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Wenn in der Medizin vom demografischen Wandel gesprochen wird [1], wird zumeist von einer rasanten Zunahme der Hochaltrigen gesprochen, bei denen aufgrund der differenziellen altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen, kardiovaskulären Erkrankungen, Krebserkrankungen und allgemeiner Multimorbidität und Gebrechlichkeit zu erwarten ist [2]. Dies ist unstrittig richtig, aber nur ein Teil der Folgen des demografischen Wandels für die psychiatrische Versorgung. Diese muss weiterhin die gesamte adulte Lebensspanne im Blick haben, da sonst Versorgungsengpässe bei ohnehin vulnerablen Patienten verstärkt werden, mit Folgen für die Morbidität und Mortalität auf Bevölkerungsebene [3].
Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD.
The involvement of charge-transfer (CT) states in the photogeneration and recombination of charge carriers has been an important focus of study within the organic photovoltaic community. In this work, we investigate the molecular factors determining the mechanism of photocurrent generation in low-donor-content organic solar cells, where the active layer is composed of vacuum-deposited C-60 and small amounts of organic donor molecules. We find a pronounced decline of all photovoltaic parameters with decreasing CT state energy. Using a combination of steady-state photocurrent measurements and time-delayed collection field experiments, we demonstrate that the power conversion efficiency, and more specifically, the fill factor of these devices, is mainly determined by the bias dependence of photocurrent generation. By combining these findings with the results from ultrafast transient absorption spectroscopy, we show that blends with small CT energies perform poorly because of an increased nonradiative CT state decay rate and that this decay obeys an energy-gap law. Our work challenges the common view that a large energy offset at the heterojunction and/or the presence of fullerene clusters guarantee efficient CT dissociation and rather indicates that charge generation benefits from high CT state energies through a slower decay to the ground state.
Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV
(2019)
People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD50.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.
The African weakly electric fish genus Campylomormyrus is a well-investigated fish group of the species-rich family Mormyridae. They are able to generate species-specific electric organ discharges (EODs) which vary in their waveform characteristics including polarity, phase umber and duration. In mormyrid species EODs are used for communication, species discrimination and mate recognition, and it is thought hat they serve as pre-zygotic isolation mechanism driving sympatric speciation by promoting assortative mating. The EOD diversification, its volutionary effects and the link to species divergence have been examined histologically, behaviorally, and genetically. Molecular analyses are a major tool to identify species and their phenotypic traits by studying the underlying genes. The genetic variability between species further provides information from which evolutionary processes, such as speciation, can be deduced. Hence, the ultimate aim of this study is the investigation of genetic variability within the African weakly electric fish genus Campylomormyrus to better understand their sympatric speciation and comprehend their evolutionary drivers. In order to extend the current knowledge and gain more insights into its species history, karyological and genomic approaches are being pursued considering species differences. Previous studies have shown that species with different EOD duration have specific gene expression patterns and single nucleotide polymorphisms (SNPs). As EODs play a crucial role during the evolution of Campylomormyrus species, the identification of its underlying genes may suggest how the EOD diversity evolved and whether this trait is based on a complex network of genetic processes or is regulated by only a few genes. The results obtained in this study suggest that genes with non-synonymous SNPs, which are exclusive to C. tshokwe with an elongated EOD, have frequent functions ssociated with tissue morphogenesis and transcriptional regulation. Therefore, it is proposed that these processes likely co-determine EOD characteristics of Campylomormyrus species. Furthermore, genome-wide analyses confirm the genetic difference among most Campylomormyrus species. In contrast, the same analyses reveal genetic similarity among individuals of the alces-complex showing different EOD waveforms. It is therefore hypothesized that the low genetic variability and high EOD diversity represents incipient sympatric speciation. The karyological description of a Campylomormyrus species provides crucial information about chromosome number and shapes. Its diploid chromosome number of 2n=48 supports the conservation of this trait within Mormyridae. Differences have been detected in the number of bi-armed chromosomes which is unusually high compared to other mormyrid species. This high amount can be due to chromosome rearrangements which could cause genetic incompatibility and reproductive isolation. Hence an alternative hypothesis regarding processes which cause sympatric speciation is that chromosome differences are involved in the speciation process of Campylomormyrus by acting as postzygotic isolation mechanism. In summary, the karyological and genomic investigations conducted in this study contributed to the increase of knowledge about Campylomormyrus species, to the solution of some existing ambiguities like phylogenetic relationships and to the raising of new hypothesis explaining the sympatric speciation of those African weakly electric fish. This study provides a basis for future genomic research to obtain a complete picture for causes and results of evolutionary processes in Campylomormyrus.
Technical report
(2019)
Design and Implementation of service-oriented architectures imposes a huge number of research questions from the fields of software engineering, system analysis and modeling, adaptability, and application integration. Component orientation and web services are two approaches for design and realization of complex web-based system. Both approaches allow for dynamic application adaptation as well as integration of enterprise application.
Commonly used technologies, such as J2EE and .NET, form de facto standards for the realization of complex distributed systems. Evolution of component systems has lead to web services and service-based architectures. This has been manifested in a multitude of industry standards and initiatives such as XML, WSDL UDDI, SOAP, etc. All these achievements lead to a new and promising paradigm in IT systems engineering which proposes to design complex software solutions as collaboration of contractually defined software services.
Service-Oriented Systems Engineering represents a symbiosis of best practices in object-orientation, component-based development, distributed computing, and business process management. It provides integration of business and IT concerns.
The annual Ph.D. Retreat of the Research School provides each member the opportunity to present his/her current state of their research and to give an outline of a prospective Ph.D. thesis. Due to the interdisciplinary structure of the research school, this technical report covers a wide range of topics. These include but are not limited to: Human Computer Interaction and Computer Vision as Service; Service-oriented Geovisualization Systems; Algorithm Engineering for Service-oriented Systems; Modeling and Verification of Self-adaptive Service-oriented Systems; Tools and Methods for Software Engineering in Service-oriented Systems; Security Engineering of Service-based IT Systems; Service-oriented Information Systems; Evolutionary Transition of Enterprise Applications to Service Orientation; Operating System Abstractions for Service-oriented Computing; and Services Specification, Composition, and Enactment.
IntroductionTo date, most studies of natural variation and metabolite quantitative trait loci (mQTL) in tomato have focused on fruit metabolism, leaving aside the identification of genomic regions involved in the regulation of leaf metabolism.ObjectiveThis study was conducted to identify leaf mQTL in tomato and to assess the association of leaf metabolites and physiological traits with the metabolite levels from other tissues.MethodsThe analysis of components of leaf metabolism was performed by phenotypying 76 tomato ILs with chromosome segments of the wild species Solanum pennellii in the genetic background of a cultivated tomato (S. lycopersicum) variety M82. The plants were cultivated in two different environments in independent years and samples were harvested from mature leaves of non-flowering plants at the middle of the light period. The non-targeted metabolite profiling was obtained by gas chromatography time-of-flight mass spectrometry (GC-TOF-MS). With the data set obtained in this study and already published metabolomics data from seed and fruit, we performed QTL mapping, heritability and correlation analyses.ResultsChanges in metabolite contents were evident in the ILs that are potentially important with respect to stress responses and plant physiology. By analyzing the obtained data, we identified 42 positive and 76 negative mQTL involved in carbon and nitrogen metabolism.ConclusionsOverall, these findings allowed the identification of S. lycopersicum genome regions involved in the regulation of leaf primary carbon and nitrogen metabolism, as well as the association of leaf metabolites with metabolites from seeds and fruits.
Plasticity in metabolism underpins local responses to nitrogen in Arabidopsis thaliana populations
(2019)
Nitrogen (N) is central for plant growth, and metabolic plasticity can provide a strategy to respond to changing N availability. We showed that two local A. thaliana populations exhibited differential plasticity in the compounds of photorespiratory and starch degradation pathways in response to three N conditions. Association of metabolite levels with growth-related and fitness traits indicated that controlled plasticity in these pathways could contribute to local adaptation and play a role in plant evolution.