Improving Step by Step

Throughout the past years we stepwise modified our immunosuppressive treatment regimen for patients with antibody-mediated rejection (ABMR). Here, we describe three consecutive groups treated with different regimens. From 2005 until 2008, we treated all patients with biopsy-proven ABMR with rituximab (500 mg), low-dose (30 g) intravenous immunoglobulins (IVIG), and plasmapheresis (PPH, 6x) (group RLP, ). Between 2009 and June 2010, patients received bortezomib (1.3 mg/m2, 4x) together with low-dose IVIG and PPH (group BLP, ). In July 2010, we increased the IVIG dose and treated all subsequent patients with bortezomib, high-dose IVIG (1.5 g/kg), and PPH (group BHP, ). Graft survival at three years after treatment was 73% in group BHP as compared to 45% in group BLP and 25% in group RLP. At six months after treatment median serum creatinine was 2.1 mg/dL, 2.9 mg/dL, and 4.2 mg/dL in groups BHP, BLP, and RLP, respectively (). Following treatment, a significant decrease of donor-specific HLA antibody (DSA) mean fluorescence intensity from to () was observed in group BHP, but not in the other groups. Our results indicate that graft survival, graft function, and DSA levels could be improved along with stepwise modifications to our treatment regimen, that is, the introduction of bortezomib and high-dose IVIG treatment

Embedded gateway services for Internet of Things applications in ubiquitous healthcare

The continuous advancement in computer and communication technologies has made personalized healthcare monitoring a rapidly growing area of interest. New features and services are envisaged, raising users' expectations in healthcare services. The emergence of Internet of Things brings people closer to connect the physical world to the Internet. In this paper, we present embedded services that are part of a ubiquitous healthcare system that allows automated and intelligent monitoring. The system uses IP connectivity and the Internet for end-to-end communication, from each 6LoWPAN sensor nodes to the web user interface on the Internet. The proposed algorithm in the Gateway performs multithreaded processing on the gathered medical signals for conversion to real data, feature extraction and wireless display. The user interface at the server allows users to access and view the medical data from mobile and portable devices. The ubiquitous system is exploring possibilities in connecting Internet with things and people for health services

Involving Sales Managers in Sales Force Compensation Design

Sales force incentive design often involves significant participation by sales managers in designing the compensation plans of salespeople who report to them. Although sales managers hold valuable territory-level information, they may benefit from misrepresenting that information given their own incentives. The author uses a game theoretic model to show (1) how a firm can efficiently leverage a manager’s true knowledge and (2) the conditions under which involving the manager is optimal. Under the proposed approach, the firm delegates sales incentive decisions to the manager within restrictive constraints. She can then request relaxed constraints by fulfilling certain requirements. The author shows how these constraints and requirements can be set to ensure the firm’s best possible outcome given the manager’s information. Thus, this “request mechanism” offers an efficient, reliable alternative to approaches often used in practice to incorporate managerial input, such as internal negotiations and behind-the-scenes lobbying. The author then identifies the conditions under which this mechanism outperforms the well-established theoretical approach of offering the salesperson a menu of contracts to reveal territory-level information

In situ characterization of soil properties using visible near-infrared diffuse reflectance spectroscopy

Diffuse reflectance spectroscopy (DRS) is a rapid proximal-sensing method that is being used more and more in laboratory settings to measure soil properties. Diffuse reflectance spectroscopy research that has been completed in laboratories shows promising results, but very little has been reported on how DRS will work in a field setting on soils scanned in situ. Seventy-two soil cores were obtained from six fields in Erath and Comanche County, Texas. Each soil core was scanned with a visible near-infrared (VNIR) spectrometer with a spectral range of 350-2500 nm in four different combinations of moisture content and pre-treatment: field-moist in situ, air-dried in situ, field-moist smeared in situ, and air-dried ground. Water potential was measured for the field-moist in situ scans. The VNIR spectra were used to predict total and fine clay content, water potential, organic C, and inorganic C of the soil using partial least squares (PLS) regression. The PLS model was validated with data 30% of the original soil cores that were randomly selected and not used in the calibration model. The root mean squared deviation (RMSD) of the air-dry ground samples were within the in situ RMSD and comparable to literature values for each soil property. The validation data set had a total clay content root mean squared deviation (RMSD) of 61 g kg-1 and 41 g kg-1 for the field-moist and air-dried in situ cores, respectively. The organic C validation data set had a RMSD of 5.8 g kg-1 and 4.6 g kg-1 for the field-moist and air-dried in situ cores, respectively. The RMSD values for inorganic C were 10.1 g kg-1 and 8.3 g kg-1 for the field moist and air-dried in situ scans, respectively. Smearing the samples increased the uncertainty of the predictions for clay content, organic C, and inorganic C. Water potential did not improve model predictions, nor did it correlate with the VNIR spectra; r2-values were below 0.31. These results show that DRS is an acceptable technique to measure selected soil properties in-situ at varying water contents and from different parent materials

Veränderungen der exekutiven Funktionen in der Depression und der Einfluss ängstlicher Persönlichkeitsmerkmale auf elektrophysiologische Korrelate inhibitorischer Prozesse

In der heutigen Zeit, in der die Menge an gleichzeitig zu verarbeitenden Sinnesreizen aus der Umwelt stetig wächst, gewinnt die Erforschung der exekutiven Funktionen immer mehr an Bedeutung, da diese die kognitive Flexibilität des Menschen gewährleisten. Depression als eine der relevantesten psychiatrischen Erkrankungen unserer Zeit scheint mit Beeinträchtigungen der exekutiven Funktionen einherzugehen. Es wird vermutet, dass kognitive Beeinträchtigungen die häufigsten Residuen einer Depression darstellen und einen relevanten Einfluss auf das Outcome und die Therapiemöglichkeiten der Patienten haben. In dieser Arbeit wird unter Verwendung eines EEG-EKP-Verfahrens untersucht, inwieweit depressive Patienten im Vergleich zu gesunden Kontrollprobanden eine Beeinträchtigung der Inhibition, einer Teilleistung der exekutiven Funktionen, auf Verhaltens- oder neuronaler Ebene aufweisen und ob das Persönlichkeitsmerkmal Ängstlichkeit einen Einfluss auf die exekutive Kontrolle hat. Dafür wurden zum einen die inhibitorische Leistung der Versuchspersonen mit Hilfe eines Go/Nogo-Paradigmas erfasst und die dabei entstandenen ereigniskorrelieren Potentiale gemessen. Zum anderen wurde untersucht, in wieweit ängstlichkeitsbezogene Persönlichkeitsmerkmale, gemessen mit dem STAI-Fragebogen, einen modulierenden Einfluss auf das Verhalten bzw. die neuronale Antwort der Versuchspersonen haben. Diese Arbeit zeigt, dass depressive Patienten auf Verhaltensebene eine schlechtere inhibitorische Kontrolle aufweisen. Die Auswertung der EKP-Daten ergab bei depressiven Patienten einen fehlenden Latenzunterschied zwischen Go- und Nogo-Bedingung im Zeitfenster der N2. Im Zeitfenster der P3 wiesen Patienten einen fehlenden Amplitudenunterschied zwischen Go- und Nogo-Bedingung auf. Diese EKP-Veränderungen können als neurophysiologische Korrelate einer defizitären Inhibition bei depressiven Patienten gewertet werden. Ein direkter Einfluss ängstlicher Persönlichkeitsmerkmale auf die exekutive Kontrolle konnte in der vorliegenden Studie nicht gezeigt werden