[Lay version of the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis : Translation into German and linguistic validation in German-speaking countries with people affected]. / Die laienverständliche Version der 2018 EULAR Empfehlungen zu körperlicher Aktivität von Menschen mit entzündlich-rheumatischen und degenerativen Erkrankungen : Übersetzung ins Deutsche und sprachliche Validierung im deutschsprachigen Raum mit Betroffenen.

BACKGROUND: Physical activity and exercise are beneficial for people with rheumatic diseases; however, recommendations for the management of rheumatoid arthritis (RA), spondyloarthritis (SpA) and hip- and knee osteoarthritis (HOA/KOA) are usually unspecific with respect to mode and dose of exercise. This is why the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis were formulated. The recommendations consist of 4 overarching principles and 10 recommendations. These were also published as a lay version in the English language. AIM: Translation of the lay version into German and its linguistic validation in Austria, Germany and Switzerland. METHODS: A professional translation was reviewed by the authors, including people with, RA, SpA, HOA/KOA from the three German-speaking countries, which provided a prefinal lay version. Subsequently, eight interviews with people with RA, SpA, HOA/KOA were conducted in each country to evaluate understandability, wording, completeness and feasibility of the prefinal lay version. Finally, the authors, i.e. those with RA, SpA, and osteoarthritis, anonymously rated their agreement to the final lay version on a 0-10 scale. RESULTS: The professional translation was substantially revised by the authors and based on the interviews. Formulations were adapted to increase readability and understandability and specify statements. Comments that would have changed content or structure were not considered. Average agreement with the particular recommendations was between 10 (SD 0) and 7.6 (SD 1.67). DISCUSSION: For people with RA/SpA/HOA/KOA the EULAR physical activity recommendations should be available in their mother language. The final German lay version is valid and accepted across all three German-speaking countries. Thus, the physical activity recommendations can be provided to people with rheumatic diseases in an understandable and feasible way.

Risk of colorectal adenomas in patients with celiac disease: a systematic review and meta-analysis. / Riesgo de adenomas colorrectales en pacientes con enfermedad celiaca: una revisión sistemática y metaanálisis.

INTRODUCTION AND AIMS: Whether celiac disease increases the risk of presenting with colorectal adenoma or not, has not been extensively evaluated. This question becomes relevant when considering early screening methods in patients with the disease. The aim of our article was to determine the risk of colorectal adenomas in celiac disease patients. MATERIALS AND METHODS: A computer-assisted search of the MEDLINE-Pubmed, EMBASE, LILACS, Cochrane Library, and Google Scholar databases was carried out, encompassing the time frame of 1966 to December 2016. The search strategy consisted of the following MESH terms: 'celiac disease' OR 'celiac sprue' AND 'colorectal' OR 'colorectal neoplasia' OR 'colorectal adenoma'. A fixed-effect model was used for the analyses. The first analysis dealt with the prevalence of all presentations of colorectal adenoma in patients with celiac disease and the second was on the prevalence of advanced adenomas. The outcomes were described as odds ratios (OR) with their 95% confidence intervals. RESULTS: The search identified 480 bibliographic citations, 17 of which were chosen for evaluation. Fourteen of those studies were rejected, leaving a final total of three for the analysis. Those studies included 367 cases of celiac disease and 682 controls. No significant heterogeneity was observed (I2=26%). There was no increased prevalence of colorectal adenomas in the celiac disease patients, when compared with the controls (OR: 0.94 [0.65-1.38]), and no significant difference was observed when assessing the prevalence of advanced adenomas (OR: 0.97 [0.48-1.97]). CONCLUSION: Celiac disease was not associated with an increased risk of colorectal adenomas. However, due to the limited evidence available, more studies are necessary to determine whether there is an actual association.

Plasmonic Purcell effect reveals obliquely ordered phosphorescent emitters in Organic LEDs.

The non-isotropic alignment of molecules can increase the interaction efficiency with propagating light fields. This applies to both emissive and absorptive systems and can be exploited for achieving unprecedented efficiencies of organic opto-electronic devices such as organic light-emitting diodes. Optical analysis has revealed certain phosphorescent emitters to align spontaneously in an advantageous orientation. Unfortunately, established approaches only determine an average orientation because emission patterns solely depend on the second moments of the transition dipole vector distribution. In order to resolve further details of such a distribution, additional differences in the emission characteristics of parallel and perpendicularly oriented emitters need to be introduced. A thin metal layer near the emitters introduces plasmon mediated losses mostly for perpendicular emitters. Then, analyzing the emission at different polarizations allows one to measure emission lifetimes of mostly parallel or mostly perpendicular oriented emitters. This should alter the transient emission when observing the temporal phosphorescence decay under different directions and/or polarizations. The angular width of the orientation distribution can be derived from the degree of such lifetime splitting. Our results suggest a narrow but obliquely oriented molecular ensemble of Ir(MDQ)2(acac) doped into the α-NPD host inside an Organic LED stack.

Electrophysiological and diffusion tensor imaging evidence of delayed corollary discharges in patients with schizophrenia.

BACKGROUND: Patients with schizophrenia (SZ) characteristically exhibit supranormal levels of cortical activity to self-induced sensory stimuli, ostensibly because of abnormalities in the neural signals (corollary discharges, CDs) normatively involved in suppressing the sensory consequences of self-generated actions. The nature of these abnormalities is unknown. This study investigated whether SZ patients experience CDs that are abnormally delayed in their arrival at the sensory cortex. METHOD: Twenty-one patients with SZ and 25 matched control participants underwent electroencephalography (EEG). Participants' level of cortical suppression was calculated as the amplitude of the N1 component evoked by a button press-elicited auditory stimulus, subtracted from the N1 amplitude evoked by the same stimulus presented passively. In the three experimental conditions, the auditory stimulus was delivered 0, 50 or 100 ms subsequent to the button-press. Fifteen SZ patients and 17 healthy controls (HCs) also underwent diffusion tensor imaging (DTI), and the fractional anisotropy (FA) of participants' arcuate fasciculus was used to predict their level of cortical suppression in the three conditions. RESULTS: While the SZ patients exhibited subnormal N1 suppression to undelayed, self-generated auditory stimuli, these deficits were eliminated by imposing a 50-ms, but not a 100-ms, delay between the button-press and the evoked stimulus. Furthermore, the extent to which the 50-ms delay normalized a patient's level of N1 suppression was linearly related to the FA of their arcuate fasciculus. CONCLUSIONS: These data suggest that SZ patients experience temporally delayed CDs to self-generated auditory stimuli, putatively because of structural damage to the white-matter (WM) fasciculus connecting the sites of discharge initiation and destination.

The apoptosis-inducing effect of gastrin on colorectal cancer cells relates to an increased IEX-1 expression mediating NF-kappa B inhibition.

Addressing the puzzling role of amidated gastrin(17) (G17) and the gastrin/CCKB/CCK2 receptor in colorectal carcinogenesis, we analysed potential candidate genes involved in G17-dependent NF-kappaB inhibition and apoptosis. The colorectal carcinoma cell line Colo320 overexpressing the wild-type CCK2 receptor (Colo320wt) underwent G17-induced apoptosis along with suppressed NF-kappaB activation and decreased expression of the antiapoptotic NF-kappaB target genes cIAP1 and cIAP2, whereas G17 was without effect on Colo320 cells expressing a CCK2 receptor bearing a loss of function mutation (Colo320mut). Gene microarray analysis revealed an elevated expression of the stress response gene IEX-1 in G17-treated Colo320wt but not Colo320mut cells. Quantitative real-time PCR and conventional RT-PCR confirmed this G17-dependent increase of IEX-1 expression in Colo320wt cells. If these cells were subjected to IEX-1 knockdown by small interfering RNA transfection, the apoptosis-inducing effect of G17 was abolished. Moreover, tumor necrosis factor alpha (TNFalpha)- or 5-FU-induced apoptosis that is greatly enhanced by G17 treatment in Colo320wt cells was prevented if IEX-1 expression was repressed. Under these conditions of blocked IEX-1 expression, the NF-kappaB activity remained unaffected by G17, in particular in Colo320wt cells co-treated with TNFalpha and also the suppressive effect of G17 on cIAP1 and cIAP2 expression was not observed anymore if IEX-1 expression was blocked. Conversely, IEX-1 overexpression in Colo320mut cells caused an increase of basal and TNFalpha- or 5-FU-induced apoptosis, an effect not further triggered by G17 treatment. Using a xenograft tumor model in severe combined immune deficiency mice, we could show that experimental systemic hypergastrinemia induced by the administration of omeprazole led to enhanced apoptosis as well as to a marked increase of IEX-1 expression in Colo320wt tumors, but not in Colo320mut tumors. These observations indicate that the proapoptotic effect of G17 on human colon cancer cells expressing the wild-type CCK2 receptor is mediated by IEX-1, which modulates NF-kappaB-dependent antiapoptotic protection and thereby exerts tumor-suppressive potential.

Proliferation studies on chromosome preparations of bone marrow in hematological disease.

The growth rate of neoplastic cells has been the subject of numerous scientific and diagnostic approaches. The study presented here analyses the relationship between mitotic activity in standardised cytogenetic bone marrow preparations from three haematological diseases and diagnostic and clinical parameters, most importantly the outcome. The disorders studied were: Acute lymphoblastic leukemia (ALL) (N=107), chronic myeloid leukemia (CML) (N=166) and aplastic anemia in childhood (AA) (N=39). A strict protocol of quantitative standardisation of cytogenetic slides was adhered to ensuring comparability both cross-sectionally and longitudinally. The samples were studied after short-term incubation without mitogenic in vitro stimuli. The most important findings include: i) ALL: Immunological subtypes can be differentiated according to their proliferation profile; there is a striking difference between childhood and adult ALL in proliferation activity; most importantly initial proliferation is much higher in patients who will relapse than in those with stable remission. ii) CML: Philadelphia-positive CML shows proliferation activities quite distinct from Philadelphia-negative CML; however there is only a small change in the proliferative activity from the chronic phase to the accelerated phase or blast crisis. iii) AA: Very low proliferation scores rise quickly to near normal levels during immunosuppressive therapy in most patients. Higher levels at diagnosis are associated with a faster and better response to therapy. In conclusion, assessment of the proliferative activity in cytogenetic preparations made from bone marrow samples of patients with haematological disease may add valuable information as to diagnostic sub-groups and clinical course and may contribute to therapeutic decisions.

Phantasy therapy in psychiatry: rediscovering reality in phantasy. A special treatment for in- and outpatients in general psychiatry.

Phantasy Therapy is an interdisciplinary depth-psychologically oriented group therapy form with focus on the treatment of psychoses in acute and remission phases. A different theme is presented to the patients every week on two consecutive days (90 min per session), coherently, via various sensory channels. On the first day, the theme is concretely and operationally introduced by means of an object, transformed into movement in the broadest sense of the word, and experienced directly with the body. The first session ends with a story, usually a fairy tale or parable, so that the body experiences can be further realized symbolically at the cognitive-emotional level. The second session treats the same theme via repetition of the chosen story with the deeper transformation of symbols into color and form. The first day is jointly led by a psychotherapist and a movement/ dance therapist, the second day by a psychotherapist and an art therapist. Our approach understands therapy as a somatesthetic experience- and synthetic expression-oriented encounter with the patient via the therapist's empathic imaginative identification with the patient by means of a progressively orchestrated, positivizing, cognitive-emotional, theme-centered rapport. In this connection six therapeutic elements are of importance: theme, object, movement, fairy tale, artwork, symbol. Phantasy Therapy offers the patient creative freedom in a humorous and playful way within a certain therapeutic security (Amae principle) and contradicts several classical prejudices concerning the treatment of psychotic patients.

Variations and interrelation between vasopressin and plasma osmolality in diabetic rats with insulin treatment.

Although it is well known that plasma osmolality and plasma vasopressin (VP) levels in diabetes mellitus are higher than in non-diabetic conditions (and that these levels return to normality with insulin therapy), there are no existing studies which examine for insulin-dependent diabetes, either the persistence of daily rhythmic variations of VP or the relationship between this variation and daily osmotic oscillations. We have therefore examined nycthaemeral variations in both plasma osmolality and plasma VP in normal (C), uncontrolled (D) and controlled insulin-dependent streptozotocin diabetic rats (DI). The uncontrolled streptozotocin treated rats presented, a loss of VP rhythmicity, together with higher values of VP than in both normal and controlled diabetic rats. The VP rhythm, however, could be restored with insulin treatment. Furthermore, the temporal VP/osmolality ratio in uncontrolled diabetic rats is higher than in normal rats, although this ratio does not show the daily rhythmic pattern that is present in both normal and diabetic rats treated with insulin. This may indicate that the lack of rhythmicity in osmotic regulation is responsible for the absence of a circadian rhythm in VP. As a result, we conclude that in uncontrolled diabetic rats, the higher VP levels and the loss of VP circadian rhythmicity could be due to a higher sensitivity in the osmoregulatory system, together with an absence of circadian variation of this system. This circadian variation could be responsible for the plasma VP rhythmicity in both normal and controlled diabetic rats.

Comparison of the effects of the M1-receptor antagonist telenzepine and the CCK-receptor antagonist loxiglumide on the pancreatic secretory response to intraduodenal tryptophan in dogs.

In six conscious dogs with chronic gastric and pancreatic fistulas we compared the action of different doses (20.25 to 81.0 nmol/kg/h) of the muscarinic M1-receptor antagonist telenzepine, the cholecystokinin (CCK) antagonist loxiglumide (2.5 to 10.0 mg/kg/h) and several combinations of both drugs on the pancreatic secretory response to intraduodenal perfusion of graded loads of tryptophan (0.37-10.0 mmol/h) given against a background of secretin (20.5 pmol/kg/h i.v.). Except for 20.25 nmol/kg/h telenzepine, all tested doses of telenzepine and/or loxiglumide decreased the 180-min integrated bicarbonate response to tryptophan by 55 to 119%. Except of 20.25 nmol/kg/h telenzepine and/or 2.5 mg/kg/h loxiglumide, all tested doses of telezepine and/or loxiglumide inhibited the tryptophan stimulated integrated pancreatic protein responses by 54 to 88%. While telenzepine mainly inhibited the bicarbonate and protein response to the lower loads of tryptophan (0.37-1.1 mmol/h), loxiglumide decreased the response to all loads of tryptophan. The inhibition evoked by the combinations of telenzepine and loxiglumide was not significantly greater than that by single infusion of either drug. The CCK plasma levels basally and in response to tryptophan were not significantly altered by telenzepine and/or loxiglumide. These findings indicate that (1) both enteropancreatic cholinergic reflexes and the hormone CCK are mediators of the protein response to intraduodenal trytophan (2) enteropancreatic cholinergic reflexes are probably the dominant mediators of the response to low amounts of tryptophan, whereas CCK is the major mediator of the response to high loads of tryptophan, (3) the two mediators seem to act independently of each other, and (4) the release of CCK by intestinal trytophan is not influenced by telenzepine or loxiglumide.

Conflicts experienced by quality assurance/improvement professionals: A Delphi study.

A Delphi survey was conducted to investigate the frequency and importance of conflicts identified by quality assurance/improvement professionals as well as the actions taken and resources used to deal with the conflicts. Responses to three rounds of the Delphi survey from 86 participants indicated that the predominant conflicts involved intrapersonal concerns, such as worry about the future, interpersonal and political barriers to change in quality work, and, rarely, ethical conflicts. A variety of collaborative and educational strategies were used to deal with conflicts. Results may be useful to examine from the perspective of health care professionals currently involved in quality work.

Redefining the role of clinical nurse specialists.

Leadership in a time of change requires personal and professional skills. As nursing responds to the evolving health care environment, the advanced skills of the clinical nurse specialist (CNS) are needed to promote a relationship with the client that is holistic and fiscally responsible. Positioned within vertically integrated corporations as community case manager, the CNS has an opportunity to bring innovative interpretations to the roles of practitioner, consultant, educator, and researcher.

[Activating effect of various kinds of semantic knowledge]. / Aktivierungswirkungen unterschiedlicher semantischer Wissensstrukturen.

The question if preactivation effects are to be observed during the within-conceptual storage of knowledge, when the prime is a general term or a peripheral term, was tested with the aid of the priming instrument. The primary effect appears only for the peripheral term-relation when the prime is presented for an interval of 1000 ms. During the between-conceptual storage, the central meaning of the predicate for active knowledge could not be confirmed. The predicate as prime led to no significant preactivation when a matched object-case was presented.

[Analytic report of the development of solutions in genetic counseling consultations]. / Analysebericht über die Lösungesentwicklung in genetischen Beratungsgesprächen.

Characteristic for a counseling-interview is the joint development of solutions by client and counselor. About this topic there is no difference in counseling psychology. This topic is the reason for a discrimination look. So we analyze 20 genetic-interviews looking for dominating activities, which induce the interaction of client and counselor to the development of solution. This way we ask for a differentiation in field, which is known until now in the psychological literature as exclusive. The transcription of the topics show the possibility of getting structures, assigned to certain fields of activity. At the same time the transparency, obtained this way, gives an insight into the centers of gravity, which are able to influence the clients behavior of decision. Having this knowledge, the practicing counselor can be stimulated to reflect his behavior thereto.