Antiepileptic drugs and pregnancy. Population based pharmaco-epidemiological study on prescription patterns, pregnancy outcome and foetal health

Aims of the study: To assess the prevalence of Antiepileptic Drug (AED) exposure in pregnant women with or without epilepsy and the comparative risk of terminations of pregnancy (TOPs), spontaneous abortions, stillbirth, major congenital malformations (MCMs) and foetal growth retardation (FGR) following intrauterine AED exposure in the Emilia Romagna region (RER), Northern Italy (4 million inhabitants). Methods: Data were obtained from official regional registries: Certificate of Delivery Assistance, Hospital Discharge Card, reimbursed prescription databases and Registry of Congenital Malformations. We identified all the deliveries, hospitalized abortions and MCMs occurred between January 2009 and December 2011. Results: We identified 145,243 pregnancies: 111,284 deliveries (112,845 live births and 279 stillbirths), 16408 spontaneous abortions and 17551 TOPs. Six hundred and eleven pregnancies (0.42% 95% Cl: 0.39-0.46) were exposed to AEDs. Twenty-one per cent of pregnancies ended in TOP in the AED group vs 12% in the non-exposed (OR:2.24; CI 1.41-3.56). The rate of spontaneous abortions and stillbirth was comparable in the two groups. Three hundred fifty-three babies (0.31%, 95% CI: 0.28-0.35) were exposed to AEDs during the first trimester. The rate of MCMs was 2.3% in the AED group (2.2% in babies exposed to monotherapy and 3.1% in babies exposed to polytherapy) vs 2.0% in the non-exposed. The risk of FGR was 12.7 % in the exposed group compared to 10% in the non-exposed. Discussion and Conclusion: The prevalence of AED exposure in pregnancy in the RER was 0.42%. The rate of MCMs in children exposed to AEDs in utero was almost superimposable to the one of the non-exposed, however polytherapy carried a slightly increased risk . The rate of TOPs was significantly higher in the exposed women. Further studies are needed to clarify whether this high rate reflects a higher rate of MCMs detected prenatally or other more elusive reasons.

Topological mass of magnetic Skyrmions probed by ultrafast dynamic imaging

In dieser Arbeit untersuchen wir mittels zeitaufgelöster Abbildungen die Gigahertz-Dynamik von magnetischen Skyrmionen, um die Bewegungsgleichungen für diese Quasiteilchen zu bestimmen. Um dieses Ziel zu erreichen haben wir zunächst ein CoB/Pt Schichtsystem entwickelt, das starke senkrechte magnetische Anisotropie mit einer besonders geringen Rauigkeit der Energielandschaft verbindet. Diese Eigenschaften sind für das repetitive dynamische Abbildungsverfahren unerlässlich. In einem zweiten Schritt haben wir das Probendesign optimiert und so weiterentwickelt, dass eine Beobachtung der Skyrmionenbewegung mit einer Auflösung von besser als 3 nm möglich wurde. Aufgrund dieser Verbesserungen ist es uns gelungen, die Trajektorie eines Skyrmionen aufzuzeichnen. Diese Bewegung ist eine Superposition von zwei Drehbewegungen, einer im Uhrzeigersinn und einer gegen läufigen. Aus der Existenz dieser zwei Moden lässt sich schließen, dass Skyrmionen träge Quasiteilchen sind, und aus den Frequenzen können wir einen Wert für die träge Masse ableiten. Es stellt sich heraus, dass die Masse von Skyrmion fünfmal größer ist als von existierenden Theorien vorhergesagt. Die Masse wird folglich durch einen neuartigen Mechanismus bestimmt, der sich aus der räumlichen Beschränkung der Skyrmionen ergibt, welche sich direkt aus der Topologie bleitenrnlässt.

Sintesi e caratterizzazione di oligo e politiofeni tioalchil sostituiti per applicazioni fotovoltaiche

Nell'ultimo decennio sono stati sviluppati numerosi materiali π-coniugati contenenti unità tiofeniche per applicazioni in dispositivi organici a film sottile. Nel campo delle celle solari, la possibilità di creare dispositivi basati sull’utilizzo di materiali organici, rispetto ai dispositivi attualmente in commercio a base di silicio, ha suscitato grande interesse soprattutto per la possibilità di realizzare dispositivi su larga area con basso costo di produzione e su substrati flessibili. Gli oligo- e i politiofeni sono eccellenti candidati grazie alle ottime proprietà di trasporto di carica e alle caratteristiche di assorbimento di luce. In celle solari di tipo Bulk-Heterojunction (BHJ), ad esempio, il poli(3-esiltiofene) è uno tra i materiali più studiati. Ad oggi, con il P3HT sono state raggiunte efficienze certificate superiori all’8%, variando sia parametri dipendenti dalla struttura molecolare, come ad esempio il peso molecolare, la regioregolarità delle catene alchiliche, il grado di polidispersità, il grado di polimerizzazione, sia parametri da cui dipende l’organizzazione della blend donatore-accettore. Per superare l’efficienza di conversione ottenuta con i polimeri classici come il P3HT è necessario progettare e sintetizzare materiali con precise caratteristiche: basso energy gap per aumentare l’assorbimento di luce, elevata mobilità di carica per avere una rapida estrazione delle cariche, posizione ottimale degli orbitali di frontiera per garantire una efficiente dissociazione dell’eccitone ed infine buona solubilità per migliorare la processabilità. Il presente lavoro di tesi si è articolato nei seguenti punti: sintesi di oligo- e politiofeni tioalchil sostituiti con inserzione di unità benzotiadiazolo per massimizzare l’assorbimento ed abbassare il gap energetico; studio dell’effetto della ramificazione del gruppo tioalchilico sull’organizzazione supramolecolare allo stato solido e successiva ottimizzazione della morfologia del film solido variando metodi di deposizione e solventi; applicazione degli oligomeri e dei polimeri sintetizzati come materiali donatori in celle fotovoltaiche di tipo Bulk-Heterojunction in presenza di fenil-C61-butirrato di metile (PCBM) come materiale accettore.

Paleoclimate reconstruction using LA-ICP-MS analyses of ostracods and stalagmite

Als paläoklimatische Archive können unter anderem Stalagmiten und Klappen von Ostrakoden herangezogen werden. Bisher gab es noch keine veröffentlichten Ergebnisse räumlich hochaufgelöster Spurenelementverteilungen in einzelnen Ostrakodenklappen. Das gleiche gilt für die Bestimmung radiogener Blei-Isotope in Stalagmiten. Um klimatische Prozesse vergangener Zeiten zu untersuchen, wurde eine neue LA-ICP-MS (Laserablations – Massenspektrometrie mit induktiv gekoppeltem Plasma) Technik für hochaufgelöste in-situ Messungen von Spurenelementen und Bleiisotopen entwickelt. rnrnZunächst wurden geeignete Materialien für die Kalibrierung der Technik untersucht; als Proben dienten die Silikatreferenzgläser BAM-S005-A und BAM-S005B der Bundesanstalt für Materialforschung und –prüfung (BAM). Die Homogenität dieser Referenzgläser wurde mit LA-ICP-MS und den anderen mikroanalytischen Methoden EPMA (Elektronenmikrosonde) und SIMS (Ionensonde) überprüft. Die Ergebnisse zeigten, dass alle Haupt- und die meisten Spurenelemente in beiden Gläsern selbst im Mikrometerbereich homogen verteilt sind. Ausnahmen sind einige Spurenelemente, wie Cs, Cl, Cr, Mo und Ni, die heterogen in den Gläsern verteilt sind. Die Hauptelementzusammensetzung von BAM-S005-A und BAM-S005-B wurde mit Hilfe der EPMA bestimmt, wobei die Ergebnisse die Referenzwerte des BAM-Zertifikats bestätigten. Mit Ausnahme von Sr, Ba, Ce und Pb, stimmten die LA-ICP-MS-Spurenelementwerte mit den zertifizierten Werten innerhalb der angegebenen Fehlergrenzen überein. Gründe für die Diskrepanz der vier oben erwähnten Elemente sind noch unklar, aber sind möglicherweise durch fehlerhafte Referenzwerte zu erklären. Zusätzlich wurden 22 Spurenelemente gemessen, deren Gehalte von BAM nicht zertifiziert wurden. Aufgrund dieser Untersuchungen konnte festgestellt werden, dass beide BAM-Gläser für mikroanalytische Anwendungen geeignet sind.rnrnUm neuartige paläoklimatische Proxies im Calcit von Ostrakoden aus tibetanischen Seesedimenten zu untersuchen, wurde die Spurenelementvariabilität in einzelnen Ostrakodenklappen durch eine neue LA-ICP-MS-Technik bestimmt. Klappen von Ostrakoden der drei Arten (Leucocytherella sinensis Huang, 1982, ?Leucocythere dorsotuberosa Huang, 1982 und ?L. dorsotuberosa f. postilirata sensu Pang, 1985) wurden aus zwei Sedimentkernen des Nam Co Sees auf dem Hochplateau von Tibet gewonnen. Zwei LA-ICP-MS-Varianten, Spot- bzw. Linienanalyse, wurden verwendet, um die Elementkonzentrationen der Spurenelemente Mg, Sr, Ba, U und die der Seltenen Erdelemente (SEE) in den Klappen einzelner Ostrakoden zu bestimmen. Die Ergebnisse zeigten, dass die Linienanalyse präzisere Daten als die Spotanalyse liefert und sie wurde daher vorgezogen. Signifikante Unterschiede in der Spurenelementzusammensetzung zwischen den verschiedenen Arten der Ostrakoden wurden nicht gefunden. Variationen der Elementverhältnisse Mg/Ca und Sr/Ca in den Klappen stimmen mit veröffentlichten Seenspiegelschwankungen während des Holozäns überein, was zeigt, dass Mg- und Sr-Messungen in den Ostrakoden zur Untersuchung paläohydrochemischer Prozesse in diesem Gebiet herangezogen werden kann. Die gute Korrelation, die in dieser Arbeit zwischen Ba/Ca und Sr/Ca gefunden wurde, ist ein Hinweis darauf, dass der Einbau von Ba und Sr in die Klappen durch den gleichen Mechanismus erfolgte. Eine mögliche Beziehung zwischen dem U/Ca-Verhältnis in den Ostrakoden und den Redoxbedingungen auf dem Boden des Sees in der Vergangenheit wird diskutiert. Relativ geringe und konstante La/Ca-Verhältnisse wurden festgestellt, deren Ursache möglicherweise entweder auf der SEE-Charakteristik des Seewassers, auf biologischen Prozessen in den Ostrakoden oder auf Kontamination von Fe-Mn und/oder organischen Substanzen beruhen. Weitere Untersuchungen an Proben aus diesem Gebiet, speziell Klappen von lebenden Ostrakoden, sind notwendig, um den Gehalt von Ba, U und den SEE in Ostrakoden als paläoklimatische Proxies von Umweltbedingungen zu verwenden.

Controlled wetting on silica-based nano- and microstructured surfaces

Der Fokus dieser Doktorarbeit liegt auf der kontrollierten Benetzung von festen Oberflächen, die in vielen Bereichen, wie zum Beispiel in der Mikrofluidik, für Beschichtungen und in biologischen Studien von Zellen oder Bakterien, von großer Bedeutung ist.rnDer erste Teil dieser Arbeit widmet sich der Frage, wie Nanorauigkeit das Benetzungsverhalten, d.h. die Kontaktwinkel und die Pinningstärke, von hydrophoben und superhydrophoben Beschichtungen beeinflusst. Hierfür wird eine neue Methode entwickelt, um eine nanoraue Silika-Beschichtung über die Gasphase auf eine superhydrophobe Oberfläche, die aus rauen Polystyrol-Silika-Kern-Schale-Partikeln besteht, aufzubringen. Es wird gezeigt, dass die Topographie und Dichte der Nanorauigkeiten bestimmt, ob sich die Superhydrophobizität verringert oder erhöht, d.h. ob sich ein Flüssigkeitstropfen im Nano-Wenzel- oder Nano-Cassie-Zustand befindet. Das verstärkte Pinning im Nano-Wenzel-Zustand beruht auf dem Eindringen von Flüssigkeitsmolekülen in die Nanoporen der Beschichtung. Im Nano-Cassie-Zustand dagegen sitzt der Tropfen auf den Nanorauigkeiten, was das Pinning vermindert. Die experimentellen Ergebnisse werden mit molekulardynamischen Simulationen in Bezug gesetzt, die den Einfluss der Oberflächenbeschichtungsdichte und der Länge von fluorinierten Silanen auf die Hydrophobizität einer Oberfläche untersuchen. rnEs wurden bereits verschiedenste Techniken zur Herstellung von transparenten superhydrophoben, d.h. extrem flüssigkeitsabweisenden, Oberflächen entwickelt. Eine aktuelle Herausforderung liegt darin, Funktionalitäten einzuführen, ohne die superhydrophoben Eigenschaften einer Oberfläche zu verändern. Dies ist extrem anspruchsvoll, da funktionelle Gruppen in der Regel hydrophil sind. In dieser Arbeit wird eine innovative Methode zur Herstellung von transparenten superhydrophoben Oberflächen aus Janus-Mikrosäulen mit variierenden Dimensionen und Topographien entwickelt. Die Janus-Säulen haben hydrophobe Seitenwände und hydrophile Silika-Oberseiten, die anschließend selektiv und ohne Verlust der superhydrophoben Eigenschaften der Oberfläche funktionalisiert werden können. Diese selektive Oberflächenfunktionalisierung wird mittels konfokaler Mikroskopie und durch das chemische Anbinden von fluoreszenten Molekülen an die Säulenoberseiten sichtbar gemacht. Außerdem wird gezeigt, dass das Benetzungsverhalten durch Wechselwirkungen zwischen Flüssigkeit und Festkörper in der Nähe der Benetzungslinie bestimmt wird. Diese Beobachtung widerlegt das allgemein akzeptierte Modell von Cassie und Baxter und beinhaltet, dass hydrophile Flächen, die durch mechanischen Abrieb freigelegt werden, nicht zu einem Verlust der Superhydrophobizität führen müssen, wie allgemein angenommen.rnBenetzung kann auch durch eine räumliche Beschränkung von Flüssigkeiten kontrolliert werden, z.B. in mikrofluidischen Systemen. Hier wird eine modifizierte Stöber-Synthese verwendet, um künstliche und natürliche Faser-Template mit einer Silika-Schicht zu ummanteln. Nach der thermischen Zersetzung des organischen Templat-Materials entstehen wohldefinierte Silika-Kanäle und Kanalkreuzungen mit gleichmäßigen Durchmessern im Nano- und Mikrometerbereich. Auf Grund ihrer Transparenz, mechanischen Stabilität und des großen Länge-zu-Durchmesser-Verhältnisses sind die Kanäle sehr gut geeignet, um die Füllgeschwindigkeiten von Flüssigkeiten mit variierenden Oberflächenspannungen und Viskositäten zu untersuchen. Konfokale Mikroskopie ermöglicht es hierbei, die Füllgeschwindigkeiten über eine Länge von mehreren Millimetern, sowie direkt am Kanaleingang zu messen. Das späte Füllstadium kann sehr gut mit der Lucas-Washburn-Gleichung beschrieben werden. Die anfänglichen Füllgeschwindigkeiten sind jedoch niedriger als theoretisch vorhergesagt. Wohingegen die vorhergehenden Abschnitte dieser Arbeit sich mit der quasistatischen Benetzung beschäftigen, spielt hier die Dynamik der Benetzung eine wichtige Rolle. Tatsächlich lassen sich die beobachteten Abweichungen durch einen geschwindigkeitsabhängigen Fortschreitkontaktwinkel erklären und durch dynamische Benetzungstheorien modellieren. Somit löst diese Arbeit das seit langem diskutierte Problem der Abweichungen von der Lucas-Washburn-Gleichung bei kleinen Füllgeschwindigkeiten.

Realizzazione e convalida del modello Monte Carlo di un calibratore di attività per radiofarmaci

I calibratori di attività sono strumenti molto importanti per la pratica, diagnostica e terapeutica, in medicina nucleare, perché permettono di associare ad un radiofarmaco una misura accurata dell’attività dell’isotopo in esso contenuto; questo è fondamentale in quanto l’attività della sorgente esprime la quantità di farmaco somministrata al paziente. In questo lavoro è stato sviluppato il modello Monte Carlo di un calibratore di attività ampiamente diffuso nei laboratori di radiofarmacia (Capintec CRC-15), utilizzando il codice Monte Carlo FLUKA. Per realizzare il modello si è posta estrema attenzione nel riprodurre al meglio tutti i dettagli delle componenti geometriche della camera e dei campioni delle sorgenti radioattive utilizzati. A tale scopo, la camera di ionizzazione di un calibratore è stata studiata mediante imaging TAC. Un’analisi preliminare è stata eseguita valutando il confronto tra l’andamento sperimentale dell’efficienza della camera in funzione dell’energia dei fotoni incidenti e quello ottenuto in simulazione. In seguito si è proceduto con la validazione: si sono studiati a questo proposito la risposta del calibratore in funzione dell’altezza della sorgente e i confronti tra i fattori relativi (rispetto ad una sorgente certificata di 137Cs) e le misure di confronto sono state eseguite con diverse sorgenti certificate di 133Ba, 68Ge-68Ga, 177Lu ed uno standard tarato internamente di 99mTc. In tale modo, si è ricoperto l'intero campo di interesse dei principali radionuclidi impiegati nelle applicazioni diagnostiche e terapeutiche di Medicina Nucleare. Il modello sviluppato rappresenta un importante risultato per l’eventuale determinazione di nuovi fattori di calibrazione o per un futuro studio relativo all’ottimizzazione della risposta del calibratore.

Equazioni stocastiche backward nel mercato delle emissioni

In questa tesi viene esposto il modello EU ETS (European Union Emission Trading Scheme) per la riduzione delle emissoni di gas serra, il quale viene formalizzato matematicamente da un sistema di FBSDE (Forward Backward Stochastic Differential Equation). Da questo sistema si ricava un'equazione differenziale non lineare con condizione al tempo finale non continua che viene studiata attraverso la teoria delle soluzioni viscosità. Inoltre il modello viene implementato numericamente per ottenere alcune simulazioni dei processi coinvolti.

Basic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state

Symptom development during the prodromal phase of psychosis was explored retrospectively in first-episode psychosis patients with special emphasis on the assumed time-related syndromic sequence of "unspecific symptoms (UN)-predictive basic symptoms (BS)-attenuated psychotic symptoms (APS)-(transient) psychotic symptoms (PS)." Onset of syndromes was defined by first occurrence of any of their respective symptoms. Group means were inspected for time differences between syndromes and influence of sociodemographic and clinical characteristics on the recalled sequence. The sequence of "UN-BS/APS-PS" was clearly supported, and both BS and, though slightly less, APS were highly sensitive. However, onset of BS and APS did not show significant time difference in the whole sample (N = 126; 90% schizophrenia), although when each symptom is considered independently, APS tended to occur later than first predictive BS. On descriptive level, about one-third each recalled an earlier, equal and later onset of BS compared with APS. Level of education showed the greatest impact on the recall of the hypothesized sequence. Thereby, those with a higher school-leaving certificate supported the assumed sequence, whereas those of low educational background retrospectively dated APS before BS. These findings rather point out recognition and recall bias inherent to the retrospective design than true group characteristics. Future long-term prospective studies will have to explore this conclusively. However, as regards the criteria, the results support the notion of BS as at least a complementary approach to the ultrahigh risk criteria, which may also allow for an earlier detection of psychosis.

Crystallization, optimization and preliminary X-ray characterization of a metal-dependent PI-PLC from Streptomyces antibioticus

A recombinant metal-dependent phosphatidylinositol-specific phospholipase C (PI-PLC) from Streptomyces antibioticus has been crystallized by the hanging-drop method with and without heavy metals. The native crystals belonged to the orthorhombic space group P222, with unit-cell parameters a = 41.26, b = 51.86, c= 154.78 A. The X-ray diffraction results showed significant differences in the crystal quality of samples soaked with heavy atoms. Additionally, drop pinning, which increases the surface area of the drops, was also used to improve crystal growth and quality. The combination of heavy-metal soaks and drop pinning was found to be critical for producing high-quality crystals that diffracted to 1.23 A resolution.

Accounting for Fetal Death: Vital Statistics and the Medicalization of Pregnancy in the United States

Recent reports by the Centers for Disease Control and Prevention have decried the high rate of fetal mortality in the contemporary United States. Much of the data about fetal and infant deaths, as well as other poor pregnancy outcomes, are tabulated and tracked through vital statistics. In this article, I demonstrate how notions of fetal death became increasingly tied to the surveillance of maternal bodies through the tabulating and tracking of vital statistics in the middle part of the twentieth century. Using a historical analysis of the revisions to the United States Standard Certificate of Live Birth, and the United States Standard Report of Fetal Death, I examine how the categories of analysis utilized in these documents becomes integrally linked to contemporary ideas about fetal and perinatal death, gestational age, and prematurity. While it is evident that there are relationships between maternal behavior and birth outcomes, in this article I interrogate the ways in which the surveillance of maternal bodies through vital statistics has naturalized these relationships. Copyright 2013 Elsevier Ltd. All rights reserved.

The Dynamics of the Policies of Ethnic Cleansing in Silesia in the Nineteenth and Twentieth Centuries

Through studying German, Polish and Czech publications on Silesia, Mr. Kamusella found that most of them, instead of trying to objectively analyse the past, are devoted to proving some essential "Germanness", "Polishness" or "Czechness" of this region. He believes that the terminology and thought-patterns of nationalist ideology are so deeply entrenched in the minds of researchers that they do not consider themselves nationalist. However, he notes that, due to the spread of the results of the latest studies on ethnicity/nationalism (by Gellner, Hobsbawm, Smith, Erikson Buillig, amongst others), German publications on Silesia have become quite objective since the 1980s, and the same process (impeded by under funding) has been taking place in Poland and the Czech Republic since 1989. His own research totals some 500 pages, in English, presented on disc. So what are the traps into which historians have been inclined to fall? There is a tendency for them to treat Silesia as an entity which has existed forever, though Mr. Kamusella points out that it emerged as a region only at the beginning of the 11th century. These same historians speak of Poles, Czechs and Germans in Silesia, though Mr. Kamusella found that before the mid-19th century, identification was with an inhabitant's local area, religion or dynasty. In fact, a German national identity started to be forged in Prussian Silesia only during the Liberation War against Napoleon (1813-1815). It was concretised in 1861 in the form of the first Prussian census, when the language a citizen spoke was equated with his/her nationality. A similar census was carried out in Austrian Silesia only in 1881. The censuses forced the Silesians to choose their nationality despite their multiethnic multicultural identities. It was the active promotion of a German identity in Prussian Silesia, and Vienna's uneasy acceptance of the national identities in Austrian Silesia which stimulated the development of Polish national, Moravian ethnic and Upper Silesian ethnic regional identities in Upper Silesia, and Polish national, Czech national, Moravian ethnic and Silesian ethnic identities in Austrian Silesia. While traditional historians speak of the "nationalist struggle" as though it were a permanent characteristic of Silesia, Mr. Kamusella points out that such a struggle only developed in earnest after 1918. What is more, he shows how it has been conveniently forgotten that, besides the national players, there were also significant ethnic movements of Moravians, Upper Silesians, Silesians and the tutejsi (i.e. those who still chose to identify with their locality). At this point Mr. Kamusella moves into the area of linguistics. While traditionally historians have spoken of the conflicts between the three national languages (German, Polish and Czech), Mr Kamusella reminds us that the standardised forms of these languages, which we choose to dub "national", were developed only in the mid-18th century, after 1869 (when Polish became the official language in Galicia), and after the 1870s (when Czech became the official language in Bohemia). As for standard German, it was only widely promoted in Silesia from the mid 19th century onwards. In fact, the majority of the population of Prussian Upper Silesia and Austrian Silesia were bi- or even multilingual. What is more, the "Polish" and "Czech" Silesians spoke were not the standard languages we know today, but a continuum of West-Slavic dialects in the countryside and a continuum of West-Slavic/German creoles in the urbanised areas. Such was the linguistic confusion that, from time to time, some ethnic/regional and Church activists strove to create a distinctive Upper Silesian/Silesian language on the basis of these dialects/creoles, but their efforts were thwarted by the staunch promotion of standard German, and after 1918, of standard Polish and Czech. Still on the subject of language, Mr. Kamusella draws attention to a problem around the issue of place names and personal names. Polish historians use current Polish versions of the Silesian place names, Czechs use current Polish/Czech versions of the place names, and Germans use the German versions which were in use in Silesia up to 1945. Mr. Kamusella attempted to avoid this, as he sees it, nationalist tendency, by using an appropriate version of a place name for a given period and providing its modern counterpart in parentheses. In the case of modern place names he gives the German version in parentheses. As for the name of historical figures, he strove to use the name entered on the birth certificate of the person involved, and by doing so avoid such confusion as, for instance, surrounds the Austrian Silesian pastor L.J. Sherschnik, who in German became Scherschnick, in Polish, Szersznik, and in Czech, Sersnik. Indeed, the prospective Silesian scholar should, Mr. Kamusella suggests, as well as the three languages directly involved in the area itself, know English and French, since many documents and books on the subject have been published in these languages, and even Latin, when dealing in depth with the period before the mid-19th century. Mr. Kamusella divides the policies of ethnic cleansing into two categories. The first he classifies as soft, meaning that policy is confined to the educational system, army, civil service and the church, and the aim is that everyone learn the language of the dominant group. The second is the group of hard policies, which amount to what is popularly labelled as ethnic cleansing. This category of policy aims at the total assimilation and/or physical liquidation of the non-dominant groups non-congruent with the ideal of homogeneity of a given nation-state. Mr. Kamusella found that soft policies were consciously and systematically employed by Prussia/Germany in Prussian Silesia from the 1860s to 1918, whereas in Austrian Silesia, Vienna quite inconsistently dabbled in them from the 1880s to 1917. In the inter-war period, the emergence of the nation-states of Poland and Czechoslovakia led to full employment of the soft policies and partial employment of the hard ones (curbed by the League of Nations minorities protection system) in Czechoslovakian Silesia, German Upper Silesia and the Polish parts of Upper and Austrian Silesia. In 1939-1945, Berlin started consistently using all the "hard" methods to homogenise Polish and Czechoslovakian Silesia which fell, in their entirety, within the Reich's borders. After World War II Czechoslovakia regained its prewar part of Silesia while Poland was given its prewar section plus almost the whole of the prewar German province. Subsequently, with the active involvement and support of the Soviet Union, Warsaw and Prague expelled the majority of Germans from Silesia in 1945-1948 (there were also instances of the Poles expelling Upper Silesian Czechs/Moravians, and of the Czechs expelling Czech Silesian Poles/pro-Polish Silesians). During the period of communist rule, the same two countries carried out a thorough Polonisation and Czechisation of Silesia, submerging this region into a new, non-historically based administrative division. Democratisation in the wake of the fall of communism, and a gradual retreat from the nationalist ideal of the homogeneous nation-state with a view to possible membership of the European Union, caused the abolition of the "hard" policies and phasing out of the "soft" ones. Consequently, limited revivals of various ethnic/national minorities have been observed in Czech and Polish Silesia, whereas Silesian regionalism has become popular in the westernmost part of Silesia which remained part of Germany. Mr. Kamusella believes it is possible that, with the overcoming of the nation-state discourse in European politics, when the expression of multiethnicity and multilingualism has become the cause of the day in Silesia, regionalism will hold sway in this region, uniting its ethnically/nationally variegated population in accordance with the principle of subsidiarity championed by the European Union.

Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006)

OBJECTIVE: To report clinical features associated with iatrogenic peripheral nerve injury in dogs and cats admitted (1997-2006) to a referral teaching hospital. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=18), 9 cats. METHODS: Patients had acute signs of monoparesis attributable to sciatic nerve dysfunction that developed after treatment. Neurologic examination and electrodiagnostic testing were performed. Surgical therapy was used for nerve entrapment and delayed reconstructive surgery used in other cases. RESULTS: Of 27 nerve injuries, 25 resulted from surgery (18 with treatment of pelvic injuries). Iliosacral luxation repair resulted in tibial (4 cats) and peroneal (3 dogs) nerve dysfunction. Other causes were intramedullary pinning of femoral fractures (3), other orthopedic surgery (cemented hip prosthesis [2] and tibial plateau-leveling osteotomy [1]), and perineal herniorrhaphy [1]. Nerve injury occurred after intramuscular injection (1 cat, 1 dog). Immediate surgical treatment was removal of intramedullary nails, extruded cement, or entrapping suture. Delayed nerve transplantation was performed in 2 dogs. Within 1 year, 13 patients recovered completely, clinical improvement occurred in 7, and there was no improvement in 7. Five of the 7 dogs that did not recover had acetabular or ilium fracture. CONCLUSION: Iatrogenic sciatic nerve injury occurred most commonly during treatment of pelvic orthopedic diseases and had a poor prognosis. Clinical variation in sciatic nerve dysfunction in dogs and cats can be explained by species anatomic differences. CLINICAL RELEVANCE: Iatrogenic sciatic nerve injury leads to severely debilitating locomotor dysfunction with an uncertain prognosis for full-functional recovery.

Integration of external and internal dosimetry in Switzerland

Individual monitoring regulations in Switzerland are based on the ICRP60 recommendations. The annual limit of 20 mSv for the effective dose applies to the sum of external and internal radiation. External radiation is monitored monthly or quarterly with TLD, DIS or CR-39 dosemeters by 10 approved external dosimetry services and reported as H(p)(10) and H(p)(0.07). Internal monitoring is done in two steps. At the workplace, simple screening measurements are done frequently in order to recognise a possible incorporation. If a nuclide dependent activity threshold is exceeded then one of the seven approved dosimetry services for internal radiation does an incorporation measurement to assess the committed effective dose E(50). The dosimetry services report all the measured or assessed dose values to the employer and to the National Dose Registry. The employer records the annually accumulated dose values into the individual dose certificate of the occupationally exposed person, both the external dose H(p)(10) and the internal dose E(50) as well as the total effective dose E = H(p)(10)+E(50). Based on the national dose registry an annual report on the dosimetry in Switzerland is published which contains the statistics for the total effective dose, as well as separate statistics for external and internal exposure.

Impact of unlinked deaths and coding changes on mortality trends in the Swiss National Cohort

BACKGROUND Results of epidemiological studies linking census with mortality records may be affected by unlinked deaths and changes in cause of death classification. We examined these issues in the Swiss National Cohort (SNC). METHODS The SNC is a longitudinal study of the entire Swiss population, based on the 1990 (6.8 million persons) and 2000 (7.3 million persons) censuses. Among 1,053,393 deaths recorded 1991-2007 5.4% could not be linked using stringent probabilistic linkage. We included the unlinked deaths using pragmatic linkages and compared mortality rates for selected causes with official mortality rates. We also examined the impact of the 1995 change in cause of death coding from version 8 (with some additional rules) to version 10 of the International Classification of Diseases (ICD), using Poisson regression models with restricted cubic splines. Finally, we compared results from Cox models including and excluding unlinked deaths of the association of education, marital status, and nationality with selected causes of death. RESULTS SNC mortality rates underestimated all cause mortality by 9.6% (range 2.4%-17.9%) in the 85+ population. Underestimation was less pronounced in years nearer the censuses and in the 75-84 age group. After including 99.7% of unlinked deaths, annual all cause SNC mortality rates were reflecting official rates (relative difference between -1.4% and +1.8%). In the 85+ population the rates for prostate and breast cancer dropped, by 16% and 21% respectively, between 1994 and 1995 coincident with the change in cause of death coding policy. For suicide in males almost no change was observed. Hazard ratios were only negligibly affected by including the unlinked deaths. A sudden decrease in breast (21% less, 95% confidence interval: 12%-28%) and prostate (16% less, 95% confidence interval: 7%-23%) cancer mortality rates in the 85+ population coincided with the 1995 change in cause of death coding policy. CONCLUSIONS Unlinked deaths bias analyses of absolute mortality rates downwards but have little effect on relative mortality. To describe time trends of cause-specific mortality in the SNC, accounting for the unlinked deaths and for the possible effect of change in death certificate coding was necessary.

Religion and suicide in patients with mental illness or cancer

In Switzerland, the highest rates of suicide are observed in persons without religious affiliation and the lowest in Catholics, with Protestants in an intermediate position. We examined whether this association was modified by concomitant psychiatric diagnoses or malignancies, based on 6,909 suicides (ICD-10 codes X60-X84) recorded in 3.69 million adult residents 2001-2008. Suicides were related to mental illness or cancer if codes F or C, respectively, were mentioned on the death certificate. The protective effect of religion was substantially stronger if a diagnosis of cancer was mentioned on the death certificate and weaker if a mental illness was mentioned.