At the frontiers of surgery: review

The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures. The task has not been easy but progress is being made as exemplified by the presentations at the 2nd Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS) in San Francisco in January 2010. We review the salient advances in the field and propose further directions of investigation.

Oral cleft prevention program (OCPP)

Background Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women. ClinicalTrials.gov Identifier NCT00397917

Environmental impact of coldset against inkjet in newspaper production: a Study

[EN] Comparative of the environmental impacts of a printed newspaper for different impacts categories using the tool of Life Cycle Assessment. The study describes the methodology, the different phases using the usual technology by coldset-offset comparing  to the new digital-inkjet printing.

IMBER mini-Symposium with Spanish oceanographers

Celebrado en la Sala de Grado de la Facultad de Ciencias del Mar (ULPGC) el 18 de junio de 2013

Teaching and learning english phonetics and phonology in the EHEA through design and creation of audiovisual material at the ULPGC

[ES]In this paper we describe the procedure followed in the design and recording of a set of videos for teaching and learning ‘English phonetics and phonology’, a second-year undergraduate course at Universidad de Las Palmas de Gran Canaria. The student’s L1 is Spanish. Two different types of technological support were used: screencast and Powerpoint® presentations. The traditional whiteboard together with the lecturer’s presence also contributed both to the integrated learning of certain acoustic/articulatory aspects of the course contents and to the use of specific software for speech analysis. This video production owns the advantage of being an interactive and autonomous tool which favours a continuous learning process on the student’s side.

Componenti spaziali della rappresentazione cognitiva della grandezza del numero

The humans process the numbers in a similar way to animals. There are countless studies in which similar performance between animals and humans (adults and/or children) are reported. Three models have been developed to explain the cognitive mechanisms underlying the number processing. The triple-code model (Dehaene, 1992) posits an mental number line as preferred way to represent magnitude. The mental number line has three particular effects: the distance, the magnitude and the SNARC effects. The SNARC effect shows a spatial association between number and space representations. In other words, the small numbers are related to left space while large numbers are related to right space. Recently a vertical SNARC effect has been found (Ito & Hatta, 2004; Schwarz & Keus, 2004), reflecting a space-related bottom-to-up representation of numbers. The magnitude representations horizontally and vertically could influence the subject performance in explicit and implicit digit tasks. The goal of this research project aimed to investigate the spatial components of number representation using different experimental designs and tasks. The experiment 1 focused on horizontal and vertical number representations in a within- and between-subjects designs in a parity and magnitude comparative tasks, presenting positive or negative Arabic digits (1-9 without 5). The experiment 1A replied the SNARC and distance effects in both spatial arrangements. The experiment 1B showed an horizontal reversed SNARC effect in both tasks while a vertical reversed SNARC effect was found only in comparative task. In the experiment 1C two groups of subjects performed both tasks in two different instruction-responding hand assignments with positive numbers. The results did not show any significant differences between two assignments, even if the vertical number line seemed to be more flexible respect to horizontal one. On the whole the experiment 1 seemed to demonstrate a contextual (i.e. task set) influences of the nature of the SNARC effect. The experiment 2 focused on the effect of horizontal and vertical number representations on spatial biases in a paper-and-pencil bisecting tasks. In the experiment 2A the participants were requested to bisect physical and number (2 or 9) lines horizontally and vertically. The findings demonstrated that digit 9 strings tended to generate a more rightward bias comparing with digit 2 strings horizontally. However in vertical condition the digit 2 strings generated a more upperward bias respect to digit 9 strings, suggesting a top-to-bottom number line. In the experiment 2B the participants were asked to bisect lines flanked by numbers (i.e. 1 or 7) in four spatial arrangements: horizontal, vertical, right-diagonal and left-diagonal lines. Four number conditions were created according to congruent or incongruent number line representation: 1-1, 1-7, 7-1 and 7-7. The main results showed a more reliable rightward bias in horizontal congruent condition (1-7) respect to incongruent condition (7-1). Vertically the incongruent condition (1-7) determined a significant bias towards bottom side of line respect to congruent condition (7-1). The experiment 2 suggested a more rigid horizontal number line while in vertical condition the number representation could be more flexible. In the experiment 3 we adopted the materials of experiment 2B in order to find a number line effect on temporal (motor) performance. The participants were presented horizontal, vertical, rightdiagonal and left-diagonal lines flanked by the same digits (i.e. 1-1 or 7-7) or by different digits (i.e. 1-7 or 7-1). The digits were spatially congruent or incongruent with their respective hypothesized mental representations. Participants were instructed to touch the lines either close to the large digit, or close to the small digit, or to bisected the lines. Number processing influenced movement execution more than movement planning. Number congruency influenced spatial biases mostly along the horizontal but also along the vertical dimension. These results support a two-dimensional magnitude representation. Finally, the experiment 4 addressed the visuo-spatial manipulation of number representations for accessing and retrieval arithmetic facts. The participants were requested to perform a number-matching and an addition verification tasks. The findings showed an interference effect between sum-nodes and neutral-nodes only with an horizontal presentation of digit-cues, in number-matching tasks. In the addition verification task, the performance was similar for horizontal and vertical presentations of arithmetic problems. In conclusion the data seemed to show an automatic activation of horizontal number line also used to retrieval arithmetic facts. The horizontal number line seemed to be more rigid and the preferred way to order number from left-to-right. A possible explanation could be the left-to-right direction for reading and writing. The vertical number line seemed to be more flexible and more dependent from the tasks, reflecting perhaps several example in the environment representing numbers either from bottom-to-top or from top-to-bottom. However the bottom-to-top number line seemed to be activated by explicit task demands.

Über die Linearität der Teichmüllerschen Modulgruppe des Torus mit zwei Punktierungen

Über die Liniarität der Teichmüllerschen Modulgruppe des Torus mit zwei Punktierungen. In meiner Arbeit beschäftige ich mich mit Darstellungen der Teichmüllerschen Modulgruppe des Torus mit zwei Punktierungen. Mein Ansatz hierbei ist, die Teichmüllersche Modulgruppe in eine p-adische Liegruppe einzubetten. Sei nun F die von zwei Elementen erzeugte freie Gruppe und Aut(F) die Automorphismengruppe von F. Inhalt des ersten Kapitels ist es nun zu zeigen, daß folgende Aussagen äquivalent sind: - Die Teichmüllersche Modulgruppe des Torus mit zwei Punktierungen ist linear, - Aut(F)ist linear, - F besitzt eine p-Kongruenzstruktur, deren Folgen- glieder von Aut(F) festgehalten werden, also charak- teristisch sind. Im zweiten Kapitel wird unter anderem gezeigt, daß es eine Einbettung einer Untergruppe endlichen Indexes der Aut(F) in die Automorphismengruppe einer einfachen p-adischen Liegruppe gibt. Bisher ist unbekannt, ob die Buraudarstellung treu ist.In dieser Arbeit wird ein unendliches, lineares Gleichungssystem, dessen Lösungen gerade die Koeffizienten der Wörter des Kernes der Buraudarstellung sind, vorgestellt.Im dritten Kapitel wird mit den Methoden des 1.Kapitels gezeigt, daß der Torus mit zwei Punktierungen genau dann linear ist, wenn die Teichmüllersche Modulgruppe der Sphäre mit 5 Punktierungen es auch ist. Bekanntlich ist die 4. Braidgruppe linear. Nun ist aber die 4. Braidgruppe letztlich die Teichmüllersche Modulgruppe der abgeschlossenen Kreisscheibe mit 5 Punktierungen. Wenn man nun deren Randpunkte miteinander identifiziert und anschließend wegläßt, erhält man die 5-fach punktiereSphäre.Mit der eben beschriebenen Abbildung kann man zeigen, daß die Teichmüllersche Modulgruppe der fünffach punktierten Sphäre linear ist.

Frammenti di Erodoto: Problemi e metodi nello studio della storiografia frammentaria

Il percorso sui Frammenti di Erodoto è cronologico. L'introduzione presenta criteri di lavoro, un esempio di studio sul Proemio delle Storie e la struttura generale. Per ogni momento è preso in considerazione un fenomeno particolare con un esempio. Il primo caso è contemporaneo ad Erodoto. Si tratta di un test che riguarda la criticità di alcuni concetti chiave tradizionali: intertestualità e riferimenti letterali. Il secondo capitolo è uno studio sulla storiografica di IV secolo a.C., periodo di fioritura e determinazione delle norme del genere. Qui si mettono in luce la criticità dei frammenti multipli aprendo in questo modo ampie possibilità di ricerca. Il capitolo successivo, sulla tradizione papiracea mostra il passaggio storico tra la tradizione indiretta a la tradizione manoscritta e permette uno sguardo all'epoca alessandrina. Include un catalogo ed alcuni aggiornamenti. Il capitolo quinto pone invece problemi tradizionali di trasmissione delle tradizioni storiche affrontando lo studio di FGrHist 104, testo che permette di osservare passaggi della storiografia di quinto e quarto secolo avanti Cristo. I due capitoli sulle immagini e sul Rinascimento, paralleli per quanto riguarda i riferimenti cronologici, offrono un ponte per passare dal discorso storiografico a quello in cui la consapevolezza di Erodoto è già maturata come parte della ”cultura”. Alto Medioevo, Umanesimo e Rinascimento offrono spazio a storie delle Storie che iniziano ad essere quasi di ricezione di Erodoto. Questo tema è l'oggetto dei due capitoli finali, studi legati alla presenza o assenza di Erodoto in discipline e pensieri moderni e contemporanei: il pensiero di genere e l’analisi conversazionale. Le appendici completano soprattutto il capitolo su Aristodemo con uno studio sul codice che lo trasmette, il papiro P.Oxy 2469 e il testo stesso, con traduzione e commento storico. Il lavoro si completa con una premessa, una bibliografia strutturata e indici di persone e passi citati.

Das neue digitale ‚Shakespeare-Bildarchiv Oppel-Hammerschmidt‘ an der Universitätsbibliothek Mainz : Reden und Beiträge anlässlich seiner öffentlichen Vorstellung am 17. November 2008 an der Johannes Gutenberg-Universität Mainz

On the basis of illustrations of Shakespeare's Hamlet, the new digital 'Oppel-Hammerschmidt Shakespeare Illustration Archive' at the Mainz University Library - together with a lavishly-constructed and multiply-linked Web interface version - was presented to the public on 17 November 2008. This e-book, edited by Andreas Anderhub and Hildegard Hammerschmidt-Hummel, contains the speeches and presentations given on the occasion of the opening ceremony of the electronic archive. The collection of the new archive, published here for the first time, holds about 3,500 images and is part of the only Shakespeare illustration archive in the world. The Shakespeare Illustration Archive was founded in 1946 by the internationally acclaimed Shakespeare and Goethe scholar, Prof. Horst Oppel. This part of the archive was donated to the Mainz University Library on condition that its holdings be digitalised and made available to the public. The collection has been named 'The Oppel-Hammerschmidt Shakespeare Illustration Archive' in accordance with the terms of the Agreement of Donation of 9, 15, and 16 September 2005, and honouring the 16 March 1988 Delegation of Authority and Declaration of Intent by Frau Ingeborg Oppel, Prof. Oppel's widow and legal assignee. Vice-President Prof. Jürgen Oldenstein opened the proceedings by noting that 2008 had been a good year for international Shakespeare scholarship. For, in London, the site of the 'Theatre' in Shoreditch, where Shakespeare's company performed, had been unearthed, and in Mainz the Shakespeare Archive had gone online with thousands of illustrations. The Dean of the Faculty of Philosophy and Philology, Prof. Mechthild Dreyer, who mentioned that she herself had long been successfully employing interdisciplinary research methods, took particular pleasure in the transdisciplinary approach to research resolutely pursued by Prof. Hammerschmidt-Hummel. Prof. Clemens Zintzen (Cologne), former President of the Mainz Academy of Literature and Sciences, recalled highlights from the more than sixty-year-long history of the Shakespeare Illustration Archive. Prof. Kurt Otten (Heidelberg and Cambridge) drew an impressive portrait of Horst Oppel's personality as an academic and praised his influential books on Goethe and Shakespeare. He pointed out that Oppel's Shakespeare Illustration Archive, the basis for many a dissertation, had enjoyed great popularity around the world. Prof. Otten also delineated the academic career of Prof. Hammerschmidt-Hummel and her new findings regarding Shakespeare's time, life and work. Prof. Rüdiger Ahrens OBE (Würzburg) drew attention to Prof. Hammerschmidt-Hummel's research results, directly or indirectly arising out of her work on the Shakespeare Illustration Archive. This research had centred on proving the authenticity of four visual representations of Shakespeare (the Chandos and Flower portraits, the Davenant bust and the Darmstadt Shakespeare death mask); solving the mystery around Shakespeare's 'Dark Lady'; and establishing the dramatist's Catholic religion. Prof. Hammerschmidt-Hummel reported on her 'Shakespeare Illustration' project, describing the nature, dimensions and significance of the Archive's pictorial material, which relates to all of Shakespeare's plays and stretches over five centuries. She explained that the digital 'Oppel-Hammerschmidt Illustration Archive' was an addition to the three-volume edition she had compiled, authored and edited for publication in 2003. Unlike the print version, however, the digital collection had only been partly editorially prepared. It represented source material and a basis for further work. Hammerschmidt-Hummel expressed her thanks to the Head of the Central University Library, Dr Andreas Anderhub, for his untiring commitment. After the initial donation had been made, he had entered enthusiastically into setting up the necessary contacts, getting all the work underway, and clearing the legal hurdles. Hammerschmidt-Hummel was especially grateful to University of Mainz librarian Heike Geisel, who had worked for nearly five years to carry out the large-scale digitalization of a total of 8,800 items. Frau Geisel was also extremely resourceful in devising ways of making the collection yield even more, e.g. by classifying and cross-linking the data, assembling clusters of individual topics that lend themselves to research, and (in collaboration with the art historian Dr Klaus Weber) making the archive's index of artists compatible with the data-bank of artists held by the University of Mainz Institute of Art History. In addition, she compiled an extremely helpful 'users' guide' to the new digital collection. Frau Geisel had enjoyed invaluable support from Dr Annette Holzapfel-Pschorn, the leading academic in the Central IT Department at the University, who set up an intelligent, most impressive Web interface using the latest application technologies. Frau Geisel and Dr Holzapfel-Pschorn were highly praised for their convincing demonstration, using illustrations to Hamlet, of how to access this well-devised and exceptionally user-friendly Web version. For legal reasons, Prof. Hammerschmidt-Hummel pointed out, the collection could not be released for open access on the internet. The media - as Dr Anderhub stressed in his foreword - had shown great interest in the new digital collection of thousands of Shakespearean illustrations (cf. Benjamin Cor's TV feature in "Tagesthemen", 17 November 2008, presented by Tom Buhrow). The ‘Oppel-Hammerschmidt Shakespeare Illustration Archive’ should also meet with particular interest not only among academic specialists, but also among the performers of the arts and persons active in the cultural realm in general, as well as theatre and film directors, literary managers, teachers, and countless Shakespeare enthusiasts.

Charakteristika und zeitliche Merkmale des Blickrichtungsnacheffekts

In der vorliegenden Arbeit werden verschiedene, insbesondere zeitliche Aspekte des Blickrichtungsnacheffekts (gaze aftereffect) untersucht. Dieser Effekt besagt, dass nach längerer Betrachtung von Bildern, die Personen mit abgewandtem Blick zeigen, die Wahrnehmung von Blickrichtungen in Richtung des adaptierten Blickes verschoben ist. Betrachter halten dann zugewandte Blicke fälschlicherweise für in die Gegenrichtung verschoben, und Blicke in die Adaptationsblickrichtung fälschlicherweise für geradeaus, d.h. sie fühlen sich angeschaut, obwohl sie es nicht werden. In dieser Dissertation wird der Blickrichtungsnacheffekt mit vier psychophysischen Experimenten untersucht, in denen die Probanden einfache kategoriale Urteile über die Blickrichtung der Testbilder abzugeben hatten.rnrnDas erste Experiment untersucht die Induktion des Blickrichtungsnacheffekts. Es wird gezeigt, dass keine separate Adaptationsphase für die Induktion des Nacheffekts notwendig ist. Auch die alleinige, relativ kurze Darbietung des zur Adaptation verwendeten Reizes (TopUp-Display) vor der Präsentation eines Testbildes führt im Laufe wiederholter experimenteller Darbietungen zu einer Verschiebung der allgemeinen Blickrichtungs-Tuningkurve, sowie zu ihrer Verbreiterung. In einem zweiten Experiment wird nachgewiesen, dass die Ausprägung des Blickrichtungsnacheffekts von der jeweiligen Darbietungszeit des Adaptationsreizes abhängt. Zwar ist der Nacheffekt umso stärker, je länger das TopUp-Display gezeigt wird. Aber auch bei sehr kurzen Darbietungszeiten von einer Sekunde kommt der Effekt bereits zustande, hier zeigt sich eine lokal begrenztere Wirkung. Die Auswertung des zeitlichen Verlaufs ergibt, dass sich der Effekt rasch vollständig aufbaut und bereits innerhalb der ersten Darbietungen entsteht. Das dritte Experiment zeigt, dass dem Nacheffekt sowohl kurzfristige Einwirkungen der direkt vor dem Testbild erfolgten Reizung zugrunde liegen, als auch langfristige Memory-Effekte, die über die im Laufe des Experiments gegebenen Wiederholungen akkumuliert werden. Bei Blickwinkeln von 5° halten sich kurzfristige und langfristige Einwirkungen in etwa die Waage. Bei Blickwinkeln von 10° aber sind nur knapp 20% kurzfristig, und etwa 80% langfristige Einwirkungen für den Effekt verantwortlich. In einem vierten Experiment wird die zeitliche Rückbildung des Effekts untersucht und gezeigt, dass sich der Blickrichtungsnacheffekt im Kontrast zu seiner schnellen Entstehung langsam, nämlich innerhalb mehrerer Minuten zurückbildet.rnrnDie Diskussion der Ergebnisse kommt zu dem Schluss, dass die hier gefundene zeitliche Dynamik des Blickrichtungsnacheffekts Adaptationsprozesse auf höheren Schichten der visuellen Informationsverarbeitung als die zugrunde liegenden Mechanismen nahe legt.

Key issues in diagnosing and treating acute aortic syndromes: results from the metropolitan area of Bologna network

Background: Survival of patients with Acute Aortic Syndrome (AAS) may relate to the speed of diagnosis. Diagnostic delay is exacerbated by non classical presentations such as myocardial ischemia or acute heart failure (AHF). However little is known about clinical implications and pathophysiological mechanisms of Troponin T elevation and AHF in AAS. Methods and Results: Data were collected from a prospective metropolitan AAS registry (398 patients diagnosed between 2000 and 2013). Troponin T values (either standard or high sensitivity assay, HS) were available in 248 patients (60%) of the registry population; the overall frequency of troponin positivity was 28% (ranging from 16% to 54%, using standard or HS assay respectively, p = 0.001). Troponin positivity was associated with a twofold increased risk of long in-hospital diagnostic time (OR 1.92, 95% CI 1.05-3.52, p = 0.03), but not with in-hospital mortality. The combination of positive troponin and ACS-like ECG abnormalities resulted in a significantly increased risk of inappropriate therapy due to a misdiagnosis of ACS (OR 2.48, 95% CI 1.12-5.54, p = 0.02). Patients with AHF were identified by the presence of dyspnea as presentation symptom or radiological signs of pulmonary congestion or cardiogenic shock. The overall frequency of AHF was 28 % (32% type A vs. 20% type B AAS, p = 0.01). AHF was due to a variety of pathophysiological mechanisms including cardiac tamponade (26%), aortic regurgitation (25%), myocardial ischemia (17%), hypertensive crisis (10%). AHF was associated with increased surgical delay and with increased risk of in-hospital death (adjusted OR 1.97 95% CI1.13-3.37,p=0.01). Conclusions: Troponin positivity (particularly HS) was a frequent finding in AAS. Abnormal troponin values were strongly associated with ACS-like ECG findings, in-hospital diagnostic delay, and inappropriate therapy. AHF was associated with increased surgical delay and was an independent predictor of in-hospital mortality.

Beyond socialism: Tanzanian theatre, neoliberalism and foreign aid complexity

Theatralität ist ein gängiges Konzept, um Theater in Afrika zu definieren. Wird dieses Konzept angewendet, so treten die historischen Unterschiede zwischen den verschiedenen Theaterformen in den Hintergrund. Deshalb ist es wichtig, Theater in einen kulturellen Kontext zu stellen, aus dem das Theater entsteht. Dadurch können nationale und internationale Suprastrukturen, die die sozialpolitische und wirtschaftliche Atmosphäre bestimmen, analysiert werden,. Da sich die aktuelle „globale“ Entwicklung auf neoliberale Grundsätze stützt, ist es offensichtlich, dass man Theater nicht diskutieren kann, ohne näher auf Neoliberalismus, Imperialismus, Kapitalismus, Entwicklungshilfe und Geberpolitik einzugehen.rnDerzeit werden die meisten Theaterprojekte in Tansania durch die Entwicklungshilfe oder ausländische Geberorganisationen unterstützt. Diese Organisationen stellen finanzielle Mittel zur Verfügung, um Theaterproduktionen auf unterschiedlichem Niveau zu ermöglichen. Diese Spendenpraxis hat zu der Fehlannahme geführt, dass Theater nur dann ein Theater ist, wenn es durch ausländische Organisationen finanziert wird. Jedoch ist es offensichtlich, dass diese finanziellen Mittel eine große Rolle in der Machtpolitik spielen. Diese Studie untersucht deshalb die Frage: Welchen Einfluss hat die neoliberale Politik, insbesondere durch die Entwicklungshilfe, auf das Theater in Tansania? Die Arbeit deckt einmal die Verbindung zwischen dem produzieren Theater und den verschiedenen dominierenden politischen Richtungen – von Nationalismus bis Neoliberalismus – auf. Darüber hinaus wird gezeigt, dass diese Verbindungen es dem Theater erschweren, diese Suprastrukturen zu vermeiden, durch die es finanziert wird. Das bedeutet, dass die neoliberale Politik mit seinen Merkmalen von Einengung, Unterdrückung und Ausbeutung auch ein eingeengtes, unterdrücktes und ausbeuterisches Theater hervorbringt. Dieser Studie bezeichnet ein solches Theater als Theater (Neo-)Liberalismus. Es ist ein Theater, das apolitisch auftritt, aber tatsächlich unter der neoliberal Politik des freien Markts und der Subventionsstreichungen ums Überleben kämpft.rnIndem diese Verbindungen zwischen Theater, Entwicklungshilfe und Geberorganisationen erläutert werden, kommt diese Forschung zu folgendem Ergebnis: Die Geberorganisationen haben kein Recht, unabhängig von der Höhe ihrer Spende, in die Souveränität eines Staates einzugreifen oder ein neues System einzuführen. Deshalb sollte die Loslösung von ausländischen Geberländern an erster Stelle stehen, damit sich das Theater ganz entwickeln und unabhängig überleben kann. Es ist deshalb notwendig, das Konzept des Volkstheaters neu zu definieren. Das Theater soll wieder mit den Initiativen von Menschen zu tun haben und ihre eigenen Themen in einem gewissen zeitlich und räumlichen Rahmen ansprechen.rnrn

The Next 10 years in the Management of Peripheral Artery Disease: Perspectives from The 'PAD 2009' Conference

OBJECTIVES: To briefly inform on the conclusions from a conference on the next 10 years in the management of peripheral artery disease (PAD). DESIGN OF THE CONFERENCE: International participation, invited presentations and open discussion were based on the following issues: Why is PAD under-recognised? Health economic impact of PAD; funding of PAD research; changes of treatment options? Aspects on clinical trials and regulatory views; and the role of guidelines. RESULTS AND CONCLUSIONS: A relative lack of knowledge about cardiovascular risk and optimal management of PAD patients exists not only among the public, but also in parts of the health-care system. Specialists are required to act for improved information. More specific PAD research is needed for risk management and to apply the best possible evaluation of evidence for treatment strategies. Better strategies for funding are required based on, for example, public/private initiatives. The proportion of endovascular treatments is steadily increasing, more frequently based on observational studies than on randomised controlled trials. The role of guidelines is therefore important to guide the profession in the assessment of most relevant treatment.

Toward optimal display of physiologic status in critical care: I. Recreating bedside displays from archived physiologic data

BACKGROUND: Physiologic data display is essential to decision making in critical care. Current displays echo first-generation hemodynamic monitors dating to the 1970s and have not kept pace with new insights into physiology or the needs of clinicians who must make progressively more complex decisions about their patients. The effectiveness of any redesign must be tested before deployment. Tools that compare current displays with novel presentations of processed physiologic data are required. Regenerating conventional physiologic displays from archived physiologic data is an essential first step. OBJECTIVES: The purposes of the study were to (1) describe the SSSI (single sensor single indicator) paradigm that is currently used for physiologic signal displays, (2) identify and discuss possible extensions and enhancements of the SSSI paradigm, and (3) develop a general approach and a software prototype to construct such "extended SSSI displays" from raw data. RESULTS: We present Multi Wave Animator (MWA) framework-a set of open source MATLAB (MathWorks, Inc., Natick, MA, USA) scripts aimed to create dynamic visualizations (eg, video files in AVI format) of patient vital signs recorded from bedside (intensive care unit or operating room) monitors. Multi Wave Animator creates animations in which vital signs are displayed to mimic their appearance on current bedside monitors. The source code of MWA is freely available online together with a detailed tutorial and sample data sets.

Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling, exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise training as central components in all rehabilitation and preventive interventions. Many of the risk factor improvements occurring in CR can be mediated through exercise training programmes. This call-for-action paper presents the key components of a CR programme: physical activity counselling and exercise training. It summarizes current evidence-based best practice for the wide range of patient presentations of interest to the general cardiology community.