[Pilot study: evaluation of manual methods for modulating the cardinal symptom tinnitus : A prospective randomized study]. / Pilotstudie: manualmedizinische Methodenevaluation zur Modulierbarkeit des Leitsymptoms Tinnitus : Eine prospektive randomisierte Studie.

BACKGROUND: Tinnitus and vertigo have been studied in many ways. This led to a variety of explanations from multiple medical disciplines. The musculature of the jaw and cervical spine have also been researched in this regard. Dysfunctional musculature can trigger tinnitus and dizziness. This subtype of tinnitus is called cervicogenic somatosensory tinnitus. OBJECTIVE: The aim of the present study was to investigate the effect of manual therapy on subject-reported, individually perceived impairment due to cervicogenic somatosensory tinnitus (Tinnitus Handicap Inventory), dizziness (Dizziness Handicap Inventory), and hypertonia of the musculature of the head and cervical spine. MATERIALS AND METHODS: In a prospective randomized trial, 80 patients (40 in the intervention group/40 in the control group) were medically examined and interviewed. Afterwards, they received targeted manual therapy. RESULTS: After manual therapy, there were significant differences in the Tinnitus Handicap Inventory, Dizziness Handicap Inventory, and muscular hypertonia between the groups, all in favor of the intervention group. CONCLUSION: Manual examination and therapy proved to be effective. It should be increasingly applied in the absence of ENT pathology and suspected cervicogenic somatosensory tinnitus. The role of individual muscles requires further investigation.

The best from East and West? Acupuncture and medical training therapy as monotherapies or in combination for adult patients with episodic and chronic tension-type headache: study protocol for a randomized controlled trial.

BACKGROUND: This study aims to evaluate the feasibility and efficacy of a complex health intervention, based on the combination of conventional Western medicine and traditional Chinese medicine (TCM), in an outpatient department of a university hospital for patients with frequent episodic or chronic tension-type headaches. METHODS/DESIGN: This is a prospective randomized controlled pilot study with four balanced treatment arms (usual care, acupuncture, training, and training plus acupuncture). Each arm will have 24 patients. After the initial screening examination and randomization, a 6-week treatment period follows, with treatment frequencies decreasing at 2-week intervals. After completion of the intervention, two follow-up evaluations will be performed 3 and 6 months after the start of treatment. At predefined times, the various outcomes (pain intensity, health-related quality of life, pain duration, autonomic regulation, and heart rate variability) as well as the participants' acceptance of the complex treatment will be evaluated with valid assessment instruments (Migraine Disability Assessment, PHQ-D, GAD-7, and SF-12) and a headache diary. The acupuncture treatment will be based on the rules of TCM, comprising a standardized combination of acupuncture points and additional points selected according to individual pain localization. The training therapy comprises a combination of strength training, endurance training, and training to improve flexibility and coordination. Besides descriptive analyses of the samples, their comparability will be assessed using an analysis of variance (ANOVA) or chi-squared tests. Analyses will be performed on an intention-to-treat basis. Potential interaction effects will be calculated using a repeated-measures ANOVA to test the primary and secondary hypotheses. In supplementary analyses, the proportion of treatment responders (those with a 50% reduction in the frequency of pain episodes) will be determined for each treatment arm. DISCUSSION: This trial may provide evidence for the additive effects of acupuncture and medical training therapy as a combination treatment and may scientifically support the implementation of this complex health intervention. TRIAL REGISTRATION: Registered on 11 Feburary 2019. German Clinical Trials Register, DRKS00016723.

[Determinants for the Access to Follow-Up Rehabilitation Concerning Cardiological Patients after Surgery]. / Einflussfaktoren des Zugangs in die Anschlussrehabilitation (AHB) von operativ versorgten kardiologischen Patienten.

OBJECTIVE: The aim was to analyze individual and environmental factors influencing the access to follow-up rehabilitation of cardiological patients after surgery. METHODS: An exploratory, cross-sectional study without intervention was conducted. A standardized questionnaire was used for data collection in two acute care clinics at cardiological and cardiosurgical wards. Multivariate logistic regression was used to measure the influence of different factors on the access to follow-up rehabilitation. In 61.0% of the patients a follow-up rehabilitation was granted. RESULTS: 210 patients were included. The average age was 52.1 years, 81.0% were male. There were significant differences between the groups with and without follow-up rehabilitation concerning age (p=0.018), sex (p=0.007), the PAREMO-scales "Änderungsbereitschaft" (p=0.011) and "Skepsis" (p=0.005) and the aim of rehabilitation to learn skills in dealing with the disease (p=0.043). The Barthel-Index was not significant different between the two groups. The chance to get a follow-up rehabilitation was significantly increased by indications corresponding to the "AHB-Indikationskatalog" (p=0.001; OR=5.76) and after request of the patients to get a follow-up rehabilitation (p<0.001; OR=17.91). DISCUSSION: The access to follow-up rehabilitation was predominantly indication-specific and depended on patients' request of cardiological patients after surgery. A follow-up rehabilitation requires an adequate rehabilitation capacity (Barthel-Index). However the effect of the Barthel-Index on the access to follow-up rehabilitation was not significant. CONCLUSION: It is still in question, to what extent the personal patient's wish can be linked to parameters of rehabilitation capacity. Furthermore it is necessary to develop concepts which increase the influence of rehabilitation capacity on the decision of a follow-up rehabilitation.

[Musculoskeletal-related chest pain]. / Muskuloskeletal bedingter Thoraxschmerz.

BACKGROUND: Approximately 10-50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions. AIM: This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy. METHODS: A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out. RESULTS AND CONCLUSION: Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain. Inflammatory diseases, such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus are much less common but are more severe conditions and therefore have to be diagnosed and treated. The diagnostics and treatment often necessitate interdisciplinary approaches. Chest pain caused by musculoskeletal diseases always represents a diagnosis by exclusion of other severe diseases of the heart, lungs and stomach. Physiotherapeutic and physical treatment measures are particularly important, including manual therapy, transcutaneous electrical stimulation and stabilization exercises, especially for functional myofascial disorders.

All-optical phase modulation in a cavity-polariton Mach-Zehnder interferometer.

Quantum fluids based on light is a highly developing research field, since they provide a nonlinear platform for developing optical functionalities and quantum simulators. An important issue in this context is the ability to coherently control the properties of the fluid. Here we propose an all-optical approach for controlling the phase of a flow of cavity-polaritons, making use of their strong interactions with localized excitons. Here we illustrate the potential of this method by implementing a compact exciton-polariton interferometer, which output intensity and polarization can be optically controlled. This interferometer is cascadable with already reported polariton devices and is promising for future polaritonic quantum optic experiments. Complex phase patterns could be also engineered using this optical method, providing a key tool to build photonic artificial gauge fields.

Realization of a double-barrier resonant tunneling diode for cavity polaritons.

We report on the realization of a double-barrier resonant tunneling diode for cavity polaritons, by lateral patterning of a one-dimensional cavity. Sharp transmission resonances are demonstrated when sending a polariton flow onto the device. We show that a nonresonant beam can be used as an optical gate and can control the device transmission. Finally, we evidence distortion of the transmission profile when going to the high-density regime, signature of polariton-polariton interactions.

K→(ππ)(I=2) decay amplitude from lattice QCD.

We report on the first realistic ab initio calculation of a hadronic weak decay, that of the amplitude A(2) for a kaon to decay into two π mesons with isospin 2. We find ReA(2)=(1.436±0.063(stat)±0.258(syst))10(-8) GeV in good agreement with the experimental result and for the hitherto unknown imaginary part we find ImA(2)=-(6.83±0.51(stat)±1.30(syst))10(-13) GeV. Moreover combining our result for ImA(2) with experimental values of ReA(2), ReA(0), and ε'/ε, we obtain the following value for the unknown ratio ImA(0)/ReA(0) within the standard model: ImA(0)/ReA(0)=-1.63(19)(stat)(20(syst)×10(-4). One consequence of these results is that the contribution from ImA(2) to the direct CP violation parameter ε' (the so-called Electroweak Penguin contribution) is Re(ε'/ε)(EWP)=-(6.52±0.49(stat)±1.24(syst))×10(-4). We explain why this calculation of A(2) represents a major milestone for lattice QCD and discuss the exciting prospects for a full quantitative understanding of CP violation in kaon decays.

Simultaneous interferometric measurement of corrosive or demineralizing bacteria and their mineral interfaces.

Here, we report simultaneous surface profile measurements of several bacterial species involved in microbially influenced corrosion and their solid-surface interfaces by using vertical scanning interferometry. The capacity to nondestructively quantify microscale topographic changes beneath a single bacterium without its removal offers a unique opportunity to examine in vivo microbe-surface interactions.

In search of the microbe/mineral interface: quantitative analysis of bacteria on metal surfaces using vertical scanning interferometry.

To understand the development of biofilms on metal surfaces, analysis of initial bacterial attachment to surfaces is crucial. Here we present the results of a study, using Shewanella oneidensis MR-1 as a model organism, in which vertical scanning interferometry (VSI) was used to investigate the initial stages of cell attachment to glass, steel and aluminium surfaces. It was found that while VSI gave unambiguous results with opaque surfaces, when reflective surfaces were used, an artifact sometimes appeared, with the bacteria appearing as rod-shaped pits rather than as cells on the surface. When the bacteria were altered to increase opacity, this artifact disappeared, and upon further investigation, it was found that the observational artifact was the result of a conflict between light reflected from the bacteria and the light reflected from the bacteria-metal interface. These results suggest that not only can bacteria be measured on surfaces using VSI, but with some modifications to the analytical software, there may be a unique window for studying the bacterial/substrate interface that can be used for quantitative observations. Imaging and characterization of the bacteria-substrate interface in vivo (previously invisible) will provide new insights into the interactions that occur at this important juncture.

Four-loop QCD corrections to the electroweak rho parameter.

The four-loop QCD corrections to the electroweak rho parameter arising from top and bottom quark loops are computed. Specifically we evaluate the missing "nonsinglet" piece. Using algebraic methods the amplitude is reduced to a set of around 50 new master integrals which are calculated with various analytical and numerical methods. The inclusion of the newly completed term halves the final value of the four-loop correction for the minimally renormalized top-quark mass. The predictions for the shift of the weak mixing angle and the W-boson mass are thus stabilized.

In-medium effects on phase space distributions of antikaons measured in proton-nucleus collisions.

Differential production cross sections of K+/- mesons have been measured in p + C and p + Au collisions at 1.6, 2.5, and 3.5 GeV proton beam energy. At beam energies close to the production threshold, the K- multiplicity is strongly enhanced with respect to proton-proton collisions. According to microscopic transport calculations, this enhancement is caused by two effects: the strangeness exchange reaction NY --> K- NN and an attractive in-medium K- N potential at saturation density.

Observation of different azimuthal emission patterns of K+ and of K- mesons in heavy-ion collisions at 1-2 A GeV.

Azimuthal distributions of pi+, K+, and K- mesons have been measured in Au+Au reactions at 1.5A GeV and Ni+Ni reactions at 1.93 A GeV. In semicentral collisions at midrapidity, pi+ and K+ mesons are emitted preferentially perpendicular to the reaction plane in both collision systems. In contrast for K- mesons in Ni+Ni reactions, an in-plane elliptic flow was observed for the first time at these incident energies.

Diagnosis of impaired glucose tolerance in hypertensive patients in daily clinical practice.

Many patients with hypertension suffer from impaired glucose tolerance or type 2 diabetes mellitus. Although these diagnoses are generally simple and reliable, it is more difficult to diagnose impaired glucose tolerance. As the gold standard (oral glucose tolerance test (OGTT)) is complicated to perform, a simpler alternative would be useful. The aims of the Pre-Diabetes Score study are to correlate demographic and/or laboratory parameters that are clinically simple to determine with the results of the OGTT and to determine the diagnostic significance of the combinations of parameters with regard to impaired glucose tolerance. A total of 260 patients were included in the evaluation; 39% had impaired glucose tolerance and 12% had diabetes mellitus. A combination of HbA1c of > or =6%, a venous fasting glucose of > or =110 mg/dl, an age of > or =55 years, a systolic blood pressure of > or =140 mmHg and an enlarged waist size is highly predictive of impaired glucose tolerance.

First evidence for different freeze-out conditions for kaons and antikaons observed in heavy-ion collisions.

Differential production cross sections of K- and K+ mesons have been measured in Ni+Ni and Au+Au collisions at a beam energy of 1.5 A GeV. The K(-)/K(+) ratio is found to be nearly constant as a function of the collision centrality and system size. The spectral slopes and the polar emission pattern differ for K- and K+ mesons. These observations indicate that K+ mesons decouple earlier from the fireball than K- mesons.

Coulomb dissociation of 8B and the low-energy cross section of the 7Be(p,gamma)8B solar fusion reaction.

An exclusive measurement of the Coulomb breakup of 8B into 7Be+p at 254A MeV allowed the study of the angular correlations of the breakup particles. These correlations demonstrate clearly that E1 multipolarity dominates and that E2 multipolarity can be neglected. By using a simple single-particle model for 8B and treating the breakup in first-order perturbation theory, we extract a zero-energy S factor of S17(0)=18.6+/-1.2+/-1.0 eV b, where the first error is experimental and the second one reflects the theoretical uncertainty in the extrapolation.

Acridizinium salts as a novel class of DNA-binding and site-selective DNA-photodamaging chromophores.

It was demonstrated that the interaction of the aminoacridizinium salts 2a-2d with DNA depends on the substitution pattern of the chromophore. Spectrophotometric and fluorometric titrations of the acridizinium salts 2a-2d with natural and synthetic polynucleotides reveal that the degree of interaction of the acridizinium salts 2a-2d with the nucleic acid differs significantly. The binding mode of the dyes with DNA was evaluated by circular dichroism and linear dichroism spectroscopy and compared with the parent system 2c. Whereas the 9-aminoacridizinium (2a) mainly intercalates into DNA, the salts 2b-c show a higher degree of association to the DNA backbone. The intercalated aminoacridizinium 2a caused few strand breaks upon UVA exposure, whereas the salts 2b-2d exhibit relatively efficient DNA-damaging properties. All acridizinium salts showed a sequence-selective strand cleavage for guanine-rich DNA regions.

Structurally related immunological effects of triterpenoid saponins.

The influence of the triterpenoid saponins 1-10 has been investigated on murine spleenocytes in the lymphocyte transformation test and on murine macrophages in an phagocytosis assay. The lymphocyte transformation test and the phagocytosis assay showed that the tested compounds have no stimulating effect. However, a significant inhibition of lymphocyte proliferation by the triterpenoid saponins 2, 6 and 10 was demonstrated.

The push-and-pull mechanism to scavenge redox-active transition metals: a novel concept in myocardial protection.

OBJECTIVE: Traces of redox-active transition metals such as iron and copper play an important role in free radical formation during postischemic reperfusion of the heart. Two studies were conducted to assess the efficacy of the complexes of desferrioxamine with zinc or gallium to prevent this aspect of reperfusion injury. METHODS: In study I, isolated working rat hearts (n = 96) were subjected to 2 hours of hypothermic arrest at 10 degrees C induced by use of St Thomas' Hospital cardioplegic solution II supplemented with desferrioxamine, zinc-histidinate, zinc-desferrioxamine, gallium-nitrate, or gallium-desferrioxamine. In study II, isolated nonworking rat hearts (n = 23) were subjected to normothermic regional (10 minutes) or global (35 minutes) unprotected ischemia. In this study, the perfusate was supplemented with gallium-desferrioxamine during preischemic and postischemic periods. RESULTS: In study I, the addition of desferrioxamine, zinc-histidinate, or gallium-nitrate to St Thomas' Hospital solution II improved postischemic aortic flow recovery. When the binary complexes zinc-desferrioxamine or gallium-desferrioxamine were added, however, functional recovery was further enhanced significantly. In study II, high-performance liquid chromatography analyses of tissue from postischemic hearts exposed to unsupplemented perfusate revealed a marked increase of malondialdehydes. In hearts perfused with perfusate supplemented with gallium-desferrioxamine, however, tissue malondialdehyde concentrations were significantly smaller, indicating reduced free radical formation. CONCLUSIONS: The data suggest synergistic protection by the complexes of the iron chelator desferrioxamine with zinc or gallium. The single components neutralize transition metals by 2 different but complementary push-and-pull mechanisms, thereby leading to an inhibition of metal-mediated site-specific free radical formation and improvement of postischemic cardiac function.