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Rabies post-exposure prophylaxis (R-PEP) including wound treatment, vaccination and application of rabies immunoglobulin (RIG) is essential in preventing rabies mortality. Today, Germany is officially declared free from terrestrial rabies and rabies is only found in bats. However, physicians in A&E Departments are frequently consulted on the need for R-PEP. We retrospectively analysed patients who received R-PEP at the A&E Department of the University Hospital Bonn between 01.01.2013 and 30.06.2019. Demographic data, travel history, clinical and laboratory findings, previous rabies vaccinations and R-PEP vaccination regimen were recorded. During the study period, 90 patients received R-PEP at the University Hospital Bonn, in 10 cases without indication for R-PEP. Altogether, we found deviations from R-PEP guidelines in 51% (n = 41/80). Infiltration of RIG was missed in 12 patients and incorrectly administrated in 24 patients. Furthermore, vaccination scheme was incorrect in 11 patients. Correct wound washing and documentation of tetanus status was missing in 14% and 63% of patients, respectively. Despite rabies elimination in Germany patients frequently seek advice for R-PEP, the majority returning from foreign travel. Our data show that there is a high need for education on indication for R-PEP before and after travel and for implementation of precise R-PEP guidelines in daily clinical practice.
ABSTRACT IMPACT: This study assesses patient and volumetric risk factors for distant recurrence within 6 months of completion of curative chemoradiation with brachytherapy in locally advanced cervical cancer. OBJECTIVES/GOALS: Initial tumor volume and tumor shrinkage velocity are prognostic of cure and survival after curative chemoradiation (CRT) for cervical cancer. We explored whether local tumor volumetric changes influence time to distant recurrences outside the radiation field. METHODS/STUDY POPULATION: We performed a retrospective cohort study of patients with FIGO Stage IB-IVA cervical cancer treated with curative CRT and brachytherapy at a tertiary academic center with minimum 3 months follow up and standard post-treatment FDG-PET. Patients received 6 weekly fractions of brachytherapy interdigitated with external beam radiation and cisplatin. Tumor volumes were assessed by MRI at brachytherapy planning. Patients who developed distant metastasis were classified as earliest (3-6 months), early (6-24 months) or late (>24 months) following completion of CRT. Absolute and percent decrease in tumor volume for each fraction were calculated with respect to first brachytherapy volume. Fisher’s exact and Mann Whitney-U tests were used for comparison of categorical and continuous variables. RESULTS/ANTICIPATED RESULTS: 143 of 574 (25%) patients developed distant metastasis. Distribution of age, histology, FIGO 2018 stage, primary tumor SUVmax, treatment length, and pre/post treatment squamous cell carcinoma antigen levels were not associated in each group. Para-aortic lymph metastases were more common in patients with earliest distant recurrence (33% earliest, 26% early, 12% late, p=0.03). Median initial tumor volume in the earliest (n=24), early (n =29) and late (n=9) groups was 57, 28 and 40 mL, respectively (p=0.08); 57 (earliest) vs 30mL (early+late groups), p=0.04. Average mid treatment (fraction 4) and end of treatment (fraction 6) percent shrinkage was 80 (earliest) vs 73 (early+late), p=0.84 and 94 vs 92, p=0.95, respectively. Neither absolute nor percent tumor shrinkage differed between early vs. late groups. DISCUSSION/SIGNIFICANCE OF FINDINGS: Tumor volumetric changes during definitive chemoradiation were not associated with the timing of developing distant metastasis, which is linked to presence of lymph node metastasis and tumor volume at diagnosis.
Our commentators explore the operation of grounded procedures across all levels of analysis in the behavioral sciences, from mental to social, developmental, and evolutionary/functional. Building on them, we offer two integrative principles for systematic effects of grounded procedures to occur. We discuss theoretical topics at each level of analysis, address methodological recommendations, and highlight further extensions of grounded procedures.
Experimental work has revealed causal links between physical cleansing and various psychological variables. Empirically, how robust are they? Theoretically, how do they operate? Major prevailing accounts focus on morality or disgust, capturing a subset of cleansing effects, but cannot easily handle cleansing effects in non-moral, non-disgusting contexts. Building on grounded views on cognitive processes and known properties of mental procedures, we propose grounded procedures of separation as a proximate mechanism underlying cleansing effects. This account differs from prevailing accounts in terms of explanatory kind, interpretive parsimony, and predictive scope. Its unique and falsifiable predictions have received empirical support: Cleansing attenuates or eliminates otherwise observed influences of prior events (1) across domains and (2) across valences. (3) Cleansing manipulations produce stronger effects the more strongly they engage sensorimotor capacities. (4) Reversing the causal arrow, motivation for cleansing is triggered more readily by negative than positive entities. (5) Conceptually similar effects extend to other physical actions of separation. On the flipside, grounded procedures of connection are also observed. Together, separation and connection organize prior findings relevant to multiple perspectives (e.g., conceptual metaphor, sympathetic magic) and open up new questions. Their predictions are more generalizable than the specific mappings in conceptual metaphors, but more fine-grained than the broad assumptions of grounded cognition. This intermediate level of analysis sheds light on the interplay between mental and physical processes.
Two new isocrinids are described from the Lower Cretaceous Agrio Formation of the Neuquén Basin, west-central Argentina. Isocrinus (Chladocrinus) covuncoensis new species is based on several beautifully preserved specimens from Valanginian beds of the Pilmatué Member. It is characterized by a small size, multiramose crown with six arm divisions, 240 arm tips, mostly isotomous branching, seven (or rarely eight) secundibrachials, smooth and stout column, short noditaxis, and pentalobate columnals. The species occurs in a 30 m thick interval of cross-bedded sandstones and mixed clastic-carbonate sediments that represent the migration of large, tidally influenced, subaqueous dunes developed in the offshore. Sudden burial of crinoids that dwelled on the dune toes and interdunes, possibly by the acceleration of the lee face migration, provided the exceptional preservation of specimens and thus this finding can be considered as a local crinoid Konservat Lagerstätte. Isocrinus (Chladocrinus) pehuenchensis new species is described from a single articulated specimen preserved in a silty calcareous concretion collected from a late Hauterivian concretion level of the Agua de la Mula Member. It is characterized by isotomous branching, eight or nine secundibrachials (IIBr), slender column ornamented with medial ridge of fine tubercles, interradius acuminated with fine tubercles on its tip, short noditaxis, and pentastellate columnals. It is associated with low-energy fall-out deposits in the offshore. The excellent state of preservation was due to an early cementation process by carbonate that enhanced lithification around the specimen.
Computer based trainings (CBTs) are established in the rehabilitation of mentally ill people to recover cognitive skills (Medalia et al., 2009). The Critique to some CBTs are lack of preparation for real life scenario, no use of tasks that simultaneously engage multiple cognitive processes and lack of enhancing motivation (Medalia & Choi, 2009). This may be summarized as a lack of biotic design in CBTs.
In depressive disorders besides other symptoms a lack of energy/motivation, forgetfulness and difficulty in concentrating are observable. The goal of this pilot study was to develop a new “biotic” designed CBT (Mebitrain) and evaluate its effect on global working memory (GWM) and motivation with data from patients suffering from depression.
To test whether Mebitrain enhances GWM (measured before and after a ten day training period with the LGT from Bäumler) and motivation (measured before and after training with custom rating scales and during the training with time and performance) five depressive (ICD diagnoses F31.0, F33.2, F32.3) patients were tested.
Differences between pre- (mean 33.6 ± 10.35) and post- (mean 38 ± 6) LGT values show a marginal significant trend (p = 0.1) with moderate effect size (d = .54).
The time finishing the training decreased per training session significantly with an increasing in performance (r = −.788, p < .005).
First results indicate that the development of a biotic designed training and its application may increase global cognitive functions and motivation in depressive patients. Limitations (e.g. sample size, transfer, etc.) of this pilot study are discussed.
A proinflammatory state in a subgroup of depressed patients has been reported repeatedly (e.g. increased interleukin-6 and tumour necrosis factor-alpha). COX-2 inhibitors down-regulate increased inflammatory markers and are therefore investigated as an add-on therapy in depression. Proinflammatory cytokines and/or kynurenine metabolites may predict the outcome of treatment with COX-2 inhibitors.
To prove or disapprove the hypothesis of a better therapy response in the group of add-on celecoxib to sertraline, particularly in patients with a more pronounced proinflammatory state at baseline. The aim is to find a biological predictor (cytokines and/or kynurenine metabolites) for treatment outcome.
This is a dual-center, randomized, double-blind, placebo-controlled, parallel group phase IIa study. It investigates the mean change in clinical outcome and in serum cytokine and kynurenine levels from baseline to endpoint (week 6) in patients with major depression (HAMD-17 ≥ 22) treated with sertraline plus celecoxib versus sertraline plus placebo for six weeks. 51 depressed patients of both gender, aged between 18 and 60 years without any recent inflammatory disease were enrolled. The study comprises six study visits (6x ratings, 3x blood collections) during six weeks of treatment and a follow-up visit 10 weeks after baseline. Cytokines were measured by Enzyme-linked Immunosorbent Assay (ELISA), kynurenine and its metabolites by High Performance Liquid Chromatography (HPLC).
Results and Conclusion
The study was completed quite recently and the results are in progress.
In schizophrenia, sex differences related to age of onset, course of illness and response to antipsychotic treatment may be mirrored by differences in the underlying molecular pathways. We attempted to increase our understanding of these phenomena by carrying out multiplex immunoassay profiling of 95 serum molecules using samples from 4 independent cohorts of male and female first episode antipsychotic naive schizophrenia patients (n=133) and matched controls (n=133). The concentrations of 16 molecules associated with hormonal, inflammation and growth factor pathways showed significant sex differences in schizophrenia patients compared with controls. In line with the numerous sex differences reported in schizophrenia, our findings included alterations in the levels of several hormones, including elevated free and total testosterone in female patients and concomitant sex differences in sex hormone binding globulin and prolactin concentrations. We also found higher levels of thyroxine binding globulin and seven inflammatory markers in male schizophrenia patients only, raising the possibility that some aspects of the widely-reported immunological abnormalities in schizophrenia may be specific for males. Several of these markers showed sexspecific associations with positive and negative syndrome scale (PANSS) scores and changes in concentration after 6 weeks of treatment with antipsychotics. Finally, we also evaluated overlapping and distinct sex-specific biomarkers for schizophrenia, Asperger syndrome, major depressive disorder and bipolar disorder. We propose that future studies should investigate the common and sex-specific aetiologies of schizophrenia, as the current findings suggest that different therapeutic strategies may be required for male and female patients.
A proinflammatory state in a subgroup of depressed patients has been reported repeatedly, for example an increase in interleukin-6 and tumour necrosis factor-a is well documented. Treatment with COX-2 inhibitors down-regulate increased inflammatory markers. Therefore an adjunctive treatment of depression with COX-2 in combination with an antidepressant might lead to a better clinical outcome.
To prove or disapprove the hypothesis of a better clinical outcome in the group with add-on celecoxib to sertraline in terms of improvement of HamD-17 and MADRS scores from baseline to endpoint.
This is a dual-center, randomized, double-blind, placebo-controlled, parallel group phase IIa study to investigate the mean change in clinical outcome and in serum expression of inflammation markers from baseline to endpoint (week 6) in patients with major depression (HAMD-17 ≥ 22) treated with celecoxib in combination with sertraline compared to sertraline combined with placebo. 51 depressed patients of both gender, aged between 18 and 60 without any recent inflammatory related disease were enrolled. The study comprises six study visits (6x ratings including HAMD-17 and MADRS, 3x blood collections) during six weeks of treatment and a follow-up visit 10 weeks after baseline.
Results and Conclusion
The study was completed quite recently and the results are in progress.
Thought about abstract concepts is grounded in more concrete physical experiences. Applying this grounded cognition perspective to Boyer & Petersen's (B&P's) folk-economic beliefs, we highlight its implications for the activation, application, cultural acceptance, and context sensitivity of folk-economic beliefs.
Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.
Data are scarce regarding combined high Se and Mn supplementation in livestock diets, however, as Se and Mn are functionally related as cofactors of glutathione peroxidase (GPx) and Mn-superoxide dismutase (SOD), respectively, beneficial synergistic effects on oxidative stability of tissues may result. This experiment evaluated the effect of an oversupply of Se and Mn within European legal limits compared with recommendations on performance, oxidative stability of the organism and meat quality in a randomised complete block design. A total of 60 crossbred gilts were fed maize–barley–soya bean meal diets formulated in a 2×2 factorial approach with inorganic Se (0.2 v. 0.5 mg/kg Se dry matter (DM)) or inorganic Mn (20 v. 150 mg/kg Mn DM) from 31 to 116 kg BW. Se supplementation reduced feed intake, whereas high Mn diets impaired average daily gain (P<0.05). Qualitative carcass characteristics were impaired by Se and Mn predominantly in the semimembranosus muscle. Activity of GPx in liver was increased by high Se diets (P<0.05). Mn supplementation increased catalase (CAT) activity in liver, GPx in plasma and total antioxidative capacity (TAC) in muscle, whereas it decreased CAT activity in plasma (P<0.05). Cu/Zn-SOD in muscle showed higher activity in high-Se-low-Mn diets but lower activity when both high Se and Mn were combined (Se×Mn P<0.05). Mn supplementation increased Mn concentration in longissimus thoracis et lumborum, but simultaneously reduced Se concentration (P<0.05). Upon retail display, Mn increased lipid oxidation more pronouncedly (higher thiobarbituric acid reactive substances; P<0.05) than Se (P<0.10). Despite some positive effects (Mn increased TAC, Se increased GPx, Se and Mn increased tenderness), no synergistic effects of high Se and Mn diets or an overall beneficial impact on meat quality, especially during storage, could be observed. Including the negative effects on performance, feeding Se and Mn up to the maximum legal level cannot be recommended.
New observations of the Magellanic Stream were made in December 1976 with the 64-m radio telescope at the Parkes Observatory of CSIRO. The ridges of H I emission of the Stream were traced from near its tip at ℓ = 90°, b = -40° to the Magellanic Clouds. This was the first time that the total length of the Stream was observed with the one system (only possible from the southern hemisphere) and with high spatial (15’ of arc) and velocity (4 km s-1) resolution. The results of this survey are presented in Figures 1 and 2 and the main features are listed below.
Our objective was to determine whether a Symbol Search paradigm developed for functional magnetic resonance imaging (FMRI) is a reliable and valid measure of cognitive processing speed (CPS) in healthy older adults. As all older adults are expected to experience cognitive declines due to aging, and CPS is one of the domains most affected by age, establishing a reliable and valid measure of CPS that can be administered inside an MR scanner may prove invaluable in future clinical and research settings. We evaluated the reliability and construct validity of a newly developed FMRI Symbol Search task by comparing participants’ performance in and outside of the scanner and to the widely used and standardized Symbol Search subtest of the Wechsler Adult Intelligence Scale (WAIS). A brief battery of neuropsychological measures was also administered to assess the convergent and discriminant validity of the FMRI Symbol Search task. The FMRI Symbol Search task demonstrated high test–retest reliability when compared to performance on the same task administered out of the scanner (r=.791; p<.001). The criterion validity of the new task was supported, as it exhibited a strong positive correlation with the WAIS Symbol Search (r=.717; p<.001). Predicted convergent and discriminant validity patterns of the FMRI Symbol Search task were also observed. The FMRI Symbol Search task is a reliable and valid measure of CPS in healthy older adults and exhibits expected sensitivity to the effects of age on CPS performance. (JINS, 2015, 22, 1–8)
This study examined whether Ascaridia galli infection can be controlled by dietary non-starch polysaccharides (NSP) in chickens. One-day-old chicks were fed either a basal diet (CON) or CON plus insoluble NSP (I-NSP), or CON plus soluble NSP (S-NSP) for 11 weeks. Three weeks later, birds from half of each feeding group were inoculated with 250 embryonated eggs of A. galli, and slaughtered 8 weeks post-infection to determine worm counts. Both NSP diets, particularly S-NSP, increased prevalence of infection (P<0·05) and worm burden (roughly +50%) of the birds (P<0·001). A. galli infection caused a less efficient (P=0·013) feed utilization for body weight gain (BWG) resulting in lower body weights (P<0·001) irrespective of type of diet consumed. NSP-fed birds, particularly those on I-NSP, consumed more (+8%) feed per unit BWG and showed retarded (P<0·001) BW development compared to CON-fed birds. Intracaecal pH was lowered by S-NSP (P<0·05). Both NSP diets increased the volatile fatty acids pool size in caeca (P<0·001) with S-NSP exerting a greater effect (+46%) than I-NSP (+24%). It is concluded that both NSPs supplemented diets alter gastrointestinal environment in favour of the nematode establishment, and thus have no potential for controlling A. galli infection in chickens.
Somatic cell count (SCC) is generally regarded as an indicator of udder health. A cut-off value of 100×103 cells/ml is currently used in Germany to differentiate between normal and abnormal secretion of quarters. In addition to SCC, differential cell counts (DCC) can be applied for a more detailed analysis of the udder health status. The aim of this study was to differentiate somatic cells in foremilk samples of udder quarters classified as normal secreting by SCC <100×103 cells/ml. Twenty cows were selected and 72 normal secreting udder quarters were compared with a control group of six diseased quarters (SCC >100×103 cells/ml). In two severely diseased quarters of the control group (SCC of 967×103 cells/ml and 1824×103 cells/ml) Escherichia coli and Staphylococcus aureus were detected. DCC patterns of milk samples (n=25) with very low SCC values of ⩽6·25×103 cells/ml revealed high lymphocyte proportions of up to 92%. Milk cell populations in samples (n=41) with SCC values of (>6·25 to ⩽25)×103 cells/ml were also dominated by lymphocytes (mean value 47%), whereas DCC patterns of milk from udder quarters (n=6) with SCC values (>25 to ⩽100)×103 cells/ml changed. While in samples (n=3) with SCC values of (27–33)×103 cells/ml macrophages were predominant (35–40%), three milk samples with (43–45)×103 cells/ml indicated already inflammatory reactions based on the predominance of polymorphonuclear leucocytes (PMN) (54–63%). In milk samples of diseased quarters PMN were categorically found as dominant cell population with proportions of ⩾65%. Macrophages were the second predominant cell population in almost all samples tested in relationship to lymphocytes and PMN. To our knowledge, this is the first study evaluating cell populations in low SCC milk in detail. Udder quarters classified as normal secreting by SCC <100×103 cells/ml revealed already inflammatory processes based on DCC.