Projections of global warming-induced impacts on winter storm losses in the German private household sector

We present projections of winter storm-induced insured losses in the German residential building sector for the 21st century. With this aim, two structurally most independent downscaling methods and one hybrid downscaling method are applied to a 3-member ensemble of ECHAM5/MPI-OM1 A1B scenario simulations. One method uses dynamical downscaling of intense winter storm events in the global model, and a transfer function to relate regional wind speeds to losses. The second method is based on a reshuffling of present day weather situations and sequences taking into account the change of their frequencies according to the linear temperature trends of the global runs. The third method uses statistical-dynamical downscaling, considering frequency changes of the occurrence of storm-prone weather patterns, and translation into loss by using empirical statistical distributions. The A1B scenario ensemble was downscaled by all three methods until 2070, and by the (statistical-) dynamical methods until 2100. Furthermore, all methods assume a constant statistical relationship between meteorology and insured losses and no developments other than climate change, such as in constructions or claims management. The study utilizes data provided by the German Insurance Association encompassing 24 years and with district-scale resolution. Compared to 1971–2000, the downscaling methods indicate an increase of 10-year return values (i.e. loss ratios per return period) of 6–35 % for 2011–2040, of 20–30 % for 2041–2070, and of 40–55 % for 2071–2100, respectively. Convolving various sources of uncertainty in one confidence statement (data-, loss model-, storm realization-, and Pareto fit-uncertainty), the return-level confidence interval for a return period of 15 years expands by more than a factor of two. Finally, we suggest how practitioners can deal with alternative scenarios or possible natural excursions of observed losses.

Motivação: um enfoque neurofisiológico

Não esquecendo toda uma conotação SOCial que está implicante ligada à motivação, o presente trabalho visa estudar em bases neurofisiológicas. Sabemos que a motivação ainda não possui seu constructo solidificado. Possui uma variabilidade de entretenimento da escola psicológica para escolas psicológicas, de pesquisador para pesquisador, de cultura para cultura, de tempo para tempo.... Este trabalho não tem um fim reducionista em apenas ver a motivação com bases neurofisiológicas. Seu objetivo é clarificar, se possível, um campo discutível. Podemos ver apesar dos vários modos de encarar a motivação como processo social, seu modo de se dar, fisiologicamente, poderá ser mais delimitado. Qualquer que seja a conceituação dada a motivação, ela possui um mecanismo fisiológico interno, inegável. Será neste campo que dedicar-me-ei. O que se dá no sistema nervoso quando um ser vivo é motivado? Será que o mecanismo fisiológico da motivação difere de ser para ser? Ou será diferente apenas de espécie para espécie? Iniciaremos nosso trabalho vendo as diferentes visões de motivação e como os cientistas a encaram. Verificamos que a preocupação dada desde muito em estabelecer um ponto de partida mais operacional para p desenvolvimento da fisiologia em cases científicas. Para isto, muito contribuíram FUNVESTEIN, CANNON, SHERRINGTON, MAGNUN e MORUZZI, SECHENOV, LASHLEY e outros. Entretanto, inicialmente esta preocupação era maior pelas manifestações viscerais e somáticas do comportamento. Só com o desenvolvimento das pesquisas sobre Hipotálamo e o Sistema Límbico foi que se conseguiu, realmente, em campo melhor para as pesquisas sobre motivação. Não podemos esquecer as contribuições de SKINNER e PAVLON sobre recompensa, as de BANDURA com a variável – Modelação do Comportamento, de BUTTLER e NISSEN com a descrição do comportamento da curiosidade exploratória, as de HEBB sobre os efeitos da estimulação sensorial restrita, as de JAMES OLDS sobre a estimulação elétrica. Estudaremos as interpretações teóricas recentes com CANON, LASHLEY, BEACH, MORGAN, LORENS, DEUTSCH, LINDSLEY, GROSSMAN. Teceremos considerações anatômicas, histológicas, fisiológicas, conexões e funções no estudo do Sistema Límbico e seus componentes. Nossa maior preocupação serpa em tentar explicar os mecanismos motivacionais na sua relação com o Sistema Nervoso. Estudaremos motivações sexual, de forma, de sede, de dor, maternal e paternal, de defesa, de ataque ou dominação e como elas estão relacionadas no sistema nervoso. Para tal apresentamos experiências realizadas sobre estimulação sensorial, motivação e emoção, e as experiências de OLDS sobre fatores motivacionais obtidos através de estimulações ou ablações de determinadas áreas do Sistema Límbico. Espero que, através desta dissertação, tenha podido contribuir um pouco para o estudo de tão vasto campo.

The genomes of two key bumblebee species with primitive eusocial organization

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

OXYGEN ABUNDANCES IN LOW- AND HIGH-alpha FIELD HALO STARS AND THE DISCOVERY OF TWO FIELD STARS BORN IN GLOBULAR CLUSTERS

Oxygen abundances of 67 dwarf stars in the metallicity range -1.6 < [Fe/H] < -0.4 are derived from a non-LTE analysis of the 777 nm O I triplet lines. These stars have precise atmospheric parameters measured by Nissen and Schuster, who find that they separate into three groups based on their kinematics and alpha-element (Mg, Si, Ca, Ti) abundances: thick disk, high-alpha halo, and low-alpha halo. We find the oxygen abundance trends of thick-disk and high-alpha halo stars very similar. The low-alpha stars show a larger star-to-star scatter in [O/Fe] at a given [Fe/H] and have systematically lower oxygen abundances compared to the other two groups. Thus, we find the behavior of oxygen abundances in these groups of stars similar to that of the a elements. We use previously published oxygen abundance data of disk and very metal-poor halo stars to present an overall view (-2.3 < [Fe/H] < +0.3) of oxygen abundance trends of stars in the solar neighborhood. Two field halo dwarf stars stand out in their O and Na abundances. Both G53-41 and G150-40 have very low oxygen and very high sodium abundances, which are key signatures of the abundance anomalies observed in globular cluster (GC) stars. Therefore, they are likely field halo stars born in GCs. If true, we estimate that at least 3% +/- 2% of the local field metal-poor star population was born in GCs.

Study of apoptotic deletion mediated by Bifidobacterium longum with construction of recombinant strains for Serpin encoding gene and phenotypes comparison in a pig cell model

The first part of the research project of the Co-Advisorship Ph.D Thesis was aimed to select the best Bifidobacterium longum strains suitable to set the basis of our study. We were looking for strains with the abilities to colonize the intestinal mucosa and with good adhesion capacities, so that we can test these strains to investigate their ability to induce apoptosis in “damaged” intestinal cells. Adhesion and apoptosis are the two process that we want to study to better understand the role of an adhesion protein that we have previously identified and that have top scores homologies with the recent serpin encoding gene identified in B. longum by Nestlè researchers. Bifidobacterium longum is a probiotic, known for its beneficial effects to the human gut and even for its immunomodulatory and antitumor activities. Recently, many studies have stressed out the intimate relation between probiotic bacteria and the GIT mucosa and their influence on human cellular homeostasis. We focused on the apoptotic deletion of cancer cells induced by B. longum. This has been valued in vitro, performing the incubation of three B.longum strains with enterocyte-like Caco- 2 cells, to evidence DNA fragmentation, a cornerstone of apoptosis. The three strains tested were defined for their adhesion properties using adhesion and autoaggregation assays. These features are considered necessary to select a probiotic strain. The three strains named B12, B18 and B2990 resulted respectively: “strong adherent”, “adherent” and “non adherent”. Then, bacteria were incubated with Caco-2 cells to investigate apoptotic deletion. Cocultures of Caco-2 cells with B. longum resulted positive in DNA fragmentation test, only when adherent strains were used (B12 and B18). These results indicate that the interaction with adherent B. longum can induce apoptotic deletion of Caco-2 cells, suggesting a role in cellular homeostasis of the gastrointestinal tract and in restoring the ecology of damaged colon tissues. These results were used to keep on researching and the strains tested were used as recipient of recombinant techniques aimed to originate new B.longum strains with enhanced capacity of apoptotic induction in “damaged” intestinal cells. To achieve this new goal it was decided to clone the serpin encoding gene of B. longum, so that we can understand its role in adhesion and apoptosis induction. Bifidobacterium longum has immunostimulant activity that in vitro can lead to apoptotic response of Caco-2 cell line. It secretes a hypothetical eukaryotic type serpin protein, which could be involved in this kind of deletion of damaged cells. We had previously characterised a protein that has homologies with the hypothetical serpin of B. longum (DD087853). In order to create Bifidobacterium serpin transformants, a B. longum cosmid library was screened with a PCR protocol using specific primers for serpin gene. After fragment extraction, the insert named S1 was sub-cloned into pRM2, an Escherichia coli - Bifidobacterium shuttle vector, to construct pRM3. Several protocols for B. longum transformation were performed and the best efficiency was obtained using MRS medium and raffinose. Finally bacterial cell supernatants were tested in a dotblot assay to detect antigens presence against anti-antitrypsin polyclonal antibody. The best signal was produced by one starin that has been renamed B. longum BLKS 7. Our research study was aimed to generate transformants able to over express serpin encoding gene, so that we can have the tools for a further study on bacterial apoptotic induction of Caco-2 cell line. After that we have originated new trasformants the next step to do was to test transformants abilities when exposed to an intestinal cell model. In fact, this part of the project was achieved in the Department of Biochemistry of the Medical Faculty of the University of Maribor, guest of the abroad supervisor of the Co-Advisorship Doctoral Thesis: Prof. Avrelija Cencic. In this study we examined the probiotic ability of some bacterial strains using intestinal cells from a 6 years old pig. The use of intestinal mammalian cells is essential to study this symbiosis and a functional cell model mimics a polarised epithelium in which enterocytes are separated by tight junctions. In this list of strains we have included the Bifidobacterium longum BKS7 transformant strain that we have previously originated; in order to compare its abilities. B. longum B12 wild type and B. longum BKS7 transformant and eight Lactobacillus strains of different sources were co-cultured with porcine small intestine epithelial cells (PSI C1) and porcine blood monocytes (PoM2) in Transwell filter inserts. The strains, including Lb. gasseri, Lb. fermentum, Lb. reuterii, Lb. plantarum and unidentified Lactobacillus from kenyan maasai milk and tanzanian coffee, were assayed for activation of cell lines, measuring nitric oxide by Griess reaction, H202 by tetramethylbenzidine reaction and O2 - by cytochrome C reduction. Cytotoxic effect by crystal violet staining and induction on metabolic activity by MTT cell proliferation assay were tested too. Transepithelial electrical resistance (TER) of polarised PSI C1 was measured during 48 hours co-culture. TER, used to observe epithelium permeability, decrease during pathogenesis and tissue becomes permeable to ion passive flow lowering epithelial barrier function. Probiotics can prevent or restore increased permeability. Lastly, dot-blot was achieved against Interleukin-6 of treated cells supernatants. The metabolic activity of PoM2 and PSI C1 increased slightly after co-culture not affecting mitochondrial functions. No strain was cytotoxic over PSI C1 and PoM2 and no cell activation was observed, as measured by the release of NO2, H202 and O2 - by PoM2 and PSI C1. During coculture TER of polarised PSI C1 was two-fold higher comparing with constant TER (~3000 ) of untreated cells. TER raise generated by bacteria maintains a low permeability of the epithelium. During treatment Interleukin-6 was detected in cell supernatants at several time points, confirming immunostimulant activity. All results were obtained using Lactobacillus paracasei Shirota e Carnobacterium divergens as controls. In conclusion we can state that both the list of putative probiotic bacteria and our new transformant strain of B. longum are not harmful when exposed to intestinal cells and could be selected as probiotics, because can strengthen epithelial barrier function and stimulate nonspecific immunity of intestinal cells on a pig cell model. Indeed, we have found out that none of the strains tested that have good adhesion abilities presents citotoxicity to the intestinal cells and that non of the strains tested can induce cell lines to produce high level of ROS, neither NO2. Moreover we have assayed even the capacity of producing certain citokynes that are correlated with immune response. The detection of Interleukin-6 was assayed in all our samples, including B.longum transformant BKS 7 strain, this result indicates that these bacteria can induce a non specific immune response in the intestinal cells. In fact, when we assayed the presence of Interferon-gamma in cells supernatant after bacterial exposure, we have no positive signals, that means that there is no activation of a specific immune response, thus confirming that these bacteria are not recognize as pathogen by the intestinal cells and are certainly not harmful for intestinal cells. The most important result is the measure of Trans Epithelial Electric Resistance that have shown how the intestinal barrier function get strengthen when cells are exposed to bacteria, due to a reduction of the epithelium permeability. We have now a new strain of B. longum that will be used for further studies above the mechanism of apoptotic induction to “damaged cells” and above the process of “restoring ecology”. This strain will be the basis to originate new transformant strains for Serpin encoding gene that must have better performance and shall be used one day even in clinical cases as in “gene therapy” for cancer treatment and prevention.

Synthese von Carbolinen durch übergangsmetall-katalysierte [2+2+2]-Cycloaddition von Alkinen und Nitrilen: Ein neuer Weg zur Totalsynthese von Lavendamycin

Carboline sind eine große Gruppe von natürlich vorkommenden Alkaloiden, die eine tricyclische Pyrido[b]indol-Ringstruktur gemeinsam habe. Das breite Spektrum biologischer Eigenschaften dieser Verbindungsklasse macht sie zu einem interessanten Syntheseziel. Die größte Herausforderung in der Darstellung von Carbolinen ist die regioselektive Funktionalisierung an den aromatischen Positionen. Im Rahmen dieser Arbeit konnte ein A ABC-Zugang zu beta- und gamma-Carbolinen entwickelt werden, dessen Schlüsselschritt der Aufbau des Carbolin-Gerüsts durch eine übergangsmetall-katalysierte [2+2+2]-Cycloaddition von 1,6-Diin-Einheiten und Nitrilen ist. Die benötigten Diin-Einheiten wurden in wenigen Schritten ausgehend von 2-Iodanilin durch eine Reaktionssequenz aus Sonogashira-Reaktion mit terminalen Alkinen, N-Tosylierung und N-Ethinylierung mit Alkinyliodonium-Salzen synthetisiert. Eine flexible Funktionalisierung dieser Diine wurde durch palladium-katalysierte sp2-sp-Kreuzkupplungsreaktionen der terminalen Alkine mit Aryl- und Alkenylhalogeniden erreicht. Cp*RuCl- und [Rh(cod)2]BF4/BINAP-katalysierte [2+2+2]-Cycloadditionen der 1,6-Diine mit elektronenarmen Nitrilen lieferte in hoher Regioselektivität beta- oder gamma-Carboline. In Übereinstimmung mit literaturbekannten übergangsmetall-katalysierten [2+2+2]-Cycloadditionen konnte dabei eine starke Abhängigkeit von sterischen und elektronischen Faktoren beobachtet werden. Um das Potential dieser Methode zu demonstrieren, wurde der Einsatz der [2+2+2]-Cycloaddition in Totalsynthese von Lavendamycin untersucht. Lavendamycin, ein aus Bakterien stammendes Chinochinolin-substituiertes beta-Carbolin mit antimikrobieller und signifikanter Antitumor-Aktivität, wurde ausgehend von Hydrochinon und 2-Iodanilin in 14 Schritten und in einer Gesamtausbeute von 29% dargestellt.

Microbial formation of nitrous acid and its exchange processes between soils and atmosphere

Salpetrige Säure (HONO) ist eine wichtige Form von reaktivem Stickstoff, die aufgrund ihrer Photolyse zu Stickstoffmonoxid (NO) und dem Hydroxylradikal (OH), sehr kurzlebig ist. Ein genaues Verständnis der Quellen und Senken von HONO ist eine grundlegende Voraussetzung, um dessen Einfluss auf die Umwelt zu beurteilen. Allerdings wird immer noch nach einer starken HONO-Quelle am Tag gesucht und nächtliche HONO-Deposition auf den Boden wurde bisher stets nur postuliert. Diese Dissertation folgt der Zielsetzung die Prozesse der HONO-Aufnahme und Freisetzung von Böden aufzudecken und die zugrunde liegenden Mechanismen zu verstehen.rnUm die Rolle von HONO-Bodenemissionen zu quantifizieren, wurden 17 Böden in einem dynamischen Kammersystem untersucht. Es konnten HONO-Emissionen derselben Größenordnung wie die bereits gut untersuchten NO-Emissionen festgestellt werden. Unerwarteter Weise wurden die stärksten Emissionen bei Böden mit neutralem pH aus ariden und landwirt¬schaftlichen Gebieten beobachtet. Die Temperaturabhängigkeit der Bodenemissionen von HONO und NO führten zu der Annahme einer mikrobiellen Freisetzung von HONO, welche durch Reinkulturexperimente mit dem ammoniumoxidierenden Bakterium Nitrosomonas europaea bestätigt werden konnte. Ein konzeptionelles Model für die Freisetzung reaktiver Stickstoffverbindungen aus Böden in Abhängigkeit des Bodenwassergehaltes wurde um HONO-Emissionen erweitert.rnDurch Nachweise mittels Reinkultur- und Inhibitionsexperimenten konnten weitere Untersuchungen der bakteriellen Freisetzung von HONO aus Böden zeigen, dass innerhalb der bakteriellen Nitrifikation nur ammoniumoxidierende Bakterien zur Emission von HONO fähig sind. Durch kontrolliert initiierte Zelllyse konnte gezeigt werden, dass intrazellulär akkumuliertes Hydroxylamin (NH2OH) für die HONO-Freisetzung verantwortlich sind. Zum ersten Mal wurde NH2OH in der Gasphase nachgewiesen und dass dieses über den gesamten Bodenfeuchtebereich von ammoniumoxidierenden Bakterien freigesetzt wird. Es wurde gezeigt, dass die heterogene Reaktion von NH2OH mit Wasserdampf auf einer Glasperlenoberfläche HONO bildet. Diese Reaktion erklärt die beobachtete Freisetzung von HONO bei niedrigen Bodenfeuchten, da nur dann die Oberfläche zur Reaktion zur Verfügung steht und nicht von Wasser bedeckt ist.rnEine 15N Isotopenmarkierungsmethode wurde entwickelt um isotopenmarkiertes gasförmiges HONO zu messen, was die Untersuchung der Bildungsprozesse von HONO und dessen Rolle in biogeochemischen Zyklen ermöglicht. Die Anwendung dieser neuen Methode auf eine Bodenprobe die mit 15N Harnstoff angereichert und in einem dynamischen Kammersystem untersucht wurde, bestätigt die obigen Ergebnisse einer starken mikrobiellen Beteiligung von Bodenbakterien zur HONO Freisetzung.rnBidirektionale Flüsse von HONO wurden für sechs untersuchte Bodenproben gefunden. Die Richtung der Flüsse hängt dabei vom Umgebungsmischungsverhältnis von HONO und dem Bodenwassergehalt ab. Eine wichtige Größe, die die bidirektionalen Flüsse von HONO beschreibt, ist das „Ökosystem spezifische Kompensationsmischungsverhältnis von HONO“, χcomp. Dieser neue Begriff wurde definiert und eingeführt, da die verschiedenen in den Bodenaustausch von HONO involvierten Prozesse nicht mit dem klassischen Kompensationspunktkonzept kompatibel sind. Die Untersuchungen bestätigen neueste Feldbeobachtungen, dass HONO, welches bei hohen Umgebungsmischungsverhältnissen vom Boden adsorbiert wird, bei niedrigen Mischungsverhält-nissen wieder vom Boden desorbiert wird. Folglich wird nächtlich akkumuliertes HONO tagsüber in eine Quelle für HONO umgewandelt. Vier Prozesse - Verteilung von HONO zwischen Gas- und Flüssigphase nach Henrys Gesetz, bakterielle HONO Bildung aus NH2OH, Adsorption und Desorption von HONO - und deren Dominanz in speziellen Bodenfeuchtebereichen wurden identifiziert. Dadurch wurde ein konzeptionelles Model für die Prozesse, die in Aufnahme und Freisetzung von HONO aus Böden involviert sind, als Funktion der Bodenfeuchte entwickelt.rnZusammenfassend hat diese Dissertation die entscheidenden Prozesse im Austausch von HONO zwischen Boden und Atmosphäre aufgeklärt und den der bakteriellen HONO Bildung zugrunde liegenden Mechanismus aufgedeckt. Es konnte gezeigt werden, dass Böden sowohl eine wichtige Quelle als auch eine Senke für HONO sind und sollten folglich in zukünftigen Feldmessungen stärker berücksichtigt werden.rn

Effects of Bovine Somatotropin and Revalor-S® on Growth Performance and Carcass Leanness in Beef Cattle

Twenty crossbred steers were used to evaluate bovine somatotropin (bST) and an anabolic steroid implant, Revalor-S® (REV), to improve growth and increase carcass leanness. During the first 70 days on feed, bST-treated steers tended to improve live weight gains, consume more feed, and numerically improve feed utilization for growth. The implanted steers grew faster and utilized feed better than steers not implanted with REV. The improvement in gain and feed utilization for growth was maintained throughout the feeding period for REV-implanted steers. At slaughter, REV steers had heavier carcasses which resulted in more pounds of muscle, bone, and fat. When adjusted for hot carcass weight, bST increased leanness of the carcass as evident by the increased weight of the semitendinosus muscle, more pounds of dissected lean, and fewer pounds of dissected fat. Thus, REV and bST can be used to improve growth performance and increase carcass leanness.

Transcatheter aortic valve implantation in failed bioprosthetic surgical valves.

IMPORTANCE Owing to a considerable shift toward bioprosthesis implantation rather than mechanical valves, it is expected that patients will increasingly present with degenerated bioprostheses in the next few years. Transcatheter aortic valve-in-valve implantation is a less invasive approach for patients with structural valve deterioration; however, a comprehensive evaluation of survival after the procedure has not yet been performed. OBJECTIVE To determine the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves. DESIGN, SETTING, AND PARTICIPANTS Correlates for survival were evaluated using a multinational valve-in-valve registry that included 459 patients with degenerated bioprosthetic valves undergoing valve-in-valve implantation between 2007 and May 2013 in 55 centers (mean age, 77.6 [SD, 9.8] years; 56% men; median Society of Thoracic Surgeons mortality prediction score, 9.8% [interquartile range, 7.7%-16%]). Surgical valves were classified as small (≤21 mm; 29.7%), intermediate (>21 and <25 mm; 39.3%), and large (≥25 mm; 31%). Implanted devices included both balloon- and self-expandable valves. MAIN OUTCOMES AND MEASURES Survival, stroke, and New York Heart Association functional class. RESULTS Modes of bioprosthesis failure were stenosis (n = 181 [39.4%]), regurgitation (n = 139 [30.3%]), and combined (n = 139 [30.3%]). The stenosis group had a higher percentage of small valves (37% vs 20.9% and 26.6% in the regurgitation and combined groups, respectively; P = .005). Within 1 month following valve-in-valve implantation, 35 (7.6%) patients died, 8 (1.7%) had major stroke, and 313 (92.6%) of surviving patients had good functional status (New York Heart Association class I/II). The overall 1-year Kaplan-Meier survival rate was 83.2% (95% CI, 80.8%-84.7%; 62 death events; 228 survivors). Patients in the stenosis group had worse 1-year survival (76.6%; 95% CI, 68.9%-83.1%; 34 deaths; 86 survivors) in comparison with the regurgitation group (91.2%; 95% CI, 85.7%-96.7%; 10 deaths; 76 survivors) and the combined group (83.9%; 95% CI, 76.8%-91%; 18 deaths; 66 survivors) (P = .01). Similarly, patients with small valves had worse 1-year survival (74.8% [95% CI, 66.2%-83.4%]; 27 deaths; 57 survivors) vs with intermediate-sized valves (81.8%; 95% CI, 75.3%-88.3%; 26 deaths; 92 survivors) and with large valves (93.3%; 95% CI, 85.7%-96.7%; 7 deaths; 73 survivors) (P = .001). Factors associated with mortality within 1 year included having small surgical bioprosthesis (≤21 mm; hazard ratio, 2.04; 95% CI, 1.14-3.67; P = .02) and baseline stenosis (vs regurgitation; hazard ratio, 3.07; 95% CI, 1.33-7.08; P = .008). CONCLUSIONS AND RELEVANCE In this registry of patients who underwent transcatheter valve-in-valve implantation for degenerated bioprosthetic aortic valves, overall 1-year survival was 83.2%. Survival was lower among patients with small bioprostheses and those with predominant surgical valve stenosis.

Surgical treatments for esophageal cancers.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy.

Natural course of pontocerebellar hypoplasia type 2A

INTRODUCTION Pontocerebellar hypoplasia Type 2 (PCH2) is a rare autosomal recessive condition, defined on MRI by a small cerebellum and ventral pons. Clinical features are severe developmental delay, microcephaly and dyskinesia.Ninety percent carry a p.A307S mutation in the TSEN54-gene. Our aim was to describe the natural course including neurological and developmental features and other aspects of care in a homogeneous group of PCH2 patients all carrying the p.A307S mutation. PATIENTS AND METHODS Patients were recruited via the German patients' organizations. Inclusion criteria were imaging findings of PCH2 and a p.A307S mutation. Data were collected using medical reports and patient questionnaires discussed in a standardized telephone interview. RESULTS Thirty-three patients were included. When considering survival until age 11 years, 53% of children had died Weight, length and head circumference, mostly in the normal range at birth, became abnormal, especially head circumference (-5.58 SD at age 5 yrs). Neurologic symptoms: Choreathetosis was present in 88% (62% with pyramidal signs), 12% had pure spasticity. Epileptic seizures were manifest in 82%, status epilepticus in 39%. Non-epileptic dystonic attacks occurred in 33%. General symptoms: feeding difficulties were recorded in 100%, sleep disorder in 96%, apneas in 67% and recurrent infections in 52%; gastroesophageal reflux disease was diagnosed in 73%, 67% got percutaneous endoscopic gastrostomy and 36% a Nissen-fundoplication. Neurodevelopmental data: All children made progress, but on a low level: such as fixing and following with the eyes was seen in 76%, attempting to grasp objects (76%), moderate head control (73%), social smile (70%), rolling from prone to supine (58%), and sitting without support (9%). Ten percent lost achieved abilities on follow-up. The presence of prenatal symptoms did not correlate with outcome. CONCLUSION Phenotype of this genetically homogeneous group of PCH2 children was severe with reduced survival, but compatible with some developmental progress. Our data support the hypothesis of an early onset degeneration which thereafter stabilizes.

Arbeitsweisen im Gegenwartstheater

"Arbeitsweisen im Gegenwartstheater", Band 1 der neuen theaterwissenschaftlichen Reihe, ist im April 2015 im Berliner Alexander Verlag erschienen. Die regelmäßig erscheinenden Ausgaben sind als Arbeitsbücher zu den "itw : im dialog"-Symposien des Instituts für Theaterwissenschaft der Universität Bern konzipiert. Die Beiträge des ersten Bandes reflektieren die komplexen und divergenten Erscheinungsformen zeitgenössischen Theaters und nähern sich aus unterschiedlichen Perspektiven der Frage nach den Zusammenhängen von Arbeitsweisen und Ästhetiken: z. B. Kollektivität und Reflexivität im Gegenwartstheater, Formen und Mobilität internationalisierten Theaters, Allianzen zwischen Freier Szene und Stadttheater sowie Autorenregie. Mit Beiträgen von Annemarie Matzke, Barbara Gronau, Sandra Umathum, Philipp Schulte, Karin Nissen-Rizvani und Gesprächen mit Alexandre Devriendt und Joeri Smet (Ontroerend Goed, Gent), Sebastian Brünger (Rimini Protokoll, Berlin), Tomas Schweigen (FADC/Theater Basel), Sabine Harbeke (Autorin/Regisseurin, Zürich).