Literatura académica sobre el tema "Dresden / Medien@age"

Objective: The purpose of this paper is to describe a minimally invasive chronic Achilles tendon rupture reconstruction combining a modified Dresden technique and endoscopic flexor hallucis longus (FHL) tendon transfer. Methods: Our prospectively collected database was queried for patients presenting with chronic Achilles tendon rupture. Patients were included if they presented any of the following criteria: more than 65 years of age, history of previous DVT, active smoking habit and Diabetes. Pre and post-operative SF-36 and AOFAS hindfoot scores, complications, and patient satisfaction grades were recorded. Results: Eight patients met the inclusion criteria; the median age was 49 years old (range 22 - 67 years). Two complications were registered (sural neuritis and minor wound dehiscence). Mean AOFAS score increased from 48 (range 40 - 63) to 91,6 (range 85 - 95). Regarding SF-36 score, the SFF-36 improved from 51,6 to 79,3 points and the SFM-36 enhance from 25 to 61,5 points. All patients evaluated their satisfaction regarding the performed procedure as satisfactory. Conclusion: Chronic Achilles tendon rupture reconstruction combining a modified Dresden technique and endoscopic FHL transfer is an attractive option in high-risk patients, with favorable results at the short-term follow-up. Level of Evidence IV; Therapeutic Study; Case Series.

Abstract Background: The effectiveness and safety of acute venous thromboembolism (VTE) treatment with rivaroxaban, demonstrated in phase-III trials, needs to be evaluated in unselected patients treated under daily care conditions. Patients and methods: The Dresden NOAC registry is a prospective regional registry in which patients with oral anticoagulation undergo prospective follow- up (FU). So far, more than 3200 patients have been enrolled, including 772 VTE patients with rivaroxaban treatment. For this analysis, only patients with acute VTE who started rivaroxaban within 14 days after diagnosis of VTE and who were enrolled within these 14 days were evaluated with regard to patient characteristics, treatment persistence and clinical outcomes. All reported outcome events were centrally adjudicated based on source documentation and standard definitions. Results: Between December 1st 2011 and March 31st 2016, 407 patients received rivaroxaban for acute VTE treatment (51.6% female, 80.8% DVT; 19.2% PE±DVT, mean age 61.4 years). Mean time between VTE diagnosis and initiation of rivaroxaban was 1.7±3.3 days (median 0d; 25th/75th percentile 0; 1d). At baseline, rivaroxaban doses consisted of 15 mg BID in 93.1%, 20 mg OD in 3.4%, 15 mg OD in 3.2% and 10 mg OD in 0.2% of patients. Reasons for not using 2x15 mg rivaroxaban BID were pre-treatment with therapeutic parenteral anticoagulants for ≥7 d in 14 cases, comorbidities (e.g. bleeding history, renal impairment) in 4 cases and unknown in 10 cases. During FU (mean 762.4±462.7d), the mean rivaroxaban exposure was 357.7±385.9 days. During treatment with rivaroxaban, 4/407 patients (1.0%) experienced a recurrent VTE, which translated into a recurrence rate of 1.0/ 100 pt. years. During treatment, 172/407 (42.3%) patients reported bleeding complications, which in 13 cases (3.2%; 3.3/100 pt. years) were major bleeding according to ISTH definition, including one fatal intracranial bleeding. Patients with deep vein thrombosis (DVT) and pulmonary embolism (PE) had similar rates of recurrent VTE during rivaroxaban treatment (1.01 and 1.01/100 pt. years) but PE patients had numerically higher rates of major bleeding (3.99/100 pt. years compared to 3.09/100 pt.years in the DVT group). Effectiveness and safety profiles were consistent across relevant subgroups (table 1). 18 patients died during FU (2.12/100 pt.years), of which 8 deaths occurred during or within 3 days after last intake of rivaroxaban. Most common causes of death were fatal cardiovascular event (n=7) and terminal malignant disease (n=4), followed by sepsis/infection (n=3), age related death (n=1), fatal bleeding (n=1) and other reasons (n=2). At 6 months (FU completed in 365 pts.), 61.4% of patients were still taking rivaroxaban. The remaining patients had a scheduled end of treatment (28.8%) or were switched to other anticoagulants (7.1%). Therefore, the rate of unplanned complete discontinuation at 6 months was 2.7%. At 12 months (FU completed in 289 pts.), 41.5% of patients were still taking rivaroxaban. The remaining patients had a scheduled end of treatment (45.0%) or were switched to other anticoagulants (8.3%). Therefore, the rate of unplanned complete discontinuation at 12 months was 5.2%. After rivaroxaban interruption for more than 3 days or permanent discontinuation, 21 patients experienced a recurrent VTE (9 PE±DVT, 12 DVT) with a mean time between last intake of rivaroxaban and VTE recurrence of 351.2±282.6 days (range 7-926d). PE was a common manifestation of VTE recurrence and, despite numerically lower bleeding rates after discontinuation, 2 cases of intracranial haemorrhage occurred (table 2). Conclusions: In unselected patients in daily care, rivaroxaban treatment for acute VTE has high effectiveness and acceptable rates major bleeding. Initial dosing was according to label in over 90% of patients and, at 6 and 12 months, persistence to rivaroxaban therapy was excellent with low rates of unplanned complete discontinuation. Fatal VTE and fatal bleeding are rare events during rivaroxaban therapy and all-cause mortality is mostly related to underlying diseases, age or acute co-morbidities. Treatment discontinuation resulted in a relevant increase in VTE recurrence, of which more than 40% manifested as PE. In contrast, major bleeding rates declined after discontinuation but with 1%/year remained at a clinically relevant level, probably due to co-morbidities. Disclosures Marten: Bayer: Honoraria; Daichii Sankyo: Honoraria. Werth:Pfizer: Honoraria; Bayer: Honoraria; Boehringer Ingelheim: Honoraria; Daiichi Sankyo: Honoraria; OmniaMed: Honoraria; LEO-Pharma: Honoraria. Beyer-Westendorf:Pfizer: Consultancy, Honoraria, Research Funding; Boehringer Ingelheim: Consultancy, Honoraria, Research Funding; Daichii Sankyo: Consultancy, Honoraria, Research Funding; Bayer: Consultancy, Honoraria, Research Funding; LEO: Consultancy, Honoraria, Research Funding.

144 Background: In Germany specialised palliative care in outpatient setting is financed by health insurances since 2007. Home Care Sachsen e.V. is a specialised palliative care provider working with two palliative care teams including qualified nurses, physicians and social workers in closely cooperation with general practitioners and nursing services. We report about the results of our work in a rural area around Dresden in Saxony, Germany. Methods: Our data were collected prospectively with PalliDoc software. Results: Between 2011 – 2013 Home Care Sachsen e.V. served for 1,572 pts (888 m, 684 f); 93% with an oncologic disease. Median age was 71 y, Karnofsky index was 40%, median caring time 27 days. In this time, 25% of our pts had one stay in hospital, 8% two and 4% three and more. 63% had no stays in hospital. At least 1,271 pts. died: 65% at home; 9% in nursing homes and hospices; 15% in palliative care units and 11% in hospital. Conclusions: Mean home death rate of oncologic pts without intervention in Germany is about 44% (Papke J, Koch R: Places of Death from Cancer in a Rural Location. Onkologie (2007) 30, 105-08). This proportion could be enhanced considerably with outpatient palliative care. Providing of specialised palliative care with a multiprofessional team is effective to increase the rate of dying at home and to fulfill one of the strongest wishes of pts in a palliative situation.

Abstract Background : Bleeding is a common complication of oral anticoagulation (OAC). In anticoagulated women of child-bearing potential (WOCBP), increase of menstrual bleeding may be discomforting and severe cases of menorrhagia may require dedicated treatment or even discontinuation of OAC. Since hypermenorrhea seems to be more frequent in patients receiving direct oral anticoagulants (DOAC) compared to classic OAC with vitamin-K antagonists, patterns of menorrhagia need to be studied in daily care cohorts. Patients and methods: Using data from the prospective, non-interventional Dresden NOAC registry and phase-III DOAC trial patients at our site, we evaluated rates, severity and management of vaginal bleeding complications in WOCBP (defined as age ≤55 years and without sterilizing procedures or age >55 years with documented menstrual bleeding). All bleeding complications were centrally adjudicated and classified according to ISTH definition. Annualized rates of vaginal bleeding and hypermenorrhea were calculated as number of bleeding events divided by cumulative days of DOAC exposure divided by 365 days. OAC treatment satisfaction was assessed in all registry patients at every follow-up visit by a simple six-graded scale (ranging from 1=very satisfied to 6=very unsatisfied). To assess impact of vaginal bleeding on quality of live, the first available score after a vaginal bleeding was compared with the last available score of WOCBPs without vaginal bleeding. Results: Until March 31th 2015, 1343 women were enrolled, of which 154 were WOCBPs (mean age 39±12 years; range 14-56). In these patients, OAC consisted of dabigatran (1.3%), rivaroxaban (92.2%), apixaban (5.8%) or edoxaban (0.6%). During follow-up (mean FU duration 24.6 months), 85 female patients reported 107 vaginal bleeding complications, of which 68 occurred in 53 WOCBPs (53 cases of hypermenorrhea and 15 bleedings unrelated to cycle). Table 1 indicates severity of hypermenorrhea and vaginal bleedings unrelated to cycle. According to ISTH definition, 37/68 (54.4%) of the vaginal bleeding in WOCBPs were minor, 25/68 (36.8%) were non-major, clinically relevant (NMCR) and 6/68 (8.8%) major bleeding (classified as "major" due to drop of hemoglobin ≥2g/l in 5 cases and/or transfusion of ≥2 units of red blood cells in 5 cases). In relation to all exposed WOCBPs, the rate of vaginal bleeding events was found to be 0.41 events per exposure year and the rate of hypermenorrhea was found to be 0.32 events per exposure year (median exposure time 243d; 25th/75th percentile 105/674d and median time to first hypermenorrhea 26d; 25th/75th percentile 10/46d). Of the 53 WOCBPs that described vaginal bleeding complications (including hypermenorrhea and cycle-unrelated bleeding), 12/53 (22.6%) experienced a 2nd and 3/53 (5.7%) a 3rd event (figure 1). While bleeding intensity remained stable in most recurrent events, bleeding intensity increased in 6 cases with a 2nd bleeding episode while bleeding intensity remained stable or decreased in all 3 cases with a third episode. In only 16 of the 53 hypermenorrhea events, anatomical causes could be established and 3 of these cases progressed to major bleeding (necessity of at ≥2 units of red blood cells). In contrast, in the 34 hypermenorrhea events without anatomical causes, bleeding intensity was less severe (table 1). Surgical or interventional treatment was necessary in 6/68 (8.8%) vaginal bleeding events. The remaining 62 (91.2%) events were treated conservatively (start or change of hormone therapy, tranexamic acid, OAC dose reduction or temporary interruption). Overall, OAC treatment satisfaction in WOCBP was good (mean score 1.6; 25th/75th percentile 1/2 with data available for 98/154 WOCBPs) and not different in patients with and without vaginal bleeding complications (1.6; 25th/75th percentile 1/2 vs. 1.5; 1/2; p=0.548). Conclusion : Vaginal bleeding and especially hypermenorrhea is a common complication in WOCBPs receiving oral anticoagulation. Only a small proportion of affected patients have underlying anatomical causes for bleeding but these patients often develop more severe bleeding. The majority of cases can be conservatively managed and bleeding intensity rarely increases over time. Overall, the impact of vaginal bleeding complications on treatment satisfaction seems small. Disclosures Marten: Bayer HealthCare: Honoraria. Beyer-Westendorf:Pfizer: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding; Boehringer Ingelheim: Honoraria, Research Funding; Bayer HealthCare: Honoraria, Research Funding.

Abstract Background : Peripheral blood progenitor cells (PBPCs) are routinely applied worldwide for allogeneic related and unrelated stem cell transplantation. Factors influencing the mobilisation of PBPC’s in healthy donors are poorly understood. The database of the Apheresis Centre at the University of Dresden was evaluated to identify predictors of PBPC mobilisation. Methods : 4050 PBPC collections (3928 first donations, 122 second donations) of healthy unrelated donors between 1/1996 and 1/2008 were carried out according to a standardized protocol and prospectively documented in a database. Peripheral blood CD 34 counts were performed before each leukapheresis. CD 34 yield of every PBPC product was calculated in absolute numbers and per kg body weight of the recipient. All parameters are presented as median and range. Mann-Whitney test was performed for discrete variables. Correlation analysis by Pearson was applied for continuous variables. Multivariate regression analysis was carried out to detect factors independently predicting mobilization efficacy. Results : The range of peripheral CD 34+ haematopoietic stem cells obtained on day 5 was 8.7–285/μl (median 67.5/μl) in male and 6–282/μl, (median 51/μl) in female donors. The median CD 34 yield from the first leukapheresis was 5.88 ×108. Inadequate CD34-yields (< 2 × 106/kg) were obtained only in 18 donors (0.45%). Peripheral CD 34 count at day 5 is significantly correlated with (positive linear regression): BMI, baseline platelet count, male sex, G-CSF application (split dose), baseline leukocyte count. Peripheral CD 34 count at day 5 correlates negatively with: female sex, single dose G-CSF application, regular alcohol consumption and regular smoking status. Linear regression analyses revealed no significant influence of donor age. Multivariate correlation analysis included sex, BMI, baseline platelets, G-CSF-application, baseline leukocytes, age and smoking. This model explained 21.2 % of the variabilityA strong correlation exists between peripheral CD 34-counts at day 5 and apheresis yield (70% of the variability explained). Conclusions : A dose of 7.5 μg/kg/d lenograstim proved to be safe and effective in a large cohort of unrelated donors for mobilizing sufficient haematopoietic progenitor cells for allogeneic transplantation. Our analysis of 4050 donations revealed significant, but very weak correlations of the peripheral CD 34-counts with donor characteristics and life style parameters. No single parameter derived from donor baseline investigation reliably predicts CD 34 yield. Further evaluation of healthy donors including comprehensive genomic linkage analysis is necessary to elucidate the variable efficiency of PBPC mobilization

Abstract Background: The most common side effects of oral anticoagulants are bleeding complications. In large trials, direct oral anticoagulants (DOAC) have been shown to reduce the risk of major bleeding compared to warfarin. However, little is known about the management and outcome of survivors of major DOAC bleeding. Patients and methods: Using data from the prospective, non-interventional Dresden NOAC registry, we evaluated the management and outcome of survivors of major DOAC bleeding. All DOAC bleeding complications were centrally adjudicated and classified according to ISTH definition. For this analysis, every ISTH major bleeding was identified in the database and for each case, the first major bleeding was evaluated. Restart of oral anticoagulation (OAC) 30 days after major DOAC bleeding was assessed and the impact of restart on the composite endpoint of (recurrent major bleeding, stroke, TIA, systemic embolism, venous thromboembolism) or survival was evaluated using Kaplan-Meier time-to-first event estimation. Results: Until January 31th 2015, 2771 patients were enrolled into the registry (1898 treated with rivaroxaban, 525 apixaban and 348 dabigatran). During follow-up (mean follow-up duration 23.6 months) 127 patients developed 170 ISTH major bleeding events during DOAC exposure (drop of hemoglobin ≥2g/l in 106 (62.4%) cases, transfusion of ≥2 units of red blood cells in 105 (61.8%) cases, critical site bleeding in 43 (25.3%) cases and/or fatal outcome in 9 cases (5.3%)). Of the 127 patients with major bleeding (mean age 77±11 years; range 37-94), 53.5% were male the median HAS-BLED score was 2 (25th/75th percentile 1/2, range 0-5). The majority major bleeding events occurred spontaneously (64.6%). In contrast, 14.2% major bleeding events occurred after trauma and 21.3% occurred after surgical or interventional procedures that were performed during treatment or within 3 days after last DOAC intake. Most common sites of bleeding were gastrointestinal tract (37%), diffuse bleeding during or after surgery (15.7%), intracranial (11%), skin/mucosal (9.4%), intraocular (8.7%), genitourinary (7.9%), intraarticular bleeding (6.3%) and bleeding in other sites (4%). 85 cases lead on to a hospitalization (mean duration 9±7d) and 11 cases were managed as outpatient. The remaining 31 bleeding events occurred during a hospital stay. The majority of cases were managed with surgical or interventional treatment (55.9%; mainly endoscopic treatment for gastrointestinal bleeding. In 75 (57.1%) cases red blood cell transfusion was given and 11 (8.7%) of cases received fresh frozen plasma. Furthermore, 15 (11.8%) of cases received PCC and 4 (3.1%) fibrinogen. The restart of OAC (DOAC or vitamin K antagonists; VKA) was assessed at day 30 after major bleeding. While OAC was restarted in 80 patients (63%) it was not restarted 30 days after bleeding in the remaining 47 (37%). Patients who restarted OAC had a similar mean age (76 vs. 78y, p=0.309) and a similar mean HAS-BLED score (1.8 vs. 2.1, p=0.115) compared to patients who did not restart OAC. During follow up after bleeding (mean follow-up duration 15.2 months), the rate of combined endpoint of recurrent major bleed and thromboembolism was significantly lower in patients that restarted OAC compared to those who did not restart (14.7/100 patient years; 95%-CI 8.0-24.7 vs. 38.6/100 patient years; 21.1-64.7; p=0.0342). All-cause mortality was found to be 23.9/100 patient years (95% CI 16.9-32.8). Mortality was significantly lower in patients that restarted OAC compared to those who did not restart (16.4/100 patient years [9.7-25.9] vs. 40.6/100 patient years [24.8-62.7]; p=0.0099). Most common cause of death was fatal cardiovascular event (12/38, 31.6%) and fatal bleeding (9/38, 23.7%) followed by terminal malignant disease (6/38, 15.8%), infection/sepsis (6/38, 15.8%) and age related death (5/38, 13.2%). Conclusion: Even in cases with major DOAC bleeding, acute mortality is low with a case-fatality rate of 5.3%. Furthermore, OAC is restarted within 30 days after major bleeding in only 63%. Patients who restarted OAC had significantly lower rates of the combined endpoint of thromboembolism or recurrent major bleeding and had a significantly better survival. Therefore, benefits of OAC continuation may outweigh the risks even in patients with major DOAC-related bleeding. Figure 1. Figure 1. Figure 2. Figure 2. Disclosures Marten: Bayer HealthCare: Honoraria. Beyer-Westendorf:Bayer HealthCare: Honoraria, Research Funding; Boehringer Ingelheim: Honoraria, Research Funding; Bristol- Myers Squibb: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding.

This study investigated the effect of weaning age on carcass characteristics of crossbred piglets reared up to 70 kg body weight (BW) under intensive system. A total of 24 piglets were used in a completely randomized design. The experiment comprised three treatments: piglets weaned at 21, 28, and 35 days of age with four replicates each with two piglets (castrate and female). At 70 kg BW two piglets (castrate and female) were randomly selected from each replicate and sacrificed for carcass evaluation. Hot carcass weight (HCW) was measured and thereafter dressing out percentage was calculated. Carcasses were chilled at 7 0C for 24 hours to determine cold dressed weight (CDW). Carcasses were cut into the left and right halves along the median line. The left half of the carcass was used to measure carcass length (CRLTH), average backfat depth and longissimus muscle area (LMA) at the 10th rib, while the right half of the carcass was physically dissected into bone, muscle and fat and thereafter tissue ratios calculated. Longissimus muscle was removed at the 10th and 11th ribs from the left half of the carcass for chemical composition analysis. Data were analysed using General Linear Model. Weaning age had no influence (p > 0.05) on HCW, dressing percentage, CDW, CRLTH, average backfat thickness, average backfat depth, LMA and carcass lean percentage. No significant differences (p > 0.05) were observed on average percentages of bone, muscle and fat tissue and their tissue ratios. Weaning age did not influence (p > 0.05) moisture, protein, fat and ash contents of the meat. In addition, weaning age had no (p > 0.05) effect on carcass characteristics, physical and chemical body composition of meat. These results indicate that piglets can be weaned at 21, 28 and 35 days of age without detrimental effects on carcass characteristics, physical and chemical body composition of pork.

Abstract Introduction In both partial thickness burns and skin graft donor sites, coverage with Polylactide-based copolymer dressing (PLBC dressing) has been shown to result in expedited healing and improved pain outcomes when compared to more traditional techniques. These advantages are generally attributed to the way in which PLBC remains as an intact coating over the wound bed throughout the healing process, protecting wounds from the contamination and microtraumas associated with changes more conventional dressings. At our institution, we began selectively utilizing PLBC as a means of securing and protecting fresh skin graft, in hopes that we would find similar benefits in this application. Methods Clinical Protocol-- The PLBC dressing was used at the attending surgeon’s discretion. In these cases, meshed STSG was placed over prepared wound beds. Staples were not utilized. PLBC dressing was then placed over the entirety of the graft surface, securing graft in place by adhering to wound bed through intercises. (Staples were not used.) The graft and PLBC complex was further dressed with a layer of non-adherent cellulose based liner with petroleum based lubricant, and an outer layer of cotton gauze placed as a wrap or bolster. Post operatively, the outer layer (“wrap”) of gauze was replaced as needed for saturation. The PLBC and adherent “inner” liner were left in place until falling off naturally over the course of outpatient follow-up. Retrospective Review-- With IRB approval, patients treated PLBC over STSG between April 2018 to March 2019 were identified via surgeon’s log and pulled for review. Documentation gathered from operative notes, progress notes (inpatient and outpatient) and clinical photography was used to identify demographics, mechanism of injury, depth, total body surface area percentage (TBSA%), size of area treated with PLBC dressing, graft loss, need for re-grafting, signs of wound infection, antibiotic treatment, and length of stay. Results Twenty-two patients had STSG secured and dressed with PLBC. Median patient age was 36.5 years. Median TBSA was 5.1%, and median treated area 375 cm2. Follow up ranged from 21 to 232 days post-operatively, with two patients lost to follow up. All patients seen in outpatient follow up were noted to have “complete graft take” or “minimal” graft. None of the areas treated with PLBC dressing required re-grafting. There were no unplanned readmissions, and no wound infections were diagnosed or treated. Practitioners in in-patient setting and in follow up clinic reported satisfaction with the PLBC dressing. Conclusions The PLBC dressing was a feasible solution for securing and dressings STSGs. Future work is needed to determine whether its use is associated with an improvement in patient outcomes.

Cadmium (Cd) concentrations in 1663 liver, 1779 kidney and 2526 muscle samples were measured in a residue survey organised by the Australian Bureau of Rural Science at meatworks throughout Australia. Cadmium concentrations in livers and kidneys were also determined in sheep ranging in age from newly born to 112 months of age which had been grazed throughout life at high or low stocking rates on an improved pasture dressed annually with superphosphate. Concentrations of Cd in the residue survey averaged (with median) 0.30 (0.11), 0.96 (0.28) and 0.03 (0.01) mg/kg freshweight in ovine liver, kidney and muscle respectively; the corresponding values in cattle were 0.18 (0.08), 0.65 (0.24) and 0.03 (0.01) mg/kg. Concentrations in liver and kidney were greater in older than in younger animals, at high than at low stocking rates, and in South and Western Australia than in other States. Cadmium concentrations increase with age because ruminants are born with a low Cd burden, and much of the Cd ingested and absorbed thereafter is retained as Cd-metallothionein in the liver and kidney. It is postulated that differences in Cd levels between geographical regions, species and stocking rate are partially due to the consumption of soil that had been fertilised with superphosphate containing Cd. Hepatic and renal Cd concentrations were highly correlated and were assumed to reflect Cd intake; correlations with copper concentrations were generally small. Eight per cent of kidneys exceeded maximum permissible Cd concentrations for human consumption (2.5 mg/kg), but only 2% of liver and 1% of muscle samples exceeded the statutory maxima (1.25 and 0.2 mg/kg respectively).

Abstract Abstract 357 Introduction: Molecular predictors for treatment outcome after allogeneic hematopoietic stem cell transplantation (HSCT) of MDS and AML patients are limited. Recently, mutations in the splicing gene machinery have been described as frequent aberrations in MDS. The aim of this study was to investigate the prognostic impact of mutations in the splicing genes U2AF1, SRSF2 and SF3B1 in a large cohort of patients with high risk MDS or secondary AML following MDS (sAML) undergoing allogeneic HSCT. Patients and Methods: Patients (n=339) with a diagnosis of MDS (50.1%) or sAML (49.9%) who received allogeneic HSCT at four German university medical centers (Dresden, Düsseldorf, Hamburg and Hannover) between 1996 and 2011 and for whom genomic DNA was available from a time when the disease was active, were evaluated for the presence of mutations in the splicing genes U2AF1, SRSF2, and SF3B1 by direct sequencing. Results: Median follow up from time of transplantation was 3.27 years. Median patient age at time of HSCT was 58 years (range 19–74). 74 patients (21.8%) were in complete remission and 265 patients (78.2%) had active disease before transplantation. Low, intermediate, and high risk cytogenetics according to IPSS were found in 204 (60.2%), 42 (12.4%), and 76 (22.4%) patients, respectively (in 5% cytogenetic information was not available). Related donor HSCT was performed in 82 patients (24.2%), and unrelated donor HSCT in 257 patients (75.8%). Myeloablative preparative regimens were used in 51 patients (15%), and a non-myeloablative regimen was given to 288 patients (85%). Mutations in U2AF1, SRSF2 and SF3B1 were detected in 14 (4.1%), 32 (9.4%) and 18 (5.3%) patients, respectively. SRSF2 and SF3B1 mutations co-occured in two patients, while the other patients had not more than one mutation in the investigated genes. Baseline characteristics were similarly distributed between U2AF1, SRSF2, or SF3B1 mutated and wildtype patients, respectively (sex, MDS vs sAML, cytogenetics, CMV status of patient, type of previous treatment, and remission status prior to transplantation), except a higher median age of U2AF1 mutated compared to wildtype patients (P=.02). There were no differences regarding transplant-related characteristics between patients with mutated or wildtype U2AF1, SRSF2, and SF3B1 (reduced intensity vs standard conditioning, GvHD prophylaxis, donor age, donor sex, CMV and HLA compatibility between recipient and donor). U2AF1 mutations were associated with a significantly shorter overall survival (OS, median 0.58 vs 3.6 years in mutated vs wildtype patients, respectively, HR 2.54; 95%CI 1.41–4.58; P=.002). The cumulative incidence of relapse (CIR) was higher in U2AF1 mutated compared to wildtype patients (3-year CIR 50% vs 22%, P=.002), while non-relapse mortality (NRM) was similar between mutated and wildtype patients (3-year NRM 43% vs 29%, P=.11). Mutations in SRSF2 and SF3B1 were not associated with OS (P=.98 and P=.44, respectively), CIR (P=.19 and P=.19, respectively), and NRM (P=.49 and P=.44, respectively). In multivariate analysis, when considering variables with P<.15 in univariate analysis (age above or below 55 years, karyotype, stage [MDS vs sAML], CMV serostatus of patient, donor type [related vs unrelated], donor sex), U2AF1 mutations independently predicted shorter OS (HR 2.6; 95%CI 1.39–4.85; P=.011) besides karyotype, stage, CMV serostatus, and donor sex. Mutations in U2AF1 independently predicted higher CIR in multivariate analysis (HR 3.02, 95% CI 1.36–6.7, P=.007). The rates of acute and chronic GvHD were similar in U2AF1 mutated and wildtype patients. Summary: U2AF1 mutations independently predicted worse patient outcome after allogeneic HSCT in MDS and sAML patients in our study due to a higher incidence of relapse. The U2AF1 mutation status may become useful to identify patients at high-risk for relapse after transplantation independent of established prognostic factors. Disclosures: Platzbecker: GlaxoSmithKline: Honoraria, Research Funding.

Ende November war es endlich so weit, in der medien@age wurde in einem neuen Bereich die bisherige Computerspielstation wiedereröffnet, ausgestattet mit PCs, Konsolen und Bildschirmen für PS3 und Wii, mit einer gesicherten Fläche für die bewegungs-intensiven Sportspiele und vielseitigem Zubehör wie Tischtennisschlägern, Lenkrädern, einem Balance-Board und sogar einer Tanzmatte. Der gesamte Bestand an PC- und Konsolenspielen fand hier seinen neuen Standort.

Shao, die Mondfee, schwebt durch den Raum, um den Ninja-Kämpfer Naruto zu treffen. Zwei unzertrennliche Katzendamen umschmeicheln Emma, das zarte Dienstmädchen aus viktorianischer Zeit. Unter den wachsamen Augen einer Krankenschwester im Minikleid versucht der Vampir vergeblich, sich zwischen Bücherregalen zu verstecken... In eine so eigenwillige wie faszinierende Szenerie kann man nicht nur auf der Buchmesse geraten. Seit November 2008 begegnen sich diese Charaktere auch ab und zu in der medien@age. Die Manga-Lounge, ein neu gestalteter Teilbereich der Dresdner Jugendbibliothek, ist zum Magneten für Fans japanischer, koreanischer und chinesischer Comic- Serien geworden.

There is a kind of perceptual-imaginative experience we have when we watch screen-based fictions. In such situations it is natural to think of ourselves as “watching Robin Hood” rather than as watching Errol Flynn dressed as Robin Hood. Screen-based fictions are not the only fictions that allow this kind of experience but they encourage it in ways that theatrical dramas cannot quite match, while still photographs do a poor job in this regard. This chapter offers an explanation of this kind of experience, partly by reference to features of the screen medium and partly by reference to aspects of human perceptual-cognitive architecture. The architectural story will tell us something about imagination that reflection on the phenomenology of imaginative experience fails to disclose. The resulting picture may also help us to understand certain kinds of delusions.

This book is an introduction to quantum optics for students who have studied electromagnetism and quantum mechanics at an advanced undergraduate or graduate level. It provides detailed expositions of theory with emphasis on general physical principles. Foundational topics in classical and quantum electrodynamics, including the semiclassical theory of atom-field interactions, the quantization of the electromagnetic field in dispersive and dissipative media, uncertainty relations, and spontaneous emission, are addressed in the first half of the book. The second half begins with a chapter on the Jaynes-Cummings model, dressed states, and some distinctly quantum-mechanical features of atom-field interactions, and includes discussion of entanglement, the no-cloning theorem, von Neumann’s proof concerning hidden variable theories, Bell’s theorem, and tests of Bell inequalities. The last two chapters focus on quantum fluctuations and fluctuation-dissipation relations, beginning with Brownian motion, the Fokker-Planck equation, and classical and quantum Langevin equations. Detailed calculations are presented for the laser linewidth, spontaneous emission noise, photon statistics of linear amplifiers and attenuators, and other phenomena. Van der Waals interactions, Casimir forces, the Lifshitz theory of molecular forces between macroscopic media, and the many-body theory of such forces based on dyadic Green functions are analyzed from the perspective of Langevin noise, vacuum field fluctuations, and zero-point energy. There are numerous historical sidelights throughout the book, and approximately seventy exercises.

The research project "COVID 19 LL Lessons Learned", funded by the German Federal Ministry of Education and Research (BMBF), aims to identify successful solutions and measures that emerged in three different German regions through a systematic analysis during the pandemic. The regions under consideration are Bavaria (TU Munich), North Rhine-Westphalia (RWTH Aachen) and Saxony (TU Dresden). The aim of the project is to identify the problems that companies and organisations are facing and what they have learned from the change process so far. In this way, it is to be determined whether innovative and digital forms of work that have emerged as a result of the pandemic can provide positive impulses that can prove their worth in the working world in the medium and long term. One of the issues under consideration is the change in competence requirements due to the pandemic-related change in work organisation. The following human-technology-organisation process model was used for the project work.

Free/Open Source software (FOSS) has made Enterprise Resource Planning (ERP) systems more accessible for Small and Medium Enterprises (SMEs) including overseas subsidiaries of large companies. However, the consulting required to configure an ERP to meet the specific needs of an organization remains a major financial and organizational burden for SMEs. Automatic ERP package configuration based on knowledge engineering, machine learning and data mining could be a solution to lessen the burden of the implementation process. This chapter presents two approaches to an automation of selected configuration options of the FOS-ERP package ERP5. These approaches are based on knowledge engineering with decision trees and machine learning with classifiers. The design of the ERP5 Artificial intelligence Toolkit (EAT) aims at the integration of these approaches into ERP5. The chapter also shows how FOS-ERP can boost Information System (IS) research. The investigation of the automation approaches was only possible because the free source code and technical documentation of ERP5 was accessible for TU Dresden researchers.

In the summer of 2015, the government of Uttar Pradesh began putting out advertisements looking for “peons”—the local term for low-ranking office helpers. UP, as the state is known, is home to more than 200 million Indians, packed into an area about the size of Texas (which has one-seventh as many inhabitants). Fittingly, UP needed a small army of new peons: in all, 368 jobs were posted. A very strange thing happened next. Applications poured in. After a painstaking survey that took weeks, 2.3 million résumés were counted. There were 6,250 candidates for each available position. Some of the applicants had doctorates. While peon jobs are stable—even respectable—they are by no means glamorous. Peons are usually the first people one sees at Indian government offices, dressed in shabby, faded khaki uniforms; their work involves tracking down dusty files, fetching tea, and ushering in guests. Salaries range from just $150 to $250 a month. The question is why these low-skill, low-paying jobs were in such high demand. There are several possible explanations. First, $250 a month may sound like a pittance, but it is not insignificant: it amounts to nearly double the median national salary. Second, peons are influential gatekeepers in Indian bureaucracy. If you need to see a local officer, a small bribe can go a long way. But workplace corruption is hardly something young, idealistic Indians aspire to (let alone the ones with doctorates). Something deeper was going on. A third possibility is that India simply isn’t creating enough jobs. A 2016 report by the United Nations Development Programme (UNDP) revealed that India’s working-age population expanded by 300 million between 1991 and 2013. But during those same twenty-two years, the UNDP says, the economy created just 140 million new jobs. Put another way, 160 million working-age Indians were without formal employment. Job creation is the number one headache for India’s policymakers. By some estimates, India needs to create a million new jobs every month simply to keep pace with the gush of new entrants to the workforce. There is little evidence that India has a plan to meet this demand.