The results of regression analysis showed a significant positive association of six SNPs located on the interleukin (IL)-1 receptor type 1 (IL-1R1) gene locus with Altman Self-Rating Mania Scale scores (FDR-adjusted p value < 0.05).
Our findings show that genetic variations in IL-1R1 may influence the pathophysiology of psychiatric disorders by affecting brain cytokine profiles associated with manic episodes. IL-1R1 encodes a membrane-bound receptor for IL-1. Several physiological functions, including inflammation, are linked to the IL-1/IL-1R1 signaling pathway. Replication of our findings is warranted
Responsibility as Method - A Model for Operationalizing Ethical Reflection in the Sciences
No full textIn this article, we show why the growing significance of ethics entails that the call for ethical evaluations is no longer just a specific issue for the particular discipline of academic ethics but a challenge for all academic researchers. Therefore, complex theoretical approaches must be put into practice, and the relationship between ethics and other scientific fields must be clarified. Hence, this essay shows how these requirements can be fulfilled and how to cope with the complexity of ethical consideration on a practical level. We aim to operationalize responsibility as a method. In order to achieve this, basic criteria of practical ethical reflection are elaborated. As a result, we suggest an extended ethical matrix covering the entire research process using a step-by-step model. Our ethical matrix is designed to help researchers reflect and make judgments on moral and ethical issues, enabling them to find their own solutions to these challenges without providing a formal guideline for moral decision-making
Von Statusdiagnostik zur prozessorientierten Förderdiagnostik.Pädagogisches Konzept für Seminare und Praktikum zur Diagnostik im Lehramt Sonderpädagogik - Förderschwerpunkt Lernen.
Get PDFStudierende der Sonderpädagogik mit dem Förderschwerpunkt Lernen erwerben im Studium vertiefte Konzepte zur pädagogischen Diagnostik, um sonderpädagogische Gutachten und Förderplanung in der pädagogischen Praxis durchzuführen. Im Studium wird neben der Statusdiagnostik auch auf prozessorientierte Diagnostik wertgelegt. Daher wird im studienbegleitenden sonderpädagogischen Praktikum die Verknüpfung von Lernverlaufsdiagnostik und individueller Förderung in den Basiskompetenzen Deutsch und Mathematik für einen bis drei Schüler:innen praktiziert. Das nachfolgende Konzept beschreibt daher die Gestaltung der Veranstaltungen zu den Grundlagen der Förderdiagnostik, pädagogische Diagnostik, Testtheorie, Statusdiagnostik, Förderplanentwurf sowie Durchführung von Förderung und Lernverlaufsdiagnostik im sonderpädagogischen Praktikum. Im Anhang sind zudem die Dokumentenvorlagen für die Ausarbeitung einer Kleingruppenförderung mit lernbegleitender Diagnostik zu finden
Residential greenspace and lung function throughout childhood and adolescence in five European birth cohorts. A CADSET initiative
No full textWhether greenspace affects lung function is unclear. We explored associations between the level of greenness or presence of urban green space near the home with lung function measures taken repeatedly during childhood and adolescence in five European birth cohorts.
Lung function was measured by spirometry between six and 22 years (2–3 times), and 9,206 participants from BAMSE (Sweden), GINI/LISA South and GINI/LISA North (Germany), PIAMA (The Netherlands) and INMA (Spain) contributed at least one lung function measurement. The mean Normalized Difference Vegetation Index (NDVI) in a 300 m buffer and presence of urban green space within a 300 m buffer (yes/no) were estimated at the home address at the time of each spirometry measurement. Cohort-specific associations were assessed using adjusted linear mixed models and combined in a random-effects meta-analysis.
Residential greenness was not associated with forced expiratory volume in one second (FEV1), forced vital capacity (FVC) or FEV1/FVC in the meta-analysis (2.3 ml [-3.2, 7.9], 6.2 ml [-3.4, 15.7] and −0.1 [-0.3, 0.1] per 0.1 increase in NDVI, respectively), nor was having a nearby urban green space (−8.6 ml [–22.3, 5.0], −7.6 ml [-24.7, 9.4] and 0.0 [-0.4, 0.3], respectively). Heterogeneity was low to moderate (I2 = 0 –39 %). Asthma, atopy, air pollution, sex, socioeconomic status and urbanization did not modify the null associations.
Using repeated data from five large independent European birth cohorts, we did not find associations between vegetation levels around the home or the presence of an urban green space and lung function levels during childhood and adolescence
