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Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs.
Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel.
Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1-25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0-88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE-syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%-subcutaneous; 29%-intravenous; 1%-unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy.
Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
The pathogenic yeast Candida albicans can develop resistance to the widely used antifungal agent fluconazole, which inhibits ergosterol biosynthesis, by the overexpression of genes encoding multidrug efflux pumps or ergosterol biosynthesis enzymes. Zinc cluster transcription factors play a central role in the transcriptional regulation of drug resistance. Mrr1 regulates the expression of the major facilitator MDR1, Tac1 controls the expression of the ABC transporters CDR1 and CDR2, and Upc2 regulates ergosterol biosynthesis (ERG) genes. Gain-of-function mutations in these transcription factors result in constitutive overexpression of their target genes and are responsible for fluconazole resistance in many clinical C. albicans isolates. The transcription factor Ndt80 contributes to the drug-induced upregulation of CDR1 and ERG genes and also binds to the MDR1 and CDR2 promoters, suggesting that it is an important component of all major transcriptional mechanisms of fluconazole resistance. However, we found that Ndt80 is not required for the induction of MDR1 and CDR2 expression by inducing chemicals. CDR2 was even partially derepressed in ndt80D mutants, indicating that Ndt80 is a repressor of CDR2 expression. Hyperactive forms of Mrr1, Tac1, and Upc2 promoted overexpression of MDR1, CDR1/CDR2, and ERG11, respectively, with the same efficiency in the presence and absence of Ndt80. Mrr1- and Tac1-mediated fluconazole resistance was even slightly enhanced in ndt80D mutants compared to wild-type cells. These results demonstrate that Ndt80 is dispensable for the constitutive overexpression of Mrr1, Tac1, and Upc2 target genes and the increased fluconazole resistance of strains that have acquired activating mutations in these transcription factors.
Domain-Specific Knowledge and Memory Performance: A Comparison of High- and Low-Aptitude Children
(1989)
Two studies compared memory performance and text comprehension of groups that were equivalent on domain-specific knowledge but differed in overall aptitude, to investigate whether prior knowledge about a particular domain or overall aptitude level was more important when the task was to acquire and use new information in the domain of interest. Both studies dealt with third-, fifth-, and seventh-grade soccer experts' and novices' memory and comprehension of a story dealing with a soccer game. Several measures of memory performance, memory monitoring, and text comprehension were used. Levels of soccer knowledge and of overall aptitude were varied in a factorial design. Neither study detected significant differences between high-aptitude and low-aptitude experts, regardless of their ages. Low aptitude experts outperformed high-aptitude novices on all memory and comprehension measures. The results indicate that domain-specific knowledge can compensate for low overall aptitude on domain-related cognitive tasks.
In a short-term longitudinal study, we investigated how domain-specific knowledge in soccer influences the amount of text recall and comprehension in elementary school and junior high school children of high and low overall aptitudes. Both level of soccer knowledge and overall aptitude were varied in a factorial design. Third, fifth, and seventh grade children were given several measures of text recall and comprehension and were retested on these measures about 1 year later. Performance was more a function of soccer knowledge than of aptitude level.
Ein Kennzeichen der spätmittelalterlichen Stadtchronistik ist das Auftreten von Autoren und Lesern aus neuen, bis dahin illiteraten sozialen Schichten. Zur Erforschung dieser Geschichtsschreibung liefert die Arbeit von Joachim Schneider am Beispiel Nürnberg mit seinen kodikologischen und rezeptionsgeschichtlichen, aber auch seinen modernen sozial- und mentalitätsgeschichtlichen Fragestellungen einen wichtigen Beitrag. Im Zentrum der Untersuchung steht die Chronik des Bierbrauers und Aufsehers über das Bettelwesen, Heinrich Deichsler. Nach eingehender Analyse von Materialgewinnung und Arbeitstechniken Deichslers ist das Bild, das die Nürnberger um 1500 von ihrer Vergangenheit hatten, ein weiterer Schwerpunkt dieses Werkes. Schneider vergleicht dazu die Deichslersche Chronik mit anderen Nürnberger historiographischen Texten. Insbesondere geht es dabei um die Gemeinsamkeiten und Unterschiede zwischen bürgerlicher und offiziöser Geschichtsbetrachtung. Zwei für die Stadt zentrale Geschichtsüberlieferungen stehen im Vordergrund: Die Erwerbung und Behauptung der Reichskleinodien sowie der Aufstand von 1348/49. Ein weiteres Kapitel der Arbeit liefert anhand der Zeitungen, Urkunden u.Ä., die Deichsler in seine Chronik als Inserte einfügte, einen Beitrag zu den noch wenig erforschten Anfängen des Zeitungswesens. Deichslers selbständige Chronistik führt schließlich mitten in das Nürnberger Alltagsleben um 1500. Auch hier zeigen sich bei Themen und Darstellungsweise bezeichnende Unterschiede zu anderen Nürnberger Chroniken, die aus sozial höherem Milieu stammen. Schneiders Untersuchung beschreibt nicht nur chronistische Techniken, Geschichtsbild und Mentalität eines bemerkenswert fleißigen Mittelschicht-Chronisten, es entsteht vielmehr ein Panorama der reichen spätmittelalterlichen Nürnberger Geschichtsschreibung und damit der Geschichte dieser Stadt selbst in ihren großen und kleinen Ereignissen - einer Stadt, die gerade damals ihre wohl größte Zeit erlebte.
In der vorliegenden Studie wurde die Frage geprüft, inwieweit Schulanfänger im Vergleich zu fortgeschrittenen Grundschülern tatsächlich nur wenig darüber wissen, welche Strategien in freien Reproduktionsaufgaben (son-recall) voneilhaft sind. Zu diesem Zweck wurde das Metagedächtnis von Zweit- und Vienkläßlern, also ihr Wissen um die Vorteile unterschiedlicher Sortier- und Lernstrategien, mit ihrem Lernverhalten bzw. ihrem Leistungsvermögen in unterschiedlichen Varianten der sort-recall-Aufgabe verglichen. Diese Prozedur gestattete es, die Bewertung unterschiedlicher Strategien direkt mit ihrer jeweiligen Wirksamkeit zu vergleichen. Die an je 32 Zweit- und Viertkläßlern gewonnenen Befunde: lassen sich insgesamt so interpretieren, daß die jüngeren Kinder kaum etwas über angemessene Verhaltensweisen bei freien Reproduktionsaufgaben wissen; sie ziehen perzeptuelle Organisationsstrategien konzeptuellen (taxonomischen) Organisationsstrategien vor, profitieren tatsächlich jedoch signifikant mehr von konzeptuellen Strategien. Demgegenüber verfügten die: Vienkläßler in der Regel über angemessenes Metagedächtnis: sie schätzten taxonomische Strategien nicht nur höher ein, sondern profitierten auch de facto deutlich mehr von solchen Techniken. Die Befunde können insgesamt als Bestätigung der in der neueren Literatur verbreiteten Annahme gewertet werden, daß sich das Wissen um Gedächtnisanforderungen bei sort-recall-Aufgaben erst gegen Ende: der Grundschulzeit herausbildet.
Background: The majority of breast cancer patients are severely psychologically affected by breast cancer diagnosis and subsequent therapeutic procedures. The COVID-19 pandemic and associated restrictions on public life have additionally caused significant psychological distress for much of the population. It is therefore plausible that breast cancer patients might be particularly susceptible to the additional psychological stress caused by the pandemic, increasing suffering. In this study we therefore aimed to assess the level of psychological distress currently experienced by a defined group of breast cancer patients in our breast cancer centre, compared to distress levels preCOVID-19 pandemic.
Methods: Female breast cancer patients of all ages receiving either adjuvant, neoadjuvant, or palliative therapies were recruited for the study. All patients were screened for current or previous COVID-19 infection. The participants completed a self-designed COVID-19 pandemic questionnaire, the Stress and Coping Inventory (SCI), the National Comprehensive Cancer Network (R) (NCCN (R)) Distress Thermometer (DT), the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30, and the BR23.
Results: Eighty-two breast cancer patients were included. Therapy status and social demographic factors did not have a significant effect on the distress caused by the COVID-19 pandemic. The results of the DT pre and during COVID-19 pandemic did not differ significantly. Using the self-designed COVID-19 pandemic questionnaire, we detected three distinct subgroups demonstrating different levels of concerns in relation to SARS-CoV-2. The subgroup with the highest levels of concern reported significantly decreased life quality, related parameters and symptoms.
Conclusions: This monocentric study demonstrated that the COVID-19 pandemic significantly affected psychological health in a subpopulation of breast cancer patients. The application of a self-created "COVID-19 pandemic questionnaire"could potentially be used to help identify breast cancer patients who are susceptible to increased psychological distress due to the COVID-19 pandemic, and therefore may need additional intensive psychological support.