To research living beings one has to participate in life.' Viktor von Weizsäcker's legacy

Viktor von Weizsäcker has been a German medical doctor and philosopher, well known throughout Europe, but hardly received in the Anglo-American culture. He focusses on the crucial epistemological question how one can conduct research on living beings. The article’s title represents a key quote of his opus magnum “Der Gestaltkreis”, which works out a theory of the unity of perception and motion. According to Viktor von Weizsäcker, one cannot separate the two, meaning that we locate ourselves in a fundamental union with the living world, which has lasting influence on our capacity of perception. This idea does not seem too different from Ian Barbour’s idea about critical realism, exploring a “consciousness of ourselves as arising out of rapport, interconnection and participation in processes reaching beyond ourselves.” Both authors, Viktor von Weizsäcker and Ian Barbour, still have lasting influence on the dialog between religion and science, each in their respective cultures – a further reason to compare their core ideas, after presenting Viktor von Weizsäcker’s life and thought. Finally, the theological impact of von Weizsäcker’s thought will be assessed. Following his philosophy, it becomes clear that the miracle of creation is the condition of the possibility of any perception.

Markers of endothelial cell activation and immune activation are increased in patients with severe leptospirosis and associated with disease severity

OBJECTIVES Previous studies concluded that haemorrhage is one of the most accurate prognostic factors of mortality in leptospirosis. Therefore, endothelial cell activation was investigated in relation to disease severity in severe leptospirosis. METHODS Prospective cohort study of severe leptospirosis patients. Plasma levels of sE-selectin and Von Willebrand factor (VWF) were determined. Consequently, an in vitro endothelial cell model was used to assess endothelial activation after exposure to virulent Leptospira. Finally, immune activation, as a potential contributing factor to endothelial cell activation, was determined by soluble IL2-receptor (sIL-2r) and soluble Fas-ligand (sFasL) levels. RESULTS Plasma levels of sE-selectin and VWF strongly increased in patients compared to healthy controls. Furthermore, sE-selectin was significantly elevated (203 ng/ml vs. 157 ng/ml, p < 0.05) in survivors compared to non-survivors. Endothelial cells exposed to virulent Leptospira showed increased VWF expression. E-selectin and ICAM-1 expression did not change. Immunohistochemistry revealed the presence of intracellular Leptospira and qPCR suggested replication. In vivo analysis showed that increased levels of sFasL and sIL-2r were both strongly associated with mortality. Furthermore sIL-2r levels were increased in patients that developed bleeding and significantly correlated to duration of hospital stay. DISCUSSION Markers of endothelial activation and immune activation were associated with disease severity in leptospirosis patients.

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

BACKGROUND Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. METHODS We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. RESULTS Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. CONCLUSIONS Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

Titanium and hydroxyapatite coating of polyetheretherketone and carbon fiber-reinforced polyetheretherketone: A pilot study in sheep

Purpose: The purpose of this study was to evaluate the bone formation capability of polyetheretherketone (PEEK) and carbon fiber-reinforced PEEK (CFR-PEEK) implants coated with different titanium and hydroxyapatite plasma-sprayed layers after 2 and 12 weeks. Methods: In six sheep 108 implants were placed in the pelvis. Altogether six different surface modifications were tested. After 2 and 12 weeks, n = 3 implants per group were examined histologically and n = 6 implants per group were tested by a pull-out test. Results: Biomechanically (p = 0.001) as well as histologically (p > 0.05) surface coating of PEEK/CFR-PEEK led to an increase of osseointegration from 2 to 12 weeks. After 12 weeks, coated implants demonstrated significant (p < 0.001) higher pull-out values in comparison to uncoated implants. Overall, the double coating (titanium bond layer and hydroxyapatite top layer) showed the most favorable results after 2 and 12 weeks. Conclusions: Plasma-sprayed titanium and hydroxyapatite coatings on PEEK or CFR-PEEK demonstrated a significant improvement of osseointegration.

Impact of fee schedules and approved doctor's list on physician availability in the Texas Workers' Compensation Program

The purpose of this study was to examine and describe the changes in physician provider workforce, before and after two regulatory changes were implemented by the Texas Workers' Compensation Commission (TWCC) in August and September of 2003: Fee schedules and the Approved Doctor's List (ADL). The number and type of physicians who participated in the program after the changes went into effect were measured and compared to projections based on natural attrition. In addition, interviews with key stakeholders were conducted regarding the program changes. ^ Collectively, this evidence suggests that physician response followed the same patterns as shown in previous research. The number of physicians who continued to participate and bill the Texas workers' compensation program decreased significantly as a result of the regulatory changes. The consequences of these changes on access and quality of care need to be documented with empirical research. The availability of physicians in the workforce is linked to access to care. The type and location of physicians who remained in the system also have impact on quality and access to care. ^

Burden of invasive pneumococcal disease in Harris County, Texas (2003--2010) and the implication for enhanced public health surveillance of isolates

Invasive pneumococcal disease (IPD) causes significant health burden in the US, is responsible for the majority of bacterial meningitis, and causes more deaths than any other vaccine preventable bacterial disease in the US. The estimated National IPD rate is 14.3 cases per 100,000 population with a case-fatality rate of 1.5 cases per 100,000 population. Although cases of IPD are routinely reported to the local health department in Harris County Texas, the incidence (IR) and case-fatality (CFR) rates have not been reported. Additionally, it is important to know which serotypes of S. pneumoniae are circulating in Harris County Texas and to determine if ‘replacement disease’ is occurring. ^ This study reported incidence and case-fatality rates from 2003 to 2009, and described the trends in IPD, including the IPD serotypes circulating in Harris County Texas during the study period, particularly in 2008 and 2010. Annual incidence rates were calculated and reported for 2003 to 2009, using complete surveillance-year data. ^ Geographic information system (GIS) software was used to create a series of maps of the data reported during the study period. Cluster and outlier analysis and hot spot analysis were conducted using both case counts by census tract and disease rate by census tract. ^ IPD age- and race-adjusted IR for Harris County Texas and their 95% confidence intervals (CIs) were 1.40 (95% CI 1.0, 1.8), 1.71 (95% CI 1.24, 2.17), 3.13 (95% CI 2.48, 3.78), 3.08 (95% CI 2.43, 3.74), 5.61 (95% CI 4.79, 6.43), 8.11 (95% CI 7.11, 9.1), and 7.65 (95% CI 6.69, 8.61) for the years 2003 to 2009, respectively (rates were age- and race-adjusted to each year's midyear US population estimates). A Poisson regression model demonstrated a statistically significant increasing trend of about 32 percent per year in the IPD rates over the course of the study period. IPD age- and race-adjusted case-fatality rates (CFR) for Harris County Texas were also calculated and reported. A Poisson regression model demonstrated a statistically significant increasing trend of about 26 percent per year in the IPD case-fatality rates from 2003 through 2009. A logistic regression model associated the risk of dying from IPD to alcohol abuse (OR 4.69, 95% CI 2.57, 8.56) and to meningitis (OR 2.42, 95% CI 1.46, 4.03). ^ The prevalence of non-vaccine serotypes (NVT) among IPD cases with serotyped isolates was 98.2 percent. In 2008, the year with the sample more geographically representative of all areas of Harris County Texas, the prevalence was 96 percent. Given these findings, it is reasonable to conclude that ‘replacement disease’ is occurring in Harris County Texas, meaning that, the majority of IPD is caused by serotypes not included in the PCV7 vaccine. Also in conclusion, IPD rates increased during the study period in Harris County Texas.^

TRPV1 Channels Contribute to Behavioral Hypersensitivity and Spontaneous Activity in Nociceptors After Spinal Cord Injury

A majority of persons who have sustained spinal cord injury (SCI) develop chronic pain. While most investigators have assumed that the critical mechanisms underlying neuropathic pain after SCI are restricted to the central nervous system (CNS), recent studies showed that contusive SCI results in a large increase in spontaneous activity in primary nociceptors, which is correlated significantly with mechanical allodynia and thermal hyperalgesia. Upregulation of ion channel transient receptor vanilloid 1 (TRPV1) has been observed in the dorsal horn of the spinal cord after SCI, and reduction of SCI-induced hyperalgesia by a TRPV1 antagonist has been claimed. However, the possibility that SCI enhances TRPV1 expression and function in nociceptors has not been tested. I produced contusive SCI at thoracic level T10 in adult, male rats and harvested lumbar (L4/L5) dorsal root ganglia (DRG) from sham-treated and SCI rats 3 days and 1 month after injury, as well as from age-matched naive control rats. Whole-cell patch clamp recordings were made from small (soma diameter <30 >μm) DRG neurons 18 hours after dissociation. Capsaicin-induced currents were significantly increased 1 month, but not 3 days, after SCI compared to neurons from control animals. In addition, Ca2+ transients imaged during capsaicin application were significantly greater 1 month after SCI. Western blot experiments indicated that expression of TRPV1 protein in DRG is also increased 1 month after SCI. A major role for TRPV1 channels in pain-related behavior was indicated by the ability of a specific TRPV1 antagonist, AMG9810, to reverse SCI-induced hypersensitivity of hindlimb withdrawal responses to heat and mechanical stimuli. Similar reversal of behavioral hypersensitivity was induced by intrathecal delivery of oligodeoxynucleotides antisense to TRPV1, which knocked down TRPV1 protein and reduced capsaicin-evoked currents. TRPV1 knockdown also decreased the incidence of spontaneous activity in dissociated nociceptors after SCI. Limited activation of TRPV1 was found to induce prolonged repetitive firing without accommodation or desensitization, and this effect was enhanced by SCI. These data suggest that SCI enhances TRPV1 expression and function in primary nociceptors, increasing the excitability and spontaneous activity of these neurons, thus contributing to chronic pain after SCI.

Grain-size analysis and geochemistry of sediment core GeoB13602-1

Grain-size, terrigenous element and rock magnetic remanence data of Quaternary marine sediments retrieved at the NW African continental margin off Gambia (gravity core GeoB 13602-1, 13°32.71' N, 17°50.96'W) were jointly analyzed by end-member (EM) unmixing methods to distinguish and budget past terrigenous fluxes. We compare and cross-validate the identified single-parameter EM systems and develop a numerical strategy to calculate associated multi-parameter EM properties. One aeolian and two fluvial EMs were found. The aeolian EM is much coarser than the fluvial EMs and is associated with a lower goethite/hematite ratio, a higher relative concentration of magnetite and lower Al/Si and Fe/K ratios. Accumulation rates and grain sizes of the fluvial sediment appear to be primarily constrained by shore distance (i.e., sea-level fluctuations) and to a lesser extent by changes in hinterland precipitation. High dust fluxes occurred during the Last Glacial Maximum (LGM) and during Heinrich Stadials (HS) while the fluvial input remained unchanged. Our approach reveals that the LGM dust fluxes were ~7 times higher than today's. However, by far the highest dust accumulation occurred during HS 1 (~300 g m**-2 yr** -1), when dust fluxes were ~80 fold higher than today. Such numbers have not yet been reported for NW Africa, and emphasize strikingly different environmental conditions during HSs. They suggest that deflation rate and areal extent of HSs dust sources were much larger due to retreating vegetation covers. Beyond its regional and temporal scope, this study develops new, in principle, generally applicable strategies for multi-method end-member interpretation, validation and flux budgeting calibration.

Electromagnetic, rock magnetic, and geochemical properties of surficial sediments in Eckernförde Bay

Submarine groundwater discharge in coastal settings can massively modify the hydraulic and geochemical conditions of the seafloor. Resulting local anomalies in the morphology and physical properties of surface sediments are usually explored with seismo-acoustic imaging techniques. Controlled source electromagnetic imaging offers an innovative dual approach to seep characterization by its ability to detect pore-water electrical conductivity, hence salinity, as well as sediment magnetic susceptibility, hence preservation or diagenetic alteration of iron oxides. The newly developed electromagnetic (EM) profiler Neridis II successfully realized this concept for a first time with a high-resolution survey of freshwater seeps in Eckernförde Bay (SW Baltic Sea). We demonstrate that EM profiling, complemented and validated by acoustic as well as sample-based rock magnetic and geochemical methods, can create a crisp and revealing fingerprint image of freshwater seepage and related reductive alteration of near-surface sediments. Our findings imply that (1) freshwater penetrates the pore space of Holocene mud sediments by both diffuse and focused advection, (2) pockmarks are marked by focused freshwater seepage, underlying sand highs, reduced mud thickness, higher porosity, fining of grain size, and anoxic conditions, (3) depletion of Fe oxides, especially magnetite, is more pervasive within pockmarks due to higher concentrations of organic and sulfidic reaction partners, and (4) freshwater advection reduces sediment magnetic susceptibility by a combination of pore-water injection (dilution) and magnetite reduction (depletion). The conductivity vs. susceptibility biplot resolves subtle lateral litho- and hydrofacies variations.

A time-slice study in Heinrich Stadial 1 and Mid Holocene sediment cores off northern Senegal

Sediment dynamics in limnic, fluvial and marine environments can be assessed by granulometric and rock-magnetic methodologies. While classical grain-size analysis by sieving or settling mainly bears information on composition and transport, the magnetic mineral assemblages reflect to a larger extent the petrology and weathering conditions in the sediment source areas. Here, we combine both methods to investigate Late Quaternary marine sediments from five cores along a transect across the continental slope off Senegal. This region near the modern summer Intertropical Convergence Zone is particularly sensitive to climate change and receives sediments from several aeolian, fluvial and marine sources. From each of the investigated five GeoB sediment cores (494-2956 m water depth) two time slices were processed which represent contrasting climatic conditions: the arid Heinrich Stadial 1 (~ 15 kyr BP) and the humid Mid Holocene (~ 6 kyr BP). Each sediment sample was split into 16 grain-size fractions ranging from 1.6 to 500 µm. Concentration and grain-size indicative magnetic parameters (susceptibility, SIRM, HIRM, ARM and ARM/IRM) were determined at room temperature for each of these fractions. The joint consideration of whole sediment and magnetic mineral grain-size distributions allows to address several important issues: (i) distinction of two aeolian sediment fractions, one carried by the north-easterly trade winds (40-63 µm) and the other by the overlying easterly Harmattan wind (10-20 µm) as well as a fluvial fraction assigned to the Senegal River (< 10 µm); (ii) identification of three terrigenous sediment source areas: southern Sahara and Sahel dust (low fine-grained magnetite amounts and a comparatively high haematite content), dust from Senegalese coastal dunes (intermediate fine-grained magnetite and haematite contents) and soils from the upper reaches of the Senegal River (high fine-grained magnetite content); (iii) detection of partial diagenetic dissolution of fine magnetite particles as a function of organic input and shore distance; (iv) analysis of magnetic properties of marine carbonates dominating the grain-size fractions 63-500 µm.

El Proceso de precarización en el mercado de trabajo del Gran La Plata. Principales características y tendencias actuales (2003-2004)

El objetivo del presente artículo es identificar las principales características y tendencias del trabajo precario en el Gran La Plata considerando la dinámica económica nacional actual. Tomando como parámetro el empleo pleno, pueden identificarse distintos grados de precariedad según la carencia de los atributos que caracterizan dicha plenitud. Existiría así una gradación de situaciones, con una referencia máxima en el empleo pleno hasta una mínima en el desempleo absoluto. El análisis partió de procesamientos propios de datos brindados por la Encuesta Permanente de Hogares (EPH). Abarca el período comprendido entre el segundo semestre de 2003 y el primero del 2004, debido a que tras la reformulación EPH sólo se dispone a la fecha de información específica de ese período. Los resultados del trabajo realizado dan cuenta de que, en la región, los trabajadores precarios representan el 39,3 de la PEA en el primer semestre de 2004. Si se suma el sector de los desocupados, la Población con Problemas de Empleo supera el 50 y muestra la presión que ejercen sobre el mercado laboral los subocupados demandantes. En el sector estatal, el 16,4 de los empleados están precarizados. Si se suman los beneficiarios de planes de empleo la cifra se eleva al 34. En el sector privado, el empleo precario comprende al 54 de sus trabajadores. Respecto a la evolución de los ingresos aun en los grupos de ocupados que mejoraron su capacidad de consumo entre 2003 y 2004, los niveles de ingresos alcanzados se hallan muy por debajo de los que percibían antes de la devaluación de 2002. Los principales aportes del trabajo consisten en la identificación, cuantificación y caracterización del empleo precario en la región en la etapa post-devaluación, sobre el análisis de la Base Usuaria de la EPH.

Susceptibility, conductivity and porosity along a GEM-SHARK profile

The coastal systems, are often subjected to high anthropogenic pressure, which makes it necessary to develop new techniques to assess the environmental impacts caused by such human activity. This paper presents the first results obtained during the development and implementation of a new equipment of submarine geophysics survey oriented to integrated coastal zone management (ICZM). It is based on the drag of a submarine in contact with the sea-bottom. The submarine is equipped with an electromagnetic sensor which allows the measurement of the magnetic susceptibility and electrical conductivity of the surface sediments continuously and to a depth of sediment of 40 cm. This system, once improved, will allow us to obtain valuable information for monitoring the environmental quality of coastal areas.

El Proceso de precarización en el mercado de trabajo del Gran La Plata. Principales características y tendencias actuales (2003-2004)

El objetivo del presente artículo es identificar las principales características y tendencias del trabajo precario en el Gran La Plata considerando la dinámica económica nacional actual. Tomando como parámetro el empleo pleno, pueden identificarse distintos grados de precariedad según la carencia de los atributos que caracterizan dicha plenitud. Existiría así una gradación de situaciones, con una referencia máxima en el empleo pleno hasta una mínima en el desempleo absoluto. El análisis partió de procesamientos propios de datos brindados por la Encuesta Permanente de Hogares (EPH). Abarca el período comprendido entre el segundo semestre de 2003 y el primero del 2004, debido a que tras la reformulación EPH sólo se dispone a la fecha de información específica de ese período. Los resultados del trabajo realizado dan cuenta de que, en la región, los trabajadores precarios representan el 39,3 de la PEA en el primer semestre de 2004. Si se suma el sector de los desocupados, la Población con Problemas de Empleo supera el 50 y muestra la presión que ejercen sobre el mercado laboral los subocupados demandantes. En el sector estatal, el 16,4 de los empleados están precarizados. Si se suman los beneficiarios de planes de empleo la cifra se eleva al 34. En el sector privado, el empleo precario comprende al 54 de sus trabajadores. Respecto a la evolución de los ingresos aun en los grupos de ocupados que mejoraron su capacidad de consumo entre 2003 y 2004, los niveles de ingresos alcanzados se hallan muy por debajo de los que percibían antes de la devaluación de 2002. Los principales aportes del trabajo consisten en la identificación, cuantificación y caracterización del empleo precario en la región en la etapa post-devaluación, sobre el análisis de la Base Usuaria de la EPH.