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Der Singing Voice Handicap Index (SVHI) wurde zur Selbstbeurteilung einer Stimmstörung für Sänger in den USA entwickelt. Eine deutsche Übersetzung wurde erstellt und einer Reliabilitäts- und Validitätsprüfung unterzogen. Es wurden 54 dysphone Sänger (35 weiblich, 19 männlich), Patienten einer phoniatrischen Klinik, befragt. 130 stimmgesunde Opern- und Rundfunkchorsänger (74 weiblich, 56 männlich) bildeten die Kontrollgruppe. Die Reliabilität ergibt sich aus einer hochsignifikanten Test-Retest-Reliabilität (r = 0,960; p <= 0,001, Pearson-Korrelation) und einem Cronbach-? von 0,975. Eine Hauptkomponentenanalyse mit Varimaxrotation und die Ergebnisse des Screeplots legen die Interpretation des SVHI als einfaktorielle Skala nahe. Die Validität zeigt sich in einem hochsignifikanten Zusammenhang zwischen dem vom Patienten selbst eingeschätzten Schweregrad der Stimmstörung und dem SVHI-Gesamtscore. Patienten haben einen signifikant höheren SVHI-Gesamtscore als die Kontrollgruppe gesunder Sänger. Der SVHI ist als diagnostisches Instrument für den deutschsprachigen Raum geeignet.
Reductions in emissions have successfully led to a regional decline in atmospheric nitrogen depositions over the past 20 years. By analyzing long-term data from 110 mountainous streams draining into German drinking water reservoirs, nitrate concentrations indeed declined in the majority of catchments. Furthermore, our meta-analysis indicates that the declining nitrate levels are linked to the release of dissolved iron to streams likely due to a reductive dissolution of iron(III) minerals in riparian wetland soils. This dissolution process mobilized adsorbed compounds, such as phosphate, dissolved organic carbon and arsenic, resulting in concentration increases in the streams and higher inputs to receiving drinking water reservoirs. Reductive mobilization was most significant in catchments with stream nitrate concentrations < 6 mg L-1. Here, nitrate, as a competing electron acceptor, was too low in concentration to inhibit microbial iron(III) reduction. Consequently, observed trends were strongest in forested catchments, where nitrate concentrations were unaffected by agricultural and urban sources and which were therefore sensitive to reductions of atmospheric nitrogen depositions. We conclude that there is strong evidence that the decline in nitrogen deposition toward pre-industrial conditions lowers the redox buffer in riparian soils, destabilizing formerly fixed problematic compounds, and results in serious implications for water quality.
Background
Antiphospholipid antibodies (aPL) can be detected in asymptomatic carriers and infectious patients. The aim was to investigate whether a novel line immunoassay (LIA) differentiates between antiphospholipid syndrome (APS) and asymptomatic aPL+ carriers or patients with infectious diseases (infectious diseases controls (IDC)).
Methods
Sixty-one patients with APS (56 primary, 22/56 with obstetric events only, and 5 secondary), 146 controls including 24 aPL+ asymptomatic carriers and 73 IDC were tested on a novel hydrophobic solid phase coated with cardiolipin (CL), phosphatic acid, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylinositol, phosphatidylserine, beta2-glycoprotein I (β2GPI), prothrombin, and annexin V. Samples were also tested by anti-CL and anti-β2GPI ELISAs and for lupus anticoagulant activity. Human monoclonal antibodies (humoAbs) against human β2GPI or PL alone were tested on the same LIA substrates in the absence or presence of human serum, purified human β2GPI or after CL-micelle absorption.
Results
Comparison of LIA with the aPL-classification assays revealed good agreement for IgG/IgM aß2GPI and aCL. Anti-CL and anti-ß2GPI IgG/IgM reactivity assessed by LIA was significantly higher in patients with APS versus healthy controls and IDCs, as detected by ELISA. IgG binding to CL and ß2GPI in the LIA was significantly lower in aPL+ carriers and Venereal Disease Research Laboratory test (VDRL) + samples than in patients with APS. HumoAb against domain 1 recognized β2GPI bound to the LIA-matrix and in anionic phospholipid (PL) complexes. Absorption with CL micelles abolished the reactivity of a PL-specific humoAb but did not affect the binding of anti-β2GPI humoAbs.
Conclusions
The LIA and ELISA have good agreement in detecting aPL in APS, but the LIA differentiates patients with APS from infectious patients and asymptomatic carriers, likely through the exposure of domain 1.