Search

Background: In MONALEESA-3 and MONALEESA-7 trials, ribociclib (RIB, a selective CDK4/6 inhibitor) in combination with endocrine therapy (aromatase inhibitor [AI] or fulvestrant [FUL]) demonstrated a significant prolongation of overall survival among patients with breast cancer (BC), regardless of menopausal status and treatment-line. In the premenopausal or perimenopausal women, RIB + AI/FUL should be combined with a luteinizing hormone-releasing hormone agonist. The real-world evidence for the effectiveness, safety, and tolerability of RIB + AI/FUL in the routine clinical practice is needed to support the use of this combination. Methods: RIBANNA is a prospective, non-interventional study ongoing in Germany since October 2017. Pre-, peri- and postmenopausal women (planned, n = 3020) treated with RIB + AI/FUL, or endocrine monotherapy (ET), or chemotherapy (CT) as the first-line treatment for HR+/HER2- aBC in accordance with German guidelines were included. Data from routine clinical practice in all 3 cohorts, including further lines of sequential therapy, were collected. Updated data on baseline demographics and safety analysis will be presented. Additionally, first experience with CANKADO, an innovative digital and patient-friendly application for electrocardiogram (ECG) measurement, are described. By combining this app to Kardia mobile (AliveCor’s single lead device), single-lead ECG can be recorded and sent via the CANKADO app for a cardiologist to read over. The cardiologist reviews the measurements, and reports the corrected QT interval by Fredericia (QTcF) results towards the trial site. Impact of the use of CANKADO onto the clinical routine will be analyzed. Results: For the second interim analysis, 1141 patients were enrolled until July 12th, 2019, while the full analysis set comprised 813 patients (Table 1). Median duration of RIB exposure in patients on RIB + AI/FUL vs total population was 151 vs 150 days respectively. At cut-off date, patients received first-line (89%, n = 1016), second-line (7%, n = 82), and third-line treatments (1%, n = 11). A starting dose of 600 mg per day for RIB in the first-line setting was seen in most of the patients (85%); data of second-line patients will be reported later. The first-line mean daily dose of RIB was 451.6 mg/day RIB was prescribed mainly in combination with letrozole (75%), fulvestrant (12%), anastrozole (7%), and exemestane (6%). A total of 62% of patients in the study were documented as therapy-naïve for ET. Of 424 patients with early breast cancer, 129 (30%) had documented prior CT without ET. The most common all-grade adverse events frequently noted in RIB + AI/FUL cohort in comparison with other cohorts were nausea (RIB [19%] vs ET [9%] vs CT [11%]), neutropenia (19% vs 1% vs 10%), fatigue (17% vs 9% vs 14%), and leukopenia (14% vs 4% vs 12%). The usage of CANKADO application to assess QTcF was initiated in the year 2019 and first data will be presented. Conclusion: RIBANNA study showed diverse population characteristics among the patients who received RIB treatment in a real-world setting. The third interim analysis is planned in October 2020, and the updated baseline data, information on safety, digital ECG measurement using CANKADO application will be presented. Baseline Demographic Characteristics as of Second Interim AnalysisDemographic VariableRIB + AI/FUL (n = 658)Endocrine Therapy (n = 78)Chemotherapy (n = 77)Mean age, years (SD)67 (11)72 (12)62 (10)Mean time since initial diagnosis, years6.17.23.6T stage at baseline*, n (%)TX204 (31)28 (36)18 (23)T0+T1132 (20)12 (15)11 (14)T2-T4302 (46)35 (45)42 (54)N stage at baseline*, n (%)NX212 (32)29 (37)28 (36)N0+N1317 (48)36 (46)35 (46)N2+N3108 (16)10 (13)8 (10)M stage at baseline*, n (%)MX6 (1)0 (0)0 (0)M018 (3)1 (1)1 (1)M1616 (94)75 (96)71 (92)Metastatic location at baseline*, n (%)CNS, liver, lungs258 (39)14 (18)42 (54)Bone only181 (28)42 (54)11 (14)Skin, lymph nodes, other149 (23)16 (20)14 (18)*Remaining cases are missing.CNS, central nervous system. Citation Format: Achim Wöckel, Cosima Brucker, Thomas Decker, Jörg Falbrede, Helmut Forstbauer, Thomas Göhler, Oliver Hoffmann, Christian Jackisch, Jan Janssen, Andreas Köhler, Kerstin Lüdtke-Heckenkamp, Diana Lüftner, Frederik Marmé, Arnd Nusch, Toralf Reimer, Christian Roos, Marcus Schmidt, Rudolf Weide, Peter Fasching. Real-world efficacy of ribociclib + aromatase inhibitor/fulvestrant, or endocrine monotherapy, or chemotherapy as first-line treatment in women with HR-positive, HER2-negative locally advanced or metastatic breast cancer: Third interim analysis from the RIBANNA study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-16.

Zusammenfassung Hintergrund Geschlechtsdysphorie (GD, ehemals Transsexualität) bezeichnet einen Leidensdruck, der sich aus der Inkongruenz zwischen den körperlichen Geschlechtsmerkmalen und dem Erleben des eigenen Geschlechts ergeben kann (Geschlechtsinkongruenz: GIK). Die Gesundheitsversorgung von Personen mit GIK/GD bezieht sich v. a. auf geschlechtsangleichende Maßnahmen (z. B. Hormonbehandlung) und Unterstützung bei assoziierten Bedürfnissen (z. B. durch Psychotherapie). Zudem gelten genitalchirurgische Eingriffe als effektive Verfahren zur Reduktion von GIK/GD und zur Verbesserung der psychischen Gesundheit und Lebensqualität. Als evidenzbasiert gilt eine integrative Gesundheitsversorgung, bei der die beteiligten Bereiche interdisziplinär kooperieren. Ziel der Studie Bei der medizinischen Versorgung von Patient_innen mit GIK/GD lassen sich grundsätzlich zwei Settings unterscheiden: interdisziplinär integriert an einem Standort vs. dezentral verteilt über mehrere Standorte. Die Trans-Gesundheitsversorgung in Deutschland ist bisher weitgehend dezentral organisiert. Wie sich das Versorgungssetting auf die Wirksamkeit und Qualität genitalangleichender Operationen auswirkt, wurde bisher nicht untersucht. Ziel der TransCare-Studie ist es daher, prospektiv katamnestisch das psychosoziale und klinische Outcome von Patient_innen mit GIK/GD zu untersuchen, die eine feminisierende Genitaloperation in Anspruch nehmen, und auf die möglichen Auswirkungen des Versorgungssettings (interdisziplinär integriert vs. dezentral verteilt) hin zu vergleichen. Methodik Im Zuge eines naturalistischen Längsschnittdesigns soll eine möglichst praxisnahe Stichprobe rekrutiert und die teilnehmenden Patient_innen prospektiv befragt werden. Ergebnisse Die Studienergebnisse sollen Erkenntnisse über die Rolle des Versorgungssettings im Rahmen der genitalchirurgischen Behandlung von Patient_innen mit GIK/GD hervorbringen. Schlussfolgerung Auf Basis der TransCare-Studie soll die Versorgungsqualität empirisch fundiert verbessert werden.

Until recently, trans persons were expected to align their sex characteristics as much as possible with the opposite sex. Today, research and health care, as well as the diagnostic criteria from DSM-5 and ICD-11, reflect a broader understanding of trans individuals. It encompasses diverse identities and treatment requests, including trans individuals not wanting or having decided against gender-affirmative medical interventions (GAMI). The present study explored this insufficiently studied group by (1) reviewing the existing literature regarding trans individuals not seeking GAMI and by (2) exploring their demographic and trans-related characteristics in a non-clinical online convenience sample from Germany. The literature review found one large survey with a single question on trans individuals not seeking GAMI. Beyond that, only community literature addressed the topic. The analyzed sample consisted of 415 trans participants, of whom 220 were assigned female at birth (AFAB) and 195 were assigned male at birth (AMAB). Fourteen (3.4%) reported neither previous nor planned GAMI (AFAB = 9, AMAB = 5). Trans individuals not seeking GAMI were significantly older and more often reported to identify with a non-binary gender. The two interdependent, central reasons for refusing GAMI were the avoidance of transition-related suffering and the lack of necessity for treatment. The diversification of gender, as reflected in the increasing visibility of non-binary or genderqueer gender identities, seems to go hand in hand with a diversification of transition-related treatment, including the option not to seek GAMI.

ZusammenfassungDie akute Beckenvenenthrombose stellt ein dramatisches Krankheitsbild dar. Auf der einen Seite geht sie mit einem hohen Risiko für eine lebensbedrohliche Lungenembolie einher, auf der anderen Seite kann sie die Entwicklung einer Phlegmasia coerulea dolens bewirken, welche zum Verlust der betroffenen Extremität führen kann und ebenfalls eine vital bedrohliche Komplikation darstellt. Neben konservativen Behandlungsansätzen wie Kompressionstherapie und Antikoagulation stehen eine Reihe interventioneller Optionen zur Verfügung, welche darauf abzielen, fatale Krankheitsverläufe zu verhindern und auch die Ausprägung eines postthrombotischen Syndroms zu begrenzen.Die Prognose der Erkrankung hängt maßgeblich von der frühzeitigen sicheren Diagnosestellung ab. Sowohl in der akuten Krankheitsphase, als auch im chronischen Stadium nimmt die Duplexsonographie die Schlüsselrolle ein. Sie gibt Aufschluss über die Pathomorphologie der Becken- und Beinvenen und liefert zusätzlich hämodynamische Informationen.Im Gegensatz zur sonographischen Befundung der tiefen und epifaszialen Beinvenen ist zur Exploration der proximalen Gefäßabschnitte neben dem Einsatz einer Linearsonde auch die Untersuchung mittels Konvexsonde erforderlich und die eingeschränkte Auflösung in der Tiefe des kleinen Beckens macht einen subtilen Umgang mit den Einstellungen des Ultraschallgerätes nötig.Im Rahmen der Behandlung postthrombotischer Veränderungen der Beckenvenen können radiologische und funktionsdiagnostische Methoden zusätzliche Informationen liefern.

We combine the empirical matched field (EMF) method and machine learning using Convolutional Neural Networks (CNNs) for calving event detection at the IMS station SPITS and GSN station KBS on the Arctic Archipelago of Svalbard. EMF detection with seismic arrays seeks to identify all signals similar to a single template generated by seismic events in a confined target region. In contrast to master event cross-correlation detectors, the detection statistic is not the waveform similarity, but the array beam power obtained using empirical phase delays (steering parameters) between the array stations. Unlike common delay-and-sum beamforming, the steering parameters do not need to represent a plane wave and are directly computed from the template signal without assuming a particular apparent velocity and back-azimuth. As for all detectors, the false alarms rate depends strongly on the beam power threshold setting and therefore needs appropriate tuning or alternatively post-processing. Here, we combine the EMF detector using a low detection threshold with a post-detection classification step. The classifier uses spectrograms of single-station three-component records and state-of-the-art CNNs pre-trained for image recognition. Spectrograms of three-component seismic data are hereby combined as RGB images. We apply the methodology to detect calving events at tidewater glaciers in the Kongsfjord region in Northwestern Svalbard. The EMF detector uses data of the SPITS array, at about 100 km distance to the glaciers, while the CNN classifier processes data from the single three-component station KBS at 15 km distance using time windows where the event is expected according to the EMF detection. The EMF detector combines templates for the P and for the S wave onsets of a confirmed, large calving event. The CNN spectrogram classifier is trained using classes of confirmed calving signals from four different glaciers in the Kongsfjord region, seismic noise examples, and regional tectonic seismic events. By splitting the data into training and test data set, the CNN classifier yields a recognition rate of 89% on average. This is encouragingly high given the complex nature of calving signals and their visually similar waveforms. Subsequently, we process continuous data of 6 months in 2016 using the EMF-CNN method to produce a time series of glacier calving. About 90% of the confirmed calving signals used for the CNN training are detected by EMF processing, and around 80% are assigned to the correct glacier after CNN classification. Such calving time series allow us to estimate and monitor ice loss at tidewater glaciers which in turn can help to better understand the impact of climate change in Polar regions. Combining the superior detection capability of (less common) seismic arrays at a larger source distance with a powerful machine learning classifier at single three-component stations closer to the source, is a promising approach not only for environmental monitoring, but also for event detection and classification in a CTBTO verification context.

Autonomous algorithms can improve the processing of aftershock sequences, for example by reducing the analyst workload. We present a system for automatic detection and location of aftershocks in a specific region following a large earthquake. The system seeks to identify all signals generated by seismic events in the target region, while passing over signals generated by sources in all other regions. For a given station, we can generate a sensitive empirical matched field (EMF) detector for the target region using only an empirical template from the mainshock signal. These EMF detectors perform much better on seismic arrays than on 3-component stations. For each selected station in the network, a multivariate detector combines the EMF detector with an optimized continuous AR-AIC detector to generate a target-optimized detection list. For arrays, an additional continuous calibrated f-k process reliably screens out likely signals from other sources. A region-specific phase association algorithm takes the screened detection lists from each station and generates a preliminary aftershock bulletin. We have processed aftershock sequences from four major earthquakes: the Tohoku event in 2011 (Japan), the Illapel event in 2015 (Chile), the Papua New Guinea event in 2018 and the Gorkha event in 2015 (Nepal).We evaluate the results in detail by comparing the automatically generated origins and corresponding phase arrival times with matching events and associated arrivals in the analyst reviewed (REB) and automatic (SEL3) bulletins issued by the CTBTO Preparatory Commission. Between 40% and 65% of all events in the REB are found to closely match the locations and origin times of the events found by our EMF-based procedure. The resulting discrepancies are assessed with respect to signal-to-noise ratio, number of defining stations, and epicentral distance. Furthermore, the REB events not detected by the EMF method are analyzed and a few phase misidentifications (i.e., P vs. pP) are assessed to better understand the limitations of the autonomous procedure. In general, we find that our EMF solutions are closer to the matching REB events than the corresponding SEL3 events. The analyst is helped both by the improved location estimates and a lower number of qualitatively incorrect event hypotheses. A key factor in the performance is the number of contributing seismic arrays. Aftershock sequences in the southern hemisphere performed the worst given the poorer array coverage.

Introduction Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health. Aim The first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions. Methods An online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg. Main Outcome Measure The main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items. Results The most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26% and 32%, respectively) and difficulties achieving an orgasm (29% and 15%, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions. Clinical implications Clinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients. Strengths & Limitations This study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons. Conclusion Sexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery.

Purpose There is an ongoing discussion about ‘undertreatment’ of breast cancer in elderly patients. Due to low accrual into clinical trials, level 1 evidence is scarce. We report prospective data of elderly patients with breast cancer treated by medical oncologists in Germany. Methods The SENORA project within the prospective cohort study TMK (Tumour Registry Breast Cancer) was conducted in 82 centres from 2007–2015. Among 2316 patients, half were enrolled with curative and half with palliative treatment intention. Overall, 478 patients (21%) were aged ≥ 70. Results In the adjuvant setting, elderly patients aged ≥ 70 had more advanced tumour stages at diagnosis and a higher prevalence of comorbidities than younger patients. Elderly patients received adjuvant chemotherapy less frequently, yet the 3-year disease-free survival was similar (86% vs. 88%). In the palliative setting, elderly patients more frequently received endocrine therapy and less frequently chemotherapy. Their median overall survival [24.9 months, 95% CI (confidence interval) 20.0–30.2] was significantly shorter than that of younger patients (39.7 months, 95% CI 34.9–44.2). A Cox proportional hazards model showed a significantly increased risk of mortality for: age ≥ 70 at start of therapy, negative HR- or HER2-status, higher number of metastatic sites, more comorbidities and high tumour grading at diagnosis. Conclusions Our results shed light on the routine treatment of elderly patients with breast cancer. A regression model demonstrated that age is but one of various prognostic factors determining the shorter overall survival of elderly patients.

Among the chrysomelids, some species are considered agricultural pests, such as some representatives of Epitrix spp. Popularly known as tobacco flea, these beetles cause damage to tobacco (Nicotiana tabacum L.) by feeding on the leaf surface, causing injuries, reducing productivity and the final quality of the product to be marketed. However, studies of the biology and interactions of these individuals with the environment become essential in order to develop effective and sustainable control measures. The objective of this study was to analyze the distribution and population fluctuation of Epitrix spp., as well as to evaluate the possible influence of temperature, rainfall and adjacent vegetation on the population dynamics of this beetle in organic tobacco growing in the municipality of Santa Cruz of the South, RS. The collections were carried out weekly during the 2011/2012 harvest, using Malaise and Pit-fall traps, distributed in four points along three lines. A total of 1584 individuals belonging to the genus Epitrix were collected, and their greatest abundance was observed in late January and early February 2012 due to climatic factors, such as rainfall and temperature, favorable to the development of specimens and the tobacco leaf harvesting reduced the availability of food and conditioned a greater movement of these individuals in the crop. The results presented here are of great importance for deciding the best methodology for controlling the smoke flea, as well as knowing the influence of abiotic factors on the behavior of these organisms in the field.

Abstract. Hypothenar or thenar hammer syndrome (HHS) and hand-arm vibration syndrome (HAVS) are diseases caused by acute or chronic trauma to the upper extremities. Since both diseases are generally related to occupation and are recognised as occupational diseases in most countries, vascular physicians need to be able to distinguish between the two entities and differentiate them from other diagnoses. A total of 867 articles were identified as part of an Internet search on PubMed and in non-listed occupational journals. For the analysis we included 119 entries on HHS as well as 101 papers on HAVS. A professional history and a job analysis were key components when surveying the patient’s medical history. The Doppler-Allen test, duplex sonography and optical acral pulse oscillometry were suitable for finding an objective basis for the clinical tests. In the case of HHS, digital subtraction angiography was used to confirm the diagnosis and plan treatment. Radiological tomographic techniques provided very limited information distal to the wrist. The vascular component of HAVS proved to be strongly dependent on temperature and had to be differentiated from the various other causes of secondary Raynaud’s phenomenon. The disease was medicated with anticoagulants and vasoactive substances. If these were not effective, a bypass was performed in addition to various endovascular interventions, especially in the case of HHS. Despite the relatively large number of people exposed, trauma-induced circulatory disorders of the hands can be observed in a comparatively small number of cases. For the diagnosis of HHS, the morphological detection of vascular lesions through imaging is essential since the disorder can be accompanied by critical limb ischaemia, which may require bypass surgery. In the case of HAVS, vascular and sensoneurological pathologies must be objectified through provocation tests. The main therapeutic approach to HAVS is preventing exposure.

Across Europe and the world, communication scientists are reflecting upon the issue of trust in journalism and the media. A significant body of analysis and research provides new perspectives on the reasons, impacts and consequences of trust or mistrust in the media and journalism. The present anthology aims to provide an overview of the empirical research on trust in media and journalism, the new perspectives, methodological approaches and current findings discussed among communication scientists at European and international scientific conferences. The anthology presents studies and findings on ethics and norms, influences on trust and the effects of populism.

A high proportion of patients with breast cancer develop bone metastases, yet data on routine treatment with bone-targeted agents (BTA) are rare. We report real-life outcome data of patients with breast cancer metastasised to the bone treated by office-based oncologists in Germany. The ongoing, prospective, multicentre, population-based cohort study Tumour Registry Breast Cancer (TMK) was started in 2007 in 140 centres across Germany. This interim analysis of 1094 patients with bone metastases revealed differences among the tumour subtypes: at start of first-line therapy, 36% of the patients with hormone receptor (HR)-positive and only 20% of the patients with HR-negative tumours presented with bone-only metastasis. The majority of patients with bone metastases (89%, n = 976) received BTA therapy. In 2014–2015, 37% of the patients received the bisphosphonate zoledronic acid and 36% the antibody denosumab. Median duration of BTA therapy was 20 months (interquartile range 31.5 months), starting a median of 3 weeks after diagnosis of bone metastases, and ending a median of 7 weeks before death. The median overall survival (OS) also varied among the types of metastasis at start of first-line therapy ranging from 54 months (95% confidence interval [CI] 37.6–70.8), 38 months (95% CI 29.4–44.2) to 28 months (95% CI 24.2–31.0) for patients with bone-only metastases, non-visceral with or without bone metastases and visceral with or without bone metastases respectively. We show that choice and duration of BTA therapies are in conformity with guidelines applicable in Germany. To our knowledge, this is the first presentation of data on incidence, metastatic pattern, treatment and survival of patients with bone metastases in routine practice.

Aim To assess the safety and tolerability of adjuvant subcutaneous trastuzumab (Herceptin ® SC, H SC), delivered from an H SC Vial via hand-held syringe (Cohort A) or single-use injection device (Cohort B), with or without chemotherapy, for human epidermal growth factor receptor 2 (HER2)-positive stage I to IIIC early breast cancer (EBC) in the phase III SafeHer study (NCT01566721). Methods Patients received 600 mg fixed-dose H SC every 3 weeks for 18 cycles. The chemotherapy partner was at the investigators' discretion (H SC monotherapy was limited to ≤10% of the population). Data from the first H SC dose until 28 days (plus a 5-day window) after the last dose are presented. Results are descriptive. Results In the overall population, 2282/2573 patients (88.7%) experienced adverse events (AEs). Of the above, 128 (5.0%) patients experienced AEs leading to study drug discontinuation; 596 (23.2%) experienced grade ≥ 3 AEs and 326 (12.7%) experienced serious AEs. Grade ≥ 3 cardiac disorders were reported in 24 patients (0.9%), including congestive heart failure in eight (0.3%). As expected, the AE rates varied according to the timing of chemotherapy in both cohorts, with higher rates in concurrent versus sequential chemotherapy subgroups. In the concurrent chemotherapy subgroup, AEs were more common during the actual period of concurrent chemotherapy compared with the period when patients did not receive concurrent chemotherapy. Conclusion SafeHer confirms the safety and tolerability of the H SC 600 mg fixed dose for 1 year (every 3 weeks for 18 cycles) as adjuvant therapy with concurrent or sequential chemotherapy for HER2-positive EBC. These primary analysis results are consistent with the known safety profile for intravenous H and H SC.

Communication studies have expanded significantly around the globe in the last decades. Due to new channels of communication and more and more mediatised societies, the role of communication has gained significance. In contrast, communication does not seem to be a topic of high priority for many corporate leaders. They often still value communication as a mere support function. This chapter explores communication courses of business schools in the United States and Europe. It is hypothesised that only if communication courses are recognised in such programmes the profession of business communicators will realise entry into the highest levels of corporate decision-making. The main question is how far top-ranked Master of Business Administration (MBA) programmes integrate communication courses. This is investigated via website analysis and interviews. This chapter also provides explanations for the current status quo. The results will be of interest to all those responsible for shaping MBA curricula and give insights into how the communication discipline is viewed by leaders of business schools.

SUMMARY Modern acquisition of seismic data on receiver networks worldwide produces an increasing amount of continuous wavefield recordings. In addition to manual data inspection, seismogram interpretation requires therefore new processing utilities for event detection, signal classification and data visualization. The use of machine learning techniques automatises decision processes and reveals the statistical properties of data. This approach is becoming more and more important and valuable for large and complex seismic records. Unsupervised learning allows the recognition of wavefield patterns, such as short-term transients and long-term variations, with a minimum of domain knowledge. This study applies an unsupervised pattern recognition approach for the discovery, imaging and interpretation of temporal patterns in seismic array recordings. For this purpose, the data is parameterized by feature vectors, which combine different real-valued wavefield attributes for short time windows. Standard seismic analysis tools are used as feature generation methods, such as frequency–wavenumber, polarization and spectral analysis. We use Self-Organizing Maps (SOMs) for a data-driven feature selection, visualization and clustering procedure. The application to continuous recordings of seismic signals from an active volcano (Mount Merapi, Java, Indonesia) shows that volcanotectonic and rockfall events can be detected and distinguished by clustering the feature vectors. Similar results are obtained in terms of correctly classifying events compared to a previously implemented supervised classification system. Furthermore, patterns in the background wavefield, that is the 24-hr cycle due to human activity, are intuitively visualized by means of the SOM representation. Finally, we apply our technique to an ambient seismic vibration record, which has been acquired for local site characterization. Disturbing wavefield patterns are identified which affect the quality of Love wave dispersion curve estimates. Particularly at night, when the overall energy of the wavefield is reduced due to the 24-hr cycle, the common assumption of stationary planar surface waves can be violated.

The vision of Pervasive Computing is built on the assumption that computers will become part of everyday objects, augmenting them with information services and enhanced functionality. This article reports on the approach we have used to assess potential side effects of this development on human health and the environment, and the major risks we identified. Social risks such as the risk of conflicts between users and non-users of the technology were also included because of their potential indirect adverse health effects. Assessing a technological vision before it has materialized makes it necessary to deal with two types of uncertainty: first, the uncertainty of how fast and to what extent the technology will be taken up and how it will be used; second, the uncertainty of causal models connecting technology-related causes with potential health or environmental effects. Due to these uncertainties, quantitative methods to evaluate expected risks are inadequate. Instead, we developed a “risk filter” that makes it possible to rank risks according to a set of qualitative criteria based on the Precautionary Principle. As the overall result, it turned out that Pervasive Computing bears potential risks to health, society, and/or the environment in the following fields: Non-ionizing radiation, stress imposed on the user, restriction of consumers’ and patients’ freedom of choice, threats to ecological sustainability, and dissipation of responsibility in computer-controlled environments.

The German meteorologist Jorg Kachelmann was taken into investigative custody on March 19th 2010 after being accused of rape. Due to Kachelmann’s high degree of popularity the case lacked objective reporting. In the course of the analysis of this case a model was developed that compared the four factors which coined the legal suit: media reporting, public relations of the public prosecutor’s department, pubic relations with regard to the image of Jorg Kachelmann and the public opinion.

Objective To determine the clinical significance of endocervical mucus pH on sperm-mucus interaction during infertility investigation. Patients and Material Two hundred sixteen couples with a median duration of infertility of 4 years (range, 1 to 19 years) presenting at the infertility unit of the Women's University Hospital of Heidelberg, Germany. Main Outcome Measures Determination of endocervical pH by colorimetric and electrometric measurement and correlation of results with the outcome of postcoital testing (PCT) and other parameters of infertility investigation (semen and cervical mucus [CM] quality, microbial colonization of cervix and ejaculates, medical history, hormonal status, and specific medication) and the subsequent fertility in a prospective study. In vitro experiments with the sperm-cervical mucus penetration test (SCMPT) used as biological model. Results The colorimetric determination of endocervical mucus pH is an easy method, suitable for routine clinical use, correlating significantly with electrometric measurement of pH. Median pH was 7.0 (range, 5.4 to 8.2). The mucus pH was significantly related with the results of PCT, even when mucus and semen variables were taken into account. No significant relationship was seen between the cervical index and mucus pH and the microbial colonization of cervix and ejaculates. The pH of endocervical secretions correlated with the peripheral hormonal status: low pH levels were significantly more frequent in patients with hyperandrogenemia, indicated by high testosterone and/or dehydroepiandrosterone sulfate levels before medication was started, and in hyperandrogenemic patients treated with dexamethasone than in the other women. Oral administration of estrogens led to a subtle alkalinization of the CM. With regard to subsequent fertility 6 months after pH testing, the pregnancy rate was significantly lower in women offering reduced mucus pH on occasion of the PCT in the group of couples with primary infertility and in couples with oligozoospermia of the male partner. The significant influence of pH on sperm-mucus interaction was confirmed in vitro with the SCMPT. Conclusions The results indicate that the pH of the CM, easily determined with pH indicator paper, is an important parameter of mucus quality with significant influence on spermatozoal viability in CM, which correlates with peripheral hormonal status and can be affected by oral medication with estrogens. Therefore the routine determination of pH on occasion of the PCT is recommended during infertility investigation.

A series of investigations has been carried out over the last decade in Europe aimed at deriving quantitative information on site amplification from non-invasive techniques, based principally on surface wave interpretations of ambient noise measurements. The present paper focuses on their key outcomes regarding three main topics. First, methodological, hardware and software developments focusing on the acquisition and the processing of both single point and array microtremor measurements, led to an efficient tool with in situ control and processing, giving rise to robust and reproducible results. A special attention has been devoted to the derivation and use of the Rayleigh wave ellipticity. Second, the reliability of these new tools has been assessed through a thorough comparison with borehole measurements for a representative – though limited – set of sites located in Southern Europe, spanning from stiff to soft, and shallow to thick. Finally, correlations between the site parameters available from such non-invasive techniques, and the actual site amplification factors as measured with standard techniques, are derived from a comprehensive analysis of the Japanese KIKNET data. This allows to propose alternative, simple site characterization providing an improved variance reduction compared with the “classical” VS30 classification. While these results could pave the road for the next generation of building codes, they can also be used now for regulatory site classification and microzonation studies, in view of improved mapping and estimation of site amplification factors, and for the characterization of existing strong motion sites.

This study presents an unsupervised feature selection and learning approach for the discovery and intuitive imaging of significant temporal patterns in seismic single-station or network recordings. For this purpose, the data are parametrized by real-valued feature vectors for short time windows using standard analysis tools for seismic data, such as frequency-wavenumber, polarization, and spectral analysis. We use Self-Organizing Maps (SOMs) for a data-driven feature selection, visualization and clustering procedure, which is in particular suitable for high-dimensional data sets. Our feature selection method is based on significance testing using the Wald-Wolfowitz runs test for individual features and on correlation hunting with SOMs in feature subsets. Using synthetics composed of Rayleigh and Love waves and real-world data, we show the robustness and the improved discriminative power of that approach compared to feature subsets manually selected from individual wavefield parametrization methods. Furthermore, the capability of the clustering and visualization techniques to investigate the discrimination of wave phases is shown by means of synthetic waveforms and regional earthquake recordings.