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Flood events can be expressed by a variety of characteristics such as flood magnitude and extent, event duration or incurred loss. Flood estimation and management may benefit from understanding how the different flood characteristics relate to the hydrological catchment conditions preceding the event and to the meteorological conditions throughout the event. In this study, we therefore propose a methodology to investigate the hydro-meteorological controls on different flood characteristics, based on the simulation of the complete flood risk chain from the flood triggering precipitation event, through runoff generation in the catchment, flood routing and possible inundation in the river system and floodplains to flood loss. Conditional cumulative distribution functions and regression tree analysis delineate the seasonal varying flood processes and indicate that the effect of the hydrological pre-conditions, i.e. soil moisture patterns, and of the meteorological conditions, i.e. weather patterns, depends on the considered flood characteristic. The methodology is exemplified for the Elbe catchment. In this catchment, the length of the build-up period, the event duration and the number of gauges undergoing at least a 10-year flood are governed by weather patterns. The affected length and the number of gauges undergoing at least a 2-year flood are however governed by soil moisture patterns. In case of flood severity and loss, the controlling factor is less pronounced. Severity is slightly governed by soil moisture patterns whereas loss is slightly governed by weather patterns. The study highlights that flood magnitude and extent arise from different flood generation processes and concludes that soil moisture patterns as well as weather patterns are not only beneficial to inform on possible flood occurrence but also on the involved flood processes and resulting flood characteristics.
A particular form of social pain is invalidation. Therefore, this study (a) investigates whether patients with chronic low back pain experience invalidation, (b) if it has an influence on their pain, and (c) explores whether various social sources (e.g. partner and work) influence physical pain differentially. A total of 92 patients completed questionnaires, and for analysis, Pearson’s correlation coefficients and hierarchical linear regression analyses were conducted. They indicated a significant association between discounting and disability due to pain (respective β = .29, p > .05). Especially, discounting by partner was linked to higher disability (β = .28, p > .05).
A growing number of expert organizations aim to provide knowledge for global environmental policy-making. Recently, there have also been explicit calls for stakeholder engagement at the global level to make scientific knowledge relevant and usable on the ground. The newly established Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) is one of the first international expert organizations to have systematically developed a strategy for stakeholder engagement in its own right. In this article, we analyze the emergence of this strategy. Employing the concept politics of legitimation, we examine how and for what reasons stakeholder engagement was introduced, justified, and finally endorsed, as well as its effects. The article explores the process of institutionalizing stakeholder engagement, as well as reconstructing the contestation of the operative norms (membership, tasks, and accountability) regulating the rules for this engagement. We conclude by discussing the broader importance of the findings for IPBES, as well as for international expert organizations in general.
Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation
(2017)
Background: In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods: From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results: One hundred and thirty-six patients (80.6 +/- 5.0 years, 47.8% male) were enrolled. 6MWD and maximum work load increased by 56.3 +/- 65.3 m (p < 0.001) and 8.0 +/- 14.9 watts (p < 0.001), respectively. An improvement in SF-12 (physical 2.5 +/- 8.7, p = 0.001, mental 3.4 +/- 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions: Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life.
The purpose of the present study was to examine the effects of unilateral fatigue of the knee extensors at different movement velocities on neuromuscular performance in the fatigued and non-fatigued leg. Unilateral fatigue of the knee extensors was induced in 11 healthy young men (23.7 +/- 3.8 years) at slower (60A degrees/s; FAT60) and faster movement velocities (240A degrees/s; FAT240) using an isokinetic dynamometer. A resting control (CON) condition was included. The fatigue protocols consisted of five sets of 15 maximal concentric knee extensions using the dominant leg. Before and after fatigue, peak isokinetic torque (PIT) and time to PIT (TTP) of the knee extensors as well as electromyographic (EMG) activity of vastus medialis, vastus lateralis, and biceps femoris muscles were assessed at 60 and 240A degrees/s movement velocities in the fatigued and non-fatigued leg. In the fatigued leg, significantly greater PIT decrements were observed following FAT60 and FAT240 (11-19%) compared to CON (3-4%, p = .002, d = 2.3). Further, EMG activity increased in vastus lateralis and biceps femoris muscle following FAT240 only (8-28%, 0.018 <= p <=.024, d = 1.8). In the non-fatigued leg, shorter TTP values were found after the FAT60 protocol (11-15%, p = .023, d = 2.4). No significant changes were found for EMG data in the non-fatigued leg. The present study revealed that both slower and faster velocity fatiguing contractions failed to show any evidence of cross-over fatigue on PIT. However, unilateral knee extensor fatigue protocols conducted at slower movement velocities (i.e., 60A degrees/s) appear to modulate torque production on the non-fatigued side (evident in shorter TTP values).
Mitogen-activated protein kinases (MAPKs) mediate plant immune responses to pathogenic bacteria. However, less is known about the cell autonomous negative regulatory mechanism controlling basal plant immunity. We report the biological role of Arabidopsis thaliana MAPK phosphatase AP2C1 as a negative regulator of plant basal resistance and defense responses to Pseudomonas syringae. AP2C2, a closely related MAPK phosphatase, also negatively controls plant resistance. Loss of AP2C1 leads to enhanced pathogen-induced MAPK activities, increased callose deposition in response to pathogen-associated molecular patterns or to P. syringae pv. tomato (Pto) DC3000, and enhanced resistance to bacterial infection with Pto. We also reveal the impact of AP2C1 on the global transcriptional reprogramming of transcription factors during Pto infection. Importantly, ap2c1 plants show salicylic acid-independent transcriptional reprogramming of several defense genes and enhanced ethylene production in response to Pto. This study pinpoints the specificity of MAPK regulation by the different MAPK phosphatases AP2C1 and MKP1, which control the same MAPK substrates, nevertheless leading to different downstream events. We suggest that precise and specific control of defined MAPKs by MAPK phosphatases during plant challenge with pathogenic bacteria can strongly influence plant resistance.
Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration as a biomarker of an acute renal damage during the follow-up of 90 days after contrast medium (CM) application. Blood samples were obtained from 330 consecutive patients with diabetes mellitus or mild renal impairment immediately before, 24 and 48 hours after the CM application for coronary angiography. The patients were followed for 90 days. The composite endpoints were major adverse renal events (MARE) defined as occurrence of death, initiation of dialysis, or a doubling of serum creatinine concentration. Overall, ADMA concentration in plasma increased after CM application, although, there was no differences between ADMA levels in patients with and without CIN. ADMA concentration 24 hours after the CM application was predictive for dialysis with a specificity of 0.889 and sensitivity of 0.653 at values higher than 0.71 mu mol/L (area under the curve: 0.854, 95% confidential interval: 0.767-0.941, P<0.001). This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. 24 hours after the CM application, ADMA concentration in plasma was predictive for MARE with a specificity of 0.833 and sensitivity of 0.636 at a value of more than 0.70 mu mol/L (area under the curve: 0.750, 95% confidence interval: 0.602-0.897, P=0.004). Multivariate logistic regression analysis confirmed that ADMA and anemia were significant predictors of MARE. Further analysis revealed that increased ADMA concentration in plasma was highly significant predictor of MARE in patients with CIN. Moreover, patients with CIN and MARE had the highest plasma ADMA levels 24 hours after CM exposure in our study cohort. The impact of ADMA on MARE was independent of such known CIN risk factors as anemia, pre-existing renal failure, pre-existing heart failure, and diabetes. ADMA concentration in plasma is a promising novel biomarker of major contrast-induced nephropathy-associated events 90 days after contrast media exposure.
Are potential cabinets more likely to form when they control institutional veto players such as symmetric second chambers or minority vetoes? Existing evidence for a causal effect of veto control has been weak. This article presents evidence for this effect on the basis of conditional and mixed logit analyses of government formations in 21 parliamentary and semi-presidential democracies between 1955 and 2012. It also shows that the size of the effect varies systematically across political-institutional contexts. The estimated causal effect was greater in countries that eventually abolished the relevant veto institutions. It is suggested that the incidence of constitutional reform is a proxy for context-specific factors that increased the incentives for veto control and simultaneously provided a stimulus for the weakening of institutional veto power.
In a recent article in this journal, Ahrne, Brunsson, and Seidl (2016) suggest a definition of organization as a ‘decided social order’ composed of five elements (membership, rules, hierarchies, monitoring, and sanctions) which rest on decisions. ‘Partial organization’ uses only one or a few of these decidable elements while ‘complete organization’ uses them all. Such decided orders may also occur outside formal organizations, as the authors observe. Although we appreciate the idea of improving our understanding of organization(s) in modern society, we believe that Ahrne, Brunsson, and Seidl's suggestion jeopardizes the concept of organization by blurring its specific meaning. As the authors already draw on the work of Niklas Luhmann, we propose taking this exploration a step further and the potential of systems theory more seriously. Organizational analysis would then be able to retain a distinctive notion of formal organization on the one hand while benefiting from an encompassing theory of modern society on the other. With this extended conceptual framework, we would expect to gain a deeper understanding of how organizations implement and shape different societal realms as well as mediate between their particular logics, and, not least, how they are related to non-organizational social forms (e.g. families).
Objective:
The purpose of this study was to examine the impact of age and weight status on adolescents' body dissatisfaction and its change over 20 months in a gender-comparing design. The influence of body image concern on eating concern was also investigated.
Method:
In a prospective study, 675 male and female adolescents aged 12–16 were assessed using self-report questionnaires on weight, shape, muscularity, and eating concerns. Height and weight measurements were taken by trained personnel. Data were analyzed using structural equation modeling.
Results:
Analyses of latent means revealed more pronounced weight/shape concern in females than males and more pronounced muscularity concern in males than females. Weight/shape concern increased in females over time, whereas muscularity concern remained stable in both genders. Baseline levels of weight/shape concern could be predicted by age and weight status in females and by weight status in males. The only predictor of change in weight/shape concern was weight status in males. Baseline levels of muscularity concern could be predicted by age in females and by weight status in males. Similar effects were found for changes in muscularity concern in both genders. Increases in weight/shape and muscularity concern were associated with more pronounced eating concern.
Discussion:
The results confirm gender differences in distinctive facets of body image concern and its prediction. The relevance of increase in body image concern in adolescents is underlined by its association with eating concern in both genders. Further explanatory variables for change in body dissatisfaction should be examined in future studies.