bluuebunny/crossref_metadata_2025 huggingface dataset:
The Leading Mode of Observed and CMIP5 ENSO-Residual Sea Surface Temperatures and Associated Changes in Indo-Pacific Climate*
Authors: Funk Chris C. , Hoell Andrew
Published: February 2015

SSTs in the western Pacific Ocean have tracked closely with CMIP5 simulations despite recent hiatus cooling in the eastern Pacific. This paper quantifies these similarities and associated circulation and precipitation variations using the first global 1900–2012 ENSO-residual empirical orthogonal functions (EOFs) of 35 variables: observed SSTs; 28 CMIP5 SST simulations; Simple Ocean Data Assimilation (SODA) 25-, 70-, and 171-m ocean temperatures and sea surface heights (SSHs); and Twentieth Century Reanalysis, version 2 (20CRv2), surface winds and precipitation.

While estimated independently, these leading EOFs across all variables fit together in a meaningful way, and the authors refer to them jointly as the west Pacific warming mode (WPWM). WPWM SST EOFs correspond closely in space and time. Their spatial patterns form a “western V” extending from the Maritime Continent into the extratropical Pacific. Their temporal principal components (PCs) have increased rapidly since 1990; this increase has been primarily due to radiative forcing and not natural decadal variability.

WPWM circulation changes appear consistent with a Matsuno–Gill-like atmospheric response associated with an ocean–atmosphere dipole structure contrasting increased (decreased) western (eastern) Pacific precipitation, SSHs, and ocean temperatures. These changes have enhanced the Walker circulation and modulated weather on a global scale. An AGCM experiment and the WPWM of global boreal spring precipitation indicate significant drying across parts of East Africa, the Middle East, the southwestern United States, southern South America, and Asia. Changes in the WPWM have tracked closely with precipitation and the increase in drought frequency over the semiarid and water-insecure areas of East Africa, the Middle East, and southwest Asia.
Microstructure–property relationships in TRIP aided medium-C bainitic steel with lamellar retained austenite
Authors: Grajcar A. , Kwaśny W. , Zalecki W.
Published: February 2015

This work discusses the development of the microstructure and mechanical properties of medium-carbon steel that contains silicon, aluminium and microadditions of Nb and Ti. Two cooling strategies were designed based on the thermodynamic equilibrium calculations and continuous cooling transformation diagram, which was determined for plastically deformed austenite. The cooling paths enabled the production of ferrite based and bainite based steels. The specimens were obtained via the thermomechanical rolling process with isothermal holding of steel at 450°C. Microstructure investigations were performed using light, scanning and transmission microscopy methods. The distribution and amount of retained austenite were determined using the electron backscatter diffraction technique, whereas transmission electron microscopy allowed the identification of the morphology of the γ phase. The amount of austenite and its carbon content were assessed using X-ray diffraction. Relations between microstructure and mechanical properties were formulated based on the mechanical stability of the retained austenite.
Element mobility during the formation of the Uzunisa-Ordu bentonite, NE Turkey, and potential applications
Authors: Özdamar Ş. , Ece Ö. I. , Uz B. , Boylu F. , Ercan H. Ü. , Yanik G.
Published: February 2015

Dacitic andesitic calc-alkaline lavas and their pyroclastic rocks of Upper Cretaceous age are widespread in the Ordu area, eastern Black Sea Coast of Turkey. Ca-bentonite and Ca/Nabentonite deposits with significant economic potential formed in the broader region. The mineralogy and geochemistry of these deposits were studied by X-ray diffraction (XRD), scanning electron microscopy (SEM) and chemical analyses. The parent rocks (PR) and bentonite samples were analysed for the major and trace element contents, including rare-earth elements, to understand the effect of differential alterations on element mobility. The bentonites contain mainly di-octahedral Ca-montmorillonite with minor amounts of illite, quartz, calcite, dolomite and feldspar. Primary K-feldspar and plagioclase phenocrysts were altered in the bentonite horizons, and were completely leached at greater depth. For this reason, the higher quality bentonites are found at deeper zones. Bentonite horizons are characterized by relatively high loss on ignition (LOI: 9.8–20.8%) and MgO content (3–5%) and low K2O (<0.5%) and Na2O (<2%) contents compared with the least altered parent rocks. Silicon, Ca, Mg, Mn and P are markedly enriched whereas Fe, Na, K and Ti are depleted in the bentonite samples. The chondrite-normalized rare earth element (REE) patterns show identical trends characterized by strong light rare earth element (LREE) enrichment in both the PR and bentonite samples. The LREE contents are higher than those of their heavy counterparts (HREE) in the samples. Alteration of the PR to bentonite is associated with intense chemical leaching and subsequent removal of K and Na in open-system conditions.
Activation of kaolin with minimum solvent consumption by microwave heating
Authors: Al Bakain R. Z. , Al-Degs Y. S. , Issa A. A. , Abdul Jawad S. , Abu Safieh K. A. , Al-Ghouti M. A.
Published: February 2015

A kaolin clay was activated with 1.0 M H2SO4 solution at minimum liquid to solid ratio (L/S) using microwave heating. The optimum experimental conditions for activation were L/S ratio 3.0 mL 1 M H2SO4 per gram kaolin, microwave input power 500–600 W, and heating time 5–10 min. Activation at L/S < 3.0 mL/g using 1.0 M H2SO4 was not efficient, indicating the influence of solvent for absorbing microwaves more intensively and thus improving activation. Significant physicochemical changes were observed by the proposed procedure with smaller volumes of activator compared to the conventional heating method. Microwave input power and heating time have a strong influence on the quality of the final material; activation at high input power (>700 W) and longer heating times (>10 min.) are not recommended since they cause dissolution of kaolinite structure. Microwave-heated kaolin manifested better adsorption for tartrazine dye due to improvements in textural and chemical properties of kaolinite. Moreover, irradiation of used kaolinite has significantly improved dye desorption, increasing the importance of microwaves in regeneration/recycling studies. Detailed dielectric measurements of kaolin-acid mixtures recorded at frequencies much lower than 2.45 GHz revealed that absorption of radiation is highly dependent on the activator solution in the mixture. For 3.0 mL/g mixtures, high dielectric constant ε’ 5223, dielectric loss factor ε” 5083, tangent loss tan d 1.30, penetration depth dp 0.57 cm at (103 Hz), and AC-conductivity σ 0.032 Om–1 were determined at 105 Hz. Filling the pores of kaolin by acid solution increased the microwave absorption and hence de-alumination of kaolinite.
Clay mineralogy in southern Africa river muds
Authors: Setti M. , Lόpez-Galindo A. , Padoan M. , Garzanti E.
Published: February 2015

The composition, morphology and crystal order of clay minerals in silt-sized sediments carried in suspensions from 25 major rivers across tropical southern Africa have been studied by X-ray diffractometry and scanning and transmission electron microscopy. Our goal was to determine the spatial variability of clay-mineral associations in diverse geological settings, and in climatic conditions ranging from humid Angola and Zambia to hyperarid Namibia and the Kalahari. Specific attention was paid to the micromorphology and chemical composition of smectite particles. The relative abundance of smectites, illite/mica, kaolinite and chlorite enabled identification of regions characterized by different physical and chemical processes: (1) negligible chemical weathering is documented in Namibia, where river muds mostly contain illite/mica or smectite derived from Damara metasedimentary or Etendeka volcanic rocks; (2) kaolinite documenting intense weathering, reaches a maximum in the Okavango, Kwando and Upper Zambezi, sourced in subequatorial Angola and Zambia; (3) suspended-load muds in the Limpopo and middle Zambezi catchments display intermediate features, with varied assemblages and smectite compositions reflecting diverse parent lithologies. Clay mineralogy and chemical composition are confirmed as a most effective tool to unravel present and past climatic conditions on a continental scale.
Aberrant B-cell homeostasis in chronic GVHD
Authors: Sarantopoulos Stefanie , Ritz Jerome
Published: February 2015

Recent studies have compelled further interest in the potential pathological role of B cells in chronic graft-versus-host disease (cGVHD). In patients with cGVHD, B cells are activated and primed for survival via B-cell activating factor and B-cell receptor–associated pathways. Understanding the signaling pathways that drive immune pathology in cGVHD will facilitate the development of new strategies to selectively target aberrantly activated B cells and restore normal B-cell homeostasis after allogeneic stem cell transplantation.
Effect of high-dose dexamethasone on perioperative lactate levels and glucose control: a randomized controlled trial
Authors: Ottens Thomas H , Nijsten Maarten WN , Hofland Jan , Dieleman Jan M , Hoekstra Miriam , van Dijk Diederik , van der Maaten Joost MAA
Published: February 2015

Introduction

Blood lactate levels are increasingly used to monitor patients. Steroids are frequently administered to critically ill patients. However, the effect of steroids on lactate levels has not been adequately investigated. We studied the effect of a single intraoperative high dose of dexamethasone on lactate and glucose levels in patients undergoing cardiac surgery.

Methods

The Dexamethasone for Cardiac Surgery (DECS) trial was a multicenter randomized trial on the effect of dexamethasone 1 mg/kg versus placebo on clinical outcomes after cardiac surgery in adults. Here we report a pre-planned secondary analysis of data from DECS trial participants included at the University Medical Center Groningen. The use of a computer-assisted glucose regulation protocol—Glucose Regulation for Intensive care Patients (GRIP)—was part of routine postoperative care. GRIP aimed at glucose levels of 4 to 8 mmol/L. Primary outcome parameters were area under the lactate and glucose curves over the first 15 hours of ICU stay (AUC15). ICU length of stay and mortality were observed as well.

Results

The primary outcome could be determined in 497 patients of the 500 included patients. During the first 15 hours of ICU stay, lactate and glucose levels were significantly higher in the dexamethasone group than in the placebo group: lactate AUC15 25.8 (13.1) versus 19.9 (11.2) mmol/L × hour, P <0.001 and glucose AUC15 126.5 (13.0) versus 114.4 (13.9) mmol/L × hour, P <0.001. In this period, patients in the dexamethasone group required twice as much insulin compared with patients who had received placebo. Multivariate and cross-correlation analyses suggest that the effect of dexamethasone on lactate levels is related to preceding increased glucose levels. Patients in the placebo group were more likely to stay in the ICU for more than 24 hours (39.2%) compared with patients in the dexamethasone group (25.0%, P = 0.001), and 30-day mortality rates were 1.6% and 2.4%, respectively (P = 0.759).

Conclusions

Intraoperative high-dose dexamethasone increased postoperative lactate and glucose levels in the first 15 hours of ICU stay. Still, patients in the dexamethasone group had a shorter ICU length of stay and similar mortality compared with controls.

Trial registration

ClinicalTrials.gov NCT00293592. Registered 16 February 2006.
Beyond dependency: the promise of Confucianism in Post-Westphalia International relations
Authors: Yue Ricky Wai-kay
Published: February 2015

The landscape of post-colonial development is marked by deepening dependency of the developing states on the core states consisted mainly of western developed countries. The continuous widening of the north–south divide is not surprising given that the discourse on international relations has been dominated by western ideologies of realism, liberalism and constructivism, resulting in an insufficient attempt to examine international relations from a non-Westphalian perspective. Through the implementation of the Washington Consensus, developing countries are being forced to follow the development model of liberal democracy designed by the West, for the benefit of the West. This paper attempts to investigate an alternative approach from a Chinese historical structural perspective. By highlighting the key tenets of Confucianism, this paper aims to contribute towards a non-Western international relations discourse that is based on moral values. Attempts by China to provide assistance to the “poor south” are marred by accusations of neo-colonialism. In order to fulfil its great power responsibility, China needs to incorporate these Confucian values into its Beijing Consensus so that the global south can abandon their dependency on the West and truly set the stage for south-south cooperation.
On Memoirs of My Nervous Illness, by Daniel Paul Schreber–
reflection
Authors: Sass Louis
Published: February 2015

Daniel Paul Schreber's Memoirs of my Nervous Illness
profoundly influenced many key figures of modern psychiatry, including
Bleuler and Jaspers, Freud and Jung. Author Elias Canetti described it as
the ‘most important document in psychiatric literature’. To read this work –
typically considered a paradigmatic expression of paranoid schizophrenia –
is to risk a shaking of one's complacency, especially concerning the key
symptom of delusion. For me personally, it was a revelation.
A gilded cage is still a cage: Cheshire West
widens ‘deprivation of liberty’
Authors: Penny Catherine , Exworthy Tim
Published: February 2015

The Supreme Court's recent judgment in Cheshire West has
clarified, and broadened, the legal definition of deprivation of liberty,
with the new definition reflecting the fact that human rights apply to
everyone in the same way. The widely criticised Deprivation of Liberty
Safeguards need to be replaced: recommendations for reform are set out.
Just a room–extra
Authors: Wadlow Clare
Published: February 2015

I am a room. Just a room. Nothing peculiar about me. Well, I don't think
that I am special. Though you might say that my walls are dull and my paint
is peeling a little, yes. You may comment that I don't seem very cosy. I
imagine you think me rather sparse. You might point out that I haven't a
curtain rail or a bar in my wardrobe to hang a hanger. My coat hooks are
rather unusual and I seem to have mislaid my bathroom plug. Yet I am proud
of my en suite wet room, well wouldn't you be? I have a big window, though
it doesn't open very far. Look, I have a box of tissues and another of
chocolates. There is a picture on the wall. That blu tack might make my
paint a little worse but I think it's worth the risk.
Community psychiatry–100 words
Authors: Craig Tom K. J.
Published: February 2015

We are social animals that exist in networks of family, friends and
acquaintances. The size and quality of these networks and the environments
within which they are embedded have profound influences on mental health.
Community psychiatry is about shaping the content and delivery of mental
healthcare to take account of this reality. It necessarily involves efforts
to improve network support including, for example, family interventions,
supported employment and peer support. Efforts to tackle stigma and to
mitigate toxic environments are also essential. Closing asylums and
developing systems to deliver care to people's homes is a job started, not
job done.
Anti-NMDA-receptor encephalitis presenting with catatonia and neuroleptic malignant syndrome in patients with intellectual disability and autism
Authors: Kiani Reza , Lawden Mark , Eames Penelope , Critchley Peter , Bhaumik Sabyasachi , Odedra Sunita , Gumber Rohit
Published: February 2015

We report anti-N-methyl-d-aspartate (NMDA) receptor encephalitis in two patients with autism and intellectual disability presenting with neuropsychiatric symptoms of catatonia and neuroleptic malignant syndrome. Case reports such as these help raise awareness of this clinical issue. By paving the way for earlier diagnoses they ultimately maximise the potential for curative treatments and prevention of long-term complications.
The planning, implementation and publication of a complex intervention trial for chronic fatigue syndrome: the PACE trial
Authors: White Peter D. , Chalder Trudie , Sharpe Michael
Published: February 2015

The PACE trial was a four-arm trial of specialist medical care, compared with specialist medical care with a supplementary therapy: adaptive pacing therapy, cognitive–behavioural therapy or graded exercise therapy, for patients with chronic fatigue syndrome. The trial found that both cognitive–behavioural and graded exercise therapies were more effective than either of the other two treatments in reducing fatigue and improving physical disability. This paper describes the design, conduct and main results of the trial, along with a description of the challenges that had to be overcome in order to produce clear answers to the clinically important questions the trial posed.
The Creation of a Social Problem: Youth Culture, Drugs, and Politics in Cold War Argentina
Authors: Manzano Valeria
Published: February 2015

This essay explores how a drug problem was manufactured in Cold War Argentina. Unlike in some of its South American neighbors, in Argentina most authorities until the late 1960s did not believe that the country had a serious drug problem, though previous episodes regarding drug usage in the interwar period, explored here, had defined the medical contours of toxicomanía (addiction). But as the 1970s progressed, new legislation framed the drug problem as one of national security, proscribing illicit drug distribution, penalizing consumers, and authorizing federal police to closely monitor areas of youth sociability. Promoted by a diverse team of new experts and in cooperation with US antidrug agencies, the campaign helped create a link between youth, deviance, and subversion, which supposedly corroded the national body. Drugs were defined in repressive terms before the military imposed its dramatic dictatorship in 1976, making drugs a lasting issue in modern Argentine politics.
Synergy Effect of Photoabsorption due to Band-gap Excitation and Surface Plasmon Resonance on Selective Photocatalytic Oxidation of Alcohols to Ketones and Aldehydes over Silver-deposited Silver Iodide
Authors: Nishino Yuri , Tanaka Atsuhiro , Hashimoto Keiji , Kominami Hiroshi
Published: February 2015

Two kinds of photoabsorption of Ag-deposited silver iodide (AgI) due to band-gap excitation of AgI and surface plasmon resonance of Ag particles each contributed to photocatalytic partial oxidation of alcohol, and a synergy effect on the reaction rate was observed when two kinds of light were simultaneously irradiated on Ag–AgI.
New Analysis on Sparse Solutions to Random Standard Quadratic Optimization Problems and Extensions
Authors: Chen Xin , Peng Jiming
Published: February 2015

The standard quadratic optimization problem (StQP) refers to the problem of minimizing a quadratic form over the standard simplex. Such a problem arises from numerous applications and is known to be NP-hard. In a recent paper [Chen X, Peng J, Zhang S (2013) Sparse solutions to random standard quadratic optimization problems. Math. Programming 141(1–2):273–293], Chen, et al. showed that with a high probability close to 1, StQPs with random data have sparse optimal solutions when the associated data matrix is randomly generated from a certain distribution such as uniform and exponential distributions. In this paper, we present a new analysis for random StQPs combining probability inequalities derived from the first-order and second-order optimality conditions. The new analysis allows us to significantly improve the probability bounds. More important, it allows us to handle normal distributions, which is left open in Chen et al. (2013). The existence of sparse approximate solutions to convex StQPs and extensions to other classes of QPs are discussed as well.
The effectiveness of business incubators as the element of the universities’ spin-off strategy in Russia
Authors: Rogova Elena
Published: February 2015

The common vision on business incubators considers them as an important part of the regional innovation infrastructure, with a special mission of innovation-based start-ups support and eco-systems creation. It seems beyond question that business incubators are also important elements of the universities’ system of technology transfer. University researchers and students create spin-off companies to commercialize valuable R&D results, while universities are interested in profits and knowledge sharing and, thus, nurture these spin-off companies via business incubators. Despite the prevalence of this vision, the problem of business incubators effectiveness assessment is not solved in a systematic way. One of the reasons is the diversity of models and institutional contexts in which business incubators act. In this article the system of performance indicators for universities, establishing business incubators, has been proposed. To develop this system, a questionnaire survey was conducted. A real options-driven approach is used for criteria selection.
The prevalence and risk factors of excessive body mass in the children of an Azerbaidjan population aged from 2 to 5 years
Authors: Valieva S T
Published: February 2015

We have undertaken a cohort study of 659 mother-child pairs for the determination of the prevalence and main risk factors of excessive body mass in the children of an Azerbaidjan population aged from 2 to 5 years. The anthropometric calculations were carried out as recommended by the relevant WHO program (Antro). The results of the study give reason to estimate the prevalence and risk factors of excessive body mass in the population of interest at 16.1%. The frequency of excessive body mass in the children delivered via Cesarean section was thrice that in the naturally born children; it was associated with the body weight at birth over 4000 grams and the start on solid foods before the age of 4 months. No relationship was documented between the mode of feeding and excessive body weight after the age above 2 years.
Pituitary adenomas in the framework of hereditary syndromes
Authors: Mamedova E O , Przhiyalkovskaya E G , Pigarova E A , Mokrysheva N G , Dzeranova L K , Tyulpakov A N
Published: February 2015

The overwhelming majority of the pituitary tumours are benign adenomas that remain a serious challenge to endocrinologists and neurosurgeons by virtue of great variety of their early manifestations, the impossibility to predict the neoplastic growth, and the influence exerted on the patients' quality of life. Most pituitary adenomas are sporadic tumours and only few of them develop in the framework of hereditary syndromes. The present review is focused on the variants of hereditary syndromes with special reference to various pituitary neoplasms. The molecular and genetic studies revealed several genetic defects that are believed to contribute to the formation of pituitary adenomas. Moreover, a few genes were identified responsible for the development of hereditary forms of pituitary tumours. Identification of such genes and pathogenetic mechanisms underlying the development of pituitary microadenomas is of paramount importance for the improvement of their diagnostics and treatment that in its turn may promote the understanding of pathogenesis of sporadic adenomas and improve their prognosis.
Religiöse Kleidung
Authors: Grigo Jacqueline
Published: February 2015

Anhand ausgewählter Fallstudien thematisiert das Buch die Bedeutung religiöser Kleidungspraxis für die Träger_innen unterschiedlicher religiöser Traditionen. Entgegen der mit religiöser Kleidung oft in Verbindung gebrachten Assoziationen von Rückständigkeit und Fremdbestimmung zeigt es die Komplexität und Kontingenz von Abwägungs- und Aushandlungsprozessen in alltäglichen vestimentären Entscheidungssituationen auf. Jacqueline Grigo zeigt: Religiöse Kleidung ist nicht nur Ausdruck sozialer Kontrolle oder Marker religiöser Zugehörigkeit respektive Differenz - vielmehr dient sie in vielfältiger Weise der Konstruktion von Identität und sozialer Selbstverortung.
Reasonable diagnostic pathways in disorders of sex development1)
Authors: Hiort Olaf
Published: February 2015

Disorders of sex development or “DSD” describe a heterogeneous group of abnormalities of sexual determination and differentiation. This may be caused by chromosomal as well as monogenic aberrations, which may lead either primarily or through endocrine mechanisms to abnormal sexual development. Laboratory investigations play an important role in the diagnostic process. However, special analytical methods have to be taken into account and the usual reference intervals do not apply. Therefore, laboratory results should be interpreted in a specialized center in context with clinical and imaging findings. Furthermore, molecular genetic analysis can be performed for several entities. In a majority of cases, however, a definitive diagnosis is not possible even today. Therefore, management by a highly specialized multidisciplinary team is necessary for stringent diagnosis, prognosis and overall therapeutic decision-making. The team must include physicians from different subspecialties as well as psychosocial experts to counsel patients and their families appropriately.
Diagnostik invasiver Pilzinfektionen/Diagnosis of invasive fungal infections
Authors: Rath Peter-Michael , Steinmann Jörg
Published: February 2015

Invasive Pilzinfektionen sind insbesondere bei Patienten mit Immunsuppression (Neutropenie, Chemotherapie, Organtransplantation) mit erheblicher Morbidität und Letalität verbunden. Am häufigsten sind Candida und Aspergillus-Arten nachzuweisen, jedoch müssen auch Kryptokokken und Pneumocystis sowie früher sehr selten anzutreffende Pilze (Fusarium, Zygomyzeten) in der Diagnostik berücksichtigt werden. Durch die steigende Anzahl von Patienten mit Risikofaktoren in allen medizinischen Disziplinen muss jedes mikrobiologische Labor in der Lage sein, diese Erreger nachzuweisen. In dieser Übersichtsarbeit wird die Labordiagnostik von Candida-, Aspergillus-, Kryptokokken-, Pneumocystis-Infektionen sowie die Diagnostik seltener Pilze zusammenfassend dargestellt.
Virologische Diagnostik der Influenza: Infektionsnachweis und Prüfung des Immunstatus/Virological diagnostics of influenza: detection of infectious agents and assessment of immunity
Authors: Doerr Hans W.
Published: February 2015

Zum virologischen Nachweis einer akuten Influenza und zur Überprüfung des Immunstatus steht eine Vielzahl von Untersuchungsmethoden zur Verfügung. Bei Verdacht auf eine Influenzavirusinfektion liefert der Rachenabstrich das geeignete Untersuchungsmaterial. Das tiefe Nasopharynxaspirat ist etwas sensitiver, Sputum etwas weniger ergiebig. Die RT-PCR ermöglicht in 1–2 h nach Materialeingang ein sensitives und spezifisches Ergebnis. Typen, Subtypen und Driftvarianten lassen sich durch geeignete Primersonden, die kommerziell zur Verfügung stehen, einwandfrei identifizieren. Demgegenüber ist die Zellkultur-gestützte Virusisolierung zeitaufwendiger und stärker abhängig von einer sachgerechten Materialgewinnung und –überbringung (Kühlkette). PCR und Virusanzüchtung ermöglichen die geno- bzw. phänotypische Testung auf Therapieresistenzen. Der Antigentest ist eine einfache (bed-side) Schnellmethode. Seine Spezifität ist gut, die Sensitivität limitiert; daher kann der Antigentest nicht zur individuellen Ausschlussdiagnose eingesetzt werden. Influenzavirusspezifische Antikörper erscheinen im Blut erst in der zweiten Krankheitswoche. Die Serodiagnostik erfolgt typenspezifisch mit Komplementbindungsreaktion (KBR), IFT und ELISA über eine signifikante Titerbewegung oder den Nachweis von IgA-Antikörpern. IgG-spezifische IFT und ELISA Methoden geben Auskunft über die Influenzavirus-typspezifische Durchseuchung. Die klinisch relevantere subtypen- und variantenspezifische Influenzavirusimmunität wird mit dem HHT oder NT gemessen.
Vitamin D und kardiovaskuläre Erkrankungen: Standortbestimmung 2012/Vitamin D and cardiovascular diseases: where do we stand in 2012?
Authors: Pilz Stefan , März Winfried
Published: February 2015

Es mehren sich die Hinweise, dass Vitamin D eine Rolle bei der Entstehung kardiovaskulärer Krankheiten spielen könnte. Vitamin D-Rezeptor (VDR) und Enzyme des Vitamin D-Stoffwechsels kommen im Gefäßsystem und im Herzen vor. VDR knock out Mäuse leiden an Herz-Kreislauf-Erkrankungen (HKE) und selektive Inaktivierung des VDR in Herzmuskelzellen verursacht Myokardhypertrophie. Viele, jedoch nicht alle Beobachtungsstudien haben gezeigt, dass Vitamin D-Mangel mit HKE und deren Risikofaktoren assoziiert ist. Niedrige Konzentrationen von 25-Hydroxy-Vitamin D (25 [OH] D) sind ein unabhängiger Risikofaktor für kardiovaskuläre Ereignisse, insbesondere für Schlaganfall und plötzlichen Herztod. Es gibt nur wenige randomisierte, kontrollierte Studien (RCT) zu diesem Thema, deren Aussagen durch die zusätzliche Gabe von Kalzium, welches das Risiko für kardiovaskuläre Erkrankungen (KVE) erhöhen kann, eingeschränkt sind. Studien, in denen nur Vitamin D supplementiert wurde, haben teilweise, aber nicht durchweg positive Auswirkungen auf kardiovaskuläre Risikofaktoren wie arterielle Hypertonie gezeitigt. Eine Reihe von großen Studien zu den Auswirkungen der Supplementierung von Vitamin D auf kardiovaskuläre Ereignisse und Mortalität haben bereits begonnen. Deren Design ist aber zum Beispiel wegen des Einschlusses von Personen mit relativ hohen 25 (OH) D-Spiegeln problematisch. Die Evidenz für allgemeine Empfehlungen zur Einnahme von Vitamin D zur Vorbeugung und Behandlung von KVE ist damit noch nicht hinreichend. Prävention und Behandlung eines Vitamin D-Mangels sind aber aufgrund der Wirkungen der Vitamin-D-Supplementation auf den Bewegungsapparat schon heute gerechtfertigt.
Zukünftiger Stellenwert von Liquor-Biomarker in der modernen MS-Therapie/Future relevance of CSF biomarkers in modern MS treatment
Authors: Pilz Georg , Wipfler Peter , Harrer Andrea , Holl Barbara , Oppermann Katrin , Golaszewski Stefan M. , Trinka Eugen , Kraus Jörg
Published: February 2015

In den letzten Jahren wurde die Therapie der Multiplen Sklerose (MS) durch neue, immunologisch selektivere und wirksamere Medikamente erweitert. Untersuchungen des Liquors cerebrospinalis (CSF) zeigten, dass diese Medikamente auch einschneidende immunologische Veränderungen hinter der Blut-CSF-Schranke induzieren. Dadurch kann einerseits die gute Wirksamkeit erklärt werden, andererseits wird aber auch das Risiko opportunistischer Infektionen im ZNS, wie z.B. das Auftreten einer progressiven multifokalen Leukenzephalopathie (PML), begünstigt. In dieser Übersichtsarbeit wird auf die bis jetzt bekannten immunologischen Veränderungen, die durch die beiden in der Behandlung der hochaktiven MS zugelassenen Medikamente-Natalizumab und Fingolimod-ausgelöst werden, eingegangen. Die Untersuchung des CSF bietet ein sehr interessantes Forschungsfeld, um zukünftig mehr über die immunologischen Veränderungen bei MS hinter der Blut-Hirn-Schranke unter Therapie herauszufinden.
Befundinterpretation der molekularen Diagnostik in der Verlaufskontrolle der chronischen myeloischen Leukämie: Empfehlungen einer deutschen Expertengruppe/Interpretation of molecular diagnostics results in routine monitoring for chronic myeloid leukemia: recommendations from a German expert panel
Authors: Hochhaus Andreas , Müller Martin C. , Lange Thoralf , Thiede Christian , Haferlach Torsten
Published: February 2015

Die chronische myeloische Leukämie ist eine neoplastische Erkrankung der Hämatopoese, charakterisiert durch die BCR-ABL1-Fusion. Zur Behandlung neu diagnostizierter Patienten sind drei selektive Tyrosinkinase-Inhibitoren zugelassen. Zur Beurteilung der Residualerkrankung ist eine frühe und engmaschige molekulargenetische Verlaufskontrolle unumgänglich. Sie ermöglicht eine frühe Prognoseeinschätzung sowie ein frühes Erkennen eines Rezidives bzw. einer Therapieresistenz. Eine Harmonisierung der Nachweismethode und des Laborberichts ist wichtig für die Beurteilung des Therapieverlaufs. Eine rasche Befundübermittlung motiviert den Patienten zur Therapietreue. In dieser Stellungnahme diskutiert eine deutsche Expertengruppe Harmonisierungsempfehlungen zur Nachweismethode und zum Laborbericht.
Hämatologische Labordiagnostik im interdisziplinären hämatologischen Kompetenzzentrum (IHK) der hämatologisch onkologischen Klinik V der Universitätsklinik Innsbruck und des Zentrallabors der Universitätsklinik Innsbruck/Laboratory examination of hematologic diseases in the Interdiscipline Hematologic Competence Center (IHK) of Innsbruck of the Clinic for Hemato-Oncology V of the University Hospital Innsbruck and the Central Laboratory of the University Hospital Innsbruck
Authors: Anliker Markus , Hammerer-Lercher Angelika , Falkner Andreas , Heiss Brigitte , Willenbacher Wolfgang , Schrezenmeier Hubert , Huber Andreas , Gastl Günther , Griesmacher Andrea
Published: February 2015

Die hämatologische Labordiagnostik hat in den letzten 30 Jahren große Fortschritte gemacht. Sie basiert heute im Wesentlichen auf vier Säulen: Zytomorphologie, Immunphänotypisierung, Zytogenetik und Molekulargenetik. Weiterhin unerlässlich steht am Anfang jeder Abklärung die Zytomorphologie meist gefolgt von einer Immunphänotypisierung. Beide Untersuchungen erfordern vom Laborteam hohe Expertise und oft Informationsaustausch mit den klinischen Zuweisern. Trotz hochspezialisierter Mitarbeiter ist es für kleine Speziallaboratorien eine große Herausforderung den Anforderungen an Qualitätssicherung und Wirtschaftlichkeit zu genügen. Eine Lösung kann die Zusammenarbeit zwischen der Labormedizin einerseits (meist in einem Zentrallabor angesiedelt) und den meist in der Hämatologie angesiedelten kleineren Speziallaboren sein, wie sie in Innsbruck seit 2008 modellhaft im interdisziplinären hämatologischen Kompetenzzentrum (IHK) praktiziert wird. Auf diese Weise wurde in Innsbruck eine interdisziplinäre Einrichtung geschaffen, welche die gesamte hämatologische Laborkompetenz der Klinik aus Zytomorphologie und Durchflusszytometrie zentral bündelt. Neben der Abklärung bekannter hämatologischer Erkrankungen bietet das IHK auch optimale Vorraussetzungen zur gezielten, zeitnahen Erstdiagnostik hämatologischer Erkrankungen (z.B. Zufallsbefunde) aber auch zum Screening von Blutproben eines großen Klinikums, die aufgrund von morphologischen oder numerischen Auffälligkeiten einer weiteren diagnostischen Abklärung bedürfen. Für die weitere Entwicklung des IHK ist eine zusätzliche Einbindung der zytogenetischen bzw. molekularbiologischen Diagnostik unerlässlich. Die interdisziplinäre Zusammenarbeit von Labormedizinern, Hämatologen, Zytogenetikern und Molekularbiologen fördert den Wissenstransfer und die Expertise aller beteiligten Mitarbeiter und steigert das Leistungspotential und Qualitätsniveau dieser Laborbereiche. Weitere Vorteile bieten sich im Bereich wichtiger Laborentwicklungsprozesse (z.B. Laborakkreditierung, Einführung neuer teurer Ausrüstungsgegenstände, wie etwa 10-Farben-Flowzytometer, moderner Labor-EDV oder Bildarchivierungssysteme), wobei durch interdiszplinäre Zusammenarbeit und gemeinsame Nutzung hohe Synergieeffekte zu erwarten sind. Die Etablierung interdisziplinärer Kompetenzzentren für hämatologische Diagnostik stellt daher einen Meilenstein in der modernen Labordiagnostik dar.
Tödliche Urosepsis durch verzögerte Diagnose einer urogenitalen Melioidose
Authors: Frickmann Hagen , Neubauer Heinrich , Haase Gerhard , Peltroche-Llacsahuanga Heidrun , Pérez-Bouza Alberto , Racz Paul , Loderstaedt Ulrike , Hagen Ralf M.
Published: February 2015

Kasuistik: Ein 54-jähriger Diabetespatient mit bekanntem Alkoholabusus wurde mit therapierefraktärem, fieberhaftem Harnwegsinfekt nach Thailandaufenthalt stationär aufgenommen. Nach Fehldiagnose von Burkholderia pseudomallei als Burkholderia cepacia im Urin kam es unter insuffizienter antibiotischer Therapie zur systemischen Ausbreitung der abszedierenden Harnwegsinfektion, woran der Patient im septischen Schock mit respiratorischem Versagen verstarb.

Ergebnisse: Die korrekte Spezies-Identifizierung erfolgte durch 16S rRNA-Gen-Sequenzierung. Zudem gelang post mortem der Nachweis von Burkholderia pseudomallei aus Prostatagewebe mittels PCR und Fluoreszenz-in-situ-Hybridisierung.

Schlussfolgerung: Die biochemische Differenzierung von Bakterien des Genus Burkholderia ist auf Speziesebene unzuverlässig. Wenn die klinische Anamnese eine B. pseudomallei Infektion wahrscheinlich erscheinen lässt, sollten molekulare Identifikationsverfahren ergänzt werden. Bei Verdacht auf abszedierende Prozesse sollte die Antibiotika-Dosierempfehlung am oberen Rand des Dosisspektrums gewählt werden.
Das neonatale Immunsystem: Modulation durch regulatorische T-Zellen und CTLA-4 (CD152)
Authors: Hebel Katrin , Pierau Mandy , Lingel Holger , Steiner Michael , Krause Hardy , Jorch Gerhard , Brunner-Weinzierl Monika C.
Published: February 2015

Fehlregulationen von CTLA-4 (CD152), einem auf der Oberfläche von Lymphozyten exprimiertem Glykoprotein, können zu chronischen Entzündungsreaktionen führen. Aufgrund neuer Erkenntnisse wird deutlich, dass CTLA-4 die Effektorfunktionen von T-Lymphozyten abschaltet und damit die Effektorphase von T-Lymphozyten beendet. Interessanterweise sind die CTLA-4 exprimierenden T-Lymphozyten resistent gegen Apoptose (programmierter Zelltod) und migrieren verstärkt in Lymphknoten und Gewebe. Weitere Studien zeigen, dass regulatorische T-Zellen, die unerwünschte Immunantworten abschalten, in vivo nur inhibieren können, wenn Sie über ein intaktes CTLA-4-Gen verfügen. Darüber hinaus hat sich bestätigt, dass CTLA-4 nicht nur-wie angenommen-auf T-Lymphozyten exprimiert wird, sondern auch auf B-Lymphozyten. So zeigen Mäuse mit genetischer Inaktivierung von CTLA-4 in B-Lymphozyten eine verstärkte Produktion von IgM nach Immunisierung. Interessanterweise exprimieren insbesondere B-Lymphozyten und T-Lymphozyten von Neugeborenen und Kleinkindern stark CTLA-4, was auf eine zentrale immunregulatorische Rolle bei frühkindlichen Immunantworten hindeutet. Moleküle, die wie CTLA-4 die Differenzierung von Lymphozyten regulieren, könnten einen neuen Ansatzpunkt bieten, um bereits im Kindesalter die Weichen für ein vor Autoimmunität und Allergie geschütztes Immunsystem zu stellen.
Key figures and benchmarking in the hospital laboratory1)
Authors: Orth Matthias , Aufenanger Johannes , Klosson Rupert J.
Published: February 2015

Benchmarking is a systematic and continuous process used to compare products, services, and processes – as regards quantitative and qualitative aspects. Benchmarking in laboratory medicine departments of hospitals is a frequently used but only poorly standardized system. Sophisticated procedures for data collection are necessary due to the large heterogeneity and complexity of activities performed in laboratory medicine with regard to the type of testing, response times, availability and amount of different resources needed for single analysis and reporting. These prerequisites are difficult to fulfill. In internal benchmarking projects – i.e., monitoring of productivity, costs, and revenues within one laboratory over an extended period of time – the current tools for data collection are generally fit for purpose. In external benchmarking, however, several pitfalls may obscure the results. In broad terms, external benchmarking projects compare only partial processes with sufficient validity. Differences in benchmarking have to be controlled for improvements of data collection and for changes in surrounding conditions outside the laboratory. This review lists different approaches for benchmarking projects in laboratory medicine departments and describes their strengths and weaknesses.
Laboratory examination of hematologic diseases at the interdisciplinary hematologic competence center (IHK) of Innsbruck of the clinic for hemato-oncology V of the university hospital Innsbruck and the central laboratory of the university hospital Innsbruck (ZIMCL)1)
Authors: Anliker Markus , Hammerer-Lercher Angelika , Falkner Andreas , Heiss Brigitte , Willenbacher Wolfgang , Schrezenmeier Hubert , Huber Andreas , Gastl Günther , Griesmacher Andrea
Published: February 2015

The laboratory examination of hematologic diseases has made great progress in the last 30 years and is now based on a fourfold strategy: cytomorphology, flow cytometry, cytogenetics, and molecular genetics. Cytomorphology is still the crucial first step, and then it usually followed by flow cytometric immunophenotyping of relevant cell population. Both investigations require a highly expert laboratory team and, often, an exchange of information among the clinicians. It is a challenge for small specialized laboratories to reach quality standards and economic efficiency nowadays, even with highly specialized personnel. One solution is the collaboration among institutes of clinical pathology (usually a central laboratory), smaller laboratories specialized in hematology, and usually residents in departments of hematologic diseases, as is the practice in the Interdiscipline Hematologic Competence Center (IHK) of Innsbruck since 2008. Thus, in Innsbruck, this competence center concentrates the whole expertise in the hematology laboratory of the hospital based on cytomorphology and flow cytometry. Besides the clarification of already identified hematologic diseases, the IHK has optimal conditions not only for the specific and prompt first-time diagnosis of hematologic diseases (e.g., additional diagnostic findings) but also for the screening of blood samples, from tertiary care hospitals, that require further diagnostic workup for specific disease clarification based on numeric and morphologic abnormalities. For the further progression of the IHK, the integration of cytogenetic and molecular genetic diagnostics is essential. The interdisciplinary collaboration of clinical pathologists, hematology clinicians, and cytogenetic and molecular genetics experts improves the knowledge transfer and expertise of all members and enhances the efficiency and quality level of such a collaborating laboratory division. Further advantages can be achieved in important laboratory development processes (e.g., laboratory accreditation, implementation of expensive laboratory equipment, such as ten-color flow cytometers, introduction of modern laboratory information systems, or image-archiving systems), with a high potential of synergetic effects stemming from the collaboration. The establishment of interdisciplinary competence centers for hematologic diagnostics is therefore a milestone in modern laboratory diagnostics.
Developments and insights into the analysis of the human microbiome
Authors: Rücker Ovidiu , Dangel Alexandra , Klein Hanns-Georg
Published: February 2015

The intense research focused on the human microbiome during the last years has shed some light on this mostly uncharacterized part of the human body. The constantly improving sequencing technologies have additionally eased the process of collecting a large amount of genome data from metagenomics samples. Using these methods, large studies with sufficient number of subjects have started to reveal the implications of our microbiome in health and disease. Here, we present a review on the last developments of sequencing technology together with an overview on the findings in this fast-evolving field of science.
Weiterbildung in der Klinischen Chemie und Laboratoriumsmedizin in Europa
Authors: Parthaune Tanja , Hendig Doris , Schaaf Christian
Published: February 2015

Die Weiterbildung in der Klinischen Chemie und Laboratoriumsmedizin ist in Europa heterogen. Mediziner, Naturwissenschaftler und Pharmazeuten können sich in Europa in der Klinischen Chemie und Laboratoriumsmedizin weiterbilden. Die Weiterbildungszeiten und -inhalte sowie Abschlussmodalitäten unterscheiden sich jedoch voneinander. Mit dem Ziel der Harmonisierung und Qualitätssicherung der Weiterbildung in Europa veröffentlichten sowohl die Sektion „Laboratory Medicine/Medical Biopathology“ der „European Union of Medical Specialists“ (UEMS) als auch die „European Federation of Clinical Chemistry and Laboratory Medicine“ (EFLM) 2012 ein überarbeitetes Curriculum für die postgraduale Weiterbildung in der Klinischen Chemie und Laboratoriumsmedizin. Die EFLM führte die Berufsbezeichnung „Specialist in Laboratory Medicine“ (ehemals „European Specialist in Clinical Chemistry and Laboratory Medicine“) ein. Die UEMS vergibt den polyvalenten Titel „Specialist in General Laboratory Medicine – Polyvalent Medical Biopathology“ sowie 4 monovalente Titel. Die vorliegende Arbeit gibt eine Übersicht zum aktuellen Stand der Weiterbildung in der Klinischen Chemie und Laboratoriumsmedizin in den EU-Staaten im Vergleich zu Deutschland. Die Ziele der UEMS und EFLM als Dachorganisationen der Klinischen Chemie und Laboratoriumsmedizin in der EU werden diskutiert.
Feasibility studies of cellulose microfiber (CMF) reinforced poly(ethylene-co-vinyl acetate) (EVA) composites for food packaging applications
Authors: Sonia Ashok Kumar , Dasan Keereyadath Priya
Published: February 2015

Recently, there has been increased interest in the extraction of cellulose microfiber (CMF)/nanofibers from plant sources and their utilization as fillers in polymers. These natural fibers are characterized by good mechanical, thermal, and biodegradability properties. The present work was aimed at studying the feasibility of these fiber-reinforced polymer in food packaging. Poly(ethylene-co-vinyl acetate) (EVA) is a common food packaging material used in refrigerated items. The CMF/EVA composite films were exposed to milk, curd, and orange juice at fixed time intervals at three different temperatures and the microbial growth profile in the food material was evaluated. The incorporation of CMF in EVA was found to have no impact on the microbial contamination or proliferation of microbial growth in the food materials.
Progress in the Development of a Method to Predict Sealant Modulus Change Due to Outdoor Weathering
Authors: White C. C. , Tan K. T. , Hunston D. L. , Pintar A. , Filliben J.
Published: February 2015

An empirically based statistical method has been created to predict the relative change in modulus for a sealant exposed to outdoor weathering. This method has not been validated. The underlying high-precision data supporting this method was obtained using the National Institute of Standards and Technology simulated photo degradation by high-energy radiant exposure (NIST SPHERE). The NIST SPHERE can independently precisely control each of the four primary components of the outdoor exposure: temperature, humidity, ultraviolet radiation, and mechanical loading. The time-dependent modulus of the sealant samples were characterized using ASTM C1735-11 [ASTM C1735-11: Standard Test Method for Measuring the Time Dependent Modulus of Sealants Using Stress Relaxation, Annual Book of ASTM Standards, ASTM International, West Conshohocken, PA] before and after each exposure period. The resulting empirically based method produces a relative prediction of modulus change for any location, provided a historical weather file is available. Additionally, the relative geographical predictions allow for future independent verification of this approach. It is important to state that these are only predictions that have not been validated with the corresponding outdoor data.
California Futures
Authors: Newitz Annalee
Published: February 2015

This short essay accompanies a gallery of six representations of possible California futures chosen by Annalee Newitz, editor of Gizmodo. The gallery includes a dystopian hellhole of scarcity and labor exploitation, a sustainable civilization of green urban designs, an Aztec-influenced cyborg, anarchist collectives, cities gone mad with class division, and a map of San Francisco’s new archipelago, created by the inevitable rising waters of a warmer world.