In search of optimal compression therapy for venous leg ulcers: a meta-analysis of studies comparing diverse [corrected] bandages with specifically designed stockings

OBJECTIVE: In search of an optimal compression therapy for venous leg ulcers, a systematic review and meta-analysis was performed of randomized controlled trials (RCT) comparing compression systems based on stockings (MCS) with divers bandages. METHODS: RCT were retrieved from six sources and reviewed independently. The primary endpoint, completion of healing within a defined time frame, and the secondary endpoints, time to healing, and pain were entered into a meta-analysis using the tools of the Cochrane Collaboration. Additional subjective endpoints were summarized. RESULTS: Eight RCT (published 1985-2008) fulfilled the predefined criteria. Data presentation was adequate and showed moderate heterogeneity. The studies included 692 patients (21-178/study, mean age 61 years, 56% women). Analyzed were 688 ulcerated legs, present for 1 week to 9 years, sizing 1 to 210 cm(2). The observation period ranged from 12 to 78 weeks. Patient and ulcer characteristics were evenly distributed in three studies, favored the stocking groups in four, and the bandage group in one. Data on the pressure exerted by stockings and bandages were reported in seven and two studies, amounting to 31-56 and 27-49 mm Hg, respectively. The proportion of ulcers healed was greater with stockings than with bandages (62.7% vs 46.6%; P < .00001). The average time to healing (seven studies, 535 patients) was 3 weeks shorter with stockings (P = .0002). In no study performed bandages better than MCS. Pain was assessed in three studies (219 patients) revealing an important advantage of stockings (P < .0001). Other subjective parameters and issues of nursing revealed an advantage of MCS as well. CONCLUSIONS: Leg compression with stockings is clearly better than compression with bandages, has a positive impact on pain, and is easier to use.

Treatment of adolescents with early-onset schizophrenia spectrum disorders: in search of a rational, evidence-informed approach

Purpose of review: We aimed to review literature on the efficacy and tolerability of psychosocial and psychopharmacological interventions in youth with early-onset schizophrenia spectrum disorders (EOS). A rationale for pragmatic psychopharmacology in EOS, including dosing, switching and adverse effect monitoring and management, is provided. Recent findings: Three randomized controlled trials (RCTs) over the last 8 years demonstrated benefits of psychosocial interventions (i.e. psychoeducation, cognitive remediation, cognitive behavioural therapy) for EOS without clear advantages of one psychosocial treatment over another. Six large, placebo-controlled, short-term RCTs over the last 4 years demonstrated that aripiprazole, olanzapine, paliperidone, quetiapine and risperidone, but not ziprasidone, were superior to placebo. Except for clozapine's superiority in treatment-refractory EOS, efficacy appeared similar across studied first-generation and second-generation antipsychotics, but tolerability varied greatly across individual agents. Summary: Antipsychotics are efficacious in the treatment of EOS. Given the lack of efficacy differences between antipsychotics (except for clozapine for treatment-refractory EOS), we propose that tolerability considerations need to guide choice of antipsychotics. Further and longer-term efficacy and effectiveness studies are urgently needed that should also explore pharmacologic and nonpharmacologic augmentation strategies.

[In search of strategies for preventing brain damage as a sequela of bacterial meningitis]

Multiplication of bacteria within the central nervous system compartment triggers a host response with an overshooting inflammatory reaction which leads to brain parenchyma damage. Some of the inflammatory and neurotoxic mediators involved in the processes leading to neuronal injury during bacterial meningitis have been identified in recent years. As a result, the therapeutic approach to the disease has widened from eradication of the bacterial pathogen with antibiotics to attenuation of the detrimental effects of host defences. Corticosteroids represent an example of the adjuvant therapeutic strategies aimed at downmodulating excessive inflammation in the infected central nervous system. Pathophysiological concepts derived from an experimental rat model of bacterial meningitis revealed possible therapeutic strategies for prevention of brain damage. The insights gained led to the evaluation of new therapeutic modalities such as anticytokine agents, matrix metalloproteinase inhibitors, antioxidants, and antagonists of endothelin and glutamate. Bacterial meningitis is still associated with persistent neurological sequelae in approximately one third of surviving patients. Future research in the model will evaluate whether the neuroprotective agents identified so far have the potential to attenuate learning disabilities as a long-term consequence of bacterial meningitis.

In search of epigenetic marks in testes and sperm cells of differentially fed boars

In search of transmittable epigenetic marks we investigated gene expression in testes and sperm cells of differentially fed F0 boars from a three generation pig feeding experiment that showed phenotypic differences in the F2 generation. RNA samples from 8 testes of boars that received either a diet enriched in methylating micronutrients or a control diet were analyzed by microarray analysis. We found moderate differential expression between testes of differentially fed boars with a high FDR of 0.82 indicating that most of the differentially expressed genes were false positives. Nevertheless, we performed a pathway analysis and found disparate pathway maps of development_A2B receptor: action via G-protein alpha s, cell adhesion_Tight junctions and cell adhesion_Endothelial cell contacts by junctional mechanisms which show inconclusive relation to epigenetic inheritance. Four RNA samples from sperm cells of these differentially fed boars were analyzed by RNA-Seq methodology. We found no differential gene expression in sperm cells of the two groups (adjusted P-value>0.05). Nevertheless, we also explored gene expression in sperm by a pathway analysis showing that genes were enriched for the pathway maps of bacterial infections in cystic fibrosis (CF) airways, glycolysis and gluconeogenesis p.3 and cell cycle_Initiation of mitosis. Again, these pathway maps are miscellaneous without an obvious relationship to epigenetic inheritance. It is concluded that the methylating micronutrients moderately if at all affects RNA expression in testes of differentially fed boars. Furthermore, gene expression in sperm cells is not significantly affected by extensive supplementation of methylating micronutrients and thus RNA molecules could not be established as the epigenetic mark in this feeding experiment.

Contemplating a ‘public service navigator’: In search of new (and better) functioning public service media

This is a paper contemplating a tool of public editorial intelligence, so that key media policy objectives can be attained in the complex and multi-faceted environment of digital media. The paper is meant to be an article of a special issue of the International Journal of Communication on "Public Media and Exposure Diversity", co-edited by Natali Helberger and Mira Burri.

Echinococcus metacestode: in search of viability markers

Epidemiological studies have demonstrated that most humans infected with Echinococcus spp. exhibit resistance to disease. When infection leads to disease, the parasite is partially controlled by host immunity: in case of immunocompetence, the normal alveolar echinococcosis (AE) or cystic echinococcosis (CE) situation, the metacestode grows slowly, and first clinical signs appear years after infection; in case of impaired immunity (AIDS; other immunodeficiencies), uncontrolled proliferation of the metacestode leads to rapidly progressing disease. Assessing Echinococcus multilocularis viability in vivo following therapeutic interventions in AE patients may be of tremendous benefit when compared with the invasive procedures used to perform biopsies. Current options are F18-fluorodeoxyglucose-positron emission tomography (FDG-PET), which visualizes periparasitic inflammation due to the metabolic activity of the metacestode, and measurement of antibodies against recEm18, a viability-associated protein, that rapidly regresses upon metacestode inactivation. For Echinococcus granulosus, similar prognosis-associated follow-up parameters are still lacking but a few candidates may be listed. Other possible markers include functional and diffusion-weighted Magnetic Resonance Imaging (MRI), and measurement of products from the parasite (circulating antigens or DNA), and from the host (inflammation markers, cytokines, or chemokines). Even though some of them have been promising in pilot studies, none has been properly validated in an appropriate number of patients until now to be recommended for further use in clinical settings. There is therefore still a need to develop reliable tools for improved viability assessment to provide the sufficient information needed to reliably withdraw anti-parasite benzimidazole chemotherapy, and a basis for the development of new alternative therapeutic tools.

In search of the internal structure of the processes underlying interval timing in the sub-second and the second range: A confirmatory factor analysis approach

One of the earliest accounts of duration perception by Karl von Vierordt implied a common process underlying the timing of intervals in the sub-second and the second range. To date, there are two major explanatory approaches for the timing of brief intervals: the Common Timing Hypothesis and the Distinct Timing Hypothesis. While the common timing hypothesis also proceeds from a unitary timing process, the distinct timing hypothesis suggests two dissociable, independent mechanisms for the timing of intervals in the sub-second and the second range, respectively. In the present paper, we introduce confirmatory factor analysis (CFA) to elucidate the internal structure of interval timing in the sub-second and the second range. Our results indicate that the assumption of two mechanisms underlying the processing of intervals in the second and the sub-second range might be more appropriate than the assumption of a unitary timing mechanism. In contrast to the basic assumption of the distinct timing hypothesis, however, these two timing mechanisms are closely associated with each other and share 77% of common variance. This finding suggests either a strong functional relationship between the two timing mechanisms or a hierarchically organized internal structure. Findings are discussed in the light of existing psychophysical and neurophysiological data.

In Search of Political Influence: Strategic Choices and Media Coverage of Political Parties, Interest Groups and Social Movements in Western European Countries

Outside lobbying is a key strategy for social movements, interest groups and political parties for mobilising public opinion through the media in order to pressure policymakers and influence the policymaking process. Relying on semi-structured interviews and newspaper content analysis in six Western European countries, this article examines the use of four outside lobbying strategies – media-related activities, informing (about) the public, mobilisation and protest – and the amount of media coverage they attract. While some strategies are systematically less pursued than others, we find variation in their relative share across institutional contexts and actor types. Given that most of these differences are not accurately mirrored in the media, we conclude that media coverage is only loosely connected to outside lobbying behaviour, and that the media respond differently to a given strategy when used by different actors. Thus, the ability of different outside lobbying strategies to generate media coverage critically depends on who makes use of them.

Finite element analysis in asymptomatic, symptomatic, and ruptured abdominal aortic aneurysms: in search of new rupture risk predictors.

OBJECTIVES To compare biomechanical rupture risk parameters of asymptomatic, symptomatic and ruptured abdominal aortic aneurysms (AAA) using finite element analysis (FEA). STUDY DESIGN Retrospective biomechanical single center analysis of asymptomatic, symptomatic, and ruptured AAAs. Comparison of biomechanical parameters from FEA. MATERIALS AND METHODS From 2011 to 2013 computed tomography angiography (CTA) data from 30 asymptomatic, 15 symptomatic, and 15 ruptured AAAs were collected consecutively. FEA was performed according to the successive steps of AAA vessel reconstruction, segmentation and finite element computation. Biomechanical parameters Peak Wall Rupture Risk Index (PWRI), Peak Wall Stress (PWS), and Rupture Risk Equivalent Diameter (RRED) were compared among the three subgroups. RESULTS PWRI differentiated between asymptomatic and symptomatic AAAs (p < .0004) better than PWS (p < .1453). PWRI-dependent RRED was higher in the symptomatic subgroup compared with the asymptomatic subgroup (p < .0004). Maximum AAA external diameters were comparable between the two groups (p < .1355). Ruptured AAAs showed the highest values for external diameter, total intraluminal thrombus volume, PWS, RRED, and PWRI compared with asymptomatic and symptomatic AAAs. In contrast with symptomatic and ruptured AAAs, none of the asymptomatic patients had a PWRI value >1.0. This threshold value might identify patients at imminent risk of rupture. CONCLUSIONS From different FEA derived parameters, PWRI distinguishes most precisely between asymptomatic and symptomatic AAAs. If elevated, this value may represent a negative prognostic factor for asymptomatic AAAs.

In search of the "why" behind campaign professionalisation: explaining the degree and profile of campaign professionalisation by an empirical analysis of 23 Swiss cantonal election campaigns

Die Organisation und die strategische Kommunikation von Wahlkämpfen haben sich in den letzten Jahrzehnten in den meisten westeuropäischen Staaten gewandelt, so auch in der Schweiz. Die Kommunikationswissenschaft hat dafür den Begriff der „Professionalisierung“ geprägt und Eigenschaften zusammengetragen, die zu einem „professionalisierten“ Wahlkampf gehören – wie z.B. die Beauftragung von externen Expertinnen und Experten oder die direkte Ansprache von Wählerinnen und Wählern („narrowcasting“). Welche Hintergründe diese Professionalisierung aber hat und wie das Phänomen nicht nur praktisch zu beschreiben, sondern auch theoretisch zu begründen ist, wurde bisher kaum diskutiert. Hier setzt die vorliegende Dissertation an. Basierend auf einer Analyse von 23 Wahlkämpfen aus den Kantonen Aargau, Appenzell Ausserrhoden, Bern, Neuchâtel und Zürich mithilfe der Methode Fuzzy Set Qualitative Comparative Analysis (fsQCA) kommt sie zum Schluss, dass die Professionalisierung der Wahlkämpfe vor dem theoretischen Hintergrund des soziologischen Neo-Institutionalismus als Anpassung von Wahlkämpfen an sich verändernde Bedingungen, Erwartungen und Anforderungen in den wichtigsten Anspruchsgruppen oder „Umwelten“ für den Wahlkampf (Wählerinnen und Wähler, Mitglieder, Medien, andere Parteien) definiert werden kann. Daraus folgt, dass es nicht nur „die“ Professionalisierung gibt, sondern dass jeder Wahlkampf an jene Umwelten angepasst wird, wo diese Anpassung den Wahlkampfverantwortlichen am dringlichsten erscheint. Daher sollte Professionalisierung mit vier einzelnen Messinstrumenten bzw. Professionalisierungsindices – einem pro Umwelt – gemessen werden. Misst man Professionalisierung wie bisher üblich nur mit einem einzigen Messinstrument, gibt der resultierende Wert nur ein ungenaues Bild vom Grad der Professionalisierung des Wahlkampfs wieder und verschleiert, als Anpassung an welche Umwelt die Professionalisierung geschieht. Hat man ermittelt, wie professionalisiert ein Wahlkampf im Hinblick auf jede der vier relevantesten Umwelten ist, können dann auch zuverlässiger die Gründe analysiert werden, die zur jeweiligen Professionalisierung geführt haben. Die empirische Analyse der kantonalen Wahlkämpfe bestätigte, dass hinter der Professionalisierung in Bezug auf jede der vier Umwelten auch tatsächlich unterschiedliche Gründe stecken. Wahlkämpfe werden in Bezug auf die Ansprache der Wähler angepasst („professionalisiert“), wenn sie in urbanen Kontexten stattfinden. Den Wahlkampf im Hinblick auf die Mitglieder zu professionalisieren ist besonders wichtig, wenn die Konkurrenz zwischen den Parteien gross ist oder wenn eine Ansprache der Gesamtwählerschaft für eine Partei wenig gewinnbringend erscheint. Die Professionalisierung des Wahlkampfes in Bezug auf die Medien erfolgt dann, wenn er eine grosse, regional stark verteilte oder aber eine urbane Wählerschaft ansprechen muss. Für die Professionalisierung der Wahlkämpfe gegenüber anderen Parteien kann kein aussagekräftiger Schluss gezogen werden, da nur wenige der untersuchten Kantonalparteien ihre Wahlkämpfe überhaupt im Hinblick auf andere Parteien professionalisierten, indem sie die gegnerischen Wahlkämpfe beobachteten und den eigenen wenn nötig entsprechend anpassten.

Comparison of real-time polymerase chain reaction and DNA-strip technology in microbiological evaluation of periodontitis treatment

The impact of a semiquantitative commercially available test based on DNA-strip technology (microIDent®, Hain Lifescience, Nehren, Germany) on diagnosis and treatment of severe chronic periodontitis of 25 periodontitis patients was evaluated in comparison with a quantitative in-house real-time PCR. Subgingival plaque samples were collected at baseline as well as at 3, 6, and 12 months later. After extracting DNA, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and several other periodontopathogens were determined by both methods. The results obtained by DNA-strip technology were analyzed semiquantitatively and additionally quantitatively by densitometry. The results for the 4 major periodontopathogenic bacterial species correlated significantly between the 2 methods. Samples detecting a high bacterial load by one method and negative by the other were always found in less than 2% of the total samples. Both technologies showed the impact of treatment on microflora. Especially the semiquantitative DNA-strip technology clearly analyzed the different loads of periodontopathogens after therapy and is useful in microbial diagnostics for patients in dental practices.

Immediate Search in the IDE as an Example of Socio-Technical Congruence in Search-Driven Development

Search-driven development is mainly concerned with code reuse but also with code navigation and debugging. In this essay we look at search-driven navigation in the IDE. We consider Smalltalk-80 as an example of a programming system with search-driven navigation capabilities and explore its human factors. We present how immediate search results lead to a user experience of code browsing rather than one of waiting for and clicking through search results. We explore the socio-technical congruence of immediate search, ie unification of tasks and breakpoints with method calls, which leads to simpler and more extensible development tools. Eventually we conclude with remarks on the socio-technical congruence of search-driven development.