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In a recent study, melanoma incidence rates for Austrian inhabitants living at higher altitudes were found to increase by as much as 30% per 100 m altitude. This strong increase cannot simply be explained by the known increase of erythemally-weighted irradiance with altitude, which ranges between 0.5% and 4% per 100 m. We assume that the discrepancy is partially explainable by upwelling UV radiation; e.g., reflected by snow-covered surfaces. Therefore, we present an approach where the human UV exposure is derived by integrating incident radiation over the 3D geometry of a human body, which enables us to take upwelling radiation into account. Calculating upwelling and downwelling radiance with a radiative transfer model for a snow-free valley and for snow-covered mountain terrain (with albedo of 0.6) yields an increase in UV exposure by 10% per 100 m altitude. The results imply that upwelling radiation plays a significant role in the increase of melanoma incidence with altitude., Competing Interests: The authors declare no conflicts of interest.

The quality of radical oncological operations for patients with rectal cancer determines the rate of local recurrence and long-term survival. Neoadjuvant chemoradiotherapy for locally advanced tumors, a standardized surgical procedure for rectal tumors less than 12 cm from the anus with total mesorectal excision (TME) and preservation of the autonomous nerve system for sexual and bladder function have significantly improved the oncological results and quality of life of patients. The TME procedure for rectal resection has been performed laparoscopically in Germany for almost 20 years; however, no reliable data are available on the frequency of laparoscopic procedures in rectal cancer patients in Germany. The rate of minimally invasive procedures is estimated to be less than 20 %. A prerequisite for using the laparoscopic approach is implicit adherence to the described standards of open surgery. Available data from prospective randomized trials, systematic reviews and meta-analyses indicate that in the early postoperative phase the generally well-known positive effects of the minimally invasive approach to the benefit of patients can be realized without any long-term negative impact on the oncological results; however, the results of many of these studies are difficult to interpret because it could not be confirmed whether the hospitals and surgeons involved had successfully completed the learning curve. In this article we would like to present our technique, which we have developed over the past 17 years in more than 1000 patients. Based on our experiences the laparoscopic approach can be highly recommended as a suitable alternative to the open procedure.

Background/aim: The angular distribution of solar radiance and its spectral characteristics is required for the determination of vitamin D3 production in humans., Materials and Methods: The vitamin D3 weighted exposure can be calculated by integrating the incident solar spectral radiance over all relevant parts of the human body. A novel instrument allowing simultaneous measurements of spectral radiance from more than 100 directions has been developed. A large solar simulator for controlled experiments is described., Results: In summer it is relatively easy to obtain sufficient vitamin D because sun exposure times are short. In winter solstice vitamin D3 cannot be obtained with realistic clothing even if the exposure were extended to all daylight hours., Conclusion: Improved and controlled experiments to determine vitamin D3 production are required to assess the positive effects of solar UV radiation and to assess its natural variability., (Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Tibetan medicines are key material objects for medical treatment and have become part of a global trend of 'pharmaceuticalisation', playing increasingly important political and socio-economic roles in an 'alternative modernity'. As I argue in this paper, they also have become key 'sites of contestation' between different epistemic values and styles of practice related to efficacy and safety that are reproduced in and through specific formulation regimes. Based on my multisited ethnography of production, prescription, and use practices of Tibetan medicines in China and Europe, this paper conceptualises three distinct formulation regimes, offering a heuristic model for transnational comparison-a classical, an industrialised or reformulated, and a polyherbal regime. The first two are the major orientations while the polyherbal is a conjoint hybrid with either the classical or the industrialised formulation regime. Globalised national drug safety regulations legalise and confer legitimacy to industrialised Tibetan formulas that follow biomedically defined efficacy, safety, and disease categories, while classical formulas produced by private physicians or small-scale cottage pharmacies are increasingly marginalised as producing 'unsafe' and at times illegal medicines, and need to find new ways for adapting and circulating their formulas.

Glutamate decarboxylases (GAD67/65; GAD1/GAD2) are crucially involved in gamma-aminobutyric acid (GABA) synthesis and thus were repeatedly suggested to play an important role in the pathogenesis of anxiety disorders. In the present study, DNA methylation patterns in the GAD1 and GAD2 promoter and GAD1 intron 2 regions were investigated for association with panic disorder, with particular attention to possible effects of environmental factors. Sixty-five patients with panic disorder (f=44, m=21) and 65 matched healthy controls were analyzed for DNA methylation status at 38 GAD1 promoter/intron2 and 10 GAD2 promoter CpG sites via direct sequencing of sodium bisulfate treated DNA extracted from blood cells. Recent positive and negative life events were ascertained. Patients and controls were genotyped for GAD1 rs3762556, rs3791878 and rs3762555, all of which are located in the analyzed promoter region. Patients with panic disorder exhibited significantly lower average GAD1 methylation than healthy controls (p<0.001), particularly at three CpG sites in the promoter as well as in intron 2. The occurrence of negative life events was correlated with relatively decreased average methylation mainly in the female subsample (p=0.01). GAD1 SNP rs3762555 conferred a significantly lower methylation at three GAD1 intron 2 CpG sites (p<0.001). No differential methylation was observed in the GAD2 gene. The present pilot data suggest a potentially compensatory role of GAD1 gene hypomethylation in panic disorder possibly mediating the influence of negative life events and depending on genetic variation. Future studies are warranted to replicate the present finding in independent samples, preferably in a longitudinal design., (© 2013.)

We present a novel method to calculate vitamin D3 -weighted exposure by integrating the incident solar spectral radiance over all relevant parts of the human body. Earlier investigations are based on the irradiance on surfaces, whereas our calculated exposure of a voxel model of a human takes into account the complex geometry of the radiation field. Assuming that sufficient vitamin D3 (1000 international units) can be produced within the human body in one minute for a completely uncovered body in vertical posture in summer at midlatitudes (e.g. Rome, June 21, noon, UV index of 10), we calculate the exposure times needed in other situations or seasons to gain enough vitamin D3 . Our calculations show that the UV index is not a good indicator for the exposure which depends on the orientation of the body (e.g. vertical (standing) or horizontal (lying down) posture). Without clothing the exposure is dominated by diffuse sky radiation and it is nearly irrelevant how the body in vertical posture is oriented toward the sun. At the winter solstice (December 21, noon, cloudy) at least in central Europe sufficient vitamin D3 cannot be obtained with realistic clothing, even if the exposure were extended to all daylight hours., (© 2013 The American Society of Photobiology.)

We describe how sky luminance can be derived from a newly developed hemispherical sky imager (HSI) system. The system contains a commercial compact charge coupled device (CCD) camera equipped with a fish-eye lens. The projection of the camera system has been found to be nearly equidistant. The luminance from the high dynamic range images has been calculated and then validated with luminance data measured by a CCD array spectroradiometer. The deviation between both datasets is less than 10% for cloudless and completely overcast skies, and differs by no more than 20% for all sky conditions. The global illuminance derived from the HSI pictures deviates by less than 5% and 20% under cloudless and cloudy skies for solar zenith angles less than 80°, respectively. This system is therefore capable of measuring sky luminance with the high spatial and temporal resolution of more than a million pixels and every 20 s respectively.

Relatively low numbers of kringle 4 type 2 repeats in apolipoprotein(a) and specific haplotypes of the SLC22A3-LPAL2-LPA region on chromosome 6 are associated with an increased risk of coronary disease. We examined the possibility that rs3798220 and rs10455872, short variations located in LPA [the apolipoprotein(a) gene], and related to the number of kringle 4 type 2 repeats, may serve as markers for the association between haplotypes and acute myocardial infarction. Genotypes were determined with TaqMan assays in a sample of 2136 cases and 1211 controls. The minor alleles of rs3798220 and rs10455872 were associated with increased risks (rs3798220-C: adjusted OR 2.14, 95% CI, 1.37-3.33, P = 0.00080; rs10455872-G: adjusted OR 1.74, 95% CI 1.36-2.24, P < 0.00001). After adjustments were made for potential confounders, none of nine polymorphisms included in a haplotype analysis were singly related to disease. Two risk haplotypes were identified; one (CCTTGTGTG; OR 1.25, 95% CI 1.08-1.45, P = 0.0022) was correlated with rs3798220-C and the other (CCCTGGATC; OR 1.65, 95% CI 1.14-2.38, P = 0.0074) with rs10455872-G. Thus, the findings allowed for a more precise definition of risk-associated markers: specific nucleotides in LPA instead of standard haplotypes defined by noneffective variants from the extensive SLC22A3-LPAL2-LPA region., (© 2012 Blackwell Publishing Ltd/University College London.)

We assessed the association between common variation at the SERPINE1 (PAI1) locus and myocardial infarction (MI). Haplotype-tagging polymorphisms, including the 4G/5G deletion/insertion polymorphism and seven single nucleotide polymorphisms, were analysed in a German sample containing 3,657 cases with MI and 1,211 controls. The association between the 4G/5G polymorphism and MI was examined in a meta-analysis of data extracted from 32 studies (13,267 cases/14,716 controls). In addition, the relation between the 4G/5G polymorphism and coronary diseases, comprising MI, coronary artery disease, coronary heart disease, or the acute coronary syndrome, was assessed in a combined analysis enclosing 43 studies (17,278 cases/18,039 controls). None of the tagging polymorphisms was associated with MI in the present sample (p 1.0%) 8-marker haplotypes was related to the risk of MI. In a meta-analysis specifically addressing the association with MI, no elevated risk was found in the carriers of the 4G allele (OR 1.07, 95% CI 0.99-1.16; p = 0.11). A more general combined analysis of coronary diseases showed a marginally increased risk in 4G allele carriers (OR 1.08, 95% CI 1.00-1.16; p = 0.044). In essence, tagging polymorphisms, including the 4G/5G polymorphism, and common haplotypes of the SERPINE1 gene region were not associated with MI in a German sample, and no compelling evidence was obtained for a relationship of the 4G/5G polymorphism to MI and coronary atherosclerosis in a meta-analysis.

Background: Johannes Heinrich Schultz (1884-1970) established the set of techniques known as "autogenic training." From 1936 until 1945 he worked as assistant director of the Göring Institute. His role during National Socialism has been underestimated in our opinion., Method: We considered Schultz's academic publications and his "autobiography" from 1964., Results: Schultz publicly advocated compulsory sterilization as well as the "annihilation of life unworthy of life" and developed a diagnostic scheme which distinguished between the neurotic/curable and the hereditary/ incurable. In fact, this classification was then employed to decide between life and death. In order to justify the "New German Psychotherapy" alongside eugenic psychiatry, Schultz carried out degrading and inhuman "treatments" of homosexual prisoners of concentration camps who were in mortal danger., Limitations: This study was based on written documents. We were not able to interview contemporary witnesses., Conclusion: By advocating compulsory sterilization and the "annihilation of life unworthy of life" and by the abuse of homosexuals as research objects Schultz violated fundamental ethical principles of psychiatry.

Previous investigations with the electron microprobe reveal that the movements of Samanea leaflets are correlated with massive redistribution of K within the pulvinus. Evidence is now presented that Cl moves with K, whether plants are in white light or darkness, whether or not the amplitude of free running oscillations has damped, and whether or not the rhythm has been rephased by phytochrome photoconversion. The mid-extensor to mid-flexor ratio of K + Cl is correlated with leaflet angle under all conditions. Total Cl in both inner cortex and motor region is approximately 0.6 as high as K. The stoichiometry between Cl and the migratory fraction of K is close to, but not precisely 1:1 in all regions of the pulvinus, suggesting that other ions or systems may also be involved in the balancing of electrical charges.

Transverse sections of Albizzia pulvinules were examined with an electron microprobe to determine ion fluxes associated with turgorcontrolled leaflet movements. K(+) and Cl(-) concentrations are high in the flexor and low in the extensor region of closed pulvini. Both ions migrate out of the flexor and into the extensor during opening as previously described for K(+). The distribution of these elements is significantly correlated in each phase of the rhythmic cycle examined, but only 50 to 60% of the ionic charge of potassium is balanced by chloride. This value increases to 65 to 85% if one considers only the mobile fraction of the potassium.The increase in concentration of both ions in the extensor region precedes the decrease in the flexor, thus indicating that there must be a storage reservoir for K(+) and Cl(-). The inner cortex is suggested as such a reservoir, and plasmodesmata are discussed as a probable pathway for ion movement.