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Purpose The Colombian Government launched an e-government initiative in 2008 to facilitate communication among the government, citizens and organizations. Considering the high level of mistrust of citizens and businesses toward governmental institutions, the government must ensure the security of the information handled and provided by online users. Results to date have not been adequate in the usage of e-government systems. The purpose of this study is to evaluate whether the level of online security affects usage and impacts the cost-effectiveness and quality of the operations and, consequently, the operational effectiveness of organizations using e-government systems. Design/methodology/approach Structural equation modeling was used to analyze the antecedents and outcomes of operational effectiveness. To this end, 440 usable questionnaires were collected from managers and personnel from Colombian organizations using e-government systems. Findings According to the findings, there is a positive predictive relationship between online security and the dimensions of electronic government effectiveness. Furthermore, neither online security nor any of the dimensions of electronic government effectiveness affect the operational costs of organizations. Nonetheless, the quality of information has a positive effect on the quality of operations. As a result, through the quality of the information, online security has an indirect impact on the quality of operations. Research limitations/implications The authors used a convenience sample, carefully selecting respondents based on their operations and practice knowledge and implementation of online security processes. Besides, compared to previous research conducted in developed nations, the sample size is relatively small. Because the survey is based on responses from official companies, it must also be taken into account that over 50% of Colombian labor is informal. Furthermore, Colombia is a nation with a high level of mistrust. When considering these factors, generalizability to all industrial sectors is questionable. Nevertheless, the findings of this study offer relevant information that indicates the need for more extended and comprehensive quantitative research. Practical implications Improvements in organizations that use e-government systems, based on the benefits that high-quality information brings to operational performance – cost and quality – will help them survive and become more sustainable and competitive. Furthermore, this study supports the assertion that aspects like online security are critical in promoting information and communication technology uptake and user acceptance in transition and rising economies like Colombia. Originality/value There is still a scarcity of information on assessing the effectiveness of electronic government systems and their impact on the quality and cost of operations in organizations that use them. Additionally, Colombia, as a country with low levels of trust between citizens, organizations and government, still lacks information about the impact of online security on the effectiveness of its operations.

Early prognostication of COVID-19 severity will potentially improve patient care. Biomarkers, such as TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10), and C-reactive protein (CRP), might represent possible tools for point-of-care testing and severity prediction.In this prospective cohort study, we analyzed serum levels of TRAIL, IP-10, and CRP in patients with COVID-19, compared them with control subjects, and investigated the association with disease severity.A total of 899 measurements were performed in 132 patients (mean age 64 years, 40.2% females). Among patients with COVID-19, TRAIL levels were lower (49.5 vs 87 pg/ml, P = 0.0142), whereas IP-10 and CRP showed higher levels (667.5 vs 127 pg/ml, P0.001; 75.3 vs 1.6 mg/l, P0.001) than healthy controls. TRAIL yielded an inverse correlation with length of hospital and intensive care unit (ICU) stay, Simplified Acute Physiology Score II, and National Early Warning Score, and IP-10 showed a positive correlation with disease severity. Multivariable regression revealed that obesity (adjusted odds ratio [aOR] 5.434, 95% confidence interval [CI] 1.005-29.38), CRP (aOR 1.014, 95% CI 1.002-1.027), and peak IP-10 (aOR 1.001, 95% CI 1.00-1.002) were independent predictors of in-ICU mortality.We demonstrated a correlation between COVID-19 severity and TRAIL, IP-10, and CRP. Multivariable regression showed a role for IP-10 in predicting unfavourable outcomes, such as in-ICU mortality.Clinicaltrials.gov, NCT04655521.

Lithium-ion battery cells with high energy density are widely used in today's electric vehicles. However, thermal runaway (TR) of a battery cell is still a major safety issue in the use of lithium-ion batteries in the automotive sector. In particular, the variability of TR, which is not yet fully understood, can lead to significant safety issues. This paper investigates the variability of individual decomposition reactions during TR and their influence on the overall scattering of TR behavior. Therefore, differential scanning calorimetry measurements on individual cell components and their combinations are carried out through multiple repetitions. It is found that the individual heat release contributions of different chemical reactions show significant variations to the overall heat release of the TR. The heat release of anode/electrolyte reactions show a variability of up to 47%, whereas the cathode/electrolyte reactions show more consistent heat release. The reactions are summarized in an energy release diagram to combine the varying behavior of individual reactions with the overall TR chain reaction mechanism. Thus, the scattering of TR behavior of a cell can be mapped based on the variability of individual reactions. These findings should help to understand the scattering of TR behavior already at the material level.

BackgroundThe human body louse (Pediculus humanus humanus) is a host-specific hematophagous ectoparasite that frequently infests populations experiencing a breakdown of hygienic conditions. Body lice are also vectors for several bacterial human pathogens, including Bartonella quintana, the agent of trench fever. However, the factors that influence immunity and infection in body lice are poorly understood. Human infection with B. quintana is associated with alcoholism and homelessness and can coincide with elevated circulating levels of the cytokine IL-10 and the inflammatory marker neopterin. Hematophagous arthropods are capable of responding physiologically and immunologically to a variety of biomolecules present in the blood of their hosts. Therefore, we sought to investigate whether ingestion of alcohol, its metabolic product acetaldehyde, IL-10 or neopterin could affect innate immunity and infection in the body louse.MethodsGroups of lice were provisioned multiple blood meals containing physiological concentrations of alcohol, acetaldehyde, IL-10 or neopterin, and expression of six previously identified immunity-related genes (Defensin 1, Defensin 2, Prophenoloxidase, Hemocytin, Noduler and Dual Oxidase) was examined by qRT-PCR.ResultsAlcohol, acetaldehyde and IL-10 had no significant effects on gene expression relative to blood-fed controls while ingestion of neopterin significantly downregulated expression of Defensin 1 and Defensin 2. Nonetheless, ingestion of neopterin concurrent with B. quintana had no significant effect on the load of infection, indicating that neopterin-induced repression of Defensin expression is insufficient to reduce resistance to the pathogen.ConclusionsOur findings demonstrate that the immune system of body lice can be affected by factors present in the blood of their human hosts and suggest potential conservation of the function of some immune molecules from human host to ectoparasite. Further, the discord between the effects of neopterin on immunity-related gene expression and B. quintana load highlights the complexity of the regulation of pathogen infection in the louse vector.

MYT1L is an autism spectrum disorder (ASD)-associated transcription factor that is expressed in virtually all neurons throughout life. How MYT1L mutations cause neurological phenotypes and whether they can be targeted remains enigmatic. Here, we examine the effects of MYT1L deficiency in human neurons and mice. Mutant mice exhibit neurodevelopmental delays with thinner cortices, behavioural phenotypes, and gene expression changes that resemble those of ASD patients. MYT1L target genes, including WNT and NOTCH, are activated upon MYT1L depletion and their chemical inhibition can rescue delayed neurogenesis in vitro. MYT1L deficiency also causes upregulation of the main cardiac sodium channel, SCN5A, and neuronal hyperactivity, which could be restored by shRNA-mediated knockdown of SCN5A or MYT1L overexpression in postmitotic neurons. Acute application of the sodium channel blocker, lamotrigine, also rescued electrophysiological defects in vitro and behaviour phenotypes in vivo. Hence, MYT1L mutation causes both developmental and postmitotic neurological defects. However, acute intervention can normalise resulting electrophysiological and behavioural phenotypes in adulthood.

Purpose We evaluated the host-response marker score “BV” and its components TRAIL, IP-10, and CRP in SARS-CoV-2 positive children, and estimated the potential impact on clinical decision-making. Methods We prospectively analyzed levels of TRAIL, IP-10, CRP, and the BV score, in children with suspected COVID-19. Classification of infectious etiology was performed by an expert panel. We used a 5-point-questionnaire to evaluate the intention to treat with antibiotics before and after receiving test results. Results We screened 111 children, of whom 6 (5.4%) were positive for SARS-CoV-2. A total of 53 children were included for the exploratory analysis. Median age was 3.1 years (interquartile range [IQR] 1.3–4.3), and 54.7% (n = 29) were girls. A viral and a bacterial biomarker pattern was found in 27/53 (50.9%) and 15/53 (28.3%), respectively. BV scores differed between COVID-19, children with other viral infections, and children with bacterial infections (medians 29.5 vs. 9 vs. 66; p = 0.0006). Similarly, median TRAIL levels were different (65.5 vs. 110 vs. 78; p = 0.037). We found no differences in IP-10 levels (555 vs. 504 vs. 285; p = 0.22). We found a concordance between physicians’ “unlikely intention to treat” children with a viral test result in most cases (n = 19/24, 79.2%). When physicians expressed a “likely intention to treat” (n = 15), BV test revealed 5 bacterial, viral, and equivocal scores each. Antibiotics were withheld in three cases (20%). Overall, 27/42 (64%) of pediatricians appraised the BV test positively, and considered it helpful in clinical practice. Conclusion Host-response based categorization of infectious diseases might help to overcome diagnostic uncertainty, support clinical decision-making and reduce unnecessary antibiotic treatment.

PurposeThis article aims to examine the influence of emotional intelligence on cross-functional teams, the formation of interorganizational networks and the impact of all three dimensions on operational effectiveness.Design/methodology/approachThe analysis was based on 250 valid questionnaires collected from organizations in the Valle del Cauca region in Colombia in the service sector. The variables were analyzed using structural equation modeling to identify their relationships.FindingsThe results suggest that emotional intelligence contributes to establishing cross-functional teams but does not impact the development of interorganizational networks, influencing operational effectiveness only indirectly through the cross-functional teams. Contrary to what the literature suggests, interorganizational networks do not influence the operational effectiveness of organizations. Hence, in the pursuit of competitive advantage, companies in the studied region should encourage the creation of cross-functional teams within their organizations to maximize the returns received through the optimization of operational effectiveness.Practical implicationsOrganizations are comprised of individuals whose emotional intelligence competencies and abilities enable them to form effective cross-functional teams. Furthermore, cross-functional teams that effectively establish relationships with other organizations are frequently employed in global, interorganizational collaboration environments like joint ventures and alliances. Cross-functional teams that fulfill their aims have the potential to benefit the organization's performance by boosting operational effectiveness and, therefore, its competitiveness.Originality/valueThe value of this article lies in providing a better understanding of the capabilities and strategies of organizations in the construction of interorganizational networks intended to improve their competitiveness. However, before operational effectiveness and a sustainable competitive advantage can be achieved, the role of the individuals comprising the cross-functional teams should be managed through the appropriate application of the concepts of emotional intelligence.

The OpAQ is an ever-growing, free, open, multi-study, item-level dataset that allows researchers to solve current challenges in anchoring effects research.

Instability is a common indication for early revision total knee arthroplasty (rTKA). The comparative performance of instability rTKA performed after primary TKA and instability rerevision TKA (rrTKA) performed after a previous rTKA performed for any aseptic indication have not been defined. This study was performed to determine the rate of adverse outcomes for patients undergoing aseptic instability TKA revision following a primary TKA or a previous aseptic any-cause rTKA. After obtaining Institutional Review Board approval, we retrospectively identified 126 rTKA and 28 rrTKA component revision procedures performed for an exclusive instability diagnosis between January 1, 2011 and April 30, 2018. We excluded patients undergoing isolated liner exchange, single component revision for mid-flexion instability, and patients treated with a constrained hinge. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and adverse postrevision outcomes (reoperation, component revision, infection, amputation) were assessed using paired Student's t-test or Fisher's exact test with a p-value

Isolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, 2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value 2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p

Wiped film evaporators (WFE) or agitated thin film evaporators are efficient equipment for separating highly thermosensitive and viscous mixtures. There are different approaches to tailor residence time distribution (RTD) for specific applications and to maximise heat and mass transfer by equipment design or process parameter adjustment, like liquid load or wiper speed. However, the fundamental principles of fluid dynamics are only known to a limited extent. Although flow patterns and mass and heat transfer are highly interdependent, the effects of different wipers on liquid flow and, finally, on residence time behaviour are poorly understood. In this work, a new model describing fluid dynamics and its impact on RTD is presented. The model is implemented in the equation-based modelling language Modelica. Several system variables – e.g. film thickness, hold-up or velocity profiles within the liquid film – can be estimated. The effect of varying process parameters, like liquid load and fluid temperature, can also be evaluated. The model has been calibrated with results from RTD experiments in a WFE using a roller wiper. It is capable of describing the residence time behaviour of the roller wiper system with good accuracy. Mean residence times can be reproduced within approx. ±20%. Further results, such as film thickness or hold-up, provide additional insight into the fluid dynamics of characteristic regions – like bow wave, wiping and thin film zone – and the effects of several process parameters.

Base de datos para el artículo SUPPLY CHAIN RESILIENCE IN THE COLOMBIAN DEFENSE SECTOR BEFORE AND DURING THE COVID-19 PANDEMIC: A COMPARATIVE STUDY

Base de datos para el artículo Strategy and additive technologies: the key to fister innovation, outsourcing and operational effectiveness?

We investigated classical psychological findings as to whether they used NHST and how strong original evidence for these effects was. This is a work in progress.

En el presente libro se presentan tres estudios relacionados con el sector de frutas frescas en el Valle del Cauca, el primero de ellos es un estudio de referenciamiento competitivo, el segundo es un estudio de inteligencia económica (vigilancia tecnológica y análisis de tendencia) y, por último, se define el modelo y los caminos de cambio del sector tomando como horizonte temporal el año 2033. Para estos tres estudios se toman como referencia cuatro cadenas productivas priorizadas; banano, piña, aguacate y cacao. Buena parte de los insumos utilizados en el libro son producto de la realización del Índice de medición y monitoreo de la competitividad del sector de frutas frescas, el cual fue desarrollado teniendo en cuenta una encuesta realizada a 354 actores del sector de frutas frescas del departamento. Para el procesamiento y análisis de la información obtenida se utilizaron metodologías como árbol de problemas, benchmarking, matriz Vester, para determinar el mapa de actores, las principales problemáticas del sector y el referenciamiento competitivo del mismo. Por otro lado, para la construcción del índice se utilizó un análisis de componentes principales debido a la gran cantidad de variables medidas, mientras que en el estudio prospectivo fue necesaria la metodología Mic-Mac. Algunas de las conclusiones del estudio apuntan a la existencia una brecha tecnológica entre la cadena productiva y los actores paralelos del sector, quien son los principales encargados de realizar las investigaciones y los procesos de transferencia de conocimientos. Se espera que este documento pueda contribuir al fortalecimiento del sistema de Competitividad, Ciencia, Tecnología e Innovación (C&CTI) y el desarrollo del Valle del Cauca, que permita la toma de decisiones inteligentes que transformen a la región en una economía del conocimiento.

Base de datos para el artículo Strategy and additive technologies: the key to fister innovation, outsourcing and operational effectiveness?

Unforeseen events can significantly affect organizations’ supply chains and disrupt their continuous flow. Therefore, organizations need to develop a response capability that allows them to minimize the negative effect of such events and quickly recover from them, also known as resilience. This research performs a comparative analysis of the influence that risk, vulnerability, and adaptability have on the resilience capability of supply chains in Colombian defense sector organizations before and during the coronavirus outbreak. Based on a literature review, a survey was designed and applied online to collect data from respondents related to the activities of the Colombian Air Force supply chain. For the first wave, data was collected between December 2019 and January 2020. Data for the second wave was collected in August 2020. Results suggest that identifying and managing risks positively impact reducing vulnerability and increasing adaptability. Moreover, by decreasing exposure and improving adaptability, the organization positively influences supply chain resilience capability. The results also indicate that the pandemic positively affected risk and vulnerability awareness. The identification of vulnerabilities had a positive impact on the resilience capacity during the Corona Virus outbreak. This research provides relevant information for the Colombian government on developing public policies and mechanisms of service and support for defense sector organizations to strengthen their resilience capability. Likewise, the study offers valuable information to those organizations interested in improving their resilience capability and that of the sector in which they are involved.

Purpose There is rising interest in Industry 4.0 as a factor in the competitiveness of the organization. Although many companies are aware of the importance of Industry 4.0, the development of such initiatives in Colombia is slow. Consequently, this research investigates the impact of additive technologies as part of the Industry 4.0 concept on operational effectiveness and, therefore, the competitiveness of the organization and tries to establish the factors that hinder the adequate implementation of such new, innovative technologies. Design/Methodology/Approach Structural equation modeling was used to analyze the antecedents and outcomes of operational effectiveness. To this end, 946 usable questionnaires were collected from managers and personnel from Colombian organizations. Findings Initial findings show that management is aware of Industry 4.0 concepts and implements strategies for such initiatives. Nevertheless, neither process innovation nor additive technologies have a significant impact on operational effectiveness and therefore on the competitiveness of the organization. Practical implications The implementation of new innovative technologies requires the closure of the digital gap between urban and rural areas and between large and medium and small enterprises. Similarly, the concept of Industry 4.0 as a new, innovative manufacturing concept requires a transversal implementation to increase the competitiveness of the organization. Originality/Value The value of this paper lies in discussing the current technological and human capabilities and strategies that Colombian organizations, as an example of a developing nation, should improve to leverage the benefits of Industry 4.0 to remain competitive. The results are probably generalizable to other regions in developing countries throughout the world.

Zusammenfassung Um die Teilnahme junger Familien an Maßnahmen der Frühen Hilfen zu erhöhen, müssen geeignete Zugänge gefunden werden. In zwei Evaluationsprojekten wurden Expert∗innen und Nutzer∗innen zur Erreichbarkeit von Familien und Effektivität der Zugangswege befragt. Aus Sicht der Befragten sind Erstbesuche nach der Geburt geeignete Zugangswege. Daneben tragen wertschätzende Kommunikation der Mitarbeitenden in den Frühen Hilfen und Partizipation der Nutzer∗innen zum Gelingen einer guten Zusammenarbeit im Sinne der Familien bei.

Los autores del presente libro aciertan cuando dicen que “gestionar adecuadamente el personal humano es un arte y una ciencia que tiene un impacto profundo en el rendimiento y desempeño empresarial”. En siete capítulos, este libro explora la incidencia de factores tecnológicos, sociales y humanos en la eficiencia de las organizaciones. El especial énfasis en este último aspecto se evidencia en la inclusión de categorías como inteligencia emocional, trabajo en equipos multidisciplinarios y resiliencia; las cuales van de la mano con otras como la innovación y la gestión de conocimiento [Carlos Enrique Ramírez]. Es evidente que los autores a través de un estudio riguroso sobre materiales académicos de referentes reconocidos a nivel mundial desarrollaron investigaciones detalladas en diferentes organizaciones con personal perteneciente a diversas áreas laborales, evaluaron numerosas hipótesis mediante ecuaciones estructurales, las mismas que condujeron a resultados significativos que dan claridad del impacto de diversos factores, sobre la efectividad operacional de las organizaciones con énfasis en el Factor Humano [BG. Alfonso Lozano Ariza].

The association of morbid obesity with increased revision total knee arthroplasty (rTKA) complications is potentially confounded by concurrent risk factors. This study was performed to evaluate whether morbid obesity was more strongly associated with adverse aseptic rTKA outcomes than diabetes or tobacco use history—when present as a solitary major risk factor. Demographic characteristics, surgical indications, and adverse outcomes (reoperation, revision, infection, and amputation) were compared between 270 index aseptic rTKA performed for patients with morbid obesity (n = 73), diabetes (n = 72), or tobacco use (n = 125) and 239 “healthy” controls without these risk factors at a mean 75.7 (range: 24–111) months. There was no difference in 2-year reoperation rate (17.8 vs. 17.6%, p = 1.0) or component revision rate (8.2 vs. 8.4%) between morbidly obese and healthy patients. However, higher reoperation rates were noted in patients with diabetes (p = 0.02) and tobacco use history (p

We investigated whether maternal psychopathology predicts offspring mental health service utilization in adolescents without mental disorders. We used weighted data (N = 2317) from NCS-A participants (age: 13-18 years) who did not meet DSM-IV criteria for any lifetime mental disorder. Adolescent mental disorders were assessed with the WHO CIDI. Maternal psychopathology was obtained by self-report. Adolescent mental health service use was assessed with the Service Assessment for Children and Adolescents. Substantial associations between maternal psychopathology and mental health service use in offspring without mental disorders were found between affective disorders and the mental health/medical specialty (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.60-3.90) and any service sector (HR = 2.14, CI = 1.45-3.16), anxiety disorders and any service sector (HR = 1.63, CI = 1.13-2.35), behavior disorders and the school (HR = 3.69, CI = 1.39-9.77) and any service sector (HR = 2.81, CI = 1.12-7.07), substance use disorders and the mental health/medical specialty (HR = 3.75, CI = 1.75-8.03), the school (HR = 3.17, CI = 1.43-7.02), and any service sector (HR = 3.66, CI = 2.00-6.70), and any mental disorder and the mental health/medical specialty (HR = 2.10, CI = 1.34-3.30) and any service sector (HR = 2.03, CI = 1.40-2.92). Results were comparable when restricting analyses to offspring with no indication of suicidality and no more than three life events during the past 12 months. The likelihood of service use was higher among offspring of mothers with mental disorders, compared to mothers without mental disorders. Considering maternal mental disorder status may help to identify subjects at risk of overtreatment.

Hintergrund: Zeitgemäße Gesundheitsversorgung setzt voraus, dass die Nutzer/innen selbstbestimmte Entscheidungen über diagnostische und therapeutische Maßnahmen treffen können. Dafür müssen sie die fraglichen Interventionen und ihre Folgen verstehen und benötigen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 5. Internationale Konferenz der Deutschen Gesellschaft für Hebammenwissenschaft (DGHWi)

This paper proposes a method called Zero Gradient Control, which is used to control the heat rejection pressure and the rotational speed of the fans of the gascooler of R-744 refrigeration cycles nearly energy optimal. The basic concept is to develop algebraic terms for the partial derivatives of the COP with respect to the heat rejection pressure and the speed of the fans. These equations are evaluated online with measurement signals and directly fed to decentralized controllers with setpoint zero. The control structure is the same for both sub- and transcritical operation, requires little parameterization and can be applied to a wide range of systems. Using Zero Gradient Control, there is no need to calculate setpoints, which simplifies the mathematical effort in the implementation. Measurements for various scenarios validate the method even in the case of atypical system behavior or gascooler fouling.

Masnahmen der Fruhe Hilfen unterstutzen Eltern in schwierigen Lebenssituationen und tragen in den ersten Lebensjahren zu einem gesunderen Aufwachsen von Kindern bei. In Berlin erhalten junge Familien uber Begrusungsprogramme nach der Geburt Gutscheine fur gesundheitsfordernde und praventive Angebote der Fruhen Hilfen. Ziel ist es, zur Inanspruchnahme der Angebote zu motivieren. In der Evaluationsstudie wurde der Zugang zu den Eltern fur die Vergabe von Familiengutscheinen uber die Begrusungsprogramme, sowie die Inanspruchnahme der Angebote durch die Eltern und damit verbundene Barrieren untersucht. Die Erhebung erfolgte in vier Berliner Bezirken mit Familiengutscheinprojekten. Im Rahmen eines Mixed-method-Designs wurden eine Dokumentenanalyse sowie leitfadengestutzte Interviews mit Expert_innen durchgefuhrt. Den Analysen wurden die Kriterien fur gute Praxis der soziallagenbezogenen Gesundheitsforderung des Kooperationsbunds Gesundheitliche Chancengleichheit als Kategoriensystem deduktiv zugrunde gelegt. Die Begrusungsprogramme bieten einen niedrigschwelligen Zugang, uber den trotz verschiedener Barrieren 80-90% der jungen Familien zur Vergabe der Gutscheine erreicht werden. Jedoch bleibt unklar, wie vulnerable Familien identifiziert werden und ob sie von den Gutscheinen profitieren. In den Projekten sind Partizipation und Empowerment grundlegende Handlungspramissen, die jedoch in ihrer Auspragung weiterer Entwicklung bedurfen. Dementsprechend wurde keine systematische Nutzerbeteiligung in der Qualitatsentwicklung der Projekte vorgefunden. Die Untersuchung bestatigt die Problematik eines effektiven Zugangs zu Eltern fur Masnahmen der Fruhen Hilfen und des noch unzureichenden Einsatzes validierter Assessmentverfahren zur Identifikation der Zielgruppen. Auf der Grundlage der gewonnen Erkenntnisse wird empfohlen, im Rahmen eines systematischen Qualitatsmanagements das Assessment zur Identifikation vulnerabler Eltern zu optimieren und die Nutzer konsequent in die Weiterentwicklung der Familiengutscheinprojekte einzubeziehen.

Zusammenfassung Hintergrund und Zielsetzung In ausgewahlten Sektoren und Settings der Gesundheitsversorgung werden Patienten und deren Angehorige heutzutage als Ko-Produzenten des Gesundheitssystems betrachtet. Damit verbunden sind modifizierte Patientenrollen und neue Beziehungsmodelle. Diesen mussen sich auch Physiotherapeuten stellen, indem sie edukative Interventionen in ihr traditionelles Handlungsspektrum integrieren. Entsprechende Interventionskonzepte fur die Physiotherapie liegen bislang aber nicht vor. Ziel dieses Beitrages ist es daher, eine empirisch-gestutzte Konzeptentwicklung anzustosen. Methode Im Rahmen einer qualitativ-empirischen Untersuchung wurden Interviews mit 15 Eltern lebenslimitierend erkrankter Kinder in vier Bundeslandern gefuhrt und mittels des Rekonstruktionsverfahrens der dokumentarischen Methode nach Bohnsack ausgewertet. Die Erfahrungen der Eltern mit der Ubernahme physiotherapeutischer Versorgung wurden genutzt, um bezugnehmend auf lerntheoretische Ansatze erste Uberlegungen fur ein instruktives Interventionskonzept anzustellen. Ergebnisse Im Zuge der Datenauswertung konnten drei divergierende Orientierungen (Elterntypen) herausgearbeitet werden. Eltern des Typs A (Autonomie) agieren weitestgehend autonom und benotigen nur punktuelle Unterstutzung. Eltern des Typs B (Verstehen) und C (Entlastung) benotigen intensivere Unterstutzung. Wahrend bei den einen (Typ B) die Edukation zur Befriedigung eines ausgepragten Wissensbedurfnisses von Bedeutung ist, wird bei den anderen (Typ C) die Ubernahme physiotherapeutischer Versorgungsleistungen generell in Frage gestellt. Diese Eltern tendieren dazu, Verantwortung an das professionelle Hilfesystem zuruckzugeben. Diskussion Bei der physiotherapeutischen Instruktion sind die unterschiedlichen Orientierungen von Eltern in Bezug auf eine Versorgungsubernahme zu berucksichtigen. Die Eltern, die motiviert sind, sich auf Lernprozesse einzulassen, wunschen sich, dass die Instruktion a) auf zentrale physiotherapeutische Masnahmen fokussiert wird, b) Face-to-Face stattfindet und dass sie dabei c) als Experten fur ihr Kind und ihre Situation anerkannt werden. Schlussfolgerung Erganzt um die Perspektive professioneller Akteure konnen die hier gewonnenen Erkenntnisse zur Elternperspektive als Basis fur empirische Wirkungsanalysen dienen. Die empirisch uberpruften Interventionskonzepte fur instruktives Handeln sind in bestehende Aus-, Fort- und Weiterbildungsangebote zu integrieren, um eine systematische Verbreitung des Wissens innerhalb der Physiotherapie gewahrleisten zu konnen. Zudem ist eine berufspolitische Debatte in Gang zu setzen, um instruktives Handeln starker im physiotherapeutischen Handlungsrepertoire zu verankern.

Induced pluripotent stem cells (iPSCs) were first described over a decade ago and are currently used in various basic biology and clinical research fields. Recent advances in the field of human iPSCs have opened the way to a better understanding of the biology of human diseases. Disease-specific iPSCs provide an unparalleled opportunity to establish novel human cell-based disease models, with the potential to enhance our understanding of the molecular mechanisms underlying human malignancies, and to accelerate the identification of effective new drugs. When combined with genome editing technologies, iPSCs represent a new approach to study single or multiple disease-causing mutations and model specific diseases in vitro. In addition, genetically corrected patient-specific iPSCs could potentially be used for stem cell based therapy. Furthermore, the reprogrammed cells share patient-specific genetic background, offering a new platform to develop personalized therapy/medicine for patients. In this review we discuss the recent advances in iPSC research technology and their potential applications in hematological diseases. Somatic cell reprogramming has presented new routes for generating patient-derived iPSCs, which can be differentiated to hematopoietic stem cells and the various downstream hematopoietic lineages. iPSC technology shows promise in the modeling of both inherited and acquired hematological disorders. A direct reprogramming and differentiation strategy is able to recapitulate hematological disorder progression and capture the earliest molecular alterations that underlie the initiation of hematological malignancies.

BACKGROUND Modulation of cigarette craving and neuronal activations from nicotine-dependent cigarette smokers using real-time functional MRI (rtfMRI)-based neurofeedback (rtfMRI-NF) has been previously reported. OBJECTIVES The aim of this study was to evaluate the efficacy of rtfMRI-NF training in reducing cigarette cravings using fMRI data acquired before and after training. METHODS Treatment-seeking male heavy cigarette smokers (N = 14) were enrolled and randomly assigned to two conditions related to rtfMRI-NF training aiming at resisting the urge to smoke. In one condition, subjects underwent conventional rtfMRI-NF training using neuronal activity as the neurofeedback signal (activity-based) within regions-of-interest (ROIs) implicated in cigarette craving. In another condition, subjects underwent rtfMRI-NF training with additional functional connectivity information included in the neurofeedback signal (functional connectivity-added). Before and after rtfMRI-NF training at each of two visits, participants underwent two fMRI runs with cigarette smoking stimuli and were asked to crave or resist the urge to smoke without neurofeedback. Cigarette craving-related or resistance-related regions were identified using a general linear model followed by paired t-tests and were evaluated using regression analysis on the basis of neuronal activation and subjective craving scores (CRSs). RESULTS Visual areas were mainly implicated in craving, whereas the superior frontal areas were associated with resistance. The degree of (a) CRS reduction and (b) the correlation between neuronal activation and CRSs were statistically significant (P