Klinik Bad Oexen

Understanding how laying hens interact with functional resources-such as drinkers, feeders, perches, nest boxes, and wintergardens-is essential for meeting their physiological needs and enabling species-specific behaviors. This knowledge is crucial for poultry welfare assessments and precision livestock management. However, traditional ethological data collection methods, including direct observation and manual video analysis, are labor-intensive, prone to observer bias, and impractical for individual-level tracking. To overcome these challenges, we developed and validated an RFID-based system for automated, non-invasive tracking of individual hens' visits to key resources, using an established ArUco-based video annotation system as the reference standard. For validation, twenty-one laying hens were fitted with RFID leg bands and 3D-ArUco markers and monitored over five days in a mobile barn setup equipped with ultra-high-frequency RFID antennas. Alignment between data from the RFID and 3D-ArUco systems allowed calculation of performance metrics such as the F1-score-defined as the harmonic mean of precision and sensitivity-for visit durations and event detections (i.e., entries and exits), and the coefficient of determination (r²) for visit counts. Wintergarden showed the highest performance (84 % F1-score, 93 % r²). Metal perch achieved F1-scores of 79 % and 86 % for access and leaving events. Nest boxes showed intermediate performance (78 % F1-score, 77 % r²), while drinkers and feeders were lower (64 % F1-score each; r² values of 69 % and 49 %). These findings confirm RFID's potential for tracking visits to wintergardens, perches, and nest boxes-demonstrating sufficient performance for practical use, though further optimization through antenna positioning remains possible. For feeders and drinkers, however, accurate tracking remains challenging, and complementary technologies may be required, as rapid movements reduce tag dwell time, overcrowding causes signal interference, and open areas increase misreads from nearby surrounding movement. This study highlights RFID's value for behavioral research at the individual level in poultry and supports research-driven innovation in housing equipment design. It also demonstrates how a computer-assisted approach can facilitate validation across diverse behavioral contexts.

Sleep problems are frequently observed in breast cancer patients. However, the relationship between sleep quality and overall quality of life (QoL) and the specificity of different sleep-related questionnaires have not yet been adequately studied in breast cancer patients. The sample of this cross-sectional study consisted of 533 breast cancer patients, recruited in a German rehabilitation clinic, with a mean age of 52.3 years (SD = 12.5 years). The following three sleep-related questionnaires were used: the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Jenkins Sleep Scale (JSS). In addition, we used the QoL instrument EORTC QLQ-C30. Sleep quality was poor in this sample of breast cancer patients. The effect sizes d, indicating the difference in sleep quality between the patient sample and the general population, were between 0.97 and 1.76 (p < 0.001). QoL was impaired in all components (p < 0.001); the impairment in the dimension of sleep quality (d = 1.70) was among the highest. Sleep quality was correlated with all components of QoL. The comparison of the three sleep-related questionnaires showed that the results obtained in oncological studies partly depend on the instrument used. As the burden of sleep problems is high, screening for sleep problems in breast cancer patients is important.

ABSTRACTBackgroundMortality in patients with cardiogenic shock (CS) remains high despite advanced treatment strategies in CS patients, underlining the need for the identification of predictors of prognosis in CS patients. Therefore, the present study investigates the prognostic impact of coronary chronic total occlusions (CTO) in patients with CS.MethodsAll consecutive patients being acutely admitted with CS to an intensive care unit (ICU) and undergoing invasive coronary angiography (ICA) from 2019 to 2021 were included, irrespective of the etiology of CS. Patients with at least one CTO were compared to non‐CTO patients with regard to the risk of all‐cause mortality at 30 days. Further risk stratification was performed according to the extent of coronary artery disease (CAD).ResultsA total of 192 CS patients undergoing ICA during index hospitalization were included. At least one CTO was present in 24% of CS patients. Patients with CTO were older (median 78 vs. 68; p = 0.001) and presented more frequently with non‐ST‐elevated myocardial infarction (21% vs. 12%; p = 0.048). The presence of a CTO was associated with higher rates of 30‐days all‐cause mortality (70.2% vs. 47.6%; HR = 1.783, 95% CI 1.176−2.702; p = 0.009), even after multivariable adjustment (adjusted HR = 1.898; 95% CI 1.116−3.229; p = 0.018). Patients with CTO were accompanied by an even higher 30‐days all‐cause mortality as compared to patients with multi‐vessel CAD without CTO (adjusted HR = 1.723; 95% CI 1.058−2.805; p = 0.029).ConclusionCoronary CTO are common in patients with CS and represent an independent predictor of all‐cause mortality at 30 days.

ObjectiveStatus epilepticus (SE) represents one of the most common neurological emergencies. The International League Against Epilepsy (ILAE) redefined SE duration thresholds from 30 to 5 min for convulsive SE in 2015. We conducted a prospective population‐based study to determine SE incidence and outcomes under the revised criteria and compared findings with historical data using the 30‐min definition.MethodsA prospective, population‐based cohort study was conducted over a period of 18 months to determine the incidence of SE in Germany, replicating the methodology of a first study conducted in this region in 1999. The study included all adults residing within the 35‐postcode area, with participation from all regional hospitals and emergency departments. SE cases were prospectively identified and reported. To ensure comparability with the historical data, the analysis focused on the Primary Service Area (PS‐Area)—the direct catchment region of the University Hospital Marburg.ResultsA total of 180 adults with SE (96 men, mean age 66.47 years, SD ± 18.5 years, range: 20–94 years). The crude annual incidence in the PS‐Area increased from 15.8/100 000 (95% confidence interval [CI] 11.2–21.6) in 1999 to 29.4/100 000 adults (95% CI 20.5–40.0). It was higher in men than in women (30.9 vs 28.1/100 000, p = .11) and in patients ≥60 years (68.5 vs 13.5/100 000; p < .0001). The calculated age‐ and gender‐adjusted incidence was 32.5/100 000 in the PS‐Area. The case–fatality rate was 5.77% (95% CI 1.2%–12.7%) and the crude annual cause‐specific mortality rate per 100 000 is 1.70 (95% CI 0.21–4.73). In 53% SE was the first seizure episode; only 47% had a history of epilepsy. When extrapolating these findings to the entire German population, there were at least 20 000 cases of SE with 1000 associated deaths annually.SignificanceThese findings provide new epidemiologic evidence that the incidence of SE has increased by ~12% with the adoption of the ILAE 2015 definition, underscoring the impact of updated diagnostic criteria on epidemiological estimates.

Health anxiety (HA) is frequently observed in patients suffering from a severe disease such as cancer. This study aimed to test the psychometric properties of the Whiteley Index-7 (WI-7) measuring HA and to identify prognostic factors for heightened HA in cancer patients. A sample of 1723 cancer patients, treated in a German rehabilitation clinic, completed the Whiteley Index-7, the Generalized Anxiety Disorder screener GAD-7, the Patient Health Questionnaire PHQ-9, the Fear of Progression questionnaire FoP-Q-12, the Concerns About Cancer Recurrence questionnaire CARQ-4, and two subscales of the EORTC QLQ-SURV100. The internal consistency of the WI-7 was good (Cronbach's α=0.85), and the correlations between the WI-7 and other scales were as follows: 0.64 (GAD-7), 0.63 (PHQ-9), 0.75 (FoP-Q-12), 0.71 (CARQ-4), 0.66 (SURV-HD), and 0.75 (SURV-NHO). Women showed markedly higher levels of HA than men (effect size: d=0.40), and patients aged 60years and above reported lower levels of HA than younger patients (d=-0.32). Melanoma patients showed the highest HA mean score (M=10.9), and patients receiving antibody therapy showed heightened levels of HA (M=10.7). When considering age and sex, the effects of tumor type and treatment become smaller than in the univariate analyses. The WI-7 is a suitable instrument for assessing HA in cancer patients. When evaluating the effects of cancer type or treatment on HA, one has to take into account the age and sex distribution. Younger patients and women deserve special attention regarding HA.

Objective Cancer patients frequently report sleep problems. The Pittsburgh Sleep Quality Index (PSQI) is a 19-item instrument for assessing sleep problems. The main objective of this study was to analyze the usefulness of the PSQI in oncological research. Methods A sample of 1,733 cancer patients with mixed diagnoses were included. In addition to the PSQI, the following questionnaires were adopted: the Insomnia Severity Index (ISI), the Jenkins Sleep Scale (JSS) and the sleep scale of the EORTC QLQ-SURV100. Results The internal consistency of the PSQI was α = 0.79. Of the PSQI subscales, the subjective sleep quality correlated most strongly with the other sleep instruments (r between 0.68 and 0.77). In total, 69.2% of the sample were poor sleepers; the effect size of the difference between the PSQI total scores of the patients and a general population sample was d = 0.83. Female patients experienced more sleep problems than male patients (d = −0.49), and younger patients (<60 years) reported more sleep problems than older patients (≥60 years) (d = 0.21). Conclusions The PSQI can be recommended for use in clinical practice since its sub-dimensions provide detailed information on the sleep situation of cancer patients.

Das Verhältnis Hermann Hesses zum Bildungswesen und seinen Institutionen und deren pädagogischen Vertretern ist ambivalent und zieht sich durch große Teile des Prosawerks. Aber auch weniger bekannte lyrische Texte thematisieren den Stellenwert von Lehrern und Meistern, wobei dort vor allem Hesses Rezeption hinduistischer und buddhistischer Gedankengebäude eine zentrale Rolle einnimmt. Der wohl berühmteste Jugend- und Schulroman Unterm Rad aus dem Jahr 1906 bildet bei der Rekonstruktion von Hesses Bildungsauffassungen den Hintergrund. Sein Kurzroman ist der Klassiker unter den Schulgeschichten aus Schülerperspektive, auch wenn diese durch einen auktorialen Erzähler und nicht aus der Ich-Perspektive wiedergegeben wird. Der Text war auch maßgeblich für alle weiteren Schulgeschichten (vgl. Vogt 2010). Vor allem unter den Aspekten „Pädagogik vs. Begabung als Konfliktmodell“ und auch „Schule und Adoleszenz als kritische Konstellation“ werden Hesses Beziehungen zum Bildungskomplex erkennbar. Dabei steht vor allem die Perspektive der Lernenden und nicht so sehr die der Lehrenden im Vordergrund, wie es beispielsweise für einen Roman aus der Lehrer-Sicht von Walter Kempowski, also für Heile Welt (1998), der Fall ist, in dem die ersten Unterrichtserfahrungen eines Grundschullehrers in einer Dorfschule beschrieben werden. Beiden Autoren ist jedoch gemeinsam, dass sie sich mit alternativen und reform-orientierten Ansätzen des Lehrens und Lernens auseinandersetzen.

ObjectivesThe Schneiderian membrane is elevated to place bone graft material during sinus floor augmentation. Since the teeth’s vascular and neurovascular supply passes through the maxillary sinus, this procedure may lead to sensitivity loss in adjacent teeth. This study is the first to prospectively analyze the vitality of adjacent teeth after sinus floor elevation.Materials and methodsData were collected between 2015 and 2023 from 158 patients, who underwent maxillary sinus floor augmentation and implant placement. A total of 378 teeth were examined for vitality using cold testing at the following time points: (1) before sinus floor elevation, (2) 2 weeks, (3) 4 months, (4) 8 months, and (5) 12 months post-surgery. Follow-up duration ranged from 12 to 32 months.ResultsTwo teeth in two patients showed no vitality before surgery, but became vital postoperatively. In 3 teeth (0.79%), pulp vitality loss was recorded 2 weeks after surgery, which was restored at the 4-month follow-up. These teeth remained vital after one year. The pre-and postoperative pulp vitality comparison showed no statistically significant difference (p = 0.625).ConclusionsThis first prospective observational study demonstrated that a few patients experienced temporary pulp sensitivity loss immediately post-surgery, which resolved within four months.Clinical relevancePulp sensitivity loss due to vascular disruption during sinus floor augmentation is rare and usually temporary. Despite potential vascular disruption, sinus floor augmentation procedures do not appear to cause permanent pulp sensitivity loss.Graphical