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Zusammenfassung.In der Onkologie ist die psychosoziale Belastung der betreuten Patienten aufgrund der potentiell lebensbedrohlichen Erkrankung erheblich. Während der akuten Behandlung wird der Einfluss auf die eigene Lebensgestaltung eingeschränkt wahrgenommen und sollte thematisiert werden. Es wurde eine kunsttherapeutische Intervention, die KSKT®, speziell für den klinisch-onkologischen Behandlungskontext entwickelt. Ziel der vorgestellten Studie ist die Identifizierung und Beschreibung der Wirkung der KSKT®aus Patientenperspektive. Daten aus Leitfaden gestützten Interviews, die zu drei Messzeitpunkten erhoben wurden (n= 5; vor der Intervention (VDI, T 0) direkt nach der Intervention (NDI, T 1) und nach drei Monaten (NDI 2, T 2), wurden mit Hilfe der Qualitativen Inhaltsanalyse (nach Mayring 2002, 2008b) ausgewertet. Aus dem umfangreichen Datenmaterial liessen sich insgesamt sechs Kategorien ermitteln. Die Sinnhaftigkeit der Erkrankung (Kat. 1) war eine der drei meistgenannten Kategorien. Diese wurde vor allem in einer Veränderung der bisherigen eigenen Einstellung gesehen. Auch nahmen die Patientinnen nur geringe Einflussmöglichkeiten auf ihre aktuelle Situation (Kat. 2), aber eine positive Wirkung der kunsttherapeutischen Intervention (Kat. 3) wahr. Die positive Bewertung der KSKT®beruht darauf, dass Patientinnen mit Hilfe der Intervention mehr Einflussmöglichkeiten wahrnahmen.

This study aims to provide insights into the ability of amphiphilic cations to influence the assembly of hybrid organic‐inorganic crystal lattices using hydrophobic interactions. To investigate the hypothesis, a prototype amphiphilic cation, tert‐butyldiethanolammonium, was employed together with molybdenum oxide clusters of increasing size and charge in the self‐assembly of type I hybrid systems. The molybdate clusters were used as model inorganic building blocks as they can be formed in situ and their size and charge can be adjusted by pH control. Using this strategy, three hybrid structures were obtained and characterized using single‐crystal X‐ray diffraction, theoretical bond valence sum calculations, elemental analysis, FTIR spectroscopy, thermogravimetry and theoretical Hirshfeld analysis. Heptamolybdate Na5[tBuNH(C2H4OH)2][Mo7O24]·ca. 14H2O (1) was isolated, which features sodium‐linked dimeric cluster species. Inaddition, octamolybdate [tBuNH(C2H4OH)2]4[Mo8O26]·ca. 4H2O (2) was isolated, which incorporates a complex cationic sodium network that contains isolated octadecanuclear sodium clusters. At low pH levels (below pH 2),[tBuNH(C2H4OH)2]14[Mo36O112(H2O)16][Mo36O112(H2O)14{tBuNH(C2H4OH)2}2]·ca. 36H2O (3) was obtained, which is based on a 36‐centre molybdenum oxide cluster. Crystallographic analysis of the assemblies showed that the formation of hydrophobic regions within the crystal lattice is affected by the size of the inorganic building blocks employed. In 1and 2, the hydrophobic tert‐butyl groups of the amphiphilic cations aggregate into hydrophobic assemblies. In contrast, the structural arrangement in 3is dominated by the large inorganic cluster and the organic cations are incorporated as isolated units. This behaviour is further supported by theoretical Hirshfeld surface analysis of the organic counterions, which suggests that, with increasing cluster size, the contribution of long‐range, hydrophobic intermolecular interactions decreases, which is in line with the crystallographic analysis for 1–3.

A supramolecular heteropolyoxovanadate structure has been synthesized and characterized using single‐crystal XRD, powder XRD and a range of spectroscopic methods. The new compound, [tBuNH(C2H4OH)2]4[H5P1V14O42]·12H2O (1) was obtained using a one‐pot strategy starting from a simple inorganic vanadium oxide precursor and an amphiphilic cation in acidic aqueous solution. The cluster anion [H5P1V14O42]4–is based on the well‐known Keggin structure but in addition features two capping vanadyl [V=O]3+units. In the crystal lattice, the clusters are arranged in linear 1D chains where neighbouring clusters are directly linked by one hydrogen bond. In addition, the assembly is stabilized by lattice water molecules and organic counterions which aggregate to form hydrophobic cavities with diameters of 0.6 nm. In order to analyze the supramolecular interactions leading to the cluster formation, we have used a combination of traditional structural analysis, theoretical bond valence sum (BVS) calculations and computational Hirshfeld surface analyses which allow the rapid determination of short‐ and long‐range intermolecular contacts. The applicability of the Hirshfeld analysis tool for complex ionic compounds is evaluated and the advantages as well as the limitations of the method are discussed. The combination of these techniques allowed us to assess the dominating intermolecular interactions and showed that the crystal packing is not only controlled by electrostatic interactions, but also by distinctive sets of hydrogen bonds and hydrophobic interactions between adjacent organic counterions.

We present a 1‐yr (2005‐2006) record of organic carbon (OC) and total nitrogen (TN) contents and their isotopic ratios (Δ13COCand Δ15N) in sinking particles from the western Gulf of Lions. Maximum OC and TN fluxes recorded in January 2006 and March‐April 2006 were associated with negative near‐bottom temperature anomalies. This reveals large inputs of resuspended organic matter from the shelf basinwards to depths ≫1500 m by dense shelf‐water cascading. The first pulse of organic matter had low Δ13COC(‐25.5‰) and N:C (0.08) and high Δ15N (6.6‰) values, indicative of the arrival of organic matter of terrestrial origin. In contrast, the second pulse had high Δ13COC(‐21.9‰) and N:C (0.15) and extremely low Δ15N (0.0‰) values, indicative of the transfer of organic matter with higher marine contribution. Though downslope export of organic matter from the adjacent shelf predominated, particles escaping from surface waters remained an important source of organic matter during low‐energy and low‐flux periods and especially during summer conditions, with significant contribution of N2fixation to organic matter export. Overall, our results suggest the export of organic matter from different sources to the deep Mediterranean basin, which in turn might alter within a couple of months the quality of the sedimentary organic matter deposited on the sea floor and thus the dynamics of the deep ecosystems.

The causal factors for the species- and sex-differences associated with ochratoxin-mediated toxicity remain unclear. Variations in kinetic parameters may play a major role in explaining these differences, however, discrepancies and inaccuracies in the toxicokinetics reported in the literature for various species, make comparison and hence the extrapolation to the human situation impossible. The one- and two-compartment open models currently proposed may be insufficient to enable an accurate representation of the actual situation in vivo. It is likely that at least three if not four compartments must be assumed to account for the reported effects. The application of such models to existing raw data would most likely provide for a more accurate base set of toxicokinetic data and contribute to a more accurate human risk assessment. Possible explanations for the reported inconsistencies and their impact on the proposed mechanism(s) of action of OTA and risk assessment are discussed.

Background: This paper reviews the literature on the identification and treatment of pregnant, alcohol‐abusing women, with special emphasis on poor women who have access to treatment through Medicaid.

Introduction:As outcomes of patients with acute myeloid leukemia (AML) have improved over the past decades, the fraction of patients surviving long-term is increasing. Information on long-term somatic and psycho-social health consequences of AML and its treatment is sparse. Previous studies suggested a higher prevalence of cardiovascular diseases in AML survivors, especially those treated with allogeneic stem cell transplantation (alloHSCT). The aim of our study was to perform a multi-dimensional analysis of health outcomes in AML long-term survivors (AML-LTS). This report focuses on somatic, especially cardiovascular, morbidity in AML-LTS. Overall and health-related quality of life are reported separately (Telzerow et al.).

Introduction

The article reviews the videogame development software articity:draft from Nevigo.

Comorbid health conditions, both those present before transplant and those acquired as late effects of allogeneic hematopoietic stem cell transplantation (alloHSCT) and the treatment of chronic graft-versus-host disease (cGVHD), represent an important covariate. While the Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) (Sorror et al. Cancer, 2008; 112(9):1992-2001) has been developed to predict non-relapse mortality and overall survival in allo-HSCT recipients, many of the chronic comorbid conditions that develop in the allogeneic post-transplant setting are not represented in the HCT-CI, and its predictive validity has had limited study in long-term transplant survivors. The objectives of this study were to: (i) establish a new measure of multimorbidity for the post-transplant setting (Post-Transplant Multimorbidity Index [PTMI]), and (ii) explore its content validity.Based on a review of the literature and the most commonly used comorbidity measures, the PTMI was developed to reflect a broad and inclusive list of comorbid conditions that may arise in the post-transplant setting. Preliminary definitions to establish the presence of each of these conditions were developed. To enhance longitudinal comparisons, the conditions and definitions from the HCT-CI were nested within the PTMI. The conditions and definitions were iteratively refined (SM and DW) through application in a cohort of 30 post-transplant patients. Subsequently, the PTMI, HCT-CI, Charlson Comorbidity Scale (CCS), and the Functional Comorbidity Index (FCI) were comparatively evaluated in a cohort of 50 alloHSCT survivors referred for comprehensive cGVHD consultation. The evaluation cohort was a mean age of 42 (range 23-68) years and a median of 33.5 (range 13-208) months post-transplant. All but two (late acute GVHD n=1; no cGVHD n=1) had active cGVHD that had been present for a median of 27 (range 3-197) months. A majority had severe cGVHD (NIH global severity score 1 n=4; 2 n=8; 3 n=36) and 90% were currently receiving systemic immunosuppression.Applying the PTMI, HCT-CI, CCS and FCI to our evaluation cohort yielded a mean of 5 (SD±2.5), 1.5 (SD±1.23), 1.39 (SD±0.78), and 2.18 (SD±1.16) co-occurring conditions, respectively. On average the HCT-CI, CCS, and FCI missed the identification of one or more comorbidities 71%, 75%, and 43% of the time. Conditions that were prevalent in the cohort but missed by the other comorbidity measures included osteoporosis, avascular necrosis, hypertriglyceridemia, hypothyroidism, BMI<22, and secondary solid malignancy (excluding nonmelanoma skin cancer) after transplant. Using the PTMI, the two most prevalent comorbid conditions were osteoporosis (64%) and underweight/sarcopenia (BMI<22) (46%), whereas the FCI identified osteoporosis and depression as most prevalent, and the HCT-CI psychiatric disturbance and peptic ulcer, and the CCS history of malignancy and peptic ulcer disease, as the two most prevalent comorbidities, respectively.Our results offer preliminary evidence that the PTMI improves the identification of chronic comorbid conditions in long-term transplant survivors with cGVHD, and demonstrate that the choice of a measure is an important methodologic issue in the design of epidemiologic studies of comorbidity in post-transplant survivors with cGVHD. Prospective studies evaluating the measurement properties of the PTMI are ongoing in post-transplant survivors with and without active chronic GVHD. With continued testing and refinement, we anticipate that this new measure will have utility for risk-adjustment and stratification in both observational studies and clinical trials in the post-transplant setting.No relevant conflicts of interest to declare.

189 patients (pts) (median age 44 years, range 18-72) after alloHSCT were prospectively evaluated using the NIH consensus criteria, including the NIH-cGVHD grading form, the FACT-BMT, the Human Activity Profile (HAP), and the SF-36 v.2. The PTMI and the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) (Sorror et al) was retrospectively documented by chart review. Enrolment occurred a median of 275 (range: 85–4003) days after alloHSCT. Based on NIH criteria, 121 pts had cGVHD (mild n=24, moderate n=59, severe n=38). Sixty eight pts without cGVHD were included as controls.The most prevalent comorbidities were infections treated as outpatient during the past 3 months (n=53; 28%) followed by mild renal function impairment (n=42; 22%), osteoporosis (DEXA t-score< -1.5) (n=27; 14%) and severe infections requiring hospitalization during the past 3 months (n=23; 12%). Applying the PTMI 47 (24%) pts had no comorbidity, while 107 (56%) pts. had 1-3 comorbidities, 24 (13%) pts 4-6 comorbidities, and 11 (6%) pts > 6 comorbidities. In the subgroup of pts with cGVHD (n=72) enroled after more than 1 year post alloHSCT 12.5% of pts had > 6 comorbidities detected by the PTMI. In contrast the HCT-CI classified only 4% of the 72 pts. as multimorbid with > 6 comorbidities. Chronic GVHD and time after transplant were significantly associated with PTMI, while age was not significant in a multivariate analysis. In contrast, the HCT-CI was not associated with the presence of cGVHD. None of the single comorbidities alone were significantly associated with having cGVHD, although osteoporosis (p=0.084) and moderate infections not requiring inpatient treatment during the last 3 months (p=0.07) approached significance. Examining the association between the PTMI sum score and QoL (FACT-BMT), physical and mental health (SF-36) and activity (HAP), a significant correlation was detected between PTMI sum score with all subscales of the FACT-BMT. Similarly, significant correlations were observed between the PTMI sum score and 6 of the 8 subscales of the SF-36 (physical functioning, role limitations due to emotional problems, mental health, vitality, general health perception and change in health), while comorbidity did not impair social functioning and role limitation due to physical problems. The PTMI sum score was also correlated with the HAP adjusted activity score (AAS) but not the maximal activity score (MAS). Osteoporosis was a significant independent predictor of impairments in QoL, physical and mental health, and activity. Infectious complications treated as outpatient during the past 3 months significantly impaired social/family and emotional wellbeing as captured by the FACT, a similar effect was detected by the social functioning and general health perception subscales of the SF36. The HCT-CI score was significantly associated with FACT-BMT and HAP-AAS, and with only 2 of the 8 SF-36 subscale scores (vitality and mental health).Comorbidity burden in alloHSCT survivors is significant, and the summative score from a new measure of post-transplant comorbidity captured a wider range of comorbid conditions and was significantly associated with the presence of cGVHD, and with impairments in QoL, physical and mental health, and PF. The HCT-CI also demonstrated associations between comorbidity and QoL, although as a measure developed primarily to predict early post-transplant mortality it missed common long term comorbidities like metabolic bone diseases and does not cover a recent history of infectious complications. Our results provide preliminary support for a new measure of comorbidity developed specifically for the post-transplant population. A multicenter trial prospectively validating the PTMI is ongoing.No relevant conflicts of interest to declare.

A low cost design concept for Fibre-based Coherent Laser Doppler Wind Profiler is presented for supporting an active pitch control of Wind Turbines (WTs). The system is based on a 1.5m Continuous-Wave (CW) semiconductor laser source plus an erbium-doped fibre amplifier (EDFA) with an output power of 1W. A coherent detection method is used for Doppler frequency measurement. In addition, a concept of wind turbine predictive pitch control system is proposed for reducing the damage caused by wind turbulence. A mathematical simulation and the experimental result based on a lab setup are presented to show the calibration of such a system.

No relevant conflicts of interest to declare.

The NIH staging and response criteria offer for the first time the chance for uniform documentation and evaluation of physical functioning and quality of life (QoL) aspects of chronic graft-versus-host disease (cGVHD). Here we present the results of an interim analysis of a prospective German multicenter study on the NIH staging criteria in cGVHD. Hundred-thirty-eight patients (median age 46 years, range 19–64) after allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies were evaluated according to the NIH criteria based cGVHD activity assessment, the Lee Chronic GVHD Symptom-Scale (L-cGVHD-SC), FACT-BMT, Human Activity Profile (HAP), SF36, Berlin Social Support Scale (BSSS), 24 Item Adjective Measure (24–AM), Hospital Anxiety and Depression Scale (HADS), and the NCCN-Distress-Thermometer. Enrolment occurred between day 100 and 1 year after HSCT or in the presence of active cGVHD also at later time points. Follow-up surveys were conducted at 1, 2, 3, 5, 8, 12 and 18 months after baseline survey. At all time points disease status, comorbidities and medication were documented. Additionally the NIH-Symptom-Scale was applied for clinician rating of cGVHD symptoms. Ninety-one patients had cGVHD (mild n=29, moderate n=38, severe n=24) while 47 patients had no cGVHD. The cGVHD NIH consensus grading correlated with impairment of the activity profile (r=0.29, p<0.01), and the FACT-G total score (r=0.29, p=0.04). Pain highly correlated with impairment of QoL (FACT-G total score) (r=0.71, p<0.01), and impairment of the activity profile (r=0.30, p<0.01) and was associated with depression (r=0.29, p<0.01). In addition, the activity profile correlated with QoL (FACT-G total score) (r=0.41, p<0.01), anxiety (r=0.20, p=0.02), and mental health (r=0.38, p<0.01). Multiple regression analysis revealed that severity of cGVHD (β=0.27, p=0.01), grade of distress measured by the distress thermometer (β=0.28, p<0.01) and extraverted personality (β= −0.27, p<0.01) significantly predicted QoL as measured by the FACT-BMT. In contrast to the FACT-BMT, the SF36 total score was not predicted from severity of cGVHD in a multiple regression analysis; the only factors that predicted the SF36 total score were comorbid diabetes mellitus (β=0.22, p=0.01) and patients age (β=0.26, p=0.01). Moreover, a multiple regression analysis including the FACT-BMT (β= −0.29, p<0.01), L-cGVHD-SC (β= −0.19, p=0.01), and SF36 showed that the SF36 (β=0.12, p=0.1) did not contribute a significant additional information in the prediction of the HAP-maximum activity score. Using a multiple regression model the HAP-maximum activity score correlated inversely with severity of cGVHD (β= −0.25, p=0.015). Male sex (β=0.24, p=0.02) as well a diligent personality (β=0.24, p=0.02) had a significant positive impact on the HAP-maximum activity score. The results demonstrate, that severity of cGVHD as assessed by the NIH consensus grading correlates with impairment of physical functioning as well as QoL. Gender as well as personality are significant modifiers of the activity profile and QoL. While the FACT-BMT correlated with severity of cGVHD the SF36 failed to detect cGVHD related impairment of QoL and the activity profile in this cohort of patients in a multiple regression analysis.

The NIH staging and response criteria offer for the first time the chance for uniform documentation and evaluation of physical functioning and quality of life aspects of chronic graft-versus-host disease (cGVHD) as well as its response to immunosuppressive treatment. Here we present the interim analysis of a prospective Germany multicenter study on the NIH staging criteria in cGVHD. Methods: Seventy-six patients (median age 46 years, range 19–64) after allogeneic hematopoetic stem cell transplantation (HSCT) for hematologic malignancies were evaluated according to the NIH criteria based cGVHD activity assessment, the Lee Chronic GVHD Symptom-Scale, FACT-BMT, human activity profile (HAP), SF 36, Berliner Social Support Scale (BSSS), 24 item Adjective Measure (24 - AM), Hospital Anxiety and Depression Scale (HADS) and the NCCN-Distress-Thermometer. Enrolment occurred between day 100 and 1 year after HSCT or in the presence of active cGVHD also at later time points. Follow-up surveys were conducted at 1, 2, 3, 5, 8, 12 and 18 months after baseline survey. At all time points disease status, comorbidities and medication were documented. Additionally the NIH-Symptom-Scale was applied for clinician rating of cGVHD symptoms. Results: Fifty-one patients had cGVHD (mild n=15, moderate n=32, severe n=4) while 25 patients did not have cGVHD. The cGVHD NIH consensus grading as well as the 10 point scale correlated with impairment of physical functioning (p<0.01, r=.48), the FACT-G total score (p=0.02, r=.33) and mental health (p<0.01, r=.41). The HAP maximum activity score correlated inversely with severity of cGVHD (p=0.028, r=.44), with the physical functioning (p<0.01, r=.53) and with role limitation due to physical problems (p<0.01, r=.43) evaluated by the SF36. In addition an impaired physical functioning correlated with role limitations due to emotional problems (p<0.01, r=.52) and with impaired mental health (p<0,01, r=.63). Moreover the HAP maximum activity score correlated with emotional well being as evaluated by the FACT (p<0.01, r=.39). Depression as measured by the HADS depression score correlated with pain (p<0,01, r=.35) and impaired physical functioning (p=0.03, r=.26) while the HADS anxiety score did not. The results demonstrate, that severity of cGVHD as assessed by the NIH consensus grading and the 10 point scale correlate with impairment of physical functioning as well as daily activities and quality of life. Moreover reduction of daily activities lead to impairment of emotional well being.

Five recipients of solid-organ transplants who were infected with human immunodeficiency virus (HIV) were studied at the University of Minnesota, and our data were compared with data from 83 reported cases of HIV-infected recipients of solid organs from other centers. Sixty-six of the 88 patients were seronegative for HIV before transplantation and received organs or transfusions of blood from individuals who were seropositive for HIV. Seven patients (four recipients of kidney transplants and three recipients of liver transplants) received transplants after routine screening for HIV. Twenty-five (28%) of the 88 patients developed AIDS, and 20 (80%) of these 25 patients died of AIDS-related complications a mean of 37 months after transplantation. Another nine patients (10%) had other HIV-related diseases. The mean time of progression to AIDS was 27.5 months among all patients with AIDS. For patients who were seronegative for HIV at the time of transplantation, the mean time of progression to AIDS was 32 months, whereas patients seropositive before transplantation developed AIDS within 17 months. Shortly after transplantation, eleven (17%) of the patients who were initially seronegative experienced a febrile syndrome attributed to HIV. Ten patients, including eight recipients of kidney transplants and two recipients of liver transplants, maintained normal allograft function despite low-dose immunosuppressive therapy.

A heat treatment technique that results in the reduction of CeO2is developed to induce the tetragonal‐to‐monoclinic phase transition in the surface of Ce‐doped tetragonal zirconia polycrystals (TZP).