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Search Results: 1 - 10 of 31131 matches for " Thomas Bruckner "
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Lifestyles and Their Impact on Energy-Related Investment Decisions  [PDF]
Maria Gr?ger, Victoria Schmid, Thomas Bruckner
Low Carbon Economy (LCE) , 2011, DOI: 10.4236/lce.2011.22014
Abstract: This paper presents an empirical survey of energy-related investment decisions made by private households in Germany. The investment behaviour is segmented and discussed by applying the milieu approach. The decision makers are clustered in certain lifestyles, as represented by the Sinus-Milieus® from the Sinus Institute. To analyse the relationship between the lifestyles of house owners and their energy-related investment decisions, telephone interviews were conducted in order to acquire data on currently installed heating systems and preferences for future heating systems in private residential buildings. The results of the survey support the hypothesis of a link between lifestyles and the energy-related investment behaviour. Based on the observed relationship between lifestyles and decisions on energy technologies, predictions of energy trends in private residential buildings can be improved. In addition, the knowledge about specific development paths allows the utilisation of the information for information campaigns and the promotion of energy supply technologies which lead to lower CO2-emissions.
Isometric muscle training of the spine musculature in patients with spinal bony metastases under radiation therapy
Harald Rief, Alexandra D Jensen, Thomas Bruckner, Klaus Herfarth, Jürgen Debus
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-482
Abstract: This study is a prospective, randomized, monocentre, controlled explorative intervention study in the parallel-group design to determine the multidimensional effects of a course of exercises at first under physiotherapeutic instruction and subsequently performed by the patients independently for strengthening the paravertebral muscles of patients with metastases of the vertebral column parallel to their percutaneous radiotherapy. On the days of radiation treatment the patients in the control group shall be given physical treatment in the form of respiratory therapy and the so-called "hot roll". The patients will be randomized into one of the two groups: differentiated muscle training or physiotherapy with thirty patients in each group.The aim of the study is to evaluate the feasibility of the training programme described here. Progression-free and fracture-free survival, improved response to radiotherapy by means of bone density, and clinical parameters such as pain, quality of life, and fatigue constitute secondary study objectives.ClinicalTrials.gov: NCT01409720Osseous metastatic involvement of the spinal column affects many patients with a primary tumour disease of all entities. In many cases this involvement is indicative of a progressed stage of a primary malignant disease. 70 percent of all patients who die of the sequelae of the tumour disease exhibit bone metastases [1]. 80 percent of all osseous metastases originate from mammary, prostatic, bronchial, renal-cell, or thyroid carcinomas [2]. In men, the primary tumour in 60 percent of all cases is a carcinoma of the prostate [3], among women, it is in 70 percent of the cases a mammary carcinoma. 30 percent of all metastases of the skeletal system and ten percent of all primary bone tumours are found in the spinal column. The former are located in the lumbar (52%), thoracic (36%) and cervical column (12%) [4]. The consequences are pain both at rest and under exertion, impairments in going about day-to-day acti
Acceptance of oral chemotherapy in breast cancer patients - a survey study
Sarah Schott, Andreas Schneeweiss, Judith Reinhardt, Thomas Bruckner, Christoph Domschke, Christof Sohn, Michael H Eichbaum
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-129
Abstract: A specific 14 item-questionnaire was designed. Patients suffering from breast cancer receiving a newly launched p.o. or i.v. chemotherapy treatment were prospectively evaluated during 4 months of time. 224 questionnaires using descriptive statistics, chi-square test, Spearman correlation were evaluated.Patients' median age was 54 years, 164 received i.v., 60 p.o therapy. 89% with p.o. and 67% with i.v. regimens would choose p.o. over i.v. therapy, if equal efficacy is guaranteed. Significant differences were especially found in terms of personal benefit (55% i.v., 92% p.o.), reduced feeling of being ill due to p.o. treatment (26% i.v., 65% p.o.), better coping with disease due to p.o. therapy (36% i.v., 68% p.o.). Side effects were significantly less often reported under p.o. treatment (19% p.o. vs. 53% i.v.)P.o. chemotherapy shows a high acceptance in MBC patients under palliative therapy. Compliance can be achieved in particular through a differentiated indication, patient education and competent support along a p.o. treatment.Breast cancer is the leading neoplastic malignancy among women worldwide affecting one in 8 women [1]. Its incidence is steady and so is the number of patients under therapy with a chronic metastatic disease [2,3]. Therefore, the search for new innovative chemotherapeutic standards is ongoing. On the one hand, facing the demand to develop new drugs with higher antitumor activity and lower systemic toxicity [3]. On the other hand aiming to find drugs that control cancer as a chronic process and match requirements of a convenient long term application with high quality of life [4-6]. Conventional anticancer chemotherapy is dominated by complex intravenous (i.v.) regimes which affect patients' life considerably [7-9]. Not only the substantial amount of time spent for the treatment as such places a major burden on patients but also the frequent placement of indwelling catheters and its associated fears or severe complications [10-12]. Thus, the
Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial
Christoph Bartl, Dirk Stengel, Thomas Bruckner, Inga Rossion, Steffen Luntz, Christoph Seiler, Florian Gebhard
Trials , 2011, DOI: 10.1186/1745-6215-12-84
Abstract: Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting.ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent monitoring institute, and a data safety monitoring board. Following approval by the institutional review boards of all participating centers, conduct and reporting will strictly adhere to national and international rules, regulations, and recommendations (e.g., Good Clinical Practice, data safety laws, and EQUATOR/CONSORT proposals)To our knowledge, ORCHID is the first multicenter RCT designed to assess quality of life and functional outcomes following operative treatment compared to conservative treatment of complex, intra-articular fractures of the distal radius in elderly patients. The results are expected to influence futur
Clustering in surgical trials - database of intracluster correlations
Jonathan A Cook, Thomas Bruckner, Graeme S MacLennan, Christoph M Seiler
Trials , 2012, DOI: 10.1186/1745-6215-13-2
Abstract: Intracluster correlation coefficients (ICCs) were calculated for outcomes from a set of 10 multicentre surgical trials for a range of outcomes and different time points for clustering at both the centre and surgeon level.ICCs were calculated for 198 outcomes across the 10 trials at both centre and surgeon cluster levels. The number of cases varied from 138 to 1370 across the trials. The median (range) average cluster size was 32 (9 to 51) and 6 (3 to 30) for centre and surgeon levels respectively. ICC estimates varied substantially between outcome type though uncertainty around individual ICC estimates was substantial, which was reflected in generally wide confidence intervals.This database of surgical trials provides trialists with valuable information on how to design surgical trials. Our data suggests clustering of outcome is more of an issue than has been previously acknowledged. We anticipate that over time the addition of ICCs from further surgical trial datasets to our database will further inform the design of surgical trials.Patients under the care of the same surgeon will be influenced in a similar manner due to the surgeon's practice, skill and experience [1]. Outcomes for those treated by the same surgeon tend to be more similar than those under the care of another surgeon due to previous experience, individual practice, training, and infrastructure [2]. This phenomenon is referred to as the clustering effect. While the impact of clustering of outcome has been widely acknowledged for cluster randomised controlled (C-RCTs) trials for some time [1,3,4], its potential impact upon individually randomised controlled trials (RCTs) evaluating therapist dependent interventions, such as surgical interventions, has only been highlighted more recently [1,5]. Models which allow for clustering have been used to analyse surgical trials though this is not commonly done [2,6-8].Clustering has implications for the required sample size of a RCT; the impact depends upon th
Decision-Making and Georgia's Perpetual Revolution: The Case of IDP Housing
Till Bruckner
Caucasian Review of International Affairs , 2009,
Abstract: Observers tend to enthuse about Georgia’s leadership or damn it, but such black-and-white views do little to explain what is really going on in the country. Examining the government’s recent efforts to provide housing to those internally displaced by the August 2008 conflict with Russia sheds light not only on the housing program itself, but on contemporary Georgian politics in general. In particular, four traits characteristic of the ruling United National Movement’s revolutionary governance are brought into focus: informal decision-making, fluid roles, heroic action, and vanguard politics.
A Model Structure On The Category Of Small Acyclic Categories
Roman Bruckner
Mathematics , 2015,
Abstract: In this paper, we show that the Thomason model structure restricts to a Quillen equivalent cofibrantly generated model structure on the category of acyclic categories, whose generating cofibrations are the same as those generating the Thomason model structure. To understand the Thomason model structure, we need to have a closer look at the (barycentric) subdivision endofunctor on the category of simplicial sets. This functor has a well known right adjoint, called Kan's Ex functor. Taking the subdivision twice and then the fundamental category yields a left adjoint of an adjunction between the category of simplicial sets and the category of small categories, whose right adjoint is given by applying the Ex functor twice on the nerve of a category. This adjunction lifts the cofibrantly generated Quillen model structure on simplicial sets to a cofibrantly generated model structure on the category of small categories, the Thomason model structure. The generating sets are given by the image of the generating sets of the Quillen model structure on simplicial sets under the aforementioned adjunction. We furthermore show that the category of acyclic categories is proper and combinatorial with respect to said model structure. That is weak equivalences behave nicely with respect to pushouts along fibrations and cofibrations, and cofibrations satisfy certain smallness conditions which allow us to work with sets instead of proper classes.
Limitations of the MELD score in predicting mortality or need for removal from waiting list in patients awaiting liver transplantation
Daniel Gotthardt, Karl Weiss, Melanie Baumg?rtner, Alexandra Zahn, Wolfgang Stremmel, Jan Schmidt, Thomas Bruckner, Peter Sauer
BMC Gastroenterology , 2009, DOI: 10.1186/1471-230x-9-72
Abstract: Data sets of 268 consecutive patients listed for single-organ liver transplantation for nonfulminant liver disease between 2003 and 2005 were included into the study. The Model for End-Stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores of all patients at the time of listing were used for calculation. The predictive ability not only for mortality on the waiting list but also for the need for withdrawal from the waiting list was calculated for both scores. The Mann-Whitney-U Test was used for the univariate analysis and the AUC-Model for discrimination of the scores.In the univariate analysis comparing patients who are still on the waiting list and patients who died or were removed from the waiting list due to poor conditions, the serum albumin, bilirubin INR, and CTP and MELD scores as well as the presence of ascites and encephalopathy were significantly different between the groups (p < 0.05), whereas serum creatinine and urea showed no difference.Comparing the predictive abilities of CTP and MELD scores, the best discrimination between patients still alive on the waiting list and patients who died on or were removed from the waiting list was achieved at a CTP score of ≥9 and a MELD score of ≥14.4. The sensitivity and specificity to identify mortality or severe deterioration for CTP was 69.0% and 70.5%, respectively; for MELD, it was 62.1% and 72.7%, respectively. This result was supported by the AUC analysis showing a strong trend for superiority of CTP over MELD scores (AUROC 0.73 and 0.68, resp.; p = 0.091).The long term prediction of mortality or removal from waiting list in patients awaiting liver transplantation might be better assessed by the CTP score than the MELD score. This might have implications for the development of new improved scoring systems.Liver transplantation (LTx) provides the only curative treatment option with excellent long-term results in patients with decompensated cirrhosis of the liver [1]. The Child-Turcotte-Pugh (CTP) sco
Endothelin receptor antagonist and airway dysfunction in pulmonary arterial hypertension
Annette S Droste, David Rohde, Mirko Voelkers, Arthur Filusch, Thomas Bruckner, Mathias M Borst, Hugo A Katus, F Joachim Meyer
Respiratory Research , 2009, DOI: 10.1186/1465-9921-10-129
Abstract: In 32 IPAH-patients (19 female, WHO functional class II (n = 10), III (n = 22); (data presented as mean ± standard deviation) pulmonary vascular resistance (11 ± 5 Wood units), lung function, 6 minute walk test (6-MWT; 364 ± 363.7 (range 179.0-627.0) m), systolic pulmonary artery pressure, sPAP, 79 ± 19 mmHg), and NT-proBNP serum levels (1427 ± 2162.7 (range 59.3-10342.0) ng/L) were measured at baseline, after 3 and 12 months of oral bosentan (125 mg twice per day).At baseline, maximal expiratory flow at 50 and 25% vital capacity were reduced to 65 ± 25 and 45 ± 24% predicted. Total lung capacity was 95.6 ± 12.5% predicted and residual volume was 109 ± 21.4% predicted. During 3 and 12 months of treatment, 6-MWT increased by 32 ± 19 and 53 ± 69 m, respectively; p < 0.01; whereas sPAP decreased by 7 ± 14 and 10 ± 19 mmHg, respectively; p < 0.05. NT-proBNP serum levels tended to be reduced by 123 ± 327 and by 529 ± 1942 ng/L; p = 0.11). There was no difference in expiratory flows or lung volumes during 3 and 12 months.This study gives first evidence in IPAH, that during long-term bosentan, improvement of hemodynamics, functional parameters or serum biomarker occur independently from persisting peripheral airway obstruction.Idiopathic pulmonary arterial hypertension (IPAH) is a rare pulmonary vasculopathy of unknown origin [1]. Patients with IPAH are often severely compromised by dyspnea, exercise intolerance and progressive right ventricular failure [1].In 171 IPAH patients, significant peripheral airway obstruction independently from pulmonary hemodynamics has been described [2]. Given the proximity of pulmonary vasculature and peripheral airways, coupling between the pulmonary blood vessels and airways has partially been attributed to mechanical forces due to shared structural changes or vascular rigidity [3]. Moreover in IPAH, the imbalance favoring mediators of increased vascular smooth muscle tone and proliferation in the affected vessels adjacent to small airways
Fractures in myelomeningocele
Michael Akbar,Bjoern Bresch,Patric Raiss,Carl Hans Fürstenberg,Thomas Bruckner,Thorsten Seyler,Claus Carstens,Rainer Abel
Journal of Orthopaedics and Traumatology , 2010, DOI: 10.1007/s10195-010-0102-2
Abstract: Patients with thoracic-level paralysis represent a group with high fracture risk. According to these results, fracture and epiphyseal injury in patients with MMC should be treated by plaster immobilization. The duration of immobilization should be kept to a minimum (<4 weeks) because of increased risk of secondary fractures. Alternatively, patients with refractures can be treated by surgery, when nonoperative treatment has failed.
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