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"Smart" mobile affinity matrix for microfluidic immunoassays.

There is a current need for simple methods for immobilizing biomolecules within microfluidic channels. Here, a technique is reported for reversibly immobilizing immunoassay components in a channel zone that can be simply controlled by integrated heating elements. Latex beads were modified with the temperature-responsive polymer poly(N-isopropylacrylamide)(PNIPAAm) and co-modified with biotinylated poly(ethylene glycol)(PEG). PNIPAAm undergoes a hydrophilic-to-hydrophobic transition when the temperature is raised above the lower critical solution temperature (LCST)( approximately 28 degrees C in the solutions used here). This reversible transition drives the aggregation and dis-aggregation of the modified beads in heated zones within poly(ethylene terephthalate)(PET) microchannels. Biotinylated monoclonal antibodies for the drug digoxin were bound via streptavidin to the biotin-PEG-coated beads. These antibody-functionalized beads were then reversibly immobilized by aggregation and hydrophobic adhesion to the surface of PET microfluidic channels in response to a thermal stimulus. The antibodies on the beads immobilized in the channel were shown to bind digoxin and a competitor fluorescent ligand from a flow stream in a quantitative competitive assay format that reported the digoxin concentration. The antibodies could be replenished for each immunoassay trial, using the reversible, temperature-controlled immobilization process. This technique allows reagent immobilization immediately prior to an analytical procedure, following the removal of previously utilized beads, guaranteeing fresh and active immobilized biomolecules. Furthermore, it provides a simple approach to multiplexing through the simultaneous or sequential injection of different antibody-coated bead species, potentially at multiple sites in the integrated device channels.

Biotin↗

Precancer of the human cervix.

The tumour biology of cervical precancer is unusual. A large variety of individually distinct forms crudely divided into slight, moderate, severe dysplasia and carcinoma in situ exist. Virtually all contain genital human papillomavirus (HPV) either as infectious virions or as episomal or integrated DNA. HPV, which occurs as hundreds of types, subtypes and variants, has a high prevalence in all human populations. Most males are symptomless reservoirs, whereas a proportion of infected women develop condyloma, precancer and subsequently, in a minority, invasive cancer. HPV has unequivocal features of a sexually transmitted infectious agent. Risk of precancer is statistically related to infection with genital HPV, but differences in risk between populations with high and low prevalence of HPV are larger than expected from a direct correlation. Findings fit with HPV as a major risk factor, but other factors must also be operative. These may include shifts in number of target cells, depending on regeneration and infection by various micro-organisms, hormones, smoking and immunity. Final proof of necessity of HPV infection for precancer can probably be delivered only after its elimination by successful vaccination. Genital condyloma, which is not precancerous, is caused by HPV low risk types, typically 6 or 11, in analogy with papilloma formation in skin and mucosa in a large variety of species. This benign lesion is the hallmark of mammalian HPV pathology and a source of interindividual spread of virus. Slight dysplasia is heterogeneous. Many lesions seem to be polyclonal, self limited cell proliferative responses to infection with low grade HPV. A small proportion are associated with either simultaneous presence or subsequent development of higher grades of dysplasia, in situ or invasive cancer. Evidence exists for two mechanisms: clonal selection of cells with increasingly undifferentiated phenotypes, and independent development of different morphological types of precancer. The relative importance of the two is unknown. High risk HPV, typically 16 or 18, is preferentially associated with high grade dysplasia and in situ cancer, either because it increases risk of clonal progression to these forms or induces them de novo. Severe dysplasia, in situ and invasive cancer always present as monoclonal lesions. Genetic links indicate that these pathologies arise by clonal selection from less advanced precursors. The number of potential target cells for precancer confined to a narrow transformation zone is small. Risk of precancer and malignant transformation per target cell is therefore probably far higher than in any other human tissue subject to cancer. Spontaneous mutation rate and physicochemical carcinogens seem insufficient for the creation of a malignant phenotype in cells of the transformation zone. Currently HPV is the only strong candidate for such a feat. Any or all of the following mechanisms may play a role: overexpression of viral E6 and E7 genes, often triggered by disruption of control elements upon integration of viral DNA into the cellular genome, activity of specific (E6?) configurations in certain HPV variants, inactivation of TP53 with decreased capacity for DNA repair and enhanced likelihood of accumulation of "transforming" mutations and viral integration at sites controlling function of cellular oncogenes and/or suppressor genes. Target cells within the transformation zone have the capacity for bidirectional (squamous and/or glandular) differentiation. HPV types seem to drive cells preferentially in different directions after infection/transformation. Low risk types are almost always associated with squamous differentiation, HPV 16 usually also with squamous differentiation and HPV 18 with adenosquamous or adenomatous differentiation. (ABSTRACT TRUNCATED)

Carcinoma in Situ↗

Effect of a change in interfacial geometry on the fatigue strength of porous-coated Ti-6A1-4V.

Porous-coated Ti-6A1-4V has a fatigue strength approximately one-third that of the uncoated alloy. The interfacial geometry between the porous coating and the implant substrate is notchlike, leading to stress concentrations that have been shown to be the main cause for the reduction in fatigue strength. In this study, the effect of interfacial geometry on fatigue strength of porous-coated Ti-6A1-4V is quantified. The interface between porous coating and implant is modeled using linear elastic, plane strain finite element analysis. Integrated with the numerical analysis is an experimental verification of enhanced fatigue behavior. Changes in interfacial geometry are conceived, and their effectiveness in reducing stress concentrations are determined. A doubling of fatigue strength can be achieved for newly conceived geometries over conventional porous coating geometries.

Alloys↗

Cytokine induction of proliferation and expression of CDC2 and cyclin A in FDC-P1 myeloid hematopoietic progenitor cells: regulation of ubiquitous and cell cycle-dependent histone gene transcription factors.

To evaluate transcriptional mechanisms during cytokine induction of myeloid progenitor cell proliferation, we examined the expression and activity of transcription factors that control cell cycle-dependent histone genes in interleukin-3 (IL-3)-dependent FDC-P1 cells. Histone genes are transcriptionally upregulated in response to a series of cellular regulatory signals that mediate competency for cell cycle progression of the G1/S-phase transition. We therefore focused on factors that are functionally related to activity of the principal cell cycle regulatory element of the histone H4 promoter: CDC2, cyclin A, as well as RB- and IRF-related proteins. Comparisons were made with activities of ubiquitous transcription factors that influence a broad spectrum of promoters independent of proliferation or expression of tissue-specific phenotypic properties. Northern blot analysis indicates that cellular levels of cyclin A and CDC2 mRNAs increase when DNA synthesis and H4 gene expression are initiated, supporting involvement in cell cycle progression. Using gel-shift assays, incorporating factor-specific antibody and oligonucleotide competition controls, we define three sequential period following cytokine stimulation of FDC-P1 cells when selective upregulation of a subset of transcription factors is observed. In the initial period, the levels of SP1 and HiNF-P are moderately elevated; ATF, AP-1, and HiNF-M/IRF-2 are maximal during the second period; while E2F and HiNF-D, which contain cyclin A as a component, predominate during the third period, coinciding with maximal H4 gene expression and DNA synthesis. Differential regulation of H4 gene transcription factors following growth stimulation is consistent with a principal role of histone gene promoter elements in integrating cues from multiple signaling pathways that control cell cycle induction and progression. Regulation of transcription factors controlling histone gene promoter activity within the context of a staged cascade of responsiveness to cyclins and other physiological mediators of proliferation in FDC-P1 cells provides a paradigm for experimentally addressing interdependent cell cycle and cell growth parameters that are operative in hematopoietic stem cells.

Base Sequence↗

Three-dimensional sonographic evaluation of the infant spine: preliminary findings.

PURPOSE: The aims of this study were to evaluate normal spinal anatomy in neonates and infants as seen by 3-dimensional sonography (3D US), to determine the value of 3D US in the evaluation of occult spinal dysraphia in infants, and to correlate the findings of 3D US with those of 2-dimensional sonography (2D US) and MRI, when available. METHODS: We used 2D US and 3D US to examine the lumbosacral spine in infants with cutaneous stigmata, syndromes associated with spinal dysraphia, and abnormal radiographs. We also evaluated, as controls, healthy infants who had no markers of spinal abnormality. 2D sonograms, 3D sonograms, radiographs, and MRI scans, when available, were compared to assess differences in the display of the infant spine. RESULTS: In total, we examined 29 infants: 18 subjects and 11 control infants. The correlation between 2D US and 3D US was 100% in the detection of congenital defects of the spinal cord, although 3D US allowed superior visualization of the vertebral bodies and posterior spinal elements. When a gross abnormality of the posterior spinal elements occurred with pathologic overlying soft tissue, interpretation was simpler with MRI than with sonography. CONCLUSIONS: 3D US is a useful adjunct to 2D US when screening the infant spine for congenital defects, particularly in showing alignment of posterior spinal elements and integrity of vertebral bodies. This ability is important because posterior spinal defects may be associated with underlying spinal cord abnormalities.

Humans↗

Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.

This article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS-UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS-UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1-day face-to-face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS-UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS-UPDRS in order to increase uniform usage. Multiple language editions are planned. A three-part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process.

Disability Evaluation↗

Psychological Capital and Perceived Stress in Nurses: The Mediating Role of Need for Recovery and Recovery Experiences.

AIM: To examine whether recovery experiences and need for recovery mediate the association between psychological capital and perceived stress in nurses. DESIGN: Cross-sectional online survey. METHODS: A total of 184 nurses currently practicing in France completed an anonymous online questionnaire administered in January 2023. Participants completed the French versions of the Psychological Capital Questionnaire, the Recovery Experience Scale, the Need for Recovery Scale, and the Perceived Stress Scale. Two mediation models were estimated using ordinary least squares regression with percentile bootstrap inference for the indirect effects. RESULTS: Psychological capital was positively associated with recovery experiences and negatively associated with need for recovery. Need for recovery was strongly and positively associated with perceived stress, while psychological capital showed no direct association with perceived stress. The indirect effect of psychological capital on perceived stress through need for recovery was statistically detectable, whereas a complementary indirect effect through recovery experiences was in the expected direction but did not meet the bootstrap criterion for statistical significance. CONCLUSION: In this cross-sectional sample, psychological capital was associated with lower perceived stress primarily through its association with reduced need for recovery rather than through a direct association with stress. Interventions intended to protect nurse well-being should therefore be conceived as combining individual resource-building with organizational architectures that enable effective recovery. IMPLICATION FOR NURSING PRACTICE: Psychological capital should be seen as one element in integrated interventions rather than a stand-alone solution to nursing stress. Brief recovery-focused interventions for nurses need to be combined with scheduling practices and organizational policies that protect rest and make recovery feasible, a configuration that appears more promising than psychological capital training alone. REPORTING METHOD: The study followed the STROBE Statement for the reporting of cross-sectional studies. NO PATIENT OR PUBLIC CONTRIBUTION: This study focused on nurses as study participants. No patient or public stakeholder was involved in the design, conduct, or interpretation of the research, since the research question concerns occupational psychological resources rather than clinical practice or care delivery.

Humans↗

Transcripts from a novel human KRAB zinc finger gene contain spliced Alu and endogenous retroviral segments.

During the course of an investigation into the potential effects of endogenous retroviruses on adjacent gene expression, we isolated two cDNA clones containing a small sequence segment belonging to the human endogenous retrovirus family, HERV-H. Characterization of the clones revealed that they represent transcripts from a novel KRAB zinc finger gene termed ZNF177. The two cDNA clones differ at their 5' termini and in the presence of a 559-bp internal exon. The clone containing this internal exon has six imperfect zinc finger motifs followed by seven perfect copies of the C2H2 type but has a frame shift between the KRAB domain and the downstream zinc finger region. The smaller clone lacks the six imperfect motifs and has an intact ORF. The 5' putative untranslated regions of both cDNAs contain an 86-bp HERV-H env segment and a segment of an Alu repeat, both in the antisense orientation, that have been incorporated by splicing. RT-PCR experiments show evidence of alternative splicing but the majority of transcripts appear to contain the Alu and env segments. Genomic PCR and hybridization experiments suggest that a partial HERV-H element is integrated within the ZNF177 locus, which Southern analysis has shown to be a single-copy gene. Northern and RT-PCR analyses suggest that ZNF177 is transcribed at a low level in a variety of cell types.

Amino Acid Sequence↗

Integration of IS3 into IS2 generates a short sequence duplication.

The Gal+ allele IS2-43 is known to segregate Gal- clones. Among 11 Gal- segregants, one was shown to be due to the integration of IS3 into IS2-43. Precise excision of the integrated IS3 element occurred at a rate of 5 x 10(-9)/cell/generation. DNA sequence analysis revealed that the termini of the IS3 element have the relation of imperfect inverted repeats and it is now flanked by a 3bp or 4bp duplication, a size which has not been seen before with other elements.

Alleles↗

Sexual fantasy and pornography: two cases of girls brought up with pornography.

A normal part of late childhood and preadolescence for boys is exposure to pornography. The visual imagery of the forbidden acts in pornography are readily integrated with sexual fantasy in masturbation and in social sex. Money and Ehrhardt (1972) have attributed the fact that proportionately more women (36%) than men (11%) do not make any use of visual imagery during sexual acts to a greater biological readiness to respond to distal, visual images with arousal among men. While such a biological threshold hypothesis may well be correct, the ubiquity of practice with norm-violative behavior in the excited and approving context of the childhood male peer group could make an important contribution to the later uptake of pornographic imagery into fantasy. A full test of the Money and Ehrhardt hypothesis would be impossible, entailing a study of adolescent fantasy among a group of girls who grew up just like boys until adolescence. Two sisters close in age, now women in their 20s, grew up with pornography ad lib because of the family's business in pornographic publishing. They were interviewed for their sexual histories. One uses visual fantasy and has integrated some elements of the imagery of the pornography for a period into her sexual life; the other has not. Implications for the definition of the two gender curricula--what boys learn from other boys and girls from other girls--are discussed.

Adolescent↗

Nuclear organization and transcriptional silencing in yeast.

Transcriptional repression at the yeast silent mating type loci requires the formation of a nucleoprotein complex at specific cis-acting elements called silencers, which in turn promotes the binding of a histone-associated Sir-protein complex to adjacent chromatin. A similar mechanism of long-range transcriptional repression appears to function near telomeric repeat sequences, where it has been demonstrated that Sir3p is a limiting factor for the propagation of silencing. A combined immunofluorescence/in situ hybridization method for budding yeast was developed that maintains the three-dimensional structure of the nucleus. In wild-type cells the immunostaining of Sir3p, Sir4p and Rap1 colocalizes with Y' subtelomeric sequences detected by in situ hybridization. All three antigens and the subtelomeric in situ hybridization signals are clustered in foci, which are often adjacent to, but not coincident with, nuclear pores. This colocalization of Rap1, Sir3p and Sir4p with telomeres is lost in sir mutants, and also when Sir4p is overexpressed. To test whether the natural positioning of the two HM loci, located roughly 10 and 25 kb from the ends of chromosome III, is important for silencer function, a reporter gene flanked by wild-type silencer elements was integrated at various internal sites on other yeast chromosomes. We find that integration at internal loci situated far from telomeres abrogates the ability of silencers to repress the reporter gene. Silencing can be restored by creation of a telomere at 13 kb from the reporter construct, or by insertion of 340 bp of yeast telomeric repeat sequence at this site without chromosomal truncation. Elevation of the internal nuclear pools of Sir1p, Sir3p and Sir4p can relieve the lack of repression at the LYS2 locus in an additive manner, suggesting that in wild-type cells silencer function is facilitated by its juxtaposition to a pool of highly concentrated Sir proteins, such as those created by telomere clustering.

Cell Nucleus↗

Screen-printed transcutaneous oxygen sensor employing polymer electrolytes.

A disposable, transcutaneous oxygen sensor has been designed and implemented using screen-printing technology for all fabrication stages. The sensor incorporates an integral heating element to promote transcutaneous diffusion of blood gases so that a reliable estimation of arterial blood gas concentration can be obtained. The oxygen sensing part of the device consists of a screen-printed Clark cell implemented as electrodes, electrolyte and membrane. A three-electrode configuration is employed with gold working and counter electrodes and a silver/silver chloride reference electrode. Several different polymer electrolyte and membrane materials were evaluated in the construction of the device, and their performances were compared. A fully automated gas testing rig was constructed to enable oxygen levels to be varied under computer control. Cyclic voltammetry and static analysis of the sensors were carried out at different oxygen concentration levels and in various test environments. Linear relationships were established with an averaged sensitivity level of 0.02 microA(mmHg)(-1) and high regression coefficients of 0.99. The prototype covered with a polytetrafluoroethylene membrane gave the experimental result of I (microA) = -0.025PO2 (mmHg) - 0.085. Several factors influenced the performance of the sensors. The investigations have greatly contributed towards an understanding of the suitability of the materials in achieving a viable, low-cost sensor.

Blood Gas Monitoring, Transcutaneous↗

Identification and characterization of a locus inhibiting extrachromosomal maintenance of the Streptomyces plasmid SLP1.

We report here the existence and initial characterization of a genetic locus (imp) that inhibits maintenance of SLP1-derived plasmids as extrachromosomal replicons in a manner distinct from normal incompatibility between autonomous SLP1 replicons. The trans-acting imp function has been localized to a 1.8 kb Eco47III restriction fragment present on integrated SLP1 elements. At least part of this DNA segment is absent from SLP1-derived plasmids. DNA sequence analysis of the imp region indicates that it contains three overlapping open reading frames (ORFs) that may constitute a polycistronic operon. The effects of insertions within the imp region indicate that uninterrupted transcription through all three ORFs is necessary for imp activity.

Amino Acid Sequence↗

Hair zinc and copper concentrations and zinc: copper ratios in pediatric malignancies and healthy children from southeastern Turkey.

Twenty-eight healthy and forty-six children with malignancy admitted to the Pediatrics Oncology Clinic and Outpatient Clinic of Dicle University, Medical Faculty, Department of Pediatrics in 1989-1990 were included into this study. The children under investigation were divided into three groups. Group 1 consisted of 28 healthy children. Twenty-eight children with newly diagnosed malignant disease, before the start of treatment, formed Group 2. Group 3 consisted of eight of these 28 children together with 18 other children with malignancy in complete remission. 1. Mean hair zinc and copper levels, and zinc/copper values for Group 2 were found to be 100.7 +/- 6.8 micrograms/g, 11.0 +/- 0.8 micrograms/g, and 10.0 +/- 0.8, respectively. 2. The corresponding values for Group 3 were obtained as 143.5 +/- 6.3 micrograms/g, 7.6 +/- 0.4 micrograms/g, and 20.2 +/- 1.4. 3. The values for Group 1 were 142.6 +/- 4.5 micrograms/g, 8.4 +/- 0.5 micrograms/g, and 19.0 +/- 1.4, respectively. 4. The differences between control-active-phase and active-phase-remission groups were statistically significant (p < 0.01), whereas almost the same values were obtained for the control and remission groups (p > 0.05). These results were valid in cases where the comparisons of these three groups were performed also for the subgroups. It was shown that hair zinc and copper levels and zinc/copper values are useful parameters for the diagnosis and treatment of the children with malignancy because of the fact that hair reflects the integrated trace element concentrations of the body, not the present one.

Adolescent↗

[The "qualified outpatient detoxification" model project].

In 1998, a model project of outpatient detoxification in alcoholics was initiated in a German outpatient clinic. Inclusion and exclusion criteria of this project, which is supported by local health care providers, are presented. Between August 1998 and June 2000, 205 patients were screened. Psychotherapeutically motivating elements are integrated, so that this may be termed a "qualified" detoxification program. One hundred forty-one patients entered the program, of whom 127 (90%) successfully finished treatment. No serious medical complications were observed. Of those who completed treatment, 121 entered further alcoholic rehabilitation programs. Some preliminary data of an ongoing catamnestic study suggest that, after a mean of 10 months post-detoxification, 61 (50%) of these patients are still abstinent and in rehabilitation programs. The findings suggest that outpatient alcohol detoxification is safe and efficient, at least for a subgroup of patients, and also indicate the possible efficacy of concomitant psychotherapeutic interventions during this mode of treatment.

Adult↗

Electrochemical sensing with electrodes modified with molecularly imprinted polymer films.

This article summarises our work on the development of voltammetric sensors based on molecularly imprinted polymers. Several recognition elements and integration strategies were used:1.membranes electropolymerised at the electrode surface; 2.casting of polymeric membranes by drop-coating a solution of pre-formed polymer (polyphosphazene) and template in a low-boiling-point solvent on to the electrode surface; 3.preparation of composite membranes containing conductive material (graphite or carbon black), acrylic-type molecularly imprinted polymers (small particle size), and PVC as binder; and 4.in-situ polymerisation of a thin layer of acrylic imprinted polymer deposited on the electrode surface by spin coating. All the options evaluated offer the possibility of controlling electrode characteristics such as hydrophobic/hydrophilic character, permeability, or film thickness, which are essential for obtaining good sensor performance.

Chemistry Techniques, Analytical↗

Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation.

The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patients with suspected internal derangements of the knee joint prospectively underwent MR imaging at 1.5 T. For signal detection, a 6-channel array coil was used. All patients were investigated with a standard imaging protocol consisting of different turbo spin-echo sequences proton density (PD), T2-weighted turbo spin echo (TSE) with and without fat suppression) in three imaging planes. All sequences were repeated with an integrated parallel acquisition technique (iPAT) using the modified sensitivity encoding (mSENSE) algorithm with an acceleration factor of 2. Two radiologists independently evaluated and scored all images with regard to overall image quality, artefacts and pathologic findings. Agreement of the parallel ratings between readers and imaging techniques, respectively, was evaluated by means of pairwise kappa coefficients that were stratified for the area of evaluation. Agreement between the parallel readers for both the iPAT imaging and the conventional technique, respectively, as well as between imaging techniques was found encouraging with inter-observer kappa values ranging between 0.78 and 0.98 for both imaging techniques, and the inter-method kappa values ranging between 0.88 and 1.00 for both clinical readers. All pathological findings (e.g. occult fractures, meniscal and cruciate ligament tears, torn and interpositioned Hoffa's cleft, cartilage damage) were detected by both techniques with comparable performance. The use of iPAT lead to a 48% reduction of acquisition time compared with standard technique. Parallel imaging using mSENSE proved to be an efficient and economic tool for fast musculoskeletal MR imaging of the knee joint with comparable diagnostic performance to conventional MR imaging.

Adolescent↗

[Are the "elderly" living at the expense of the "young"? Remarks on the burden distribution between "generations" in an aging population from the economic perspective].

Public and scientific discussion on the effects of an aging population is often biased: aging is primarily seen as an economic burden. Increasing contribution rates in pension schemes, health and long-term care insurance are highlighted. This paper tries to provide a more balanced view. The distinction between a cross-sectional and a longitudinal view already gives different information on distributional effects. Labeling older people as "economically inactive" is a much too narrow perspective focused on the activity on the labor market only. Other types of work are neglected such as caring for children or frail elderly as well as economic activities from wealth, consumption as well as paying taxes to finance public expenditure. The approach of "generational accounting" is also narrow, focusing on public expenditure, social insurance contributions and only some types of taxes, but not dealing with private, especially intrafamily transfers. In economic terms, a comprehensive approach is needed regarding the effect of institutions and measures on the economic situation of cohorts. The role of investment in human capital is mentioned as a decisive factor for productivity in a country. Further education and retraining of older workers is one important element. An integrative approach dealing with the different fields of activities is needed when analyzing the intergenerational as well as the intragenerational distribution. This requires an elaborated and differentiated reporting of distributional effects. This important precondition, however, does not exist in Germany.

Aged↗