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"Müller, Andreas"
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Difficulties and challenges experienced by nurses in eldercare institutions in Albania: A qualitative content analysis
The global and Albanian populations of elderly people are steadily increasing. It is estimated that the number of elderly adults requiring care in Albania will rise from 90.9 thousand to 130.4 thousand by 2030. Despite the envisaged increase in the number and life expectancy of the elderly population in Albania, which will result in an increased demand for nursing care, little is known about the difficulties and challenges that nurses face while providing care for elderly Albanian individuals.
To explore the difficulties and challenges nurses experience while caring for elderly people in Albanian eldercare institutions.
The study employed a qualitative design using purposive sampling of 20 nurses in 8 eldercare institutions who participated in face-to-face semi-structured interviews. The audio-recorded interviews were transcribed and subsequently subjected to analysis using Graneheim and Lundman's qualitative conventional content analysis. Data analysis was supported by the qualitative data analysis software MAXQDA 2020. The reporting of this study followed the consolidated criteria for reporting qualitative research (COREQ) checklist.
Five key categories emerged from data analysis: (1) professional difficulties, (2) educational difficulties, (3) relationship challenges, (4) increased mental stress, and (5) participation in advocacy. This study showed that nursing staff experienced many barriers, challenges, and unmet needs when implementing care for elderly people in long-term care facilities.
The findings indicate that nurses working in eldercare institutions faced significant challenges in caring for elderly people. Nurses need more legal, financial, educational, and emotional support. The study indicates that more organizational and national support is necessary for nursing staff to care for elderly people in eldercare Albanian institutions properly. Eldercare institution leaders need to recognize the importance of their role in overcoming the barriers and providing adequate support for their staff in caring for elderly people.
Journal Article
Charter of Dubai : a manifesto of critical urban transformation
The man-made peninsular Palm Jumeirah on the coast of Dubai is a superlative project and an exemplary model for the Gated Communities and Resorts that have developed worldwide in property bubbles. The development may be spectacular, but cannot conceal the fact that the former marketing success story is faced with serious problems. How can an isolated anti-urban exclave be opened up and integrated? Can issues concerning networking, the public sphere and affordable housing, as well as climate change adaptation, biodiversity and the supply of energy be resolved through targeted tactical interventions? The 'Charter of Dubai' is a manifesto of critical urban transformation. It subversively encourages the conversion of isolated quarters into a socially and ecologically open urban space. The detailed catalog of the individual measures, richly illustrated with clear sketches and references, make the Charter a handbook for urban transformation that takes social and ecological aspects into account.
Book
Analysis of Deep-Learning Methods in an ISO/TS 15066–Compliant Human–Robot Safety Framework
Over the last years collaborative robots have gained great success in manufacturing applications where human and robot work together in close proximity. However, current ISO/TS-15066-compliant implementations often limit the efficiency of collaborative tasks due to conservative speed restrictions. For this reason, this paper introduces a deep-learning-based human–robot–safety framework (HRSF) that aims at a dynamical adaptation of robot velocities depending on the separation distance between human and robot while respecting maximum biomechanical force and pressure limits. The applicability of the framework was investigated for four different deep learning approaches that can be used for human body extraction: human body recognition, human body segmentation, human pose estimation, and human body part segmentation. Unlike conventional industrial safety systems, the proposed HRSF differentiates individual human body parts from other objects, enabling optimized robot process execution. Experiments demonstrated a quantitative reduction in cycle time of up to 15% compared to conventional safety technology.
Journal Article
Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review
In 2018, a consortium of government bodies in China led by the Ministry of Education released the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT), aiming to reduce the incidence of myopia and control myopic progression in China. Recommendations span from home-based to school-based interventions, including time outdoors, physical activity, light exposure, near-work activity, screen time, Chinese eye exercises, diet and sleep. To date, the levels of evidence for this suite of interventions have not been thoroughly investigated. This review has summarised the evidence of the interventions recommended by the CPPNCT in myopia prevention and control. Thus, the following statements are supposed by the evidence: (1) Increasing time outdoors and reducing near-work time are effective in lowering incident myopia in school-aged children. (2) All interventions have a limited effect on myopia progression. Ongoing research may lead to a better understanding of the underlying mechanisms of myopia development, the interaction of different interventions and recommendations, confounding variables and their true effect on myopia prevention, and the identification of those most likely to respond to specific interventions. This field may also benefit from longer-term studies of the various interventions or strategies covered within this review article, to better understand the persistence of treatment effects over time and explore more novel approaches to myopia control.
Journal Article
Rapid Sequestration of Leishmania mexicana by Neutrophils Contributes to the Development of Chronic Lesion
The protozoan Leishmania mexicana parasite causes chronic non-healing cutaneous lesions in humans and mice with poor parasite control. The mechanisms preventing the development of a protective immune response against this parasite are unclear. Here we provide data demonstrating that parasite sequestration by neutrophils is responsible for disease progression in mice. Within hours of infection L. mexicana induced the local recruitment of neutrophils, which ingested parasites and formed extracellular traps without markedly impairing parasite survival. We further showed that the L. mexicana-induced recruitment of neutrophils impaired the early recruitment of dendritic cells at the site of infection as observed by intravital 2-photon microscopy and flow cytometry analysis. Indeed, infection of neutropenic Genista mice and of mice depleted of neutrophils at the onset of infection demonstrated a prominent role for neutrophils in this process. Furthermore, an increase in monocyte-derived dendritic cells was also observed in draining lymph nodes of neutropenic mice, correlating with subsequent increased frequency of IFNγ-secreting T helper cells, and better parasite control leading ultimately to complete healing of the lesion. Altogether, these findings show that L. mexicana exploits neutrophils to block the induction of a protective immune response and impairs the control of lesion development. Our data thus demonstrate an unanticipated negative role for these innate immune cells in host defense, suggesting that in certain forms of cutaneous leishmaniasis, regulating neutrophil recruitment could be a strategy to promote lesion healing.
Journal Article
Collective nitric oxide production provides tissue-wide immunity during Leishmania infection
Nitric oxide (NO) production is critical for the host defense against intracellular pathogens; however, it is unclear whether NO-dependent control of intracellular organisms depends on cell-intrinsic or cell-extrinsic activity of NO. For example, NO production by infected phagocytes may enable these cells to individually control their pathogen burden. Alternatively, the ability of NO to diffuse across cell membranes might be critical for infection control. Here, using a murine ear infection model, we found that, during infection with the intracellular parasite Leishmania major, expression of inducible NO synthase does not confer a cell-intrinsic ability to lower parasite content. We demonstrated that the diffusion of NO promotes equally effective parasite killing in NO-producing and bystander cells. Importantly, the collective production of NO by numerous phagocytes was necessary to reach an effective antimicrobial activity. We propose that, in contrast to a cell-autonomous mode of pathogen control, this cooperative mechanism generates an antimicrobial milieu that provides the basis for pathogen containment at the tissue level.
Journal Article
CD4+ T cell-induced inflammatory cell death controls immune-evasive tumours
Most clinically applied cancer immunotherapies rely on the ability of CD8
+
cytolytic T cells to directly recognize and kill tumour cells
1
–
3
. These strategies are limited by the emergence of major histocompatibility complex (MHC)-deficient tumour cells and the formation of an immunosuppressive tumour microenvironment
4
–
6
. The ability of CD4
+
effector cells to contribute to antitumour immunity independently of CD8
+
T cells is increasingly recognized, but strategies to unleash their full potential remain to be identified
7
–
10
. Here, we describe a mechanism whereby a small number of CD4
+
T cells is sufficient to eradicate MHC-deficient tumours that escape direct CD8
+
T cell targeting. The CD4
+
effector T cells preferentially cluster at tumour invasive margins where they interact with MHC-II
+
CD11c
+
antigen-presenting cells. We show that T helper type 1 cell-directed CD4
+
T cells and innate immune stimulation reprogramme the tumour-associated myeloid cell network towards interferon-activated antigen-presenting and iNOS-expressing tumouricidal effector phenotypes. Together, CD4
+
T cells and tumouricidal myeloid cells orchestrate the induction of remote inflammatory cell death that indirectly eradicates interferon-unresponsive and MHC-deficient tumours. These results warrant the clinical exploitation of this ability of CD4
+
T cells and innate immune stimulators in a strategy to complement the direct cytolytic activity of CD8
+
T cells and natural killer cells and advance cancer immunotherapies.
This article describes a mechanism through which CD4
+
T cells can eradicate MHC-deficient tumours that escape direct CD8
+
T cell targeting and thereby complement the activity of CD8
+
T cells and natural killer cells to advance cancer immunotherapies.
Journal Article
More than 75 percent decline over 27 years in total flying insect biomass in protected areas
Global declines in insects have sparked wide interest among scientists, politicians, and the general public. Loss of insect diversity and abundance is expected to provoke cascading effects on food webs and to jeopardize ecosystem services. Our understanding of the extent and underlying causes of this decline is based on the abundance of single species or taxonomic groups only, rather than changes in insect biomass which is more relevant for ecological functioning. Here, we used a standardized protocol to measure total insect biomass using Malaise traps, deployed over 27 years in 63 nature protection areas in Germany (96 unique location-year combinations) to infer on the status and trend of local entomofauna. Our analysis estimates a seasonal decline of 76%, and mid-summer decline of 82% in flying insect biomass over the 27 years of study. We show that this decline is apparent regardless of habitat type, while changes in weather, land use, and habitat characteristics cannot explain this overall decline. This yet unrecognized loss of insect biomass must be taken into account in evaluating declines in abundance of species depending on insects as a food source, and ecosystem functioning in the European landscape.
Journal Article
Content-aware image restoration: pushing the limits of fluorescence microscopy
Fluorescence microscopy is a key driver of discoveries in the life sciences, with observable phenomena being limited by the optics of the microscope, the chemistry of the fluorophores, and the maximum photon exposure tolerated by the sample. These limits necessitate trade-offs between imaging speed, spatial resolution, light exposure, and imaging depth. In this work we show how content-aware image restoration based on deep learning extends the range of biological phenomena observable by microscopy. We demonstrate on eight concrete examples how microscopy images can be restored even if 60-fold fewer photons are used during acquisition, how near isotropic resolution can be achieved with up to tenfold under-sampling along the axial direction, and how tubular and granular structures smaller than the diffraction limit can be resolved at 20-times-higher frame rates compared to state-of-the-art methods. All developed image restoration methods are freely available as open source software in Python, FIJI, and KNIME.
Journal Article