1,505 research outputs found
Herbert Gutschera, Joachim Maier, Jörg Thierfelder, Geschichte der Kirchen. Ein ökumenisches Sachbuch mit Bildern, Mayence, éditions Mathias Grünewald - Stuttgart, Quell, 1992
No full textLienhard Marc. Herbert Gutschera, Joachim Maier, Jörg Thierfelder, Geschichte der Kirchen. Ein ökumenisches Sachbuch mit Bildern, Mayence, éditions Mathias Grünewald - Stuttgart, Quell, 1992. In: Revue d'histoire et de philosophie religieuses, 74e année n°3, Juillet-août-septembre 1994. p. 304
Retinale Gefäßverschlüsse: Moderne Therapieansätze
No full textZusammenfassungArterielle Gefäßverschlüsse sollten als Notfall bewertet werden und sind als okuläres Analogon zum zerebralen Apoplex zu sehen. Sie besitzen dieselben arteriosklerotischen Risikofaktoren, die auch bei Herz-, Kreislauf- und zerebrovaskulären Erkrankungen ursächlich sind, weshalb eine intensive interdisziplinäre Abklärung erforderlich ist, um mögliche Komorbiditäten rechtzeitig zu erkennen und gegebenenfalls zu behandeln. Die derzeitigen Therapiemöglichkeiten eines akuten arteriellen Gefäßverschlusses sind in ihrer Effizienz hinsichtlich Visusverbesserung sehr limitiert. Verfahren zur systemischen Lyse können in der Routineversorgung aufgrund ihres deutlich erhöhten Nebenwirkungsprofils nicht empfohlen werden. Hinzu kommt ein begrenztes Zeitfenster von bis zu 6 Stunden nach Symptombeginn (Retinatoleranzzeit), in dem nach Studienlage eine Intervention überhaupt nur sinnvoll zu sein scheint. Dagegen haben die neuen Therapiemöglichkeiten retinaler Venenverschlüsse, insbesondere durch die intravitreale operative Medikamentenapplikation, zu deutlichen Visusverbesserungen geführt. Die Wirksamkeit und Effizienz der einzelnen Anti-VEGF-Medikamente ist nach aktueller Studienlage vergleichbar. Alternativ kann auch der Einsatz von Steroiden erwogen werden, wobei hierbei das Nebenwirkungsprofil sorgfältig abgewogen werden sollte. Des Weiteren kann ergänzend und gerade beim Vorliegen von retinalen Ischämien die periphere Photolaserkoagulation einen visusstabilisierenden Effekt haben und die Ausbildung von Neovaskularisationen verhindern. Es wird angenommen, dass die Kombination aus IVOM- und Lasertherapie einen symbiotischen Effekt haben könnte.</jats:p
Mauersegler weiter Wege. Mathias Enard: Kompass
No full textAnalysis of the peculiar scientific narrative in the novel of the Prix-Goncourt winning author Mathias Enard
Active documents supporting knowledge sharing in knowledge- intensive cooperation
No full textAs the knowledge perspective has become more important and knowledge has been accepted as a resource with ever increasing importance for an organization's success, it has also changed the views on cooperation. Working in partnerships focused on supporting each other in creating and sharing knowledge seems to be an efficient way to reduce costs and enable synergistic effects. This has given rise to the knowledge-intensive cooperation as a special kind of cooperation. A huge amount of transferred knowledge in this kind of cooperation are shared, e.g., by transferring electronic documents. Today, organizations have the choice of a considerable number of knowledge management instruments to support humans to overcome timeor spatial-based barriers concerning knowledge transfer. These instruments can be bundled into complex enterprise knowledge infrastructure (EKI)1 suites. However, these have an organizational focus and are rarely prepared for knowledge that crosses organizational boundaries. Taking into account the considerable efforts for establishing EKIs, start up of an EKI specifically for knowledge-intensive cooperation is expensive, takes a lot of time and, in case of a network of multiple and changing partners, often is infeasible. The goal of this article is offering the concept of active documents as a way to overcome restrictions of EKI in knowledge sharing between organizational boundaries in knowledge-intensive cooperation. Using active documents makes it easy to start document-based knowledge sharing based on a more client perspective. Additionally it offers comfortable possibilities for automatic integration of those documents into a server based EKI in the future
Doppler flow morphology characteristics of epiaortic arteries in aortic valve pathologies: a retrospective study on a cohort of patients with ischemic stroke
No full textAbstract Background and aims Neurovascular ultrasound (nvUS) of the epiaortic arteries is an integral part of the etiologic workup in patients with ischemic stroke. Aortic valve disease shares similar vascular risk profiles and therefore not only presents a common comorbidity, but also an etiologic entity. The aim of this study is to investigate the predictive value of specific Doppler curve flow characteristics in epiaortic arteries and the presence of aortic valve disease. Methods Retrospective, single-center analysis of ischemic stroke patients, both receiving full nvUS of the extracranial common- (CCA), internal- (ICA) and external carotid artery (ECA) and echocardiography (TTE/TEE) during their inpatient stay. A rater blinded for the TTE/TEE results investigated Doppler flow curves for the following characteristics: ‘pulsus tardus et parvus’ for aortic valve stenosis (AS) and ‘bisferious pulse’, ‘diastolic reversal’, ‘zero diastole’ and ‘no dicrotic notch’ for aortic valve regurgitation (AR). Predictive value of these Doppler flow characteristics was investigated using multivariate logistic regression models. Results Of 1320 patients with complete examination of Doppler flow curves and TTE/TEE, 75 (5.7%) showed an AS and 482 (36.5%) showed an AR. Sixty-one (4.6%) patients at least showed a moderate-to-severe AS and 100 (7.6%) at least showed a moderate-to-severe AR. After adjustment for age, coronary artery disease, arterial hypertension, diabetes mellitus, smoking, peripheral arterial disease, renal failure and atrial fibrillation, the following flow pattern predicted aortic valve disease: ‘pulsus tardus et parvus’ in the CCA and ICA was highly predictive for a moderate-to-severe AS (OR 1158.5, 95% CI 364.2–3684.8, p < 0.001). ‘No dicrotic notch’ (OR 102.1, 95% CI 12.4–839.4, p < 0.001), a ‘bisferious pulse’ (OR 10.8, 95% CI 3.2–33.9, p < 0.001) and a ‘diastolic reversal’ (OR 15.4, 95% CI 3.2–74.6, p < 0.001) in the CCA and ICA predicted a moderate-to-severe AR. The inclusion of Doppler flow characteristics of the ECA did not increase predictive value. Conclusions Well defined, qualitative Doppler flow characteristics detectable in the CCA and ICA are highly predictive for aortic valve disease. The consideration of these flow characteristics can be useful to streamline diagnostic and therapeutic measures, especially in the outpatient setting
Les commissions électorales en Afrique de l'Ouest
No full text[author: Mathias Hounkpe ; Ismaila Madior Fall]Electronic ed.: Abuja ; Bonn : FES, 201
ASPECTOS TEÓRICOS ACERCA DE TAREFAS QUE DESENVOLVEM AS HABILIDADES DE VISUALIZAÇÃO ESPACIAL
No full textSpatial Visualization Skills (SVS) represent one of the pillars of geometric thinking, which is an important competence in cognitive and mathematical development. In this way, there are vast researches that investigate and analyze these tasks and the need to understand which specific skills each type of task develops emerges. In this context, the objective of this article is to analyze how tasks that demand SVS have been classified throughout the literature. Therefore, this qualitative bibliographic research describes and correlates Del Grande\u27s Spatial Skills (1994), Maier\u27s Five Elements of Spatial Thinking (1996) and Visualization Actions by Gonzato, Fernández and Díaz (2011) with Categorization of Visualization Actions by Mathias and Simas (2021) designed for the analysis of textbook tasks that require SVS. Based on the discussions, this research expands the specific skills addressed by these authors and discusses how the Visualization Actions defined in Mathias and Simas (2021) broadly contemplate SVS and can be used as a basis for future analysis of visualization tasks.Las Habilidades de Visualización Espacial (HVE) representan uno de los pilares del pensamiento geométrico, que es una competencia importante en el desarrollo cognitivo y matemático. De esta forma, existen vastas investigaciones que investigan y analizan estas tareas y surge la necesidad de comprender qué habilidades específicas desarrolla cada tipo de tarea. En este contexto, el objetivo de este artículo es analizar cómo las tareas que demandan HVE han sido clasificadas a lo largo de la literatura. Por tanto, esta investigación bibliográfica cualitativa describe y correlaciona las Habilidades Espaciales de Del Grande (1994), los Cinco Elementos del Pensamiento Espacial de Maier (1996) y las Acciones de Visualización de Gonzato, Fernández y Díaz (2011) con la Categorización de las Acciones de Visualización de Mathias y Simas (2021). diseñado para el análisis de tareas de libros de texto que requieren HVE. Con base en las discusiones, esta investigación amplía las habilidades específicas abordadas por estos autores y discute cómo las Acciones de Visualización definidas en Mathias y Simas (2021) contemplan ampliamente la HVE y pueden ser utilizadas como base para futuros análisis de tareas de visualización.As Habilidades de Visualização Espacial (HVE) representam um dos pilares do pensamento geométrico, que é uma importante competência no desenvolvimento cognitivo e matemático. Dessa forma, são vastas as pesquisas que investigam e analisam essas tarefas e emerge a necessidade de compreender quais habilidades específicas cada tipo de tarefa desenvolve. Nesse contexto, o objetivo deste artigo é analisar como as tarefas que demandam HVE têm sido classificadas ao longo da literatura. Sendo assim, esta pesquisa bibliográfica de abordagem qualitativa descreve e correlaciona as Aptidões Espaciais de Del Grande (1994), os Cinco Elementos do Pensamento Espacial de Maier (1996) e as Ações de Visualização de Gonzato, Fernández e Díaz (2011) com a Categorização de Ações de Visualização de Mathias e Simas (2021) elaboradas para a análise de tarefas de livros didáticos que demandam HVE. A partir das discussões, esta pesquisa expande as habilidades específicas abordadas por esses autores e discute como as Ações de Visualização definidas em Mathias e Simas (2021) contemplam as HVE de forma ampla e podem ser utilizadas como base para futuras análises de tarefas de visualização
Methylprednisolone increases neuronal apoptosis during autoimmune CNS inflammation by inhibition of an endogenous neuroprotective pathway
No full textOptic neuritis is one of the most common clinical manifestations of multiple sclerosis ( MS), a chronic inflammatory disease of the CNS. High-dosage methylprednisolone treatment has been established as the standard therapy of acute inflammation of the optic nerve ( ON). The rationale for corticosteroid treatment lies in the antiinflammatory and immunosuppressive properties of these drugs, as shown in experimental autoimmune encephalomyelitis (EAE), the animal model of MS. To investigate the influence of methylprednisolone therapy on the survival of retinal ganglion cells (RGCs), the neurons that form the axons of the ON, we used a rat model of myelin oligodendrocyte glycoprotein (MOG)-induced EAE. Optic neuritis was diagnosed by recording visual evoked potentials, and RGC function was monitored by measuring electroretinograms. Methylprednisolone treatment significantly increased RGC apoptosis during MOG-EAE. By Western blot analysis, we identified the underlying molecular mechanism: a suppression of mitogen-activated protein kinase ( MAPK) phosphorylation, which is a key event in an endogenous neuroprotective pathway. The methylprednisolone-induced inhibition of MAPK phosphorylation was calcium dependent. Hence, we provide evidence for negative effects of steroid treatment on neuronal survival during chronic inflammatory autoimmune disease of the CNS, which should result in a reevaluation of the current therapy regimen
Predictive Factors for the Need of Tracheostomy in Patients With Large Vessel Occlusion Stroke Being Treated With Mechanical Thrombectomy
No full textBackground: Patients with large vessel occlusion stroke (LVOS) eligible for mechanical thrombectomy (MT) are at risk for stroke- and non-stroke-related complications resulting in the need for tracheostomy (TS). Risk factors for TS have not yet been systematically investigated in this subgroup of stroke patients. Methods: Prospectively derived data from patients with LVOS and MT being treated in a large, academic neurological ICU (neuro-ICU) between 2014 and 2019 were analyzed in this single-center study. Predictive value of peri- and post-interventional factors, stroke imaging, and pre-stroke medical history were investigated for their potential to predict tracheostomy during ICU stay using logistic regression models. Results: From 635 LVOS-patients treated with MT, 40 (6.3%) underwent tracheostomy during their neuro-ICU stay. Patients receiving tracheostomy were younger [71 (62–75) vs. 77 (66–83), p < 0.001], had a higher National Institute of Health Stroke Scale (NIHSS) at baseline [18 (15–20) vs. 15 (10–19), p = 0.009] as well as higher rates of hospital acquired pneumonia (HAP) [39 (97.5%) vs. 224 (37.6%), p < 0.001], failed extubation [15 (37.5%) vs. 19 (3.2%), p < 0.001], sepsis [11 (27.5%) vs. 16 (2.7%), p < 0.001], symptomatic intracerebral hemorrhage [5 (12.5%) vs. 22 (3.9%), p = 0.026] and decompressive hemicraniectomy (DH) [19 (51.4%) vs. 21 (3.8%), p < 0.001]. In multivariate logistic regression analysis, HAP (OR 21.26 (CI 2.76–163.56), p = 0.003], Sepsis [OR 5.39 (1.71–16.91), p = 0.004], failed extubation [OR 8.41 (3.09–22.93), p < 0.001] and DH [OR 9.94 (3.92–25.21), p < 0.001] remained as strongest predictors for TS. Patients with longer periods from admission to TS had longer ICU length of stay ( r = 0.384, p = 0.03). There was no association between the time from admission to TS and clinical outcome (NIHSS at discharge: r = 0.125, p = 0.461; mRS at 90 days: r = −0.179, p = 0.403). Conclusions: Patients with LVOS undergoing MT are at high risk to require TS if extubation after the intervention fails, DH is needed, and severe infectious complications occur in the acute phase after ischemic stroke. These factors are likely to be useful for the indication and timing of TS to reduce overall sedation and shorten ICU length of stay.Background: Patients with large vessel occlusion stroke (LVOS) eligible for mechanical thrombectomy (MT) are at risk for stroke- and non-stroke-related complications resulting in the need for tracheostomy (TS). Risk factors for TS have not yet been systematically investigated in this subgroup of stroke patients. Methods: Prospectively derived data from patients with LVOS and MT being treated in a large, academic neurological ICU (neuro-ICU) between 2014 and 2019 were analyzed in this single-center study. Predictive value of peri- and post-interventional factors, stroke imaging, and pre-stroke medical history were investigated for their potential to predict tracheostomy during ICU stay using logistic regression models. Results: From 635 LVOS-patients treated with MT, 40 (6.3%) underwent tracheostomy during their neuro-ICU stay. Patients receiving tracheostomy were younger [71 (62–75) vs. 77 (66–83), p < 0.001], had a higher National Institute of Health Stroke Scale (NIHSS) at baseline [18 (15–20) vs. 15 (10–19), p = 0.009] as well as higher rates of hospital acquired pneumonia (HAP) [39 (97.5%) vs. 224 (37.6%), p < 0.001], failed extubation [15 (37.5%) vs. 19 (3.2%), p < 0.001], sepsis [11 (27.5%) vs. 16 (2.7%), p < 0.001], symptomatic intracerebral hemorrhage [5 (12.5%) vs. 22 (3.9%), p = 0.026] and decompressive hemicraniectomy (DH) [19 (51.4%) vs. 21 (3.8%), p < 0.001]. In multivariate logistic regression analysis, HAP (OR 21.26 (CI 2.76–163.56), p = 0.003], Sepsis [OR 5.39 (1.71–16.91), p = 0.004], failed extubation [OR 8.41 (3.09–22.93), p < 0.001] and DH [OR 9.94 (3.92–25.21), p < 0.001] remained as strongest predictors for TS. Patients with longer periods from admission to TS had longer ICU length of stay ( r = 0.384, p = 0.03). There was no association between the time from admission to TS and clinical outcome (NIHSS at discharge: r = 0.125, p = 0.461; mRS at 90 days: r = −0.179, p = 0.403). Conclusions: Patients with LVOS undergoing MT are at high risk to require TS if extubation after the intervention fails, DH is needed, and severe infectious complications occur in the acute phase after ischemic stroke. These factors are likely to be useful for the indication and timing of TS to reduce overall sedation and shorten ICU length of stay
Methylprednisolone increases neuronal apoptosis during autoimmune CNS inflammation by inhibition of an endogenous neuroprotective pathway
No full textOptic neuritis is one of the most common clinical manifestations of multiple sclerosis ( MS), a chronic inflammatory disease of the CNS. High-dosage methylprednisolone treatment has been established as the standard therapy of acute inflammation of the optic nerve ( ON). The rationale for corticosteroid treatment lies in the antiinflammatory and immunosuppressive properties of these drugs, as shown in experimental autoimmune encephalomyelitis (EAE), the animal model of MS. To investigate the influence of methylprednisolone therapy on the survival of retinal ganglion cells (RGCs), the neurons that form the axons of the ON, we used a rat model of myelin oligodendrocyte glycoprotein (MOG)-induced EAE. Optic neuritis was diagnosed by recording visual evoked potentials, and RGC function was monitored by measuring electroretinograms. Methylprednisolone treatment significantly increased RGC apoptosis during MOG-EAE. By Western blot analysis, we identified the underlying molecular mechanism: a suppression of mitogen-activated protein kinase ( MAPK) phosphorylation, which is a key event in an endogenous neuroprotective pathway. The methylprednisolone-induced inhibition of MAPK phosphorylation was calcium dependent. Hence, we provide evidence for negative effects of steroid treatment on neuronal survival during chronic inflammatory autoimmune disease of the CNS, which should result in a reevaluation of the current therapy regimen
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