Background: Delivery room management (DR) of the newly born infant should be performed according to international guidelines, but no recommendations are available for an infant’s position immediately after birth. The present study was performed to answer the following questions: 1. How often is DR-management performed in term infants in side position? 2. Is routine DR-management possible in side position? 3. Is there any benefit of side position with respect to agitation or vital parameters? Methods: Cross-sectional study of video-recorded DR-management in term newborns delivered by C-section in 2012. Videos were analysed for infant’s position, administered interventions, vital parameters and agitation. Results: 187 videos were analysed. The Main Position (defined as position spent more than 70% of the time) was “supine” in 91, “side” in 63 and “not determinable” in 33 infants. “Supine” infants received significantly (p < 0.001) more often stimulation (12.5% of the total time) than “side” infants (3.9% of time). There were no differences between both groups with regard to suctioning; CPAP was exclusively (98%) administered in supine position. Newborns on side were less agitated than those on supine. There was a trend towards a better oxygenation in “side” positioned infants (p = 0.055) and significantly (p = 0.04) higher saturation values in “left-sided” infants than “right-sided” infants at 8th minute. “Side” positioned infants reached oxygen saturation values >90% earlier than “supine” positioned infants (p = 0.16). Conclusions: DR-management is feasible in the side position in term infants. Side position seems to be associated with reduced agitation and improved oxygenation. However, it remains unclear whether this represents a causal relationship or an association. The study supports the need for a randomized controlled trial.

Objectives. Polyamide-12 (PA) is a flexible material suited for denture bases and clasping. This study investigated its potential aging effects with a focus on surface roughness, color stability, and elasticity. Methods. PA specimens (Valplast) of 40 × 10 × 2mm and equally measuring PMMA specimens (Palapress) as control were fabricated. Color changes after storage in air, water, coffee, and red wine (n = 10) were measured using the CIE L*a*b color specification. Elasticity after thermocycling (1000, 3000, and 7000 cycles, n = 15) was measured by three-point bending testing. Mean surface roughness (Ra) was determined after storage in the liquids mentioned above and thermocycling (n = 10). Results. Tukey’s HSD test (P < 0.05) revealed statistically significant color changes of PA in red wine (ΔE = 4.27 after 12 days, EΔE = 6.90 after 12 days) and coffee (ΔE = 3.93 after 36 days) but no color changes in PMMA. Elastic modulus of PA was 845MPa and not affected by thermocycling (Tukey’s HSD test, P > 0.81). Dry specimens showed significantly decreased elasticity (P < 0.001). Mean surface roughness (PA 0.20 μm, PMMA 0.28 μm) did not change significantly after thermocycling or storage (Mann-Whitney U-test, 0.16 < P < 0.65). Significance. PA exhibited a higher susceptibility to discoloration than PMMA. Neither surface roughness nor elasticity of PA was altered by artificial aging.

Aicardi-Goutières syndrome (AGS) is a rare inflammatory encephalopathy mimicking in utero acquired viral infection. Cardinal findings comprise leukodystrophy, basal ganglia calcifications and cerebral atrophy along with cerebrospinal fluid lymphocytosis and elevated interferon-α. In the majority of cases AGS is inherited as an autosomal recessive trait and caused by mutations in six genes including RNASEH2A, RNASEH2B, RNASEH2C, TREX1, SAMHD1 and ADAR1, all of which encode enzymes acting on nucleic acid species. Most patients present with first neurological signs in early infancy and experience severe global developmental delay. Here, we report on the unusual divergent phenotype of two siblings who both carry the most frequent AGS causing p.A177T (c.529G > A) RNASEH2B mutation in the homozygous state. While one sibling showed a typical AGS presentation with early onset and severe statomotor and mental impairment, the older sibling was intellectually completely normal. She was only diagnosed because of mild spasticity of the legs and serological signs of autoimmunity. These findings highlight the phenotypic variability of AGS and suggest that AGS may be underdiagnosed among children with mild cerebral palsy.

Purpose: To enhance prognostic information of protein biomarkers for clear cell renal cell carcinomas (ccRCCs), we analyzed them within prognostic groups of ccRCC harboring different tumor characteristics of this clinically and molecularly heterogeneous tumor entity. Methods: Tissue microarrays from 145 patients with primary ccRCC were immunohistochemically analyzed for VHL (von Hippel-Lindau tumor suppressor), Ki67 (marker of proliferation 1), p53 (tumor protein p53), p21 (cyclin-dependent kinase inhibitor 1A), survivin (baculoviral IAP repeat containing 5), and UEA-1 (ulex europaeus agglutinin I) to assess microvessel-density. Results: When analyzing all patients, nuclear staining of Ki67 (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.04–1.12) and nuclear survivin (nS; HR 1.04, 95% CI 1.01–1.08) were significantly associated with disease-specific survival (DSS). In the cohort of patients with advanced localized or metastasized ccRCC, high staining of Ki67, p53 and nS predicted shorter DSS (Ki67: HR 1.07, 95% CI 1.02–1.11; p53: HR 1.05, 95% CI 1.01–1.09; nS: HR 1.08, 95% CI 1.02–1.14). In organ-confined ccRCC, patients with high p21-staining had a longer DSS (HR 0.96, 95% CI 0.92–0.99). In a multivariate model with stepwise backward elimination, tumor size and p21-staining showed a significant association with DSS in patients with "organ-confined" ccRCCs. The p21-staining increased the concordance index of tumor size from 0.75 to 0.78. In patients with "organ-confined" ccRCC, no disease-related deaths occurred in the group with p21-expression below the threshold of 32.5% p21-positive cells (log rank test: P=0.002). Conclusion: The prognostic information of the studied protein biomarkers depended on anatomic tumor stages, which displayed different acquired biological tumor characteristics. Analysis of prognostic factors within different clinical ccRCC groups could help to enhance their prognostic power. The p21-staining was an independent prognostic factor and increased prognostic accuracy in a predictive model in "organ-confined" ccRCC.

Teaching in the field of public health needs to employ a global perspective to account for the fact that public health problems and solutions have global determinants and implications as well. International university partnerships can promote such a perspective through the strengthening of cooperation, exchange, and communication between academic institutions across national boundaries. As an example for such an academic network in the field of public health, we introduce the International Public Health Partnership—a collaboration between a university in Germany and universities in India, Turkey, and Nigeria. Formed in 2005, it facilitated the exchange of information, fostered discussion about the transferability of public health concepts, contributed to the structural development of the universities involved, and promoted an intercultural dialog through a combination of local and distance learning activities. Although well accepted by students and staff, different obstacles were encountered; these included limited external funding, scarce own financial, time and personnel resources, and diverging regulations and structures of degree programs at the partnership sites. In the present article, we share several lessons that we learned during our joint collaboration and provide recommendations for other universities that are involved in partnerships with institutions of higher education or are interested to initiate such collaborations.

Objective Skin temperatures are known to increase cutaneous sensitivity. However, it is unclear whether the amount of improved sensitivity differs depending on the protocol of heat application. Therefore, this study aimed to investigate the effects of active (treadmill walking) and passive (infrared radiator) warming of the foot sole on vibration perception thresholds. Methods Sixty healthy and injury-free subjects voluntarily participated in this study. Vibration perception thresholds (200 Hz) and plantar temperatures were measured at the hallux and 1st metatarsal head. In experiment 1, warming and mechanically stimulating the skin was achieved by walking on a treadmill for 30 min. In a follow-up study (experiment 2), external plantar heat was administered via an infrared radiator (30 min). Results In both experiments, increasing temperatures led to increased plantar sensitivity. However, the amount of improved sensitivity was greater in experiment 1, although plantar temperature increases were lower compared to experiment 2. Conclusions Warming in conjunction with mechanical stimulation seems to have a greater potential to enhance plantar sensitivity compared to external heat supply only. Significance The possible influence of mechanical stimulation and warming towards superior plantar afferent feedback highlights its importance regarding human posture and fall prevention.

The understanding of the subjective experience of a visually stable world despite the occurrence of an observer's eye movements has been the focus of extensive research for over 20 years. These studies have revealed fundamental mechanisms such as anticipatory receptive field (RF) shifts and the saccadic suppression of stimulus displacements, yet there currently exists no single explanatory framework for these observations. We show that a previously presented neuro-computational model of peri-saccadic mislocalization accounts for the phenomenon of predictive remapping and for the observation of saccadic suppression of displacement (SSD). This converging evidence allows us to identify the potential ingredients of perceptual stability that generalize beyond different data sets in a formal physiology-based model. In particular we propose that predictive remapping stabilizes the visual world across saccades by introducing a feedback loop and, as an emergent result, small displacements of stimuli are not noticed by the visual system. The model provides a link from neural dynamics, to neural mechanism and finally to behavior, and thus offers a testable comprehensive framework of visual stability.

In the course of revitalizing the Poseidon Building in Frankfurt, an energetically optimized façade, made of architectural concrete was developed. The development of a fiber-reinforced architectural concrete had to consider the necessary mechanical strength, design technology and surface quality. The fiber-reinforced architectural concrete has a compressive strength of 104.1 MPa and a 3-point bending tensile strength of 19.5 MPa. Beyond that, it was ensured that the fiber-reinforced high-performance concrete had a high durability, which has been shown by the capillary suction of de-icing solution and freeze thaw test with a weathering of abrasion of 113 g/m² after 28 freeze-thaw cycles and a mean water penetration depth of 11 mm.

Background: The purpose of this study was the comparison of the calculated (MLSSC) and experimental power (MLSSE) in maximal lactate steady-state (MLSS) during cycling. Methods: 13 male subjects (24.2 ± 4.76 years, 72.9 ± 6.9 kg, 178.5 ± 5.9 cm, V_O2max: 60.4 ± 8.6 ml min−1 kg−1, V_ Lamax: 0.9 ± 0.19 mmol l-1 s-1) performed a ramp-test for determining the V_O2max and a 15 s sprint-test for measuring the maximal glycolytic rate (V_ Lamax). All tests were performed on a Lode-Cycle-Ergometer. V_O2max and V_ Lamax were used to calculate MLSSC. For the determination of MLSSE several 30 min constant load tests were performed. MLSSE was defined as the highest workload that can be maintained without an increase of blood-lactate-concentration (BLC) of more than 0.05 mmol l−1 min−1 during the last 20 min. Power in following constant-load test was set higher or lower depending on BLC. Results: MLSSE and MLSSC were measured respectively at 217 ± 51 W and 229 ± 47 W, while mean difference was −12 ± 20 W. Orthogonal regression was calculated with r = 0.92 (p < 0.001). Conclusions: The difference of 12 W can be explained by the biological variability of V_O2max and V_ Lamax. The knowledge of both parameters, as well as their individual influence on MLSS, could be important for establishing training recommendations, which could lead to either an improvement in V_O2max or V_ Lamax by performing high intensity or low intensity exercise training, respectively. Furthermore the validity of V_ Lamax -test should be focused in further studies.

Listening to music usually elicits emotions that can vary considerably in their intensity over the course of listening. Yet, after listening to a piece of music, people are easily able to evaluate the music's overall emotional intensity. There are two different hypotheses about how affective experiences are temporally processed and integrated: (1) all moments' intensities are integrated, resulting in an averaged value; (2) the overall evaluation is built from specific single moments, such as the moments of highest emotional intensity (peaks), the end, or a combination of these. Here we investigated what listeners do when building an overall evaluation of a musical experience. Participants listened to unknown songs and provided moment-to-moment ratings of experienced intensity of emotions. Subsequently, they evaluated the overall emotional intensity of each song. Results indicate that participants' evaluations were predominantly influenced by their average impression but that, in addition, the peaks and end emotional intensities contributed substantially. These results indicate that both types of processes play a role: All moments are integrated into an averaged value but single moments might be assigned a higher value in the calculation of this average.