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Objective: Fluconazle or posaconazole is a standard of care in antifungal prophylaxis for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). However, many patients need to interrupt standard prophylaxis due to intolerability, drug‐drug interactions, or toxicity. Micafungin has come to prominence for these patients. However, the optimal biological dose of micafungin stays unclear.
Methods: We retrospectively evaluated the efficacy of micafungin as antifungal prophylaxis in HSCT patients. Micafungin was applied as bridging in patients who were not eligible to receive oral posaconazole. Micafungin was either given at a dose of 100 mg or 50 mg SID.
Results: A total of 173 patients received micafungin prophylaxis, 62 in the 100 mg and 111 in the 50 mg dose group. The incidence of probable or proven breakthrough IFDs during the observation period was one in the 100 mg and one in the 50 mg group. Fungal‐free survival after 100 days was 98% and 99% (P = .842), and overall survival after 365 days was 60% and 63% (P = .8) respectively. In both groups, micafungin was well tolerated with no grade 3 or 4 toxicities.
Conclusion: In this retrospective analysis, which was not powered to detect non‐inferiority, micafungin is effective and complements posaconazole as fungal prophylaxis in HSCT.
Review of: Vinzenz Brinkmann, Oliver Primavesi, Max Hollein (eds.), Circumlitio. The Polychromy of Antique and Medieval Sculpture. Proceedings of the Johann David Passavant Colloquium, 10-12 December 2008. Liebighaus Skulpturensammlung, Frankfurt am Main, 2010, 423 pp., 334 colour ill.,ISBN 978-3-7774-2871-0
New scientific methods now being applied to the analysis of traces of pigments and gilding on ancient Greek and Roman marble statuary, and other marble artefacts, have the potential to revolutionise our understanding of the relationship between form and colour in antiquity. At present the enquiry is still in its infancy, but the papers delivered at a conference held in Frankfurt in 2008, reviewed here, provide a general introduction to the subject and to a wide range of work in progress.
Characteristics and clinical outcome of breast cancer patients with asymptomatic brain metastases
(2020)
Simple Summary: The prognosis for patients with breast cancer that has spread to the brain is poor, and survival for these women hasn’t improved over the last few decades. We do not currently test for asymptomatic brain metastases in breast cancer patients, although this does happen in some other types of cancer. In this study we wanted to find out more about breast cancer that has spread to the brain and in particular to see whether there might be any advantage to spotting brain metastases before the development of neurological symptoms. Overall, our results suggest that women could be better off if their brain metastases are diagnosed before they begin to cause symptoms. We now need to carry out a clinical trial to see what happens if we screen high-risk breast cancer patients for brain metastases. This will verify whether doing so could increase survival, symptom control or quality of life.
Abstract: Background: Brain metastases (BM) have become a major challenge in patients with metastatic breast cancer. Methods: The aim of this analysis was to characterize patients with asymptomatic BM (n = 580) in the overall cohort of 2589 patients with BM from our Brain Metastases in Breast Cancer Network Germany (BMBC) registry. Results: Compared to symptomatic patients, asymptomatic patients were slightly younger at diagnosis (median age: 55.5 vs. 57.0 years, p = 0.01), had a better performance status at diagnosis (Karnofsky index 80–100%: 68.4% vs. 57%, p < 0.001), a lower number of BM (>1 BM: 56% vs. 70%, p = 0.027), and a slightly smaller diameter of BM (median: 1.5 vs. 2.2 cm, p < 0.001). Asymptomatic patients were more likely to have extracranial metastases (86.7% vs. 81.5%, p = 0.003) but were less likely to have leptomeningeal metastasis (6.3% vs. 10.9%, p < 0.001). Asymptomatic patients underwent less intensive BM therapy but had a longer median overall survival (statistically significant for a cohort of HER2-positive patients) compared to symptomatic patients (10.4 vs. 6.9 months, p < 0.001). Conclusions: These analyses show a trend that asymptomatic patients have less severe metastatic brain disease and despite less intensive local BM therapy still have a better outcome (statistically significant for a cohort of HER2-positive patients) than patients who present with symptomatic BM, although a lead time bias of the earlier diagnosis cannot be ruled out. Our analysis is of clinical relevance in the context of potential trials examining the benefit of early detection and treatment of BM.
The ecological validity of neuropsychological testing (NT) has been questioned in the sports environment. A frequent criticism is that NT, mostly consisting of pen and paper or digital assessments, lacks relevant bodily movement. This study aimed to identify the determinants of a newly developed testing battery integrating both cognitive and motor demands. Twenty active individuals (25 ± 3 years, 11 males) completed the new motor-cognitive testing battery (MC), traditional NT (Stroop test, Trail Making test, Digit Span test) and isolated assessments of motor function (MF; Y-balance test, 20m-sprint, counter-movement jump). Kendal’s tau and partial Spearman correlations were used to detect associations between MC and NT/MF. Except for two items (Reactive Agility A and counter-movement jump; Run-Decide and sprint time; r = 0.37, p < 0.05), MC was not related to MF. Similarly, MC and NT were mostly unrelated, even when controlling for the two significant motor covariates (p > 0.05). The only MC item with (weak to moderate) associations to NT was the Memory Span test (Digit Span backwards and composite; r = 0.43–0.54, p < 0.05). In sum, motor-cognitive function appears to be largely independent from its two assumed components NT and MF and may represent a new parameter in performance diagnostics.
Diverse extracellular signals induce plasma membrane translocation of sphingosine kinase-1 (SphK1), thereby enabling inside-out signaling of sphingosine-1-phosphate. We have shown before that Gq-coupled receptors and constitutively active Gαq/11 specifically induced a rapid and long-lasting SphK1 translocation, independently of canonical Gq/phospholipase C (PLC) signaling. Here, we further characterized Gq/11 regulation of SphK1. SphK1 translocation by the M3 receptor in HEK-293 cells was delayed by expression of catalytically inactive G-protein-coupled receptor kinase-2, p63Rho guanine nucleotide exchange factor (p63RhoGEF), and catalytically inactive PLCβ3, but accelerated by wild-type PLCβ3 and the PLCδ PH domain. Both wild-type SphK1 and catalytically inactive SphK1-G82D reduced M3 receptor-stimulated inositol phosphate production, suggesting competition at Gαq. Embryonic fibroblasts from Gαq/11 double-deficient mice were used to show that amino acids W263 and T257 of Gαq, which interact directly with PLCβ3 and p63RhoGEF, were important for bradykinin B2 receptor-induced SphK1 translocation. Finally, an AIXXPL motif was identified in vertebrate SphK1 (positions 100–105 in human SphK1a), which resembles the Gαq binding motif, ALXXPI, in PLCβ and p63RhoGEF. After M3 receptor stimulation, SphK1-A100E-I101E and SphK1-P104A-L105A translocated in only 25% and 56% of cells, respectively, and translocation efficiency was significantly reduced. The data suggest that both the AIXXPL motif and currently unknown consequences of PLCβ/PLCδ(PH) expression are important for regulation of SphK1 by Gq/11.
Crustal structure at the western end of the North Anatolian Fault Zone from deep seismic sounding
(2001)
The first deep seismic sounding experiment in Northwestern Anatolia was carried out in October 1991 as part of the "German - Turkish Project on Earthquake Prediction Research" in the Mudurnu area of the North Anatolian Fault Zone. The experiment was a joint enterprise by the Institute of Meteorology and Geophysics of Frankfurt University, the Earthquake Research Institute (ERI) in Ankara, and the Turkish Oil Company (TPAO). Two orthogonal profiles, each 120 km in length with a crossing point near Akyazi, were covered in succession by 30 short period tape recording seismograph stations with 2 km station spacing. 12 shots, with charge sizes between 100 and 250 kg, were fired and 342 seismograms out of 360 were used for evaluation. By coincidence an M b = 4.5 earthquake located below Imroz Island was also recorded and provided additional information on Moho and the sub-Moho velocity. A ray tracing method orginally developed by Weber (1986) was used for travel time inversion. From a compilation of all data two generalized crustal models were derived, one with velocity gradients within the layers and one with constant layer velocities. The latter consists of a sediment cover of about 2 km with V p » 3.6 km/s, an upper crystalline crust down to 13 km with V p » 5.9 km/s, a middle crust down to 25 km depth with V p » 6.5 km/s, a lower crust down to 39 km Moho depth with V p » 7.0 km/s and V p » 8.05 km/s below the Moho. The structure of the individual profiles differs slightly. The thickest sediment cover is reached in the Izmit-Sapanca-trough and in the Akyazi basin. Of particular interest is a step of about 4 km in the lower crust near Lake Sapanca and probably an even larger one in the Moho (derived from the Imroz earthquake data). After the catastrophic earthquake of Izmit on 17 August 1999 this significant heterogeneity in crustal structure appears in a new light with regard to the possible cause of the Izmit earthquake. Heterogeneities in structure are frequently also heterogeneities in strength and stress that impede or even lock rupture. The Izmit earthquake is discussed in relation to a large stepover or jog at the North Anatolian Fault.
Background: A large number of idiosyncratic drug induced liver injury (iDILI) and herb induced liver injury(HILI) cases of variable quality has been published but some are a matter of concern if the cases were not evaluated for causality using a robust causality assessment method (CAM) such as RUCAM (Roussel Uclaf Causality Assessment Method) as diagnostiinjuryc algorithm. The purpose of this analysis was to evaluate the worldwide use of RUCAM in iDILI and HILI cases. Methods: The PubMed database (1993–30 June 2020) was searched for articles by using the following key terms: Roussel Uclaf Causality Assessment Method; RUCAM; Idiosyncratic drug induced liver injury; iDILI; Herb induced liver injury; HILI. Results: Considering reports published worldwide since 1993, our analysis showed the use of RUCAM for causality assessment in 95,885 cases of liver injury including 81,856 cases of idiosyncratic DILI and 14,029 cases of HILI. Among the top countries providing RUCAM based DILI cases were, in decreasing order, China, the US, Germany, Korea, and Italy, with China, Korea, Germany, India, and the US as the top countries for HILI. Conclusion: Since 1993 RUCAM is certainly the most widely used method to assess causality in IDILI and HILI. This should encourage practitioner, experts, and regulatory agencies to use it in order to reinforce their diagnosis and to take sound decisions.
We model the decisions of young individuals to stay in school or drop out and engage in criminal activities. We build on the literature on human capital and crime engagement and use the framework of Banerjee (1993) that assumes that the information needed to engage in crime arrives in the form of a rumour and that individuals update their beliefs about the profitability of crime relative to education. These assumptions allow us to study the effect of social interactions on crime. In our model, we investigate informational spillovers from the actions of talented students to less talented students. We show that policies that decrease the cost of education for talented students may increase the vulnerability of less talented students to crime. The effect is exacerbated when students do not fully understand the underlying learning dynamics.
Various strategies have been employed to speed tissue regeneration using bioactive molecules. Interestingly, platelet concentrates derived from a patient’s own blood have been utilized as a regenerative strategy in recent years. In the present study, a novel liquid platelet formulation prepared without the use of anti-coagulants (injectable-platelet-rich fibrin, i-PRF) was compared to standard platelet-rich plasma (PRP) with gingival fibroblasts cultured on smooth and roughened titanium implant surfaces. Standard PRP and i-PRF (centrifuged at 700 rpm (60× g) for 3 min) were compared by assays for fibroblast biocompatibility, migration, adhesion, proliferation, as well as expression of platelet-derived growth factor (PDGF), transforming growth factor-β (TGF-β), collagen1 (COL1) and fibronectin (FN). The results demonstrate that i-PRF induced significantly higher cell migration, as well as higher messenger RNA (mRNA) levels of PDGF, TGF-β, collagen1 and fibronectin when compared to PRP. Furthermore, collagen1 synthesis was highest in the i-PRF group. These findings demonstrate that liquid platelet concentrates can be formulated without the use of anticoagulants and present much translational potential for future research. Future animal and clinical trials are now necessary to further investigate the potential of utilizing i-PRF for soft tissue regenerative protocols in combination with various biomaterials.
We aim to understand whether Greek and Italian, two null subject languages, differ in the use and interpretation of null subjects, based on evidence from both a production and a comprehension experiment. The results of the two experiments show that the two languages differ in the extent to which they comply with the Position of Antecedent Strategy as formulated by Carminati (2002). In order to account for this difference, we introduce a principle which defines prominence of sentence constituents in terms of hierarchical height, elaborating on a recent proposal by Rizzi (2018). Then we show that the prominence of subject and object constituents in Greek and Italian reflects word-order differences between the two languages (Roussou & Tsimpli 2006). In more general terms, this paper argues in favour of a multi-factorial approach to reference interpretation, in that syntactic factors interact with discourse factors, leading to a gradient variety of reference possibilities.