Engrailed 1 deficiency induces changes in ciliogenesis during human neuronal differentiation.

A key pathological feature of Parkinson's Disease (PD) is the progressive degeneration of dopaminergic neurons (DAns) in the substantia nigra pars compacta. Considering the major role of EN1 in the development and maintenance of these DAns and the implications from En1 mouse models, it is highly interesting to study the molecular and protective effect of EN1 also in a human cellular model. Therefore, we generated EN1 knock-out (ko) human induced pluripotent stem cell (hiPSCs) lines and analyzed these during neuronal differentiation. Although the EN1 ko didn't interfere with neuronal differentiation and generation of tyrosine hydroxylase positive (TH+) neurons per se, the neurons exhibited shorter neurites. Furthermore, mitochondrial respiration, as well as mitochondrial complex I abundance was significantly reduced in fully differentiated neurons. To understand the implications of an EN1 ko during differentiation, we performed a transcriptome analysis of human neuronal precursor cells (hNPCs) which unveiled alterations in cilia-associated pathways. Further analysis of ciliary morphology revealed an elongation of primary cilia in EN1-deficient hNPCs. Besides, also Wnt signaling pathways were severely affected. Upon stimulating hNPCs with Wnt which drastically increased EN1 expression in WT lines, the phenotypes concerning mitochondrial function and cilia were exacerbated in EN1 ko hNPCs. They failed to enhance the expression of the complex I subunits NDUFS1 and 3, and now displayed a reduced mitochondrial respiration. Furthermore, Wnt stimulation decreased ciliogenesis in EN1 ko hNPCs but increased ciliary length even further. This further highlights the relevance of primary cilia next to mitochondria for the functionality and correct maintenance of human DAns and provides new possibilities to establish neuroprotective therapies for PD.

Simplifying radiologic reports with natural language processing: a novel approach using ChatGPT in enhancing patient understanding of MRI results.

PURPOSE: The aim of this prospective cohort study was to assess the factual accuracy, completeness of medical information, and potential harmfulness of incorrect conclusions by medical professionals in automatically generated texts of varying complexity (1) using ChatGPT, Furthermore, patients without a medical background were asked to evaluate comprehensibility, information density, and conclusion possibilities (2). METHODS: In the study, five different simplified versions of MRI findings of the knee of different complexity (A: simple, B: moderate, C: complex) were each created using ChatGPT. Subsequently, a group of four medical professionals (two orthopedic surgeons and two radiologists) and a group of 20 consecutive patients evaluated the created reports. For this purpose, all participants received a group of simplified reports (simple, moderate, and severe) at intervals of 1 week each for their respective evaluation using a specific questionnaire. Each questionnaire consisted of the original report, the simplified report, and a series of statements to assess the quality of the simplified reports. Participants were asked to rate their level of agreement with a five-point Likert scale. RESULTS: The evaluation of the medical specialists showed that the findings produced were consistent in quality depending on their complexity. Factual correctness, reproduction of relevant information and comprehensibility for patients were rated on average as "Agree". The question about possible harm resulted in an average of "Disagree". The evaluation of patients also revealed consistent quality of reports, depending on complexity. Simplicity of word choice and sentence structure was rated "Agree" on average, with significant differences between simple and complex findings (p = 0.0039) as well as between moderate and complex findings (p = 0.0222). Participants reported being significantly better at knowing what the text was about (p = 0.001) and drawing the correct conclusions the more simplified the report of findings was (p = 0.013829). The question of whether the text informed them as well as a healthcare professional was answered as "Neutral" across all findings. CONCLUSION: By using ChatGPT, MRI reports can be simplified automatically with consistent quality so that the relevant information is understandable to patients. However, a report generated in this way does not replace a thorough discussion between specialist and patient.

[CF Lung Disease - a German S3 Guideline: Pseudomonas aeruginosa]. / S3-Leitlinie: Lungenerkrankung bei Mukoviszidose ­ Pseudomonas aeruginosa.

Cystic Fibrosis (CF) is the most common autosomal recessive genetic multisystemic disease. In Germany, it affects at least 8000 people. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the airway epithelial lining fluid which leads to reduction of the mucociliary clearance.Even if highly effective, CFTR modulator therapy has been available for some years and people with CF are getting much older than before, recurrent and chronic infections of the airways as well as pulmonary exacerbations still occur. In adult CF life, Pseudomonas aeruginosa (PA) is the most relevant pathogen in colonisation and chronic infection of the lung, leading to further loss of lung function. There are many possibilities to treat PA-infection.This is a S3-clinical guideline which implements a definition for chronic PA-infection and demonstrates evidence-based diagnostic methods and medical treatment in order to give guidance for individual treatment options.

Ion-molecule reactions in the HBr+ + HCl (DCl) system: a combined experimental and theoretical study.

Reactions in the system HBr+ + HCl (DCl) were investigated inside a guided ion-beam apparatus under single-collision conditions. In the HBr+ + HCl system, the proton transfer (PTHCl) and charge transfer (CT) are observable. In the HBr+ + DCl system, proton transfer (PTDCl) and deuterium abstraction (DA) are accessible. The cross sections for all reaction channels were measured as a function of the collision energy Ecm and of the rotational energy Erot of the ion. The rotationally state-selective formation of the ionic species was realized by resonance-enhanced multiphoton ionization (REMPI). As expected, the PT-channels are exothermic, and the cross section decreases with increasing collision energy for both PTHCl and PTDCl. The cross section for DA also decreases with an increasing Ec.m.. In the case of a considerably endothermic CT-channel, the reaction efficiency increases with increasing collision energy but has an overall much smaller cross sections compared to PT and DA reactions. Both PT-reactions are hindered by ion rotation, whereas DA is independent of Erot. The CT-channel shows a rotational enhancement near the thermochemical threshold. The experiment is complemented by theory, using ab initio molecular dynamics (AIMD, also known as direct dynamics) simulations and taking the rotational enhancement of HBr+ into account. The simulations show good agreement with the experimental results. The cross section of PTHCl decreases with an increase of the rotational energy. Furthermore, the absolute cross sections are in the same order of magnitude. The CT channel shows no reactions in the simulation.

[Specific Workloads among Employees with a Migration Background in Nursing and Geriatric Care: A Systematic Review]. / Spezifische Arbeitsbelastungen bei Mitarbeitenden mit Migrationshintergrund in der Kranken- und Altenpflege: Ein systematisches Review.

BACKGROUND: Multimorbidity, increasing numbers of chronically ill patients and demographic change are leading to increased care costs in Germany with an increasing shortage of staff in skilled nursing and geriatric care. In this context, more and more caregivers with a migration background of the 1st generation (PmMH) are being recruited and integrated into existing (corporate) cultures. This represents an important starting point for a permanent and needs-based supply landscape. THE AIM OF THE STUDY: The aim of the study was to identify and analyze the specific stresses of PmMH at the workplace in nursing and geriatric care MATERIAL AND METHODS: A systematic literature search was carried out in relevant specialist databases (Pubmed, PsychInfo, Web of Science, Cochrane), supplemented by an extended snowball and hand search. This was followed by a descriptive presentation of the results of the study content, which in a subsequent step was iteratively brought together and consolidated into thematic categories by several people. RESULTS: A total of 15 publications were identified as relevant and included in the analysis. Specific, migration-associated stress factors could be identified. In particular, the categories: "Discrimination and racism", "Language and communication problems" and "Cultural adjustment" characterized the (collaborative) work in nursing and care for the elderly and led to additional stress for employees and patients. DISCUSSION: The present review article identified and summarized specific burdens of PmMH. At this point it can be assumed that these affect both PmMH and patients. So far, operational concepts do not seem to be able to adequately solve the challenges, so that effective, sustainable approaches have to be found. The extent to which the specificed stress factors only affect PmMH is not considered in this context, so that further research is needed.

[Strengthening the Role of Public Health Service: a Comparison of the Public Health Service Quota Selection Procedures in Germany]. / Die Rolle des Öffentlichen Gesundheitsdiensts stärken ­ ein Vergleich der ÖGD-Quotenauswahlverfahren in Deutschland.

To combat the shortage of skilled workers in the Public Health Service sector, the federal states of Bavaria, Hesse, Rhineland-Palatinate, and Saxony-Anhalt have a study placement system for students of Public Health Service. A comparison of the selection procedures showed that three out of the four federal states (Bavaria, Hesse, and Rhineland-Palatinate) used a two-step procedure. In the second step, eligibility for was determined based on interviews to assess social and communication skills as well as personal aptitude of the applicants to study and work in the Public Health Service. To find out whether the role of the Public Health Service and public health care is strengthened by the quotas, a nationwide comparison of the selection procedures including evaluation is necessary.

[On the Effectiveness of Digital Workplace Health Promotion in Times of Home Office: A Systematic Review]. / Zur Wirksamkeit der digitalen betrieblichen Gesundheitsförderung in Zeiten von Home-Office: Eine systematische Übersichtsarbeit.

BACKGROUND: In the face of an increasingly aging, multimorbid, chronically ill workforce, company health promotion (BGF) is an important instrument for promoting and maintaining the health of employees in the workplace. Due to digitization and the increasing possibilities of working from home, digital offers for workplace health promotion (dBGF) are being used increasingly in organizations. The portfolio of offers ranges from fitness trackers, online platforms, and health apps to so-called wearables, so that a broad, individual selection is possible for both organizations and employees. THE AIM OF THE STUDY: The aim of the study was to identify and analyze randomized controlled trials (RCT) with regard to the health-promoting effectiveness of dBGF. MATERIAL AND METHODS: A systematic literature search was carried out in relevant specialist databases (PubMed, Livivo, Cochrane Library). The identified studies were selected, evaluated and then descriptively presented by several people systematically and independently. RESULTS: 17 relevant contributions could be identified and analyzed. Above all, measures to promote physical activity and programs to improve mental health were identified in the RCT studies that were carried out. The results of the studies carried out indicate that dBGF can promote health in a variety of ways and support organizations in providing a health-promoting working environment. DISCUSSION: The effectiveness of dBGF could be proven on the basis of the studies identified, whereby the effects are undoubtedly influenced and determined by the employees, above all by their health competence. In order to ensure the long-term effectiveness of dBGF, it will be necessary in the future to increase the interest and motivation of employees with regard to personal health promotion and illness prevention.

[Cognitive and Non-Cognitive, Doctor-Relevant Competencies for the Selection of Prospective Country Doctors in Bavaria: Corona-Compliant Selection Process Across Institutes]. / Kognitive und nicht-kognitive, arztrelevante Kompetenzen zur Auswahl angehender Landärzt*innen in Bayern: Institutsübergreifendes Corona-konformes Auswahlverfahren.

OBJECTIVE: The challenge is to counteract the undersupply of doctors in rural areas in Bavaria. As one possibility, the "Country Doctor Quota" measure provides for the allocation of dedicated medical study places for prospective specialists with general practice activities. A specific selection process for future medical students was established and safely implemented under the safety and hygiene conditions of the corona pandemic. METHOD: In Bavaria, a two-stage selection process was developed and used in full for the first time in 2021 for the selection of students. Due to the corona pandemic, only the results of stage 1 of the process for the selection of prospective students were taken into account in the previous year. Cognitive and non-cognitive criteria were included in a 2-stage selection process. In the second stage, physician-relevant competencies (e. g. resilience, problem-solving ability, empathy and compassion, communication skills, ethical decision-making, as well as consulting and social skills) were assessed by Bavarian family doctors in four multiple mini interviews and a 10-minute, semi-structured individual interview. A maximum of 100 points could be achieved. A digital, contact-free selection process was established and successfully implemented to ensure protection and hygiene conditions in the context of the interviews. RESULTS: A total of 436 people applied as part of the Bavarian country doctor quota for the 2021/2022 winter semester; 226 applicants were invited to the selection interviews at the second stage, of which 115 applicants received a place at the university. 64% of the participants had already completed medical vocational training, the high school graduation grade average was 2.4. CONCLUSION: The developed selection process identified applicants as part of the Bavarian country doctor quota and selected using objective criteria. All available medical study places were filled with the 115 finally selected applicants. To what extent the selected applicants (can) counteract the impending shortage of prospective specialists with general practitioner work remains to be seen.

Analysis and 3D correction of glenoid dysplasia with metal hemi-wedge base plate augment: short-term radiographic outcomes.

BACKGROUND: Glenoid defects can be addressed traditionally by asymmetric reaming or by bone-preserving correction to a more lateral joint line by bone or metal augmented baseplates in reverse shoulder arthroplasties. While there is more evidence in literature regarding the outcome and complications of Bony Increased Offset Reversed Shoulder Arthroplasty (BIO-RSA), there is minimal reported experience with the outcome after metal glenoid augments. The aim of this study was to determine whether a metal augment can correct the glenoid deformity in an anatomic manner. METHODS: Glenoid morphology and deformity were determined in 50 patients with Walch type B1, B2, D and Favard type E0-E3 glenoid defects using preoperative radiographic and computed tomography (CT) analysis. All patients received a preoperative planning CT with 3D planning, and measurements of glenoid inclination (in 3 planes proximal, middle, distal), reversed shoulder arthroplasty angle (RSA) and glenoid version were obtained. All patients had a pathologic inclination in the coronal or frontal planes of > 10°. Above the threshold of 10° pathological glenoid version or inclination metal hemi-augments of 10°, 20°, or 30° were used which allow an individual 360° augment positioning according to the patient glenoid deformity. RESULTS: The mean preoperative numbers of the glenoid version demonstrate that most glenoids were in retroversion and superior inclination. In total 2410° wedges, 1820° wedges and 8 30° wedges were used. In the majority of cases, the wedge was positioned posteriorly and/or cranially between 10:00 and 12:00 o'clock, which allows a correction in a 3D manner of the glenoid inclination and version. The mean RSA angle could be corrected from 22.76 ± 6.06 to 0.19° ± 2.7 (p < 0.0001). The highest retroversion of the glenoid is evidenced in the proximal section and it could be corrected from - 23.32° ± 4.56 to - 6.74° ± 7.75 (p < 0.0001) and in the middle section from - 18.93° ± 3.35 to - 7.66° ± 5.28 (p < 0.0001). A mean sphere bone overhang distance (SBOD) of 5.70 ± 2.04 mm was found in order to avoid or minimize relevant scapular notching. CONCLUSION: By using a new 360° metal-augmented baseplate, the preoperative pathological inclination and retroversion can be corrected without medialization of the joint line. Future clinical results will show whether this bone-preserving procedure improves also the clinical outcomes as compared to asymmetric medialized reaming or wedged BIO-RSA. LEVEL OF EVIDENCE: Level IV, Case series.

Galectin network in osteoarthritis: galectin-4 programs a pathogenic signature of gene and effector expression in human chondrocytes in vitro.

Galectin-4 (Gal-4) is a member of the galectin family, which have been identified as galactose-binding proteins. Gal-4 possesses two tandem repeat carbohydrate recognition domains and acts as a cross-linking bridge in sulfatide-dependent glycoprotein routing. We herein document its upregulation in osteoarthritis (OA) in correlation with the extent of cartilage degradation in vivo. Primary human OA chondrocytes in vitro respond to carbohydrate-inhibitable Gal-4 binding with the upregulation of pro-degradative/-inflammatory proteins such as interleukin-1ß (IL-1ß) and matrix metalloproteinase-13 (MMP-13), as documented by RT-qPCR-based mRNA profiling and transcriptome data processing. Activation of p65 by phosphorylation of Ser536 within the NF-κB pathway and the effect of three p65 inhibitors on Gal-4 activity support downstream involvement of such signaling. In 3D (pellet) cultures, Gal-4 presence causes morphological and biochemical signs of degradation. Taken together, our findings strongly support the concept of galectins acting as a network in OA pathogenesis and suggest that blocking their activity in disease progression may become clinically relevant in the future.

Mn12 -Acetate Complexes Studied as Single Molecules.

The phenomenon of single molecule magnet (SMM) behavior of mixed valent Mn12 coordination clusters of general formula [MnIII 8 MnIV 4 O12 (RCOO)16 (H2 O)4 ] had been exemplified by bulk samples of the archetypal [MnIII 8 MnIV 4 O12 (CH3 COO)16 (H2 O)4 ] (4) molecule, and the molecular origin of the observed magnetic behavior has found support from extensive studies on the Mn12 system within crystalline material or on molecules attached to a variety of surfaces. Here we report the magnetic signature of the isolated cationic species [Mn12 O12 (CH3 COO)15 (CH3 CN)]+ (1) by gas phase X-ray Magnetic Circular Dichroism (XMCD) spectroscopy, and we find it closely resembling that of the corresponding bulk samples. Furthermore, we report broken symmetry DFT calculations of spin densities and single ion tensors of the isolated, optimized complexes [Mn12 O12 (CH3 COO)15 (CH3 CN)]+ (1), [Mn12 O12 (CH3 COO)16 ] (2), [Mn12 O12 (CH3 COO)16 (H2 O)4 ] (3), and the complex in bulk geometry [MnIII 8 MnIV 4 O12 (CH3 COO)16 (H2 O)4 ] (5). The found magnetic fingerprints - experiment and theory alike - are of a remarkable robustness: The MnIV 4 core bears almost no magnetic anisotropy while the surrounding MnIII 8 ring is highly anisotropic. These signatures are truly intrinsic properties of the Mn12 core scaffold within all of these complexes and largely void of the environment. This likely holds irrespective of bulk packing effects.

Length doesn't play a role - Sexual activity in men after short stem Total hip Arthroplasty.

BACKGROUND: Chronic hip pain due to osteoarthritis or hip dysplasia has been shown to negatively affect many daily life aspects. One aspect, however, which persists underestimated is sexual health. The number of total hip arthroplasties (THA) are increasing, especially in young patients who have high functional expectations, not only to pain relief, but to an increase in hip mobility and quality of life as well as sexual activity. AIM: (1) to report the demographic factors, (2) the sexual activity before and after THA, as well as the concerns related to sexual activity after THA and (3) the patient-reported outcome measurements (PROMs) in sexually active male patients. METHODS: We evaluated the results of patients between 18 and 65 years of age following primary cementless short femoral stem THA using a direct anterior approach (DAA) at a midterm follow-up of 4 years. A web-based questionnaire (via SurveyMonkey) was chosen to assess frequency, positions, complaints, fears, dealing with the questions and PROMs. Our patients sexual activity was via The Sexual Health Inventory for Men (SHIM) validated. RESULTS: Patients resumed their sexual activities after 6 weeks. The two main causes of difficulty in sexual activity before surgery were pain and limitation of the range of motion of the hip joint. Patients experienced less pain and an improvement in hip range of motion after THA. 89% of patients expressed a desire for more detailed and specific information on the subject. The patients foremost concern about muscle weakness, surgical scar or fear of dislocation. After 4 years follow-up our patients presented a significant improvement of the modified Harris Hip Score (mHHS) from 34.1 preoperative to 92.6 after THA. CONCLUSION: THA improves the quality in sexual life, in relation to less pain and improvement in the range of motion, but not in the frequency of sexual activity. Men's sexual positions required less mobility and could therefore be considered safer.

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry.

BACKGROUND: Pelvic fractures are often associated with spine injury in polytrauma patients. This study aimed to determine whether concomitant spine injury influence the surgical outcome of pelvic fracture. METHODS: We performed a retrospective analysis of data of patients registered in the German Pelvic Registry between January 2003 and December 2017. Clinical characteristics, surgical parameters, and outcomes were compared between patients with isolated pelvic fracture (group A) and patients with pelvic fracture plus spine injury (group B). We also compared apart patients with isolated acetabular fracture (group C) versus patients with acetabular fracture plus spine injury (group D). RESULTS: Surgery for pelvic fracture was significantly more common in group B than in group A (38.3% vs. 36.6%; p = 0.0002), as also emergency pelvic stabilizations (9.5% vs. 6.7%; p < 0.0001). The mean time to emergency stabilization was longer in group B (137 ± 106 min vs. 113 ± 97 min; p < 0.0001), as well as the mean time until definitive stabilization of the pelvic fracture (7.3 ± 4 days vs. 5.4 ± 8.0 days; p = 0.147). The mean duration of treatment and the morbidity and mortality rates were all significantly higher in group B (p < 0.0001). Operation time was significantly shorter in group C than in group D (176 ± 81 min vs. 203 ± 119 min, p < 0.0001). Intraoperative blood loss was not significantly different between the two groups with acetabular injuries. Although preoperative acetabular fracture dislocation was slightly less common in group D, postoperative fracture dislocation was slightly more common. The distribution of Matta grades was significantly different between the two groups. Patients with isolated acetabular injuries were significantly less likely to have neurological deficit at discharge (94.5%; p < 0.0001). In-hospital complications were more common in patients with combined spine plus pelvic injuries (groups B and D) than in patients with isolated pelvic and acetabular injury (groups A and C). CONCLUSIONS: Delaying definitive surgical treatment of pelvic fractures due to spinal cord injury appears to have a negative impact on the outcome of pelvic fractures, especially on the quality of reduction of acetabular fractures.

Treatment of acquired patella baja by proximalization tibial tubercle osteotomy significantly improved knee joint function but overall patient-reported outcome measures remain diminished after two to four years of follow-up.

INTRODUCTION: Acquired patella baja is often characterized by painful limitation of knee joint range of motion and anterior knee pain (AKP). Only few studies have evaluated the effectiveness of surgical treatment in terms of patient-reported outcome measures (PROM's) and sports activity. Thus, the goal of this study was to assess PROM's and sports activity after proximalization tibial tubercle osteotomy (P-TTO) in patients with symptomatic patella baja. METHODS: Between 2016 and 2018, a case series of 11 patients (male/female 4/7; age 48 ± 12 years) were treated by P-TTO and were retrospectively evaluated after a mean of 33.7 months (range 24-51 months). The Tegner activity score and the Kujala anterior knee pain scale were used in addition to a visual analogue scale (VAS; 0-10) regarding self-reported knee joint function and intensity of AKP. Radiographic assessment included the measure of patellar height using the Caton-Deschamps (CD) and Blackburne-Peel (BP) index. RESULTS: Postoperatively both the CD and the BP index increased to normality (p < 0.0001; p = 0.0012). Knee joint flexion improved from 100 ± 32° preoperatively to 123 ± 14° postoperatively (p = 0.0235). AKP decreased from 6.5 ± 2.1 points preoperatively to 3.7 ± 2.1 points postoperatively (p = 0.0061). This was accompanied by a significant increase in self-reported knee joint function from 1.8 ± 1.2 points preoperatively to 6.8 ± 2.3 points postoperatively (p = 0.0001) and an increase of the Tegner activity score from 1.8 ± 1.6 points preoperatively to 3.9 ± 1.5 points postoperatively (p = 0.0074). Although the Kujala score improved significantly by an average of 31.55 points (p = 0.001) overall score results remained reduced at 65.6 ± 17.9 points at final follow-up. CONCLUSION: P-TTO yielded significant improvements in terms of AKP, subjective knee joint function and sports activity. However, the overall Kujala score results remained reduced, indicating that surgical correction of patellar height is not sufficient to relieve all patients' complaints. In addition, the incidence of postoperative complications was high.

[Chronobiological interventions for prevention and treatment of delirium in critically ill patients]. / Chronobiologische Interventionen zur Prävention und Therapie von Delirien bei Intensivpatienten.

Circadian body and behavior rhythms serve to coordinate and maintain the physiological processes in the human body. A disruption of these rhythms frequently occurs in intensive care patients and can be the cause for the development of delirium. This review article discusses the underlying pathophysiological mechanisms and develops a chronobiologically oriented prevention and treatment approach for delirium in the context of intensive care medicine.

[Light Therapy for Prevention of Delirium in Critically Ill Patients: What's the Evidence?] / Lichttherapie zur Delirprävention bei Intensivpatienten: Was sagt die Evidenz?

Circadian dysrhythmia affects the majority of ICU patients and has far-reaching effects on organ functioning. At the level of the central nervous system, circadian misalignment facilitates executive cognitive dysfunction and the development of ICU delirium. The pathophysiological mechanisms, especially in the cohort of critically ill patients, appear to be complex, multilayered and far from understood. Results from preliminary research indicate that multidimensional, patient-specific chronotherapeutic concepts developed specifically for the ICU setting may help improve the healing process of patients. Circadian lighting therapy might be a promising intervention in this context.

Fresh Extraction of the Proton Charge Radius from Electron Scattering.

We present a novel method for extracting the proton radius from elastic electron-proton (ep) scattering data. The approach is based on interpolation via continued fractions augmented by statistical sampling and avoids any assumptions on the form of function used for the representation of data and subsequent extrapolation onto Q^{2}≃0. Applying the method to extant modern ep datasets, we find that all results are mutually consistent and, combining them, we arrive at r_{p}=0.847(8) fm. This result compares favorably with values obtained from contemporary measurements of the Lamb shift in muonic hydrogen, transitions in electronic hydrogen, and muonic deuterium spectroscopy.

Perioperative Outcomes of Transurethral Resection, Open Prostatectomy, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruction: A "Real-World" Data Analysis from the URO-Cert Prostate Centers.

INTRODUCTION: The aim of the study is to compare length of hospital stay, transfusion rates, and re-intervention rates during hospitalization for transurethral resection of the prostate (TUR-P), open prostatectomy (OP), and laser therapy (LT) for surgical treatment of benign prostatic obstruction (BPO). METHODS: URO-Cert is an organization, in which clinical data of prostatic diseases from 2 university, 19 public, and 3 private hospitals and 270 office-based urologists are collected in order to document treatment quality. Data on diagnostics, therapy, and course of disease are recorded web based. The analysis includes datasets from 2005 to 2017. RESULTS: Of 10,420 patients, 8,389 were treated with TUR-P, 1,334 with OP, and 697 with LT. Median length of hospital stay was 6 days (IQR: 4-7) for TUR-P, 9 days (IQR: 7-11) for OP, and 5 days (IQR: 4-6) for LT (p < 0.001). Risk for a hospital stay ≥7 days was higher for OP versus TUR-P (OR: 7.25; 95% CI = 6.27-8.36; p < 0.001) and LT (OR: 17.89; 95% CI = 14.12-22.65; p < 0.001) and higher for TUR-P versus LT (OR: 2.47; 95% CI = 2.03-3.01; p < 0.001). OP had a significantly higher risk for transfusions than TUR-P (OR: 2.44; 95% CI = 1.74-3.41; p < 0.001) and LT (OR: 3.32; 95% CI = 1.56-7.01; p < 0.001). Transfusion rates were not significantly different between TUR-P and LT (OR: 1.36; 95% CI = 0.66-2.79; p = 0.51). Risk of re-intervention was not different between all 3 approaches. CONCLUSION: OP was associated with higher transfusion rates and longer hospital stay than TUR-P and LT. Risk of transfusion was not different between TUR-P and LT, but TUR-P was inferior to LT concerning length of hospital stay. Re-intervention rates during hospitalization did not differ between the groups.

Epistemic Blame and the Normativity of Evidence.

The normative force of evidence can seem puzzling. It seems that having conclusive evidence for a proposition does not, by itself, make it true that one ought to believe the proposition. But spelling out the condition that evidence must meet in order to provide us with genuine normative reasons for belief seems to lead us into a dilemma: the condition either fails to explain the normative significance of epistemic reasons or it renders the content of epistemic norms practical. The first aim of this paper is to spell out this challenge for the normativity of evidence. I argue that the challenge rests on a plausible assumption about the conceptual connection between normative reasons and blameworthiness. The second aim of the paper is to show how we can meet the challenge by spelling out a concept of epistemic blameworthiness. Drawing on recent accounts of doxastic responsibility and epistemic blame, I suggest that the normativity of evidence is revealed in our practice of suspending epistemic trust in response to impaired epistemic relationships. Recognizing suspension of trust as a form of epistemic blame allows us to make sense of a purely epistemic kind of normativity the existence of which has recently been called into doubt by certain versions of pragmatism and instrumentalism.

Chicken lens development: complete signature of expression of galectins during embryogenesis and evidence for their complex formation with α-, ß-, δ-, and τ-crystallins, N-CAM, and N-cadherin obtained by affinity chromatography.

The emerging multifunctionality of galectins by specific protein-glycan/protein interactions explains the interest to determine their expression during embryogenesis. Complete network analysis of all seven chicken galectins (CGs) is presented in the course of differentiation of eye lens that originates from a single type of progenitor cell. It answers the questions on levels of expression and individual patterns of distribution. A qualitative difference occurs in the CG-1A/B paralogue pair, underscoring conspicuous divergence. Considering different cell phenotypes, lens fiber and also epithelial cells can both express the same CG, with developmental upregulation for CG-3 and CG-8. Except for expression of the lens-specific CG (C-GRIFIN), no other CG appeared to be controlled by the transcription factors L-Maf and Pax6. Studying presence and nature of binding partners for CGs, we tested labeled galectins in histochemistry and in ligand blotting. Mass spectrometric (glyco)protein identification after affinity chromatography prominently yielded four types of crystallins, N-CAM, and, in the cases of CG-3 and CG-8, N-cadherin. Should such pairing be functional in situ, it may be involved in tightly packing intracellular lens proteins and forming membrane contact as well as in gaining plasticity and stability of adhesion processes. The expression of CGs throughout embryogenesis is postulated to give meaning to spatiotemporal alterations in the local glycome.