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Gunnar Duttge Prof. Dr. iur. Gunnar Duttge, Zentrum für Medizinrecht, Georg-August-Universität, Platz der Göttinger Sieben 6, 37073 Göttingen, Deutschland 926 MedR (2017) 35: 926 ... Beck, Huster, Lipp), ohne damit allerdings auch dem Willküreinwand bereits entgangen zu sein -was also das jeweils abweichende spezifische Begriffsverständnis eigentlich rechtfertigt. ...doi:10.1007/s00350-017-4759-x fatcat:avad2orro5h3xjeat6zfniqr2a
The PSG data and the values of the Visual Analog Scale (VAS) of fatigue, Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory ... PSQI  , Visual Analog Scale (VAS) of fatigue scored 0-10 cm  , Modified Fatigue Impact Scale (MFIS)  , Fatigue Severity Scale (FSS)  , Epworth Sleepiness Scale (ESS)  , and the Beck ... periodic limb movement disorder; RLS: restless legs syndrome; VAS: Visual Analog Scale; MFIS: Modified Fatigue Impact Scale; PSQI: Pittsburgh Sleep Quality Index; ESS: Epworth Sleepiness Scale; BDI: Beck ...doi:10.1155/2016/8378423 pmid:26885399 pmcid:PMC4739473 fatcat:cjaengzgsfgvpl74l5t3jnkm3a
, Brehm, and Fiedler Beck, Brehm, and Fiedler Beck, Brehm, and Fiedler ... In warmer tropical lowland habitats on the contrary, moths may spread their temporal flight niches across the night (Beck & Linsenmair 2006) . ...doi:10.1111/j.1744-7429.2010.00689.x fatcat:4u3rj7qmdnclbfrwo2fbu2yp4y
The aim of this study was to assess diaphragm electrical activation and diaphragm strength in patients with advanced Duchenne muscular dystrophy during resting conditions. Eight patients with advanced Duchenne muscular dystrophy (age of 25G2 years) were studied during tidal breathing, maximal inspiratory capacity, maximal sniff inhalations, and magnetic stimulation of the phrenic nerves. Six patients were prescribed home mechanical ventilation (five non-invasive and one tracheotomy).doi:10.1016/j.nmd.2006.01.003 pmid:16488607 fatcat:afdtpmtwabhw7nw67axolu6kpa
more »... agmatic pressure and diaphragm electrical activation were measured using an esophageal catheter. During tidal breathing (tidal volume 198G83 ml, breathing frequency 25G7), inspiratory diaphragm electrical activation was clearly detectable in seven out of eight patients and was 12G7 times above the noise level, and represented 45G19% of the maximum diaphragm electrical activation. Mean inspiratory transdiaphragmatic pressure during tidal breathing was 1.5G1.2 cmH 2 O, and during maximal sniff was 7.6G3.6 cmH 2 O. Twitch transdiaphragmatic pressure deflections could not be detected. This study shows that despite near complete loss of diaphragm strength in advanced Duchenne muscular dystrophy, diaphragm electrical activation measured with an esophageal electrode array remains clearly detectable in all but one patient. q
(Leiden/Boston: Brill, 2014) 295-341. 23 Gunnar Beck, The Legal Reasoning of the Court of Justice of the EU (Oxford: Hart Publishing, 2013) at 287-33. 24 Ibid 286. ... See further, Beck (n 23), 280-93; Cf. ...doi:10.1093/yel/yew018 fatcat:ly2lydvcnfchrd26frhzmrsxj4
This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and to identify the basis for differences in cancer classifications and OELs between various scientific organizations and countries. Differences in cancer classification exist in part due to differencesdoi:10.1006/rtph.2001.1490 pmid:11603958 fatcat:r5zajemxrzb2fix6fwx7ua7jta
more »... in the ultimate purpose of classification and to the relative importance of different types of data (i.e., animal vs human data, mechanistic data, and data from benign vs malignant tumors). In general, the groups surveyed tend to agree on classification of chemicals with good evidence of carcinogenicity in humans, and agree less on classification of chemicals with positive evidence in animals and inadequate or limited evidence in humans. Most entities surveyed distinguish between genotoxic and nongenotoxic chemicals when conducting risk assessments. Although the risk assessment approach used for nongenotoxic chemicals is fairly similar among groups, risk assessment approaches for genotoxic carcinogens vary widely. In addition to risk assessment approaches, other factors which can affect OELs include selection of the critical effect, use of healthbased vs technology-based exposure limits, and consideration of technological feasibility and socioeconomic factors. C 2001 Academic Press
The rates of missed gastric cancers (MGC) at upper endoscopy (UE) has been reported at 5–10% in Western countries. We aimed to calculate the rate of MGC and identify factors associated with MGC. Methods: Retrospective population-based cohort study including 730 patients diagnosed with gastric adenocarcinoma in Central Norway 2007–2016. MGCs were incident gastric adenocarcinomas diagnosed 6–36 months after a previous UE. Factors associated with MGC were examined. Definitely missed (UE 6–12doi:10.3390/cancers13225628 pmid:34830783 pmcid:PMC8616093 fatcat:scjgv3eskne4pmdfwzip73k3s4
more »... prior) and potentially missed (UE 12–36 months prior) MGCs were compared. Results: Sixty-seven (9.2%) of 730 gastric cancers were MGC. MGC were associated with localization (p = 0.009) and more frequent in the corpus, Lauren's histological type (p = 0.028) and diffuse type more prevalent, and previous Billroth 2-operation (14.9% vs. 4.7%, p = 0.001). MGCs were diagnosed at earlier stages (p = 0.037). An ulceration was more common in patients with definitely missed than potentially MGC (40.9% vs. 17.8%, p = 0.041). Conclusions: MGC accounted for 9.2% of gastric cancers in Central Norway. MGC were associated with localization in the corpus, Lauren´s diffuse type and previous Billroth-2-operation. Intensified follow-up and adequate biopsy sampling of patients with gastric ulcerations could reduce the rate of missed gastric cancers.
Ecological patterns are difficult to extract directly from vegetation data. The respective surveys provide a high number of interrelated species occurrence variables. Since often only a limited number of ecological gradients determine species distributions, the data might be represented by much fewer but effectively independent variables. This can be achieved by reducing the dimensionality of the data. Conventional methods are either limited to linear feature extraction (e.g., principaldoi:10.1016/j.ecoinf.2007.05.002 fatcat:uebpihq6fvbhfbpjfglozaihfu
more »... t analysis, and Classical Multidimensional Scaling, CMDS) or require a priori assumptions on the intrinsic data dimensionality (e.g., Nonmetric Multidimensional Scaling, NMDS, and self organized maps, SOM). In this study we explored the potential of Isometric Feature Mapping (Isomap). This new method of dimensionality reduction is a nonlinear generalization of CMDS. Isomap is based on a nonlinear geodesic inter-point distance matrix. Estimating geodesic distances requires one free threshold parameter, which defines linear geometry to be preserved in the global nonlinear distance structure. We compared Isomap to its linear (CMDS) and nonmetric (NMDS) equivalents. Furthermore, the use of geodesic distances allowed also extending NMDS to a version that we called NMDS-G. In addition we investigated a supervised Isomap variant (S-Isomap) and showed that all these techniques are interpretable within a single methodical framework. As an example we investigated seven plots (subdivided in 456 subplots) in different secondary tropical montane forests with 773 species of vascular plants. A key problem for the study of tropical vegetation data is the heterogeneous small scale variability implying large ranges of βdiversity. The CMDS and NMDS methods did not reduce the data dimensionality reasonably. On the contrary, Isomap explained 95% of the data variance in the first five dimensions and provided ecologically interpretable visualizations; NMDS-G yielded similar results. The main shortcoming of the latter was the high computational cost and the requirement to predefine the dimension of the embedding space. The S-Isomap learning scheme did not improve the Isomap variant for an optimal threshold parameter but substantially improved the nonoptimal solutions. We conclude that Isomap as a new ordination method allows effective representations of high dimensional vegetation data sets. The method is promising since it does not require a priori assumptions, and is computationally highly effective.
In the DAC a similar technique has been used in the reflection mode, called the transient heating technique (THT) (Beck et al., 2007) . ...doi:10.1107/s1600577513027434 pmid:24365921 pmcid:PMC4861204 fatcat:aotu5lehlnaknodr7a475a4gri
Under stressful conditions such as in an emergency situation, efficient information processing is essential for reasonable responses. Purpose of the Study: Virtual Reality (VR) technology is used to induce stress and to test three main cognitive functions for decision making in stressful situations. Methods: A VR task was developed to induce stress following the Trier Social Stress Test (TSST) protocol and two VR cognitive performance tests to measure learning aptitude, spatial orientation anddoi:10.1186/s40359-015-0080-5 pmid:26146558 pmcid:PMC4491419 fatcat:nqah4xs6xzge7mwdh63c43plgu
more »... ognitive flexibility. Participants (N = 31) gave a public speech in front of a virtual audience (TSST) and later had to find their way out of different VR labyrinths. The first exercise tested spatial orientation and learning aptitude where participants had to learn aspects of the ground layout and geometric icons had to be identified as correct in order to be able to exit. The second labyrinth tested cognitive flexibility on the background of the Wisconsin Card Sorting Test. Statistical tests: Correlations were analyzed using Kendall Tau Correlation (One-tailed tests with p set to 0.05 for all analyses). Heart rate (HR) was calculated from the RR time values and averaged across the TSST-speech and the post-stress period. Autonomic nervous system reactivity was defined as the deviation of HR during TSST-speech condition from post-stress baseline measurement. A repeated-measures t-test was used to analyze differences. Results: The newly developed virtual stress test was successfully adapted from the original TSST. Participants perceived the task as stressful and scored an average of 5.7 points on a 1-8 Likert Scale. As a physiological stress parameter, increased heart rates of the participants showed that they were more stressed during the TSST procedure compared to the post-stress period. Also, the subjective stress perception, has a strong correlation with the results of the cognitive tasks performed after the stress induction. Conclusions: The more a participant experienced the TSST as stressful, the lower their learning aptitude and spatial orientation were found to be at the end of the study. On the other hand, if someone perceived the virtual TSST as "unexpected", as an indicator for a mild stress response, their cognitive flexibility was improved. Potential Implications: The findings indicate that both, the VR stress induction scenario using TSST, as well as the VR cognitive tests, are a first successful step towards a better ecological validity in neuropsychological testing.
The method has been adapted to refugee trauma treatment by the authors Beck, Moe and Meyer  . ...doi:10.1186/s13063-018-2662-z pmid:29848343 pmcid:PMC5977477 fatcat:xkuqmixqcvd2hjfdn3sxegfseu
Previous studies on shoulder patients have suggested that the prevalence of rotator cuff or bursa abnormalities are weakly related to symptoms and that similar findings are often found in asymptomatic persons. In addition, it is largely unknown whether structural changes identified by magnetic resonance imaging (MRI) affect outcome after treatment for shoulder pain. The purpose of this study was therefore to evaluate the presence of structural changes on MRI in patients with subacromial paindoi:10.1186/s12891-017-1827-3 pmid:29157224 pmcid:PMC5696760 fatcat:bsijgewuangvbk3q6e24ua34ka
more »... drome and to determine to what extent these changes are associated with symptoms and predict outcome after treatment (evaluated by the Shoulder Pain and Disability Index (SPADI)). Methods: A prospective, observational assessment of a subset of shoulder patients who were included in a randomized study was performed. All participants had an MRI of the shoulder. An MRI total score for findings at the AC joint, subacromial bursa and rotator cuff was calculated. Multiple linear regression analysis was applied to examine the relationship between the MRI total score and the outcome measure at baseline and to examine to what extent the MRI total score was associated with the change in the SPADI score from baseline to the one year follow-up. Results: There was a weak, inverse association between the SPADI score at baseline and the MRI total score (β = −3.1, with 95% CI −5.9 to −0.34; p = 0.03), i.e. the SPADI score was higher for patients with a lower MRI total score. There was an association between the change in the SPADI score from baseline to the one year follow-up and the MRI total score (β = 8.1, 95% CI -12.3 to −3.8; p < 0.001), with a poorer outcome for patients with a higher MRI total score. Both tendinosis (p = 0.01) and bursitis (p = 0.04) were associated with a poorer outcome after one year. Conclusions: In this study, MRI findings were significantly associated with the change in the SPADI score from baseline and to one year follow-up, with a poorer outcome after treatment for the patients with higher MRI total score, tendinosis and bursitis on MRI. Trial registration: Clinicaltrials.gov no NCT01441830. September 28, 2011.
Gunnar JoHANSSON. ... Comparative Study of Oral Changes in Dogs Due to Deficiencies of Panto- thenic Acid, Nicotinic Acid and Un- knowns of the B Vitamin Complex By Hermann Becks Et AL. ...doi:10.14219/jada.archive.1943.0168 fatcat:46myyeefyjfc3g6u5ebuqufike
SUMMARYThe melanocortin-4 receptor (MC4R), a hypothalamic master regulator of energy homeostasis and appetite, is a G-protein coupled receptor and a prime target for the treatment of obesity. Here, we present cryo-electron microscopy structures of MC4R− Gs-protein complexes with two recently FDA-approved drugs, the peptide agonists NDP-α-MSH and setmelanotide, with 2.9 Å and 2.6 Å resolution. Together with signaling data, the complex structures reveal the agonist-induced origin of transmembranedoi:10.1101/2021.04.22.440868 fatcat:hrmxfw3slrbble7k734rtmlz3y
more »... helix (TM) 6 regulated receptor activation. In both structures, different ligand binding modes of NDP-α-MSH, a high-affinity variant of the endogenous agonist, and setmelanotide, an anti-obesity drug with biased signaling, underline the key role of TM3 for ligand-specific interactions and of calcium ion as a ligand-adaptable cofactor. The agonist-TM3 interplay subsequently impacts the receptor− Gs-protein interfaces, mainly at intracellular loop 2. These structures reveal mechanistic details of MC4R activation or inhibition and provide important insights into receptor selectivity that will facilitate the development of tailored anti-obesity drugs.
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