610 Medizin und Gesundheit
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- bacteria (2)
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- balance strategy (2)
- basic need satisfaction and frustration (2)
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- categories (2)
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- cells (2)
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- cost-effectiveness (2)
- counter-speech (2)
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- craving and relapse (2)
- cross-lagged panel analysis (2)
- cross-modal generalisation (2)
- cruciate ligament injury (2)
- crystal-structure (2)
- cyberhate (2)
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- database (2)
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- decomposition (2)
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- development (2)
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- emerging adults (2)
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- ethnic (2)
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- evaluation (2)
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Archaea belonging to the phylum Bathyarchaeota are the predominant archaeal species in cold, anoxic marine sediments and additionally occur in a variety of habitats, both natural and man-made. Metagenomic and single-cell sequencing studies suggest that Bathyarchaeota may have a significant impact on the emissions of greenhouse gases into the atmosphere, either through direct production of methane or through the degradation of complex organic matter that can subsequently be converted into methane. This is especially relevant in permafrost regions where climate change leads to thawing of permafrost, making high amounts of stored carbon bioavailable. Here we present the analysis of nineteen draft genomes recovered from a sediment core metagenome of the Polar Fox Lagoon, a thermokarst lake located on the Bykovsky Peninsula in Siberia, Russia, which is connected to the brackish Tiksi Bay. We show that the Bathyarchaeota in this lake are predominantly peptide degraders, producing reduced ferredoxin from the fermentation of peptides, while degradation pathways for plant-derived polymers were found to be incomplete. Several genomes encoded the potential for acetogenesis through the Wood-Ljungdahl pathway, but methanogenesis was determined to be unlikely due to the lack of genes encoding the key enzyme in methanogenesis, methyl-CoM reductase. Many genomes lacked a clear pathway for recycling reduced ferredoxin. Hydrogen metabolism was also hardly found: one type 4e [NiFe] hydrogenase was annotated in a single MAG and no [FeFe] hydrogenases were detected. Little evidence was found for syntrophy through formate or direct interspecies electron transfer, leaving a significant gap in our understanding of the metabolism of these organisms.
Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe
(2022)
Objectives:
Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU.
Methods:
We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week).
Results:
Overall, past week alcohol consumption was 5.0 units (+/- 7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender.
Conclusions:
HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.
Can compression garments reduce the deleterious effects of physical exercise on muscle strength?
(2022)
Background
The use of compression garments (CGs) during or after training and competition has gained popularity in the last few decades. However, the data concerning CGs' beneficial effects on muscle strength-related outcomes after physical exercise remain inconclusive.
Objective
The aim was to determine whether wearing CGs during or after physical exercise would facilitate the recovery of muscle strength-related outcomes.
Methods
A systematic literature search was conducted across five databases (PubMed, SPORTDiscus, Web of Science, Scopus, and EBSCOhost). Data from 19 randomized controlled trials (RCTs) including 350 healthy participants were extracted and meta-analytically computed. Weighted between-study standardized mean differences (SMDs) with respect to their standard errors (SEs) were aggregated and corrected for sample size to compute overall SMDs. The type of physical exercise, the body area and timing of CG application, and the time interval between the end of the exercise and subsequent testing were assessed.
Results
CGs produced no strength-sparing effects (SMD [95% confidence interval]) at the following time points (t) after physical exercise: immediately <= t < 24 h: - 0.02 (- 0.22 to 0.19), p = 0.87; 24 <= t < 48 h: - 0.00 (- 0.22 to 0.21), p = 0.98; 48 <= t < 72 h: - 0.03 (- 0.43 to 0.37), p = 0.87; 72 <= t < 96 h: 0.14 (- 0.21 to 0.49), p = 0.43; 96 h <= t: 0.26 (- 0.33 to 0.85), p = 0.38. The body area where the CG was applied had no strength-sparing effects. CGs revealed weak strength-sparing effects after plyometric exercise.
Conclusion
Meta-analytical evidence suggests that wearing a CG during or after training does not seem to facilitate the recovery of muscle strength following physical exercise. Practitioners, athletes, coaches, and trainers should reconsider the use of CG as a tool to reduce the effects of physical exercise on muscle strength.
Background
The role of trunk muscle training (TMT) for physical fitness (e.g., muscle power) and sport-specific performance measures (e.g., swimming time) in athletic populations has been extensively examined over the last decades. However, a recent systematic review and meta-analysis on the effects of TMT on measures of physical fitness and sport-specific performance in young and adult athletes is lacking.
Objective
To aggregate the effects of TMT on measures of physical fitness and sport-specific performance in young and adult athletes and identify potential subject-related moderator variables (e.g., age, sex, expertise level) and training-related programming parameters (e.g., frequency, study length, session duration, and number of training sessions) for TMT effects.
Data Sources
A systematic literature search was conducted with PubMed, Web of Science, and SPORTDiscus, with no date restrictions, up to June 2021.
Study Eligibility Criteria
Only controlled trials with baseline and follow-up measures were included if they examined the effects of TMT on at least one measure of physical fitness (e.g., maximal muscle strength, change-of-direction speed (CODS)/agility, linear sprint speed) and sport-specific performance (e.g., throwing velocity, swimming time) in young or adult competitive athletes at a regional, national, or international level. The expertise level was classified as either elite (competing at national and/or international level) or regional (i.e., recreational and sub-elite).
Study Appraisal and Synthesis Methods
The methodological quality of TMT studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. A random-effects model was used to calculate weighted standardized mean differences (SMDs) between intervention and active control groups. Additionally, univariate sub-group analyses were independently computed for subject-related moderator variables and training-related programming parameters.
Results
Overall, 31 studies with 693 participants aged 11-37 years were eligible for inclusion. The methodological quality of the included studies was 5 on the PEDro scale. In terms of physical fitness, there were significant, small-to-large effects of TMT on maximal muscle strength (SMD = 0.39), local muscular endurance (SMD = 1.29), lower limb muscle power (SMD = 0.30), linear sprint speed (SMD = 0.66), and CODS/agility (SMD = 0.70). Furthermore, a significant and moderate TMT effect was found for sport-specific performance (SMD = 0.64). Univariate sub-group analyses for subject-related moderator variables revealed significant effects of age on CODS/agility (p = 0.04), with significantly large effects for children (SMD = 1.53, p = 0.002). Further, there was a significant effect of number of training sessions on muscle power and linear sprint speed (p <= 0.03), with significant, small-to-large effects of TMT for > 18 sessions compared to <= 18 sessions (0.45 <= SMD <= 0.84, p <= 0.003). Additionally, session duration significantly modulated TMT effects on linear sprint speed, CODS/agility, and sport-specific performance (p <= 0.05). TMT with session durations <= 30 min resulted in significant, large effects on linear sprint speed and CODS/agility (1.66 <= SMD <= 2.42, p <= 0.002), whereas session durations > 30 min resulted in significant, large effects on sport-specific performance (SMD = 1.22, p = 0.008).
Conclusions
Our findings indicate that TMT is an effective means to improve selected measures of physical fitness and sport-specific performance in young and adult athletes. <br /> Independent sub-group analyses suggest that TMT has the potential to improve CODS/agility, but only in children. Additionally, more (> 18) and/or shorter duration (<= 30 min) TMT sessions appear to be more effective for improving lower limb muscle power, linear sprint speed, and CODS/agility in young or adult competitive athletes.
The public health insurance in Germany will face huge economic challenges in the upcoming years. New diagnostic and therapeutic methods as well as the demographic change contribute to constantly rising expenditure. Although incentives for health-promoting behaviour or financial sanctions for an unhealthy lifestyle have been already discussed in the past, there has been a general reluctance to legally establish corresponding mechanisms for fear of eroding solidarity and increasing state control. In the course of the Coronavirus pandemic however, a stronger awareness rose to the fact that personal health-related life choices can have a huge impact on the stability of the healthcare system including public health insurance. Not only in Germany but throughout much of Europe, the pandemic led to a new and more fundamental debate about the relationship between individual responsibility for personal health and the wider responsibility for public health assumed by the community of solidarity.
Congenital adrenal hyperplasia (CAH) is the most common form of adrenal insufficiency in childhood; it requires cortisol replacement therapy with hydrocortisone (HC, synthetic cortisol) from birth and therapy monitoring for successful treatment. In children, the less invasive dried blood spot (DBS) sampling with whole blood including red blood cells (RBCs) provides an advantageous alternative to plasma sampling.
Potential differences in binding/association processes between plasma and DBS however need to be considered to correctly interpret DBS measurements for therapy monitoring. While capillary DBS samples would be used in clinical practice, venous cortisol DBS samples from children with adrenal insufficiency were analyzed due to data availability and to directly compare and thus understand potential differences between venous DBS and plasma. A previously published HC plasma pharmacokinetic (PK) model was extended by leveraging these DBS concentrations.
In addition to previously characterized binding of cortisol to albumin (linear process) and corticosteroid-binding globulin (CBG; saturable process), DBS data enabled the characterization of a linear cortisol association with RBCs, and thereby providing a quantitative link between DBS and plasma cortisol concentrations. The ratio between the observed cortisol plasma and DBS concentrations varies highly from 2 to 8. Deterministic simulations of the different cortisol binding/association fractions demonstrated that with higher blood cortisol concentrations, saturation of cortisol binding to CBG was observed, leading to an increase in all other cortisol binding fractions.
In conclusion, a mathematical PK model was developed which links DBS measurements to plasma exposure and thus allows for quantitative interpretation of measurements of DBS samples.
Sulfated biomolecules are known to influence numerous biological processes in all living organisms. Particularly, they contribute to prevent and inhibit the hypercoagulation condition. The failure of polymeric implants and blood contacting devices is often related to hypercoagulation and microbial contamination. Here, bioactive sulfated biomacromolecules are mimicked by sulfation of poly(glycerol glycidyl ether) (polyGGE) films. Autoclaving, gamma-ray irradiation and ethylene oxide (EtO) gas sterilization techniques were applied to functionalized materials. The sulfate group density and hydrophilicity of sulfated polymers were decreased while chain mobility and thermal degradation were enhanced post autoclaving when compared to those after EtO sterilization. These results suggest that a quality control after sterilization is mandatory to ensure the amount and functionality of functionalized groups are retained.
Die interventionelle Behandlung des Vorhofflimmerns verursacht häufiger als in der Vergangenheit wahrgenommen eine Beeinträchtigung benachbarter Gewebe und Organe. Im Vordergrund der Betrachtungen dieser Arbeit stehen Schäden des Oesophagus, die aufgrund der schlechten Vorhersagbarkeit, des zeitlich verzögerten Auftretens und der fatalen Prognose bei Ausbildung einer atrio-oesophagealen Fistel besondere Relevanz haben.
Das Vorhofflimmern selbst ist nicht mit einer unmittelbaren vitalen Bedrohung verbunden, aber durch seine Komplikationen (z.B. Herzinsuffizienz, Schlaganfall) dennoch prognostisch relevant. Durch Antiarrhythmika gelingt keine Verbesserung der Rhythmuskontrolle (Arrhythmie-Freiheit), eine katheterinterventionelle Behandlung ist der medikamentösen Therapie überlegen. Durch eine frühzeitige und erfolgreiche Behandlung des Vorhofflimmerns konnte eine Verbesserung klinischer Endpunkte und der Prognose erreicht werden. Das Risiko einer invasiven Behandlung (insbesondere hinsichtlich des Auftretens prognoserelevanter Komplikationen) muss jedoch bei der Indikationsstellung und der Prozedur-Durchführung bedacht und gegenüber den günstigen Effekten der Behandlung abgewogen werden.
Untersuchungen zur Vermeidung der sehr seltenen atrio-oesophagealen Fisteln bedienen sich Surrogat-Parametern, hier bisher ausschließlich den ablationsinduzierten Schleimhaut-Läsionen des Oesophagus. Die Untersuchungen dieser Arbeit zeigen ein komplexeres Bild der (peri)-oesophagealen Schädigungen nach Vorhofflimmern-Ablation mit thermischen Energiequellen.
(1) Neue Definition der Oesophagus-Schäden: Oesophageale und perioesophageale Beeinträchtigungen treten sehr häufig auf (nach der hier verwendeten erweiterten Definition bei zwei Drittel der Patienten) und sind unabhängig von der verwendeten Ablationsenergie. Unterschiede finden sich in den Manifestationen der Oesophagus-Schäden für die verschiedenen Energie-Protokolle, ohne dass der Mechanismus hierfür aufgeklärt ist. Diese Arbeit beschreibt die unterschiedlichen Ausprägungen thermischer Oesophagus-Schäden, deren Determinanten und pathophysiologische Relevanz.
(2) Die Detektion (zum Teil subtiler) Oesophagus-Schäden ist maßgeblich von der Intensität der Nachsorge abhängig. Eine Beschränkung auf subjektive Schilderungen (z.B. Schmerzen beim Schluckakt, Sodbrennen) ist irreführend, die Mehrzahl der Veränderungen bleibt asymptomatisch, die Symptome der ausgebildeten atrio-oesophagealen Fistel (meist nach mehreren Wochen) bereits mit einer sehr schlechten Prognose belastet. Eine Endoskopie der Speiseröhre findet in den meisten elektrophysiologischen Zentren nicht oder nur bei anhaltenden Symptomen statt und kann ausschließlich Mukosa-Läsionen nachweisen. Damit wird das Ausmaß des oesophagealen und perioesophagealen Schadens bei Weitem unterschätzt. Veränderungen des perioesophagealen Raums, deren klinische Relevanz (noch) unklar ist, werden nicht erfasst, und damit ein Wandödem und Schäden im Gewebe zwischen linkem Vorhof und Speiseröhre (einschl. Nerven und Gefäßen) ignoriert.
Die Studien tragen auch zur Neubewertung etablierter Messgrößen und Risikofaktoren der Oesophagus-Schäden bei.
(3) Das Temperaturmonitoring im Oesophagus anhand der Maximalabweichungen ist erst für Extremwerte aussagekräftig und dadurch nicht hilfreich, Oesophagus-Läsionen zu vermeiden. Die komplexe Analyse der Temperatur-Rohdaten (bisher nur offline möglich) liefert in der AUC für RF-Ablationen einen prädiktiven Parameter für Oesophagus-Schäden, der eine Strukturierung der weiteren endoskopischen Diagnostik erlaubt. Ein vergleich¬barer Wert für die Cryoablationen konnte in den Analysen nicht gefunden werden.
(4) Eine chronische Entzündung des unteren Oesophagus-Drittels behindert nicht nur das Abheilen einer thermischen Oesophagus-Läsion, sondern kann das Auftreten solcher Läsionen durch die Ablation begünstigen. Die große Zahl vorbestehender Oesophagus-Veränderungen, die eine erhöhte Vulnerabilität anzeigen, und die Bedeutung für die Ent¬stehung thermischer Läsionen können der Ansatzpunkt präventiver Maßnahmen sein.
Ergänzend werden Ausprägungen der Oesophagus-Schäden durch umfangreiche Diagnostik erfasst und beschrieben, die aus pathophysiologischen Überlegungen relevant sein können.
(5) Die systematische Erweiterung der bildgebenden Diagnostik auf den perioesophagealen Raum durch Endosonographie zeigte, dass Schleimhaut-Läsionen alleine nur einen geringen Teil der Oesophagus-Schäden darstellen. Schleimhaut-Läsionen infolge einer instrumentellen Verletzung sind nicht mit dem Risiko der Ausbildung einer atrio-oesophagealen Fistel verbunden und unterstreichen die pathophysiologische Relevanz der perioesophagealen Veränderungen.
(6) Eine funktionelle Diagnostik thermischer Schäden des perioesophagealen Vagus-Plexus identifiziert Patienten mit Oesophagus-Schäden, die bildgebend nicht erfasst wurden, jedoch in ihren Auswirkungen (Nahrungsretention und gastro-oesophagealer Reflux) zur Läsionsprogression beitragen können.
On their way from inland to the ocean, flowing water bodies, their constituents and their biotic communities are ex-posed to complex transport and transformation processes. However, detailed process knowledge as revealed by La-grangian measurements adjusted to travel time is rare in large rivers, in particular at hydrological extremes. To fill this gap, we investigated autotrophic processes, heterotrophic carbon utilization, and micropollutant concentrations applying a Lagrangian sampling design in a 600 km section of the River Elbe (Germany) at historically low discharge. Under base flow conditions, we expect the maximum intensity of instream processes and of point source impacts. Phy-toplankton biomass and photosynthesis increased from upstream to downstream sites but maximum chlorophyll con-centration was lower than at mean discharge. Concentrations of dissolved macronutrients decreased to almost complete phosphate depletion and low nitrate values. The longitudinal increase of bacterial abundance and production was less pronounced than in wetter years and bacterial community composition changed downstream. Molecular analyses revealed a longitudinal increase of many DOM components due to microbial production, whereas saturated lipid-like DOM, unsaturated aromatics and polyphenols, and some CHOS surfactants declined. In decomposition exper-iments, DOM components with high O/C ratios and high masses decreased whereas those with low O/C ratios, low masses, and high nitrogen content increased at all sites. Radiocarbon age analyses showed that DOC was relatively old (890-1870 years B.P.), whereas the mineralized fraction was much younger suggesting predominant oxidation of algal lysis products and exudates particularly at downstream sites. Micropollutants determining toxicity for algae (terbuthylazine, terbutryn, isoproturon and lenacil), hexachlorocyclohexanes and DDTs showed higher concentrations from the middle towards the downstream part but calculated toxicity was not negatively correlated to phytoplankton. Overall, autotrophic and heterotrophic process rates and micropollutant concentrations increased from up-to down-stream reaches, but their magnitudes were not distinctly different to conditions at medium discharges.
Myasthenia gravis is an autoimmune disease affecting neuromuscular transmission and causing skeletal muscle weakness. Additionally, systemic inflammation, cognitive deficits and autonomic dysfunction have been described.
However, little is known about myasthenia gravis-related reorganization of the brain. In this study, we thus investigated the structural and functional brain changes in myasthenia gravis patients.
Eleven myasthenia gravis patients (age: 70.64 +/- 9.27; 11 males) were compared to age-, sex- and education-matched healthy controls (age: 70.18 +/- 8.98; 11 males). Most of the patients (n = 10, 0.91%) received cholinesterase inhibitors.
Structural brain changes were determined by applying voxel-based morphometry using high-resolution T-1-weighted sequences. Functional brain changes were assessed with a neuropsychological test battery (including attention, memory and executive functions), a spatial orientation task and brain-derived neurotrophic factor blood levels.
Myasthenia gravis patients showed significant grey matter volume reductions in the cingulate gyrus, in the inferior parietal lobe and in the fusiform gyrus. Furthermore, myasthenia gravis patients showed significantly lower performance in executive functions, working memory (Spatial Span, P = 0.034, d = 1.466), verbal episodic memory (P = 0.003, d = 1.468) and somatosensory-related spatial orientation (Triangle Completion Test, P = 0.003, d = 1.200).
Additionally, serum brain-derived neurotrophic factor levels were significantly higher in myasthenia gravis patients (P = 0.001, d = 2.040). Our results indicate that myasthenia gravis is associated with structural and functional brain alterations. Especially the grey matter volume changes in the cingulate gyrus and the inferior parietal lobe could be associated with cognitive deficits in memory and executive functions.
Furthermore, deficits in somatosensory-related spatial orientation could be associated with the lower volumes in the inferior parietal lobe. Future research is needed to replicate these findings independently in a larger sample and to investigate the underlying mechanisms in more detail.
Klaus et al. compared myasthenia gravis patients to matched healthy control subjects and identified functional alterations in memory functions as well as structural alterations in the cingulate gyrus, in the inferior parietal lobe and in the fusiform gyrus.