Doctor of Philosophy / Curriculum and Instruction Programs / Charles Heerman / The purpose of the study was to determine the reading methods New Mexico teachers considered important to use in their classrooms and schools. Design of the study was based on a fixed goals COBRA (content-based reading approach) model, which is in development by Heerman (2002). The New Mexico COBRA model was revised to fit the socio-cultural context of the diverse student population served by middle schools in the state. Teachers in New Mexico were asked to respond to a reading survey built around 44 reading methods distributed among seven goals of the COBRA model. The researcher surveyed 153 New Mexico middle school educators in 110 middle school building in order to determine the relative emphasis placed on various reading methods. A revision of the original survey used by Al-Fadda was conducted, which included drafting ELL survey items used at the middle schools with reference to culturally and linguistically diverse students or ELLs. Five research questions were used to build the rationale for the COBRA framework, develop the survey, conduct the survey research, and analyze the results. Middle schools included in this survey research were characterized as middle schools with a student population of 200 and above. The pool of educators asked to participate in the survey taught or were involved with the reading program at their respective schools. These included reading teachers, English language arts teachers, Bilingual/ESL/TESOL teachers, and instructional and school improvement leaders familiar with the building’s reading program. These middle level teachers perceive as important a first line conventional framework for middle level reading, which includes skills instruction, narrative literature instruction, and writing. These teachers give first emphases to reading instruction and communicative competence while content reading instruction is a secondary emphasis.

L’objectif de ce travail est de contribuer à la modélisation du couplage hydromécanique, existant entre la déformation de la préforme fibreuse et l’écoulement de la résine, et par la suite à la simulation des procédés d’infusion. La méthode de résolution numérique déployée dans ce cadre est de type éléments finis avec volumes de contrôles (CVFEM) formulée en 2D½. Une nouvelle approche de modélisation de procédé d’infusion est proposée. Dans cette méthode, nous avons introduit des éléments 1D qui traduisent l’écoulement transverse. Cette approche permet de surmonter la difficulté numérique relative à l’usage des éléments finis volumiques pour un calcul 3D, notamment pour simuler la mise en œuvre des pièces industrielles de grandes dimensions. Le modèle fait appel à des lois de comportements caractérisées expérimentalement et qui permettent de tenir compte de l’évolution de la perméabilité et la compressibilité du milieu fibreux au cours de l’infusion. Diverses confrontations entre le modèle numérique proposé, des méthodes analytiques et expérimentales ont été menées. Une application du modèle dans la simulation de l’infusion d’un démonstrateur industriel de géométrie complexe est également réalisée. Les résultats obtenus sont très encourageants et révèlent l’efficacité de l’outil développé dans la simulation du procédé d’infusion / The aim of this work is to model the hydromechanical coupling that exists between the preform compressibility and the resin flow in order to simulate the infusion processes. The numerical method used in this study is based on the Control Volume Finite Elements Method (CVFEM) in 2D½. A new modelling approach of the infusion process is proposed. In this method, we introduced 1D elements to include through-the-thickness flow. This approach allows to reduce the computational time in comparison with full 3D modelling, especially in the simulation of industrial part infusion with large dimensions. The developed model is alimented by behavior laws that we characterized experimentally. These laws allow to take into account the evolution of the permeability and the compressibility of the fibrous medium during the infusion. We validated our model by comparing its results with analytical and experimental data. Additionally, an application of this simulation approach has been carried out to simulate the infusion of an industrial demonstrator with complex geometry. These comparisons show a good agreement between numerical and experimental results and reveal the efficiency of the developed tool in the infusion process simulation.

INTRODUÇÃO: As vantagens da utilização do Cateter Central de Inserção Periférica (CCIP) no ambiente hospitalar faz com que esse cateter ocupe uma posição de destaque na terapia intravenosa dos pacientes com indicação de administração de drogas com características que danificam a rede venosa periférica. A possibilidade de inserção do cateter a beira do leito por enfermeiros capacitados conferem maior facilidade para a inserção deste dispositivo. Por ser um cateter seguro e de fácil manutenção possibilita ainda a desospitalização precoce dos pacientes em antibioticoterapia e quimioterapia. Este trabalho relata o uso do CCIP nos pacientes do Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Universidade de São Paulo (IOT-HC-FMUSP) nos últimos 10 anos. MÉTODOS: Foram analisados 1.057 prontuários de pacientes submetidos a inserção do CCIP por enfermeiros qualificados no Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo entre os anos de 2007 e 2017. Destes, 34 foram excluídos por não apresentar dados completos no prontuário para a análise posterior. Foram incluídos 1023 prontuários no total, onde foram analisados: idade, sexo dos pacientes, veia puncionada, diagnóstico, número de punções, tempo em que o paciente permaneceu com o cateter, motivo da retirada e posicionamento da ponta do CCIP. RESULTADOS: Um total de 1023 CCIPs inseridos durante o período de 10 anos cumpriram os critérios para inclusão neste estudo. Destes, 720 (70,4%) foram considerados adequadamente posicionados. O tempo médio de utilização do cateter foi de 34,3 dias. A veia basílica foi utilizada em 528 (51,6%) pacientes enquanto que a veia cefálica foi utilizada em 392 (38,3%) pacientes. Cento e cinquenta e sete (15,4%) cateteres foram removidos devido a complicações, sendo a oclusão a complicação mais frequentemente reportada, com 58 (5,7%) casos. Nenhum caso de trombose ou infecção relacionada ao cateter foi encontrado. Oitocentos e sessenta e seis (84,6%) pacientes completaram o tratamento. Destes, 791 (77,3%) completaram durante a hospitalização e 75 (7,3%) receberam alta com o dispositivo. A principal indicação do CCIP nos pacientes ortopédicos é a antibioticoterapia. CONCLUSÃO: Este estudo sugere que o CCIP é um dispositivo intravenoso seguro e pode ser utilizado para terapia intravenosa de média e longa duração em pacientes ortopédicos hospitalizados ou desospitalizados Benefits and risks of the peripherally inserted central catheter (PICC) / INTRODUCTION: The advantages of using a Peripherally Inserted Central Catheter (PICC) in hospitalized patients gives this dispositive great importance for the intravenous therapy, especially in patients with the indication of drugs that have a potential to damage peripheral veins. The possibility of inserting this catheter at bedside, procedure that should be realized by trained nurses, gives the use of this device an excellent choice for intravenous therapies. Also, for being a safe an easy maintain dispositive, it gives the patient the option of an early dismissal from the hospital to continue the intravenous therapy at home. This paper describes the uses of the Peripherally Inserted Central Catheter (PICC) in adult patients that used this device for intravenous therapy, and had complete information in the medical records between 2007 and 2016, at the Orthopedics and Traumatology Institute of the Clinics Hospital of the Medical School of the University of São Paulo. METHODS: This is a retrospective study in which we used 1.057 medical records from patients that receive intravenous therapy through a Peripherally Inserted Central Catheter (PICC). The procedure was carried out by trained nurses from the Orthopedics and Traumatology Institute of the Clinics Hospital of the Medical School of the University of São Paulo between 2007 and 2017. From the 1.057 medical records studied, 34 were excluded due to the lack of information or incomplete data at the time of the analyses. There were 1.023 medical files with complete information included in the study. We obtained the following information: age, gender, place of insertion, punctured vein, number of punctures, diagnosis, duration of the catheterization, complications of the catheter and positioning. RESULTS: A total of 1023 PICCs inserted during a 10 year period met eligibility criteria for this study. Of these, 720 (70.4%) were considered successfully positioned. Mean duration of catheterization was 34.3 days. The basilic vein was used in 528 (51.6%) patients, while the cephalic vein was used in 392 (38.3%) patients. One hundred and fifty seven (15.4%) catheters were removed due to complications. Of the complications, occlusion was reported in 58 (5.7%) patients. Incidence of catheter related thrombosis or infection was not found. Eight hundred and sixty six (84.6%) patients completed the treatment. Of these, 791 (77.3%) completed it during hospitalization and 75 (7.3%) were discharged with the catheter. PICCs in orthopedic patients are mainly used for antibiotic treatment. CONCLUSION: Our study suggests that PICC is a safe intravenous device that can be successfully utilized for medium and long lasting intravenous therapy in hospitalized and non-hospitalized orthopedic patients

Context: The metabolic syndrome, characterized by central obesity with dyslipidemia, hypertension, and hyperglycemia, identifies people at high risk for type 2 diabetes. Objective: Our objective was to determine how the insulin resistance of the metabolic syndrome is related to muscle fiber composition. Design:Thirty-nine sedentary men and women (including 22 with the metabolic syndrome) had insulin responsiveness quantified using euglycemic clamps and underwent biopsies of the vastus lateralis muscle. Expression of insulin receptors, insulin receptor substrate-1, glucose transporter 4, and ATP synthase were quantified with immunoblots and immunohistochemistry. Participants and Setting: Participants were nondiabetic,metabolic syndrome volunteers and sedentary control subjects studied at an outpatient clinic. Main Outcome Measures: Insulin responsiveness during an insulin clamp and the fiber composition of a muscle biopsy specimen were evaluated. Results: There were fewer type I fibers and more mixed (type IIa) fibers in metabolic syndrome subjects.Insulin responsiveness and maximal oxygen uptake correlated with the proportion of type I fibers.Insulin receptor,insulin receptor substrate-1, and glucose transporter 4 expression were not different in whole muscle but all were significantly less in the type I fibers of metabolic syndrome subjects when adjusted for fiber proportion and fiber size.Fat oxidation and muscle mitochondrial expression were not different in the metabolic syndrome subjects. Conclusion:Lower proportion of type I fibers in metabolic syndrome muscle correlated with the severity of insulin resistance. Even though whole muscle content was normal, key elements of insulin action were consistently less in type I muscle fibers, suggesting their distribution was important in mediating insulin effects

Gezielte Präventionsmaßnahmen für Jugendliche mit einem hohen Risiko für alkoholbezogene Störungen sind wichtig, allerdings sind die dazu erforderlichen Kenntnisse über prädisponierende Faktoren begrenzt. Deshalb wurden zwei Studien durchgeführt, um biologische und psychologische Risikofaktoren für das jugendliche Trinkverhalten zu untersuchen. In beiden Studien wurde das CAIS (Computer-assisted Alcohol Infusion System) erstmals bei 18-19-Jährigen angewendet, was im Vergleich zur oralen Alkoholgabe eine genauere Kontrolle über die Blutalkoholspiegel und deren zeitlichen Verlauf ermöglicht. In der ersten Studie konnten sich die Jugendlichen den Alkohol selbst per Knopfdruck verabreichen, während in der zweiten Studie ein Blutalkoholspiegel von 0.8 ‰ induziert und stabil gehalten wurde. Die hier berichteten Studien legen nahe, dass es folgende Risikofaktoren für den Alkoholkonsum bei 18-19-Jährigen gibt: männliches Geschlecht, starke explizite Trinkmotive im nüchternen Zustand, starke explizite und implizite Trinkmotive im alkoholisierten Zustand sowie vermehrt zielgerichtetes Verhalten im alkoholisierten Zustand bei 0.8 ‰.:Hinweise zur vorliegenden Dissertation 1 Danksagung 3 Abkürzungsverzeichnis 4 1. Einführung 6 1.1 Riskanter Konsum, schädlicher Gebrauch, Abhängigkeit 6 1.2 Durch Alkohol verursachte Schäden 8 1.3 Derzeitiger Forschungsstand und Forschungslücken 9 1.4. Ziele der vorliegenden Arbeit 13 Studie 1: Dresden Longitudinal study on Alcohol use in Young Adults (D-LAYA) 14 Studie 2: Acute effects of alcohol on learning and habitization 14 2. Zusammenfassung der Ergebnisse 16 3. Diskussion 17 3.1 Stärken und Limitationen 20 3.2 Schlussfolgerungen 22 4. Zusammenfassung 24 4.1 Hintergrund 24 4.2 Fragestellungen/ Hypothesen 25 4.3 Material und Methoden 25 4.4 Ergebnisse 26 4.5 Schlussfolgerungen 26 6. Summary 28 6.1 Background 28 6.2 Research questions 28 6.3 Methods 29 6.4 Results 29 6.5 Conclusions 30 7. Literaturverzeichnis 31 8. Anhang 37 IV 8.1 Artikel 1 37 8.2 Artikel 2 49 8.3 Artikel 3 65 8.4 Erklärung über die Eigenständigkeit (Formblatt 1.2.1) 79 8.5 Erklärung über die Einhaltung der aktuellen gesetzlichen Vorgaben im Rahmen der Dissertation (Formblatt 1.1) 81

Many steps go into developing a clinical viral gene therapy. The course starts with appropriate disease selection and moves through the many hurdles of in-vitro testing, animal model validation and proof-of-concept studies, all the way through pre-clinical large animal studies. In this thesis, I propose to outline the process of developing a translation pathway for a gene therapy using recombinant adeno-associated virus (rAAV). I will expand on this outline using data that I have generated during the course of my Ph.D. that ranges from animal model validation all the way through pre-clinical vector stability studies. Two disease models will be discussed throughout this thesis, Cockayne Syndrome (CS) and Alpha-1 Antitrypsin Deficiency (AATD). Cockayne Syndrome is a rare autosomal recessive genetic disorder involving mutations in either the CSA or CSB gene, leading to defects in DNA repair. Clinically this presents as progressive degeneration of the central nervous system, retina, cardiovascular system, and cochlea, which leads to mental retardation, post-natal growth defects, ocular abnormalities, and shortened life expectancy. Alpha-1 antitrypsin is a serine protease inhibitor largely produced in the liver that mainly functions to inhibit neutrophil elastase within the lung. AATD leads to an increased risk of emphysema, with shortened life expectancy, and also results in accumulations of mutant AAT polymers in the liver, sometimes leading to liver failure. Using these two disease models I will outline the upstream and downstream pre-clinical work as well as the transition to clinical trials of a rAAV based gene therapy.

Nowadays the use of chemical gel injection for humid masonry provides many benefits. If we consider the financial aspects of this kind of remediation of humid masonry, we can say that this method is least expensive and time-consuming. In comparison with other remediation methods major interventions into the structure is not required, which could result in deterioration of the structural analysis of the works and the consequent need of special machinery, which subsequently increases spent effort and resources. There is also need for additional screens easily applied to walls breached by rising damp and this need is also required for research in dealing with this issue. Only a standard regulation dealing with remediation of wet masonry using chemical injection is directive WTA 4-4-04 / D – Injection of masonry against capillary moisture. From this point of view there is a clear need for further development in this area.

Die zytostatische Chemotherapie ist wesentlicher Bestandteil der palliativen Therapie von Patienten mit metastasiertem kolorektalen Karzinom. Gegenüber einer rein supportiven Behandlung verbessert eine auf 5-Fluorouracil (5-FU) basierende Chemotherapie die Lebensqualität und verlängert das Überleben der Patienten. 5- FU-Dauerinfusion moduliert mit Folinsäure ist die beste Grundlage für die Kombination mit Irinotecan oder Oxaliplatin. Randomisierte Studien zum Einsatz von Irinotecan zeigten signifikante Vorteile im Hinblick auf die Remissionsrate, das progressionsfreie Überleben und auch die mediane Überlebenszeit. Randomisierte Studien zum Einsatz von Oxaliplatin zeigten ebenfalls höhere Remissionsraten und ein verlängertes progressionsfreies Überleben ohne eine verlängerte Überlebenszeit nachweisen zu können. Heutzutage sollten alle Patienten mit einer Kombinationschemotherapie behandelt werden und im Verlauf ihrer Erkrankung, soweit möglich, alle zur Verfügung stehenden Medikamente erhalten. Nur dadurch können mediane Überlebenszeiten von über 20 Monaten erreicht werden. Der Einsatz oraler Fluoropyrimidine statt einer 5-FU-Dauerinfusion in Kombination mit Irinotecan und Oxaliplatin ist viel versprechend, jedoch Gegenstand laufender Studien. Monoklonale Antikörper gegen den EGF-Rezeptor bzw. gegen VEGF haben ebenfalls viel versprechende Ergebnisse gezeigt und werden wahrscheinlich die Behandlungsmöglichkeiten in der Zukunft wesentlich verbessern. / Systemic chemotherapy has a key role in the palliative treatment of patients with metastatic colorectal cancer. Compared to best supportive care, 5-fluorouracil (5-FU)-based therapy prolongs survival and improves quality of life. 5-FU continuous infusion modulated by Leukovorin (LV) is the optimal basis for a combination therapy with irinotecan or oxaliplatin. Randomized trials investigating the role of irinotecan in combination with 5-FU/LV relative to 5-FU/LV alone demonstrated a significant improvement in the response rate, progression free survival and overall survival. Randomized studies using oxaliplatin/ 5-FU/LV vs. FU/LV alone resulted in a higher response rate and longer progression-free survival while the overall survival was not significantly different. Today, all patients should receive combination treatment in first line and should be offered all active compounds during the course of their disease. Hereby, median survival times of more than 20 months are achievable. The use of oral fluoropyrimidines as a substitute of infusional 5-FU in combination with irinotecan or oxaliplatin is promising and subject of clinical trials. Monoclonal antibodies directed against the EGF-receptor or against VEGF have demonstrated interesting results and may be a treatment option in the future. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Hybrid composites play a key role in sustainable development. For many years, carbon fibres in an epoxy matrix have been an attractive option for many structural applications because of their higher specific mechanical properties mostly. However, recycling and sustainability are some of the composite shortcomings; and in that context, natural fibres have gained popularity.  The present study aimed to design and manufacture short carbon/flax hybrid composites. Two different arrangements were chosen: random and layers configuration. Resin Transfer Moulding (RTM) was used to fabricate these hybrid composites. Mechanical tests and optical microscopy technique were conducted to understand the effect of the interaction of these two different reinforcements. Mechanical tests showed a remarkable difference between the hybrid configurations under flexural loadings. Furthermore, outstanding property values were observed in the hybrid configurations compared to single fibre composites. The resultant materials have seemed an attractive combination of fibres with a remarkable balance between mechanical performance and eco-friendliness.

A stationary or portable infusion pump can be used to administer home parenteral nutrition (HPN). The stationary pump (SP) must be fasten to the infusion stand, so patients administer infusions in night mode to maintain their quality of life and mobility in the daytime. However, administering the HPN at nighttime can cause complications. Conversely, the portable pump (PP) does not have to be fasten to the infusion stand and the infusions can be administered in day mode during activities, as the PP can be placed in a special backpack. The aim of this diploma thesis is to evaluate the administration of HPN in day mode in patients with a PP and further to evaluate and compare the results of quality of life and liver function tests results in patients with a PP and a SP. HPN patients with a PP and a SP completed the HPN-QOL questionnaire in the nutritional clinic at the 4th internal clinic of the General University Hospital in Prague during outpatient visits. In addition to that, patients with a PP completed a questionnaire focused on the administration of HPN in day mode. Liver function tests results (total bilirubin, ALT, AST, GGT, ALP, cholinesterase and albumin) were obtained from patients' medical records. A total of 14 respondents with a PP and 14 respondents with a SP were included in the...