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The CBM experiment will investigate heavy-ion collisions at beam energies from 8 to 45 AGeV at the future accelerator facility FAIR. The goal of the experiment is to study the QCD phase diagram in the vincinity of the QCD critical point. To do so, CBM aims at measuring rare probes among them open charm. In order to identify those rare and short lived particles despite the rich combinatorial background generated in heavy ion collisions, a micro vertex detector (MVD) providing an unprecedented combination of high rate capability and radiation hardness, very light material budget and excellent granularity is required. In this work, we will discuss the concept of this detector and summarize the status of the R&D.
In der vorliegenden Arbeit wird die Einbindung der Navigation in die operative Versorgung der Femurfrakur beschrieben und mit der konventionellen Methode verglichen. Die Marknagelung ist eine von Prof. Dr. G. B. G. Küntscher in den 40er Jahren des 20ten Jahrhunderts entwickelte Behandlung zur Bruchversorgung und Durchführung von Arthrodesen. Die Navigation ist eine Variante der computer-assistierten Chirurgie. Diese Technologien haben in den 90er Jahren des 20ten Jahrhunderts Einzug in die Operationssäle gehalten. Die Navigationssysteme erfahren eine fortwährende Entwicklung und Ausweitung des Einsatzgebietes. Sie konnten sich bis jetzt jedoch nicht, trotz der Möglichkeiten, gegenüber den bisherigen konventionellen Entwicklungen im Bereich der intramedullären Marknagelversorgung durchsetzen. Den Vorzügen der Navigation, der Reduktion der Strahlenbelastung und Erhöhung der Präzision, werden hohe Anschaffungskosten, eine lange Einarbeitungszeit, längere Vorbereitungs- und Operationszeiten und der personelle Mehraufwand gegenüber gestellt. Ein ausführlicher Vergleich der Navigation mit dem konventionellen Verfahren existiert in der Fachliteratur bis jetzt nur auf einzelne Arbeitsschritte bezogen, wie z.B. dem Vorgang der distalen Verriegelung. In unseren Untersuchungen wurden 22 Patienten mit der Navigation versorgt. Die konventionelle Methode wurde bei 12 Patienten verwendet. Alle entscheidenden Schritte der Femurmarknagelversorgung, die Nageleintrittsbestimmung, die Frakturreposition und die distale Verriegelung wurden in der Dauer und Strahlenbelastung erfasst, ebenso die Gesamtoperationszeit und Gesamtstrahlenbelastung einander gegenübergestellt und mit den vorhandenen Daten in der Fachliteratur verglichen. Die Verwendung der Navigation hat den Arbeitsschritt des Nageleintritts verlängert (23,3 min vs 14,8 min). Gegenüber der konventionellen Methode konnte eine Reduktion der Röntgenzeit um 22 % (0,39 min vs 0,5 min) bei diesem Vorgang beobachtet werden. Die navigierte Frakturreposition dauerte im Durchschnitt 25,1 min vs 16,8 min bei der konventionellen Methode. Die Strahlenbelastung konnte um 70 % auf 0,39 min vs 1,28 min gesenkt werden. Die Rate der geschlossenen Frakturrepositionen lag bei 86 % gegenüber 67 % bei dem konventionellen Vorgehen. Die distale Verriegelung mit zwei Bolzen konnte mit der Navigation in 28,9 min vs 13,9 min bei der konventionellen Methode durchgeführt werden. Die Röntgenzeit wurde mit Hilfe der Navigation um 50 % reduziert (0,39 min vs 0,78 min). Die Präzision bei der distalen Verriegelung konnte mit dem Verfahren der Navigation gegenüber der konventionellen Methode und dem strahlendurchlässigen Winkelgetriebe nur geringfügig gesteigert werden (93 % bei 44 Bolzen vs 91 % bei 23 Bolzen). Die Gesamtoperationszeit der navigierten Fälle war durchschnittlich 43,2 min länger als die konventionell behandelten Fälle (150,1 min vs 106,9 min). Die Gesamtstrahlenzeit konnte mit der Navigation gegenüber der konventionellen Methode um 37,5 % gesenkt werden (2,5 min vs 4 min). Die Vorteile der Navigation zeigten sich vorallem bei der Frakturreposition. Hier konnte die Strahlenbelastung deutlich gesenkt werden (70 %, 0,39 min vs 1,28 min). Die Rate der erfolgreichen geschlossenen Manöver wurde gegenüber der konventionellen Methode gesteigert (86 % vs 67 %).
Bei der distalen Verriegelung haben wir eine Reduktion der Dauer einer Bohrung mit Navigation um 14 % gegenüber der konventionellen Methode mit dem strahlendurchlässigen Winkelgetriebe festgestellt (3,6 min vs 4,2 min, gemessen Haut-inzision und Bohrung bis Gegencorticalis). Die Gesamtstrahlenzeit für den Vorgang der distalen Verriegelung mit zwei Bolzen und sich anschließender Lagekontrolle zeigte sich mit der Navigation um 50 % redziert (0,39 min vs 0,78 min). Ein zeitlicher Mehraufwand wurde durch die Vorbereitung der Navigation bei allen Arbeitsschritten festgestellt.
Mechanistic and structural insights into the quality control of the MHC I antigen processing pathway
(2022)
The human body is permanently exposed to its environment and thus to viruses and other pathogens, which require a flexible response and defense. Alongside to the innate immune system, the adaptive immune system provides highly specialized protection against these threats. The major histocompatibility complex class I (MHC I) antigen presentation system is a cornerstone of the adaptive immune system and a major constituent of cellular immunity. Pathogens such as viruses that invade a cell will leave traces in the form of proteins and peptides which are degraded and loaded onto MHC I molecules. MHC I peptide loading is performed by peptide loading complex (PLC) in the membrane of the endoplasmic reticulum as part of a multifaceted and comprehensive quality control machinery. Monitored by multiple layers of quality assurance, the MHC I molecules consequently display the immune status of the cell on its surface. In this context, the captured fragment of the virus serves as a call for help issued by the cell, alerting the adaptive immune system to the infection to mount an appropriate immune response.
The three-dimensional structure as well as the mechanistic details of parts of this complex machinery were characterized in the context of this dissertation. Among other tools, light-modulable nanotools were developed in this thesis, which permit external regulation of cellular processes in temporal and spatial resolution. Furthermore, methods and model systems for the biochemical characterization of cellular signaling cascades, proteins, as well as entire cell organelles were developed, which are likely to influence the field of cellular immunity and protein biochemistry in the future.
This cumulative work comprises a total of six publications whose scientific key advances will be briefly outlined in this abstract. In the introduction, the scientific background as well as the current state of research and methodological background knowledge are conveyed. The results section condenses the main aspects of the publications and links them to each other. Further details can be retrieved from the attached original publications.
In “Semisynthetic viral inhibitor for light control of the MHC I peptide loading complex, Winter, Domnick et al., Angew Chem Int Ed 2022” a photocleavable viral inhibitor of the peptide loading complex was produced by semi-synthesis. This nanotool was shown to be suitable for both purifying the PLC from human Raji cells as well as reactivating it in a light-controlled manner. Thus, this tool establishes the isolation of a fully intact and functional peptide loading complex for biochemical characterization. In addition, a novel flow cytometric analysis pipeline for microsomes was developed, allowing cellular vesicles to be characterized with single organelle resolution, similar to cells.
In “Molecular basis of MHC I quality control in the peptide loading complex, Domnick, Winter et al., Nat Commun 2022” the peptide loading complex was reconstituted into large nanodiscs, and a cryo-EM structural model of the editing module at 3.7 Å resolution was generated. By combining the structural model with in vitro glycan editing assays, an allosteric coupling between peptide-MHC I assembly and glycan processing was revealed, extending the known model of MHC I loading and dissociation from the PLC. These mechanisms provide a prototypical example for endoplasmic reticulum quality control.
In a related context, in “Structure of an MHC I–tapasin–ERp57 editing complex defines chaperone promiscuity, Müller, Winter et al., Nat Commun 2022” a recombinantly assembled editing module comprised of MHC I-tapasin-ERp57 was crystallized for X-ray structural biology. The resulting crystal structure at a resolution of 2.7 Å permitted the precise identification of characteristic features of the editing module and particularly of the peptide proofreading mechanism of tapasin. This study provided pivotal insights into the tapasin-mediated peptide editing of different MHC I allomorphs as well as similarities to TAPBPR-based MHC I peptide proofreading.
In “TAPBPR is necessary and sufficient for UGGT1-mediated quality control of MHC I, Sagert, Winter et al. (in preparation)” novel insights concerning the peptide proofreader TAPBPR and its close interplay with the folding sensor and glucosyltransferase UGGT1 were obtained. It was shown that TAPBPR is an integral part of the second level of endoplasmic quality control and is indispensable for effective MHC I coordination by UGGT1.
In “Light-guided intrabodies for on-demand in situ target recognition in human cells, Joest, Winter et al., Chem Sci 2021” intracellular nanobodies were equipped with a photocaged target recognition domain by genetic code expansion via amber suppression. These intrabodies, acting as high-affinity binding partners endowed with a fluorophore, could be used in a light-triggered approach to instantaneously visualize their target molecule...
A positive association between brain size and intelligence is firmly established, but whether region-specific anatomical differences contribute to general intelligence remains an open question. Results from voxel-based morphometry (VBM) - one of the most widely used morphometric methods - have remained inconclusive so far. Here, we applied cross-validated machine learning-based predictive modeling to test whether out-of-sample prediction of individual intelligence scores is possible on the basis of voxel-wise gray matter volume. Features were derived from structural magnetic resonance imaging data (N = 308) using (a) a purely data-driven method (principal component analysis) and (b) a domain knowledge-based approach (atlas parcellation). When using relative gray matter (corrected for total brain size), only the atlas-based approach provided significant prediction, while absolute gray matter (uncorrected) allowed for above-chance prediction with both approaches. Importantly, in all significant predictions, the absolute error was relatively high, i.e., greater than ten IQ points, and in the atlas-based models, the predicted IQ scores varied closely around the sample mean. This renders the practical value even of statistically significant prediction results questionable. Analyses based on the gray matter of functional brain networks yielded significant predictions for the fronto-parietal network and the cerebellum. However, the mean absolute errors were not reduced in contrast to the global models, suggesting that general intelligence may be related more to global than region-specific differences in gray matter volume. More generally, our study highlights the importance of predictive statistical analysis approaches for clarifying the neurobiological bases of intelligence and provides important suggestions for future research using predictive modeling.
Downstream effects of plectin mutations in epidermolysis bullosa simplex with muscular dystrophy
(2016)
Mutations of the human plectin gene (PLEC) on chromosome 8q24 cause autosomal recessive epidermolysis bullosa simplex with muscular dystrophy (EBS-MD). In the present study we analyzed the downstream effects of PLEC mutations on plectin protein expression and localization, the structure of the extrasarcomeric desmin cytoskeleton, protein aggregate formation and mitochondrial distribution in skeletal muscle tissue from three EBS-MD patients.
PLEC gene analysis in a not previously reported 35-year-old EBS-MD patient with additional disease features of cardiomyopathy and malignant arrhythmias revealed novel compound heterozygous (p.(Phe755del) and p.(Lys1040Argfs*139)) mutations resulting in complete abolition of plectin protein expression. In contrast, the other two patients with different homozygous PLEC mutations showed preserved plectin protein expression with one only expressing rodless plectin variants, and the other markedly reduced protein levels. Analysis of skeletal muscle tissue from all three patients revealed severe disruption of the extrasarcomeric intermediate filament cytoskeleton, protein aggregates positive for desmin, syncoilin, and synemin, degenerative myofibrillar changes, and mitochondrial abnormalities comprising respiratory chain dysfunction and an altered organelle distribution and amount.
Our study demonstrates that EBS-MD causing PLEC mutations universally result in a desmin protein aggregate myopathy phenotype despite marked differences in individual plectin protein expression patterns. Since plectin is the key cytolinker protein that regulates the structural and functional organization of desmin filaments, the defective anchorage and spacing of assembled desmin filaments is the key pathogenetic event that triggers the formation of desmin protein aggregates as well as secondary mitochondrial pathology.
Methodik
(2002)
Die vegetationskundliche und strukturelle Zuordnung der Lebensraumtypen erfolgt nach der vorrangig von Braun-Blanquet entwickelten Vegetationsklassifizierung, einer hierarchischen Gliederung der Vegetationstypen (Syntaxonomie), die die Ebenen der Assoziation, des Verbandes, der Ordnung und der Klasse umfasst. Hierbei ist die Assoziation die grundlegende Einheit, in der die Pflanzengesellschaften zusammengefasst werden, die sich durch gleiche charakteristische Arten(gruppen)kombinationen auszeichnen. Der Verband vereinigt ähnliche Assoziationen. Das sind bereits umfassendere, jedoch standörtlich noch recht einheitliche Vegetationseinheiten. In Ordnungen werden ähnliche Verbände zusammengefasst. Die Klasse vereinigt ähnliche Ordnungen.
Objective: This study was undertaken to elicit patients' preferences for attributes characterizing antiseizure medication (ASM) monotherapy options before treatment consultation, and to explore the trade-offs patients consider between treatment efficacy and risks of side effects. Further objectives were to explore how treatment consultation may affect patient preferences, to elicit physicians' preferences in selecting treatment, and to compare patient and physician preferences for treatment.
Methods: This prospective, observational study (EP0076; VOTE) included adults with focal seizures requiring a change in their ASM monotherapy. Patients completed a discrete choice experiment (DCE) survey before and after treatment consultation. Physicians completed a similar survey after the consultation. The DCE comprised 12 choices between two hypothetical treatments defined by seven attributes. The conditional relative importance of each attribute was calculated.
Results: Three hundred ten patients (mean [SD] age = 46.8 [18.3] years, 52.3% female) were enrolled from eight European countries, of whom 305 completed the survey before consultation and 273 completed the survey before and after consultation. Overall, this preference study in patients who intended to receive a new ASM monotherapy suggests that patient preferences were ordered as expected, with better outcomes being preferred to worse outcomes; patients preferred a higher chance of seizure freedom, lower risk of developing clinical depression, and fewer severe adverse events; avoiding moderate-to-severe “trouble thinking clearly” was more important than avoiding any other side effect. There were qualitative differences in what patients and physicians considered to be the most important aspects of treatment for patients; compared with patients, physicians had a qualitatively stronger preference for greater chance of seizure freedom and avoiding personality changes. Patients' preference weights were qualitatively similar before and after treatment consultation.
Significance: For patients, seizure freedom and avoiding trouble thinking clearly were the most important treatment attributes. Physicians and patients may differ in the emphasis they place on specific attributes.
