Connectedness and ICT: Opening the door to possibilities for people with intellectual disabilities.

This study aimed to investigate the experiences of people with intellectual disability (ID) using information and communication technologies (ICTs) and the ways these technologies foster social connectedness. In partnership with a community mental health organization, this qualitative descriptive study explored the experiences of 10 people with ID using ICTs. Participants described how ICTs Opened the Door to Possibilities in their life - ICTs provided an avenue for connecting with other people, a means to pursue personal interests and a tool for organizing everyday life. Opening the door to possibilities was further understood as movement towards digital inclusion for people with ID, conceptualized as the fit between social opportunity and personal skills. We have identified the prominent role social supports play in creating (and constraining) opportunities for digital inclusion, and that digital inclusion has the potential to enable social connectedness and the development of agency. Consideration of the complex interaction between social opportunity and personal skills, and the mediating influence of supports, will enhance the inclusion of people with ID.

Electron and recoil ion momentum imaging with a magneto-optically trapped target.

A reaction microscope (ReMi) has been combined with a magneto-optical trap (MOT) for the kinematically complete investigation of atomic break-up processes. With the novel MOTReMi apparatus, the momentum vectors of the fragments of laser-cooled and state-prepared lithium atoms are measured in coincidence and over the full solid angle. The first successful implementation of a MOTReMi could be realized due to an optimized design of the present setup, a nonstandard operation of the MOT, and by employing a switching cycle with alternating measuring and trapping periods. The very low target temperature in the MOT (∼2 mK) allows for an excellent momentum resolution. Optical preparation of the target atoms in the excited Li 2(2)P3/2 state was demonstrated providing an atomic polarization of close to 100%. While first experimental results were reported earlier, in this work, we focus on the technical description of the setup and its performance in commissioning experiments involving target ionization in 266 nm laser pulses and in collisions with projectile ions.

Polarization and interference effects in ionization of Li by ion impact.

We present initial-state selective fully differential cross sections for ionization of lithium by 24 MeV O8+ impact. The data for ionization from the 2s and 2p states look qualitatively different from each other and from 1s ionization of He. For ionization from the 2p state, to which in our study the m(L)=-1 substate predominantly contributes, we observe orientational dichroism and for 2s ionization pronounced interference which we trace back to the nodal structure of the initial-state wave function.

Ion-lithium collision dynamics studied with a laser-cooled in-ring target.

We present a novel experimental tool allowing for kinematically complete studies of break-up processes of laser-cooled atoms. This apparatus, the 'MOTReMi,' is a combination of a magneto-optical trap (MOT) and a reaction microscope (ReMi). Operated in an ion-storage ring, the new setup enables us to study the dynamics in swift ion-atom collisions on an unprecedented level of precision and detail. In the inaugural experiment on collisions with 1.5 MeV/amu O(8+)-Li the pure ionization of the valence electron as well as the ionization-excitation of the lithium target was investigated.

Longitudinal evaluation of the hypothalamic-pituitary-testicular function in 8 boys with adrenal hypoplasia congenita (AHC) due to NR0B1 mutations.

BACKGROUND: Boys carrying mutations in the NR0B1 gene develop adrenal hypoplasia congenita (AHC) and impaired sexual development due to the combination of hypogonadotropic hypogonadism (HH) and primary defects in spermatogenesis. METHODS: We analysed the evolution of hypothalamic-pituitary-testicular function of 8 boys with AHC due to NR0B1 mutations. Our objective was to characterize and monitor the progressive deterioration of this function. RESULTS: The first symptoms appeared in the neonatal period (n = 5) or between 6 months and 8.7 years (n = 3). Basal plasma adrenocorticotrophic hormone (ACTH) concentrations increased in all boys, whilst cortisol levels decreased in one case. The natremia was equal or below 134 mmol/L and kaliemia was over 5 mmol/L. All had increased plasma renin. In 3 of 4 patients diagnosed in the neonatal period and evaluated during the first year, the basal plasma gonadotropins concentrations, and their response to gonadotropin releasing hormone (GnRH) test (n = 2), and those of testosterone were normal. The plasma inhibin B levels were normal in the first year of life. With the exception of two cases these concentrations decreased to below the normal for age. Anti-Müllerian hormone concentrations were normal for age in all except one case, which had low concentrations before the initiation of testosterone treatment. In 3 of the 8 cases the gene was deleted and the remaining 5 cases carried frameshift mutations that are predicted to introduce a downstream nonsense mutation resulting in a truncated protein. CONCLUSIONS: The decreases in testosterone and inhibin B levels indicated a progressive loss of testicular function in boys carrying NR0B1 mutations. These non-invasive examinations can help to estimate the age of the testicular degradation and cryopreservation of semen may be considered in these cases as investigational procedure with the aim of restoring fertility.

[Mucinous adenocarcinomas of the large intestine in Crohn disease]. / Mucinöse Adenocarcinome des Dickdarms bei Morbus Crohn.

In two patients with Crohn's disease of long duration after more than 17 and 12 years respectively a mucinous adenocarcinoma of the ascending colon and a perianal mucinous carcinoma deriving from the anal ducts developed. The possible pathogenetic connections between chronic inflammatory bowel disease and tumour origin are considered. In particular, both the histologically identifiable dysplasia of the mucosa and the fistulae originating in the anal ducts are discussed.

Experience with the Berlin Heart Assist Device.

Different mechanical circulatory support systems (MCSS) have been in clinical use since 1987 to keep patients alive by assisting the heart during cardiac recovery after open heart surgery, myocardial infarction, acute graft failure after heart transplantation, or as a bridge to transplantation in heart transplant candidates. Four different hospitals in Germany used the Berlin Heart Assist Device. Up until 1993, there were 22 patients in the "recovery" group; 4 patients were weaned from the system, and only 1 patient was discharged from the hospital. In 112 patients the Berlin Heart Assist Device was implanted for the purpose of a bridge to transplantation, 68 were transplanted and 46 patients left the hospital. It was concluded that patients may be kept alive with this system for weeks and months after any kind of cardiogenic shock. Complete cardiac recovery may be achieved in patients with early posttransplant graft failure. Reliable prediction of outcome in bridge-to-transplantation patients requires further experience and improvement of system components.