[Self-hypnosis training for in-hospital chronic pain patients : A retrolective observational study]. / "Selbsthypnosetraining" bei chronischen stationären Schmerzpatienten : Eine retrolektive Beobachtungsstudie.

BACKGROUND: Hypnosis is probably one of the oldest therapies known to man. In the last decades modern hypnosis has mainly been used by psychotherapists; however, hypnosis is becoming increasingly more important as a therapeutic method in medicine. Hypnosis can be used for a variety of medical indications. In the literature there is much evidence for the effectiveness of hypnosis. The aim of the present investigation was to demonstrate the effectiveness of hypnosis in inpatient treatment of chronic pain patients and to present a self-hypnosis program, which can be easily integrated into pain therapy. METHODS: From October 2012 to April 2013 all inpatient chronic pain patients were included (group 1: non-hypnosis group, group 2: hypnosis group). Concerning group 2 a standardized protocol for hypnotherapy was integrated in addition to the standardized pain management program. The main goal of hypnotherapy was to integrate a self-hypnosis training so that further implementation in a domestic setting could be guaranteed. By means of standardized test procedures, e. g. Patient Health Questionnaire (PHQ-9), Pain Disability Index (PDI), Generalized Anxiety Disorder (GAD-7) and Numerical Rating Scales (NRS) for pain and general well-being, data were evaluated before and after the pain therapy. RESULTS: The prestandardized and poststandardized test procedures of 30 chronic pain patients were evaluated (17 patients without hypnosis, 13 patients with hypnosis). The main diagnosis according to ICD-10 was "chronic pain disorder" (F45.41) with a MPSS stage III in all patients. The PDI was significantly improved in the hypnosis group (p = 0.019). The other items all showed a trend towards improvement in the hypnosis group (exception GAD-7) but without statistical significance (p > 0.05). DISCUSSION: In a small patient collective, the present investigation was able to show that the integration of modern hypnotherapy into the treatment of chronic pain patients in an inpatient setting can be another useful therapeutic aspect. In particular, the instructions for learning independently seem to be useful due to the limited in-patient time. More research needs to be carried out to support our initial findings.

Piezotronic Tuning of Potential Barriers in ZnO Bicrystals.

Coupling of magnetic, ferroelectric, or piezoelectric properties with charge transport at oxide interfaces provides the option to revolutionize classical electronics. Here, the modulation of electrostatic potential barriers at tailored ZnO bicrystal interfaces by stress-induced piezoelectric polarization is reported. Specimen design by epitaxial solid-state transformation allows for both optimal polarization vector alignment and tailoring of defect states at a semiconductor-semiconductor interface. Both quantities are probed by transmission electron microscopy. Consequently, uniaxial compressive stress affords a complete reduction of the potential barrier height at interfaces with head-to-head orientation of the piezoelectric polarization vectors and an increase in potential barrier height at interfaces with tail-to-tail orientation. The magnitude of this coupling between mechanical input and electrical transport opens pathways to the design of multifunctional electronic devices like strain triggered transistors, diodes, and stress sensors with feasible applications for human-computer interfacing.

MultiSense: A Multimodal Sensor Tool Enabling the High-Throughput Analysis of Respiration.

The high-throughput analysis of respiratory activity has become an important component of many biological investigations. Here, a technological platform, denoted the "MultiSense tool," is described. The tool enables the parallel monitoring of respiration in 100 samples over an extended time period, by dynamically tracking the concentrations of oxygen (O2) and/or carbon dioxide (CO2) and/or pH within an airtight vial. Its flexible design supports the quantification of respiration based on either oxygen consumption or carbon dioxide release, thereby allowing for the determination of the physiologically significant respiratory quotient (the ratio between the quantities of CO2 released and the O2 consumed). It requires an LED light source to be mounted above the sample, together with a CCD camera system, adjusted to enable the capture of analyte-specific wavelengths, and fluorescent sensor spots inserted into the sample vial. Here, a demonstration is given of the use of the MultiSense tool to quantify respiration in imbibing plant seeds, for which an appropriate step-by-step protocol is provided. The technology can be easily adapted for a wide range of applications, including the monitoring of gas exchange in any kind of liquid culture system (algae, embryo and tissue culture, cell suspensions, microbial cultures).

Physiological capacities decline during induced bioprocesses leading to substrate accumulation.

During the cultivation of E. coli for recombinant protein production, substrate accumulation is often observed in induction phase. Uncontrolled substrate accumulation leads to difficulties in transferring or scaling processes and even to failed batches. The phenomenon of metabolite/substrate accumulation occurs as a result of exceeding the physiological capacity to metabolize substrate (qScrit ). In contrast to the common understanding of qScrit as "static" value, we hypothesize that qScrit essentially has a dynamic nature. Following the state of the art approach of physio logical strain characterization, substrate pulse experiments were used to quantify qScrit in induction phase. The qScrit was found to be temperature and time dependent. Subsequently, qScrit was expressed through a linear equation, to serve as boundary for physiologically controlled experiments. Nevertheless, accumulation was observed within a physiologically controlled verification experiment, although the qScrit boundary was not exceeded. A second set of experiments was conducted, by oscillating the qS set point between discrete plateaus during physiologically controlled experiments. From the results, we deduced a significant interrelation between the metabolic activity and the timely decline of qScrit. This finding highlights the necessity of a comprehensive but laborious physiological characterization for each strain or alternatively, to use physio logical feedback control to facilitate real time monitoring of qScrit , in order to effectively avoid substrate accumulation.

Studies on the mechanism of synthesis of ethyl acetate in Kluyveromyces marxianus DSM 5422.

Kluyveromyces marxianus converts whey-borne sugar into ethyl acetate, an environmentally friendly solvent with many applications. K. marxianus DSM 5422 presumably synthesizes ethyl acetate from acetyl-SCoA. Iron limitation as a trigger for this synthesis is explained by a diminished aconitase and succinate dehydrogenase activity (both enzymes depend on iron) causing diversion of acetyl-SCoA from the tricarboxic acid cycle to ester synthesis. Copper limitation as another trigger for ester synthesis in this yeast refers to involvement of the electron transport chain (all ETC complexes depend on iron and complex IV requires copper). This hypothesis was checked by using several ETC inhibitors. Malonate was ineffective but carboxin partially inhibited complex II and initiated ester synthesis. Antimycin A and cyanide as complexes III and IV inhibitors initiated ester synthesis only at moderate levels while higher concentrations disrupted all respiration and caused ethanol formation. A restricted supply of oxygen (the terminal electron acceptor) also initiated some ester synthesis but primarily forced ethanol production. A switch from aerobic to anaerobic conditions nearly stopped ester synthesis and induced ethanol formation. Iron-limited ester formation was compared with anaerobic ethanol production; the ester yield was lower than the ethanol yield but a higher market price, a reduced number of process stages, a faster process, and decreased expenses for product recovery by stripping favor biotechnological ester production.

Geriatrics in medical students' curricula: questionnaire-based analysis.

BACKGROUND: Demographic development is accompanied by an increasingly aging society. Concerning medical education, the treatment of older people as well as the scientific research and exploration of ageing aspects in the coming years need to be considered. Aim of the study was to ascertain medical students' knowledge, interest, and attitudes regarding older patients and geriatric medicine. METHODS: Each participant completed a self-designed questionnaire. This questionnaire was based on three validated internationally recognised questionnaires ("Facts on Aging Quiz--FAQ", "Expectations Regarding Aging--ERA" and the "Aging Semantic Differential--ASD"). The inquiry and survey were performed at the beginning of the summer term in 2012 at the University of Regensburg Medical School. RESULTS: A total of n = 184/253 (72.7%) students participated in this survey. The results of the FAQ 25+ showed that respondents were able to answer an average of M = 20.4 of 36 questions (56.7%) correctly (Median, Md = 21; SD ±6.1). The personal attitudes and expectations of ageing averaged M = 41.2 points on the Likert-scale that ranged from 0 to 100 (Md = 40.4; SD ±13.7). Respondents' attitudes towards the elderly (ASD 24) averaged M = 3.5 points on the Likert-scale (range 1-7, Md 3.6, SD ±0.8). CONCLUSIONS: In our investigation, medical students' knowledge of ageing was comparable to previous surveys. Attitudes and expectations of ageing were more positive compared to previous studies. Overall, medical students expect markedly high cognitive capacities towards older people that can actively prevent cognitive impairment. However, medical students' personal interest in medicine of ageing and older people seems to be rather slight.

Individual and team training with first time users of the Pelvic C-Clamp: do they remember or will we need refresher trainings?

BACKGROUND: Pelvic ring injuries with associated hemorrhage from the presacral venous plexus are major contributors to morbidity and mortality in trauma patients. The Pelvic C-Clamp is an often discussed, yet seldom used device for both skeletal and hemodynamic stabilization. In a recent study we have addressed this issue and have stressed the importance of regular training sessions with the device. This study is aimed as an extended follow up with a special focus on how trained skills are retained over time. MATERIALS AND METHODS: 32 participants with various levels of training were taught to use the clamp. Thirty-six hours later, a hands-on session was performed where the time needed for placement and accuracy of placement were evaluated on a model in individual and team settings. 12 months later a re-evaluation was performed. RESULTS: Evaluation showed that during the first session, 57/64 pins (89.15 %) were placed inside the safe area. The team training results showed reduced times for assembly and more exact pin placement. In the re-evaluation 1 year later, 75 % of all pins were safely placed and the time needed for assembly was significantly longer. CONCLUSIONS: The majority of 57 pins were placed in the safe area within 6 min after one single training session. This reproduces the Australian data and supports the theory that adequately educated and skilled physicians should be able to handle the device properly. The data from the re-evaluation suggest that repeating the training session with the device improves performance.