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Borsch, Thomas ; Stevens, Albert-Dieter ; Häffner, Eva ; Güntsch, Anton ; Berendsohn, Walter G. ; Appelhans, Marc Sebastian ; Barilaro, Christina ; Beszteri, Bánk ; Blattner, Frank R. ; Bossdorf, Oliver ; Dalitz, Helmut ; Dressler, Stefan ; Duque-Thüs, Rhinaixa ; Esser, Hans-Joachim ; Franzke, Andreas ; Goetze, Dethardt ; Grein, Michaela ; Grünert, Uta ; Hellwig, Frank ; Hentschel, Jörn ; Hörandl, Elvira ; Janßen, Thomas ; Jürgens, Norbert ; Kadereit, Gudrun ; Karisch, Timm ; Koch, Marcus ; Müller, Frank ; Müller, Jochen ; Ober, Dietrich ; Porembski, Stefan ; Poschlod, Peter ; Printzen, Christian ; Röser, Martin ; Sack, Peter ; Schlüter, Philipp M. ; Schmidt, Marco ; Schnittler, Martin ; Scholler, Markus ; Schultz, Matthias ; Seeber, Elke ; Simmel, Josef ; Stiller, Michael ; Thiv, Mike ; Thüs, Holger ; Tkach, Natalia ; Triebel, Dagmar ; Warnke, Ursula ; Weibulat, Tanja ; Wesche, Karsten ; Yurkov, Andrey ; Zizka, Georg
Plants, fungi and algae are important components of global biodiversity and are fundamental to all ecosystems. They are the basis for human well-being, providing food, materials and medicines. Specimens of all three groups of organisms are accommodated in herbaria, where they are commonly referred to as botanical specimens.The large number of specimens in herbaria provides an ample, permanent and continuously improving knowledge base on these organisms and an indispensable source for the analysis of the distribution of species in space and time critical for current and future research relating to global biodiversity. In order to make full use of this resource, a research infrastructure has to be built that grants comprehensive and free access to the information in herbaria and botanical collections in general. This can be achieved through digitization of the botanical objects and associated data.The botanical research community can count on a long-standing tradition of collaboration among institutions and individuals. It agreed on data standards and standard services even before the advent of computerization and information networking, an example being the Index Herbariorum as a global registry of herbaria helping towards the unique identification of specimens cited in the literature.In the spirit of this collaborative history, 51 representatives from 30 institutions advocate to start the digitization of botanical collections with the overall wall-to-wall digitization of the flat objects stored in German herbaria. Germany has 70 herbaria holding almost 23 million specimens according to a national survey carried out in 2019. 87% of these specimens are not yet digitized. Experiences from other countries like France, the Netherlands, Finland, the US and Australia show that herbaria can be comprehensively and cost-efficiently digitized in a relatively short time due to established workflows and protocols for the high-throughput digitization of flat objects.Most of the herbaria are part of a university (34), fewer belong to municipal museums (10) or state museums (8), six herbaria belong to institutions also supported by federal funds such as Leibniz institutes, and four belong to non-governmental organizations. A common data infrastructure must therefore integrate different kinds of institutions.Making full use of the data gained by digitization requires the set-up of a digital infrastructure for storage, archiving, content indexing and networking as well as standardized access for the scientific use of digital objects. A standards-based portfolio of technical components has already been developed and successfully tested by the Biodiversity Informatics Community over the last two decades, comprising among others access protocols, collection databases, portals, tools for semantic enrichment and annotation, international networking, storage and archiving in accordance with international standards. This was achieved through the funding by national and international programs and initiatives, which also paved the road for the German contribution to the Global Biodiversity Information Facility (GBIF).Herbaria constitute a large part of the German botanical collections that also comprise living collections in botanical gardens and seed banks, DNA- and tissue samples, specimens preserved in fluids or on microscope slides and more. Once the herbaria are digitized, these resources can be integrated, adding to the value of the overall research infrastructure. The community has agreed on tasks that are shared between the herbaria, as the German GBIF model already successfully demonstrates.We have compiled nine scientific use cases of immediate societal relevance for an integrated infrastructure of botanical collections. They address accelerated biodiversity discovery and research, biomonitoring and conservation planning, biodiversity modelling, the generation of trait information, automated image recognition by artificial intelligence, automated pathogen detection, contextualization by interlinking objects, enabling provenance research, as well as education, outreach and citizen science.We propose to start this initiative now in order to valorize German botanical collections as a vital part of a worldwide biodiversity data pool.
Niemi, Mari K. ; Karjalainen, Juha ; Liao, Rachel G. ; Neale, Benjamin M. ; Daly, Mark ; Ganna, Andrea ; Pathak, Gita A. ; Andrews, Shea J. ; Kanai, Masahiro ; Veerapen, Kumar ; Fernandez-Cadenas, Israel ; Schulte, Eva C. ; Striano, Pasquale ; Marttila, Minttu ; Minica, Camelia ; Marouli, Eirini ; Karim, Mohd Anisul ; Wendt, Frank R. ; Savage, Jeanne ; Sloofman, Laura ; Butler-Laporte, Guillaume ; Kim, Han-Na ; Kanoni, Stavroula ; Okada, Yukinori ; Byun, Jinyoung ; Han, Younghun ; Uddin, Mohammed Jashim ; Smith, George Davey ; Willer, Cristen J. ; Buxbaum, Joseph D. ; Mehtonen, Juha ; Finucane, Hilary ; Cordioli, Mattia ; Martin, Alicia R. ; Zhou, Wei ; Pasaniuc, Bogdan ; Julienne, Hanna ; Aschard, Hugues ; Shi, Huwenbo ; Yengo, Loic ; Polimanti, Renato ; Ghoussaini, Maya ; Schwartzentruber, Jeremy ; Dunham, Ian ; Chwialkowska, Karolina ; Francescatto, Margherita ; Trankiem, Amy ; Balaconis, Mary K. ; Davis, Lea ; Lee, Sulggi ; Priest, James ; Renieri, Alessandra ; Sankaran, Vijay G. ; van Heel, David ; Deelen, Patrick ; Richards, J. Brent ; Nakanishi, Tomoko ; Biesecker, Les ; Kerchberger, V. Eric ; Baillie, J. Kenneth ; Mari, Francesca ; Bernasconi, Anna ; Baillie, Stefano Ceri ; Canakoglu, Arif ; Wolford, Brooke ; Faucon, Annika ; Dutta, Atanu Kumar ; Schurmann, Claudia ; Harry, Emi ; Birney, Ewan ; Nguyen, Huy ; Nasir, Jamal ; Kaunisto, Mari ; Solomonson, Matthew ; Dueker, Nicole ; Vadgama, Nirmal ; Limou, Sophie ; Rahmouni, Souad ; Mbarek, Hamdi ; Darwish, Dima ; Uddin, Md Mesbah ; Albertos, Raquel ; Pérez-Tur, Jordi ; Li, Ruolin ; Folkersen, Lasse ; Moltke, Ida ; Koelling, Nils ; Teumer, Alexander ; Kousathanas, Athanasios ; Utrilla, Alicia ; Verdugo, Ricardo A. ; Zárate, Ruth ; Medina-Gómez, Carolina ; Gómez-Cabrero, David ; Carnero-Montoro, Elena ; Cadilla, Carmen L. ; Moreno-Estrada, Andrés ; Garmendia, Adriana ; Moya, Leire ; Sedaghati-Khayat, Bahar ; Boua, Palwendé Romuald ; Favé, Marie-Julie ; Francioli, Laurent ; Lemaçon, Audrey ; Migeotte, Isabelle ; Patel, Sanjay ; Varnai, Reka ; Szentpeteri, Jozsef L. ; Sipeky, Csilla ; Colombo, Francesca ; von Hohenstaufen, Kathrin ; Lio, Pietro ; Vallerga, Costanza ; Wang, Qingbo ; Tanigawa, Yosuke ; Im, Hogune ; Han, Chulho ; Song, Han ; Lim, Jiwoo ; Lee, Younhe ; Kim, Sugyeong ; Im, Sangyoon ; Atanasovska, Biljana ; Ahmad, Hajar Fauzan ; Boer, Cindy ; Jansen, Philip ; Franke, Lude ; Kaja, Elżbieta ; Pasko, Dorota ; Kennis-Szilagyi, Ingrid ; Kornilov, Sergey A. ; Prijatelj, Vid ; Prokić, Ivana ; Sivanadhan, Ilangkumaran ; Perumal, Sarala ; Esmaeeli, Sahar ; Pearson, Nathaniel M. ; Auton, Adam ; Shelton, Janie F. ; Shastri, Anjali J. ; Filshtein-Sonmez, Teresa ; Coker, Daniella ; Symons, Antony ; Esparza-Gordillo, Jorge ; Aslibekyan, Stella ; O’Connell, Jared ; Ye, Chelsea ; Weldon, Catherine H. ; Perera, Minoli ; O’Leary, Kevin ; Tuck, Matthew ; O’Brien, Travis ; Meltzer, David ; O’Donnell, Peter ; Nutescu, Edith ; Yang, Guang ; Alarcon, Cristina ; Herrmann, Stefanie ; Mazurek, Sophia ; Banagan, Jeff ; Hamidi, Zacharia ; Barbour, April ; Raffat, Noora ; Moreno, Diana ; Friedman, Paula ; Ferwerda, Bart ; van de Beek, Diederik ; Brouwer, Matthijs C. ; Vlaar, Alexander P. J. ; Wiersinga, W. Joost ; Posthuma, Danielle ; Tissink, Elleke ; Koos Zwinderman, A. H. ; Uffelmann, Emil ; van Agtmael, Michiel ; Algera, Anne Geke ; van Baarle, Frank ; Bax, Diane ; Beudel, Martijn ; Jan Bogaard, Harm ; Bomers, Marije ; Bonta, Peter I. ; Bos, Lieuwe ; Botta, Michela ; de Brabander, Justin ; de Bree, Godelieve ; de Bruin, Sanne ; Bugiani, Marianna ; Bulle, Esther ; Chouchane, Osoul ; Cloherty, Alex ; Dongelmans, Dave ; Elbers, Paul ; Fleuren, Lucas ; Geerlings, Suzanne ; Geerts, Bart ; Geijtenbeek, Theo ; Girbes, Armand ; Goorhuis, Bram ; Grobusch, Martin P. ; Hafkamp, Florianne ; Hagens, Laura ; Hamann, Jorg ; Harris, Vanessa ; Hemke, Robert ; Hermans, Sabine M. ; Heunks, Leo ; Hollmann, Markus ; Horn, Janneke ; Hovius, Joppe W. ; de Jong, Menno D. ; Koning, Rutger ; van Mourik, Niels ; Nellen, Jeannine ; Nossent, Esther J. ; Paulus, Frederique ; Peters, Edgar ; van der Poll, Tom ; Preckel, Bennedikt ; Prins, Jan M. ; Raasveld, Jorinde ; Reijnders, Tom ; Schinkel, Michiel ; Schultz, Marcus J. ; Schuurman, Alex ; Sigaloff, Kim ; Smit, Marry ; Stijnis, Cornelis S. ; Stilma, Willemke ; Teunissen, Charlotte ; Thoral, Patrick ; Tsonas, Anissa ; van der Valk, Marc ; Veelo, Denise ; de Vries, Heder ; van Vugt, Michèle ; Wouters, Dorien ; Minnaar, René P. ; Kromhout, Adrie ; van Uffelen, Kees W. J. ; Wolterman, Ruud A. ; Roberts, Genevieve ; Park, Danny ; Ball, Catherine A. ; Coignet, Marie ; McCurdy, Shannon ; Knight, Spencer ; Partha, Raghavendran ; Rhead, Brooke ; Zhang, Miao ; Berkowitz, Nathan ; Gaddis, Michael ; Noto, Keith ; Ruiz, Luong ; Pavlovic, Milos ; Hong, Eurie L. ; Rand, Kristin ; Girshick, Ahna ; Guturu, Harendra ; Baltzell, Asher Haug ; Rahmouni, Souad ; Guntz, Julien ; Beguin, Yves ; Pigazzini, Sara ; Nkambule, Lindokuhle ; Bouysran, Youssef ; Busson, Adeline ; Peyrassol, Xavier ; Wilkin, Françoise ; Pichon, Bruno ; Smits, Guillaume ; Vandernoot, Isabelle ; Goffard, Jean-Christophe ; Georges, Michel ; Moutschen, Michel ; Misset, Benoit ; Darcis, Gilles ; Guiot, Julien ; Jadot, Laurent ; Azarzar, Samira ; Dellot, Patricia ; Gofflot, Stéphanie ; Claassen, Sabine ; Bertrand, Axelle ; Parzibut, Gilles ; Clarinval, Mathilde ; Moermans, Catherine ; Malaise, Olivier ; El Kandoussi, Kamilia ; Thonon, Raphaël ; Huynen, Pascale ; Mesdagh, Alyssia ; Melo, Sofia ; Jacques, Nicolas ; Di Valentin, Emmanuel ; Giroule, François ; Collignon, Alice ; Radermecker, Coraline ; Lebrun, Marielle ; Perée, Hélène ; Latour, Samuel ; Barada, Olivia ; Sanchez, Judit ; Josse, Claire ; Boujemla, Bouchra ; Meunier, Margot ; Mariavelle, Emeline ; Anania, Sandy ; Gazon, Hélène ; Juszczak, Danusia ; Fadeur, Marjorie ; Camby, Séverine ; Meuris, Christelle ; Thys, Marie ; Jacques, Jessica ; Henket, Monique ; Léonard, Philippe ; Frippiat, Frederic ; Giot, Jean-Baptiste ; Sauvage, Anne-Sophie ; Von Frenckell, Christian ; Mni, Myriam ; Wéry, Marie ; Staderoli, Alicia ; Belhaj, Yasmine ; Lambermont, Bernard ; Morrison, David R. ; Mooser, Vincent ; Forgetta, Vincenzo ; Li, Rui ; Ghosh, Biswarup ; Laurent, Laetitia ; Belisle, Alexandre ; Henry, Danielle ; Abdullah, Tala ; Adeleye, Olumide ; Mamlouk, Noor ; Kimchi, Nofar ; Afrasiabi, Zaman ; Rezk, Nardin ; Vulesevic, Branka ; Bouab, Meriem ; Guzman, Charlotte ; Petitjean, Louis ; Tselios, Chris ; Xue, Xiaoqing ; Afilalo, Jonathan ; Afilalo, Marc ; Oliveira, Maureen ; Brenner, Bluma ; Brassard, Nathalie ; Durand, Madeleine ; Schurr, Erwin ; Lepage, Pierre ; Ragoussis, Jiannis ; Auld, Daniel ; Chassé, Michaël ; Kaufmann, Daniel E. ; Lathrop, G. Mark ; Adra, Darin ; Davis, Lea K. ; Cox, Nancy J. ; Below, Jennifer E. ; Sealock, Julia M. ; Faucon, Annika B. ; Shuey, Megan M. ; Polikowsky, Hannah G. ; Petty, Lauren E. ; Shaw, Douglas M. ; Chen, Hung-Hsin ; Zhu, Wanying ; Ludwig, Kerstin U. ; Schröder, Julia ; Maj, Carlo ; Rolker, Selina ; Nöthen, Markus M. ; Fazaal, Julia ; Keitel, Verena ; Jensen, Björn-Erik Ole ; Feldt, Torsten ; Kurth, Ingo ; Marx, Nikolaus ; Dreher, Michael ; Pink, Isabell ; Cornberg, Markus ; Illig, Thomas ; Lehmann, Clara ; Schommers, Philipp ; Augustin, Max ; Rybniker, Jan ; Knopp, Lisa ; Eggermann, Thomas ; Volland, Sonja ; Altmüller, Janine ; Berger, Marc M. ; Brenner, Thorsten ; Hinney, Anke ; Witzke, Oliver ; Bals, Robert ; Herr, Christian ; Ludwig, Nicole ; Walter, Jörn ; Fuchsberger, Christian ; Pattaro, Cristian ; De Grandi, Alessandro ; Pramstaller, Peter ; Emmert, David ; Melotti, Roberto ; Foco, Luisa ; Mascalzoni, Deborah ; Gögele, Martin ; Domingues, Francisco ; Hicks, Andrew ; Gignoux, Christopher R. ; Wicks, Stephen J. ; Crooks, Kristy ; Barnes, Kathleen C. ; Daya, Michelle ; Shortt, Jonathan ; Rafaels, Nicholas ; Chavan, Sameer ; Goldstein, David B. ; Kiryluk, Krzysztof ; Sengupta, Soumitra ; Chung, Wendy ; Reilly, Muredach P. ; Khan, Atlas ; Wang, Chen ; Povysil, Gundula ; Bhardwaj, Nitin ; Gharavi, Ali G. ; Ionita-Laza, Iuliana ; Shang, Ning ; O’Byrne, Sheila M. ; Nandakumar, Renu ; Menon, Amritha ; So, Yat S. ; Hod, Eldad ; Pendrick, Danielle ; Kim, Han-Na ; Park, Soo-Kyung ; Kim, Hyung-Lae ; Kang, Chang Kyung ; Lee, Hyo-Jung ; Song, Kyoung-Ho ; Jae Yoon, Kyung ; Paik, Nam-Jong ; Seok, Woojin ; Yoon, Heejun ; Joo, Eun-Jeong ; Chang, Yoosoo ; Ryu, Seungho ; Park, Wan Beom ; Su Park, Jeong ; Un Park, Kyoung ; Ham, Sin Young ; Jung, Jongtak ; Kim, Eu Suk ; Kim, Hong Bin ; Ellinghaus, David ; Degenhardt, Frauke ; Cáceres, Mario ; Juzenas, Simonas ; Lenz, Tobias L. ; Albillos, Agustín ; Julià, Antonio ; Heidecker, Bettina ; Garcia, Federico ; Kurth, Florian ; Tran, Florian ; Hanses, Frank ; Zoller, Heinz ; Holter, Jan C. ; Fernández, Javier ; Sander, Leif Erik ; Rosenstiel, Philip ; Koehler, Philipp ; de Cid, Rafael ; Asselta, Rosanna ; Schreiber, Stefan ; Hehr, Ute ; Prati, Daniele ; Baselli, Guido ; Valenti, Luca ; Bujanda, Luis ; Banales, Jesus M. ; Duga, Stefano ; D’Amato, Mauro ; Romero-Gómez, Manuel ; Buti, Maria ; Invernizzi, Pietro ; Franke, Andre ; Hov, Johannes R. ; Karlsen, Tom H. ; Folseraas, Trine ; Maya-Miles, Douglas ; Teles, Ana ; Azuure, Clinton ; Wacker, Eike Matthias ; Uellendahl-Werth, Florian ; ElAbd, Hesham ; Arora, Jatin ; Lerga-Jaso, Jon ; Wienbrandt, Lars ; Rühlemann, Malte Christoph ; Wendorff, Mareike ; Vadla, May Sissel ; Lenning, Ole Bernt ; Özer, Onur ; Myhre, Ronny ; Raychaudhuri, Soumya ; Tanck, Anja ; Gassner, Christoph ; Hemmrich-Stanisak, Georg ; Kässens, Jan ; Figuera Basso, Maria E. ; Schulzky, Martin ; Wittig, Michael ; Braun, Nicole ; Wesse, Tanja ; Albrecht, Wolfgang ; Yi, Xiaoli ; Ortiz, Aaron Blandino ; Chercoles, Adolfo Garrido ; Ruiz, Agustín ; Mantovani, Alberto ; Holten, Aleksander Rygh ; Mayer, Alena ; Cherubini, Alessandro ; Protti, Alessandro ; Aghemo, Alessio ; Gerussi, Alessio ; Ramirez, Alfredo ; Braun, Alice ; Barreira, Ana ; Lleo, Ana ; Kildal, Anders Benjamin ; Glück, Andreas ; Nolla, Anna Carreras ; Latiano, Anna ; Dyrhol-Riise, Anne Ma ; Muscatello, Antonio ; Voza, Antonio ; Rando-Segura, Ariadna ; Solier, Aurora ; Karina, Banasik ; Cortes, Beatriz ; Mateos, Beatriz ; Nafria-Jimenez, Beatriz ; Schaefer, Benedikt ; Bellinghausen, Carla ; Ferrando, Carlos ; Quereda, Carmen ; Skurk, Carsten ; Thibeault, Charlotte ; Spinner, Christoph D. ; Lange, Christoph ; Hu, Cinzia ; Cappadona, Claudio ; Bianco, Cristiana ; Sancho, Cristina ; Lihaug Hoff, Dag Arne ; Galimberti, Daniela ; Jiménez, David ; Pestaña, David ; Toapanta, David ; Azzolini, Elena ; Scarpini, Elio ; Helbig, Elisa T. ; Urrechaga, Eloisa ; Paraboschi, Elvezia Maria ; Pontali, Emanuele ; Reverter, Enric ; Navas, Enrique ; Arana, Eunate ; Sánchez, Félix García ; Ceriotti, Ferruccio ; Malvestiti, Francesco ; Mesonero, Francisco ; Pezzoli, Gianni ; Lamorte, Giuseppe ; Neb, Holger ; My, Ilaria ; Hernández, Isabel ; de Rojas, Itziar ; Galván-Femenia, Iván ; Heyckendorf, Jan ; Rybniker, Jan ; Badia, Joan Ramon ; Schneider, Jochen ; Goikoetxea, Josune ; Kraft, Julia ; Müller, Karl Erik ; Gaede, Karoline I. ; Garcia-Etxebarria, Koldo ; Tonby, Kristian ; Heggelund, Lars ; Izquierdo-Sanchez, Laura ; Sumoy, Lauro ; Lippert, Lena J. ; Terranova, Leonardo ; Garbarino, Lucia ; Téllez, Luis ; Roade, Luisa ; Ostadreza, Mahnoosh ; Intxausti, Maider ; Kogevinas, Manolis ; Gutiérrez-Stampa, María A. ; Vehreschild, Maria J. G. T. ; Marquié, Marta ; Castoldi, Massimo ; Cecconi, Maurizio ; Boada, Mercè ; Seilmaier, Michael J. ; Mazzocco, Michela ; Rodríguez-Gandía, Miguel ; Ayo, Natale Imaz ; Blay, Natalia ; Martínez, Nilda ; Cornely, Oliver A. ; Palmieri, Orazio ; Tentorio, Paolo ; Rodrigues, Pedro M. ; España, Pedro P. ; Hoffmann, Per ; Bacher, Petra ; Suwalski, Phillip ; de Pablo, Raúl ; Nieto, Rosa ; Badalamenti, Salvatore ; Ciesek, Sandra ; Bombace, Sara ; Wilfling, Sibylle ; Brunak, Søren ; Heilmann-Heimbach, Stefanie ; Ripke, Stephan ; Bahmer, Thomas ; Landmesser, Ulf ; Protzer, Ulrike ; Rimoldi, Valeria ; Skogen, Vegard ; Andrade, Victor ; Moreno, Victor ; Poller, Wolfgang ; Farre, Xavier ; Wang, Xiaomin ; Khodamoradi, Yascha ; Karadeniz, Zehra ; de Salazar, Adolfo ; Palom, Adriana ; Garcia-Fernandez, Alba-Estela ; Blanco-Grau, Albert ; Zanella, Alberto ; Bandera, Alessandra ; Nebel, Almut ; Biondi, Andrea ; Caballero-Garralda, Andrea ; Gori, Andrea ; Lind, Andreas ; Fracanzani, Anna Ludovica ; Peschuck, Anna ; Pesenti, Antonio ; de la Horra, Carmen ; Milani, Chiara ; Paccapelo, Cinzia ; Angelini, Claudio ; Cea, Cristina ; Muñiz-Diaz, Eduardo ; Sandoval, Elena ; Calderón, Enrique J. ; Solligård, Erik ; Aziz, Fátima ; Martinelli-Boneschi, Filippo ; Peyvandi, Flora ; Blasi, Francesco ; Medrano, Francisco J. ; Rodriguez-Frias, Francisco ; Müller, Fredrik ; Grasselli, Giacomo ; Costantino, Giorgio ; Cardamone, Giulia ; Foti, Giuseppe ; Matullo, Giuseppe ; Kurihara, Hayato ; Afset, Jan Egil ; Damås, Jan Kristian ; Ampuero, Javier ; Martín, Javier ; Erdmann, Jeanette ; Bergan, Jonas ; Goerg, Siegfried ; Ferrusquía-Acosta, Jose ; Quero, Jose Hernández ; Delgado, Juan ; Guerrero, Juan M. ; Risnes, Kari ; Bettini, Laura Rachele ; Moreira, Leticia ; Gustad, Lise Tuset ; Santoro, Luigi ; Scudeller, Luigia ; Riveiro-Barciela, Mar ; Schaefer, Marco ; Carrabba, Maria ; Valsecchi, Maria G. ; Hernandez-Tejero, María ; Acosta-Herrera, Marialbert ; D’Angiò, Mariella ; Baldini, Marina ; Cazzaniga, Marina ; Ciccarelli, Michele ; Bocciolone, Monica ; Miozzo, Monica ; Chueca, Natalia ; Montano, Nicola ; Faverio, Paola ; Preatoni, Paoletta ; Bonfanti, Paolo ; Omodei, Paolo ; Castro, Pedro ; Ferrer, Ricard ; Gualtierotti, Roberta ; Gallego-Durán, Rocío ; Morilla, Rubén ; Haider, Sammra ; Marsal, Sara ; Aneli, Serena ; Pelusi, Serena ; Bosari, Silvano ; Aliberti, Stefano ; Dudman, Susanne ; Zheng, Tenghao ; Pumarola, Tomas ; Cejudo, Trinidad Gonzalez ; Monzani, Valter ; Friaza, Vicente ; Peter, Wolfgang ; Dopazo, Ximo ; Duga, Stefano ; May, Sandra ; Grimsrud, Marit M. ; Gudbjartsson, Daniel F. ; Stefansson, Kari ; Sulem, Patrick ; Sveinbjornsson, Gardar ; Melsted, Pall ; Norddahl, Gudmundur ; Swerford Moore, Kristjan Helgi ; Thorsteinsdottir, Unnur ; Holm, Hilma ; Alarcón-Riquelme, Marta E. ; Bernardo, David ; Martínez-Bueno, Manuel ; Rello, Silvia Rojo ; Magi, Reedik ; Milani, Lili ; Metspalu, Andres ; Laisk, Triin ; Läll, Kristi ; Lepamets, Maarja ; Esko, Tõnu ; Reimann, Ene ; Naaber, Paul ; Laane, Edward ; Pesukova, Jaana ; Peterson, Pärt ; Kisand, Kai ; Tabri, Jekaterina ; Allos, Raili ; Hensen, Kati ; Starkopf, Joel ; Ringmets, Inge ; Tamm, Anu ; Kallaste, Anne ; Alavere, Helene ; Metsalu, Kristjan ; Puusepp, Mairo ; Kristiansson, Kati ; Koskelainen, Sami ; Perola, Markus ; Donner, Kati ; Kivinen, Katja ; Palotie, Aarno ; Palotie, Aarno ; Rivolta, Carlo ; Bochud, Pierre-Yves ; Bibert, Stéphanie ; Boillat, Noémie ; Nussle, Semira Gonseth ; Albrich, Werner ; Quinodoz, Mathieu ; Kamdar, Dhryata ; Suh, Noémie ; Neofytos, Dionysios ; Erard, Véronique ; Voide, Cathy ; Bochud, P. Y. ; Rivolta, C. ; Bibert, S. ; Quinodoz, M. ; Kamdar, D. ; Neofytos, D. ; Erard, V. ; Voide, C. ; Friolet, R. ; Vollenweider, P. ; Pagani, J. L. ; Oddo, M. ; zu Bentrup, F. Meyer ; Conen, A. ; Clerc, O. ; Marchetti, O. ; Guillet, A. ; Guyat-Jacques, C. ; Foucras, S. ; Rime, M. ; Chassot, J. ; Jaquet, M. ; Viollet, R. Merlet ; Lannepoudenx, Y. ; Portopena, L. ; Desgranges, F. ; Filippidis, P. ; Guéry, B. ; Haefliger, D. ; Kampouri, E. E. ; Manuel, O. ; Munting, A. ; Papadimitriou-Olivgeris, M. ; Regina, J. ; Rochat-Stettler, L. ; Suttels, V. ; Tadini, E. ; Tschopp, J. ; Van Singer, M. ; Viala, B. ; Boillat-Blanco, N. ; Brahier, T. ; Hügli, O. ; Meuwly, J. Y. ; Pantet, O. ; Nussle, S. Gonseth ; Bochud, M. ; D’Acremont, V. ; Younes, S. Estoppey ; Albrich, W. C. ; Suh, N. ; Cerny, A. ; O’Mahony, L. ; von Mering, C. ; Bochud, P. Y. ; Frischknecht, M. ; Kleger, G.-R. ; Filipovic, M. ; Kahlert, C. R. ; Wozniak, H. ; Negro, T. Rochat ; Pugin, J. ; Bouras, K. ; Knapp, C. ; Egger, T. ; Perret, A. ; Montillier, P. ; di Bartolomeo, C. ; Barda, B. ; de Cid, Rafael ; Carreras, Anna ; Moreno, Victor ; Galván-Femenía, Iván ; Blay, Natalia ; Farré, Xavier ; Sumoy, Lauro ; Cortés, Beatriz ; Mercader, Josep Maria ; Guindo-Martinez, Marta ; Torrents, David ; Garcia-Aymerich, Judith ; Castaño-Vinyals, Gemma ; Dobaño, Carlota ; Gori, Marco ; Renieri, Alessandra ; Mondelli, Mario Umberto ; Castelli, Francesco ; Vaghi, Massimo ; Rusconi, Stefano ; Montagnani, Francesca ; Bargagli, Elena ; Franchi, Federico ; Mazzei, Maria Antonietta ; Cantarini, Luca ; Tacconi, Danilo ; Feri, Marco ; Scala, Raffaele ; Spargi, Genni ; Nencioni, Cesira ; Bandini, Maria ; Caldarelli, Gian Piero ; Spagnesi, Maurizio ; Canaccini, Anna ; Ognibene, Agostino ; D’Arminio Monforte, Antonella ; Girardis, Massimo ; Antinori, Andrea ; Francisci, Daniela ; Schiaroli, Elisabetta ; Scotton, Pier Giorgio ; Panese, Sandro ; Scaggiante, Renzo ; Monica, Matteo Della ; Capasso, Mario ; Fiorentino, Giuseppe ; Castori, Marco ; Aucella, Filippo ; Di Biagio, Antonio ; Masucci, Luca ; Valente, Serafina ; Mandalà, Marco ; Zucchi, Patrizia ; Giannattasio, Ferdinando ; Coviello, Domenico A. ; Mussini, Cristina ; Bosio, Giancarlo ; Tavecchia, Luisa ; Crotti, Lia ; Rizzi, Marco ; La Rovere, Maria Teresa ; Sarzi-Braga, Simona ; Bussotti, Maurizio ; Ravaglia, Sabrina ; Artuso, Rosangela ; Perrella, Antonio ; Romani, Davide ; Bergomi, Paola ; Catena, Emanuele ; Vincenti, Antonella ; Ferri, Claudio ; Grassi, Davide ; Pessina, Gloria ; Tumbarello, Mario ; Di Pietro, Massimo ; Sabrina, Ravaglia ; Luchi, Sauro ; Barbieri, Chiara ; Acquilini, Donatella ; Andreucci, Elena ; Paciosi, Francesco ; Segala, Francesco Vladimiro ; Tiseo, Giusy ; Falcone, Marco ; Lista, Mirjam ; Poscente, Monica ; De Vivo, Oreste ; Petrocelli, Paola ; Guarnaccia, Alessandra ; Baroni, Silvia ; Perticaroli, Valentina ; Furini, Simone ; Dei, Simona ; Benetti, Elisa ; Picchiotti, Nicola ; Sanarico, Maurizio ; Ceri, Stefano ; Pinoli, Pietro ; Raimondi, Francesco ; Biscarini, Filippo ; Stella, Alessandra ; Bergomi, Mattia ; Zguro, Kristina ; Capitani, Katia ; Tanfoni, Marco ; Fallerini, Chiara ; Daga, Sergio ; Baldassarri, Margherita ; Fava, Francesca ; Frullanti, Elisa ; Valentino, Floriana ; Doddato, Gabriella ; Giliberti, Annarita ; Tita, Rossella ; Amitrano, Sara ; Bruttini, Mirella ; Croci, Susanna ; Meloni, Ilaria ; Mencarelli, Maria Antonietta ; Lo Rizzo, Caterina ; Pinto, Anna Maria ; Beligni, Giada ; Tommasi, Andrea ; Di Sarno, Laura ; Palmieri, Maria ; Carriero, Miriam Lucia ; Alaverdian, Diana ; Iuso, Nicola ; Inchingolo, Gabriele ; Busani, Stefano ; Bruno, Raffaele ; Vecchia, Marco ; Belli, Mary Ann ; Mantovani, Stefania ; Ludovisi, Serena ; Quiros-Roldan, Eugenia ; Antoni, Melania Degli ; Zanella, Isabella ; Siano, Matteo ; Emiliozzi, Arianna ; Fabbiani, Massimiliano ; Rossetti, Barbara ; Zanelli, Giacomo ; Bergantini, Laura ; D’Alessandro, Miriana ; Cameli, Paolo ; Bennet, David ; Anedda, Federico ; Marcantonio, Simona ; Scolletta, Sabino ; Guerrini, Susanna ; Conticini, Edoardo ; Frediani, Bruno ; Spertilli, Chiara ; Donati, Alice ; Guidelli, Luca ; Corridi, Marta ; Croci, Leonardo ; Piacentini, Paolo ; Desanctis, Elena ; Cappelli, Silvia ; Verzuri, Agnese ; Anemoli, Valentina ; Pancrazi, Alessandro ; Lorubbio, Maria ; Merlini, Esther ; Miraglia, Federica Gaia ; Venturelli, Sophie ; Cossarizza, Andrea ; Vergori, Alessandra ; Gabrieli, Arianna ; Riva, Agostino ; Paciosi, Francesco ; Andretta, Francesca ; Gatti, Francesca ; Parisi, Saverio Giuseppe ; Baratti, Stefano ; Piscopo, Carmelo ; Russo, Roberta ; Andolfo, Immacolata ; Iolascon, Achille ; Carella, Massimo ; Merla, Giuseppe ; Squeo, Gabriella Maria ; Raggi, Pamela ; Marciano, Carmen ; Perna, Rita ; Bassetti, Matteo ; Sanguinetti, Maurizio ; Giorli, Alessia ; Salerni, Lorenzo ; Parravicini, Pierpaolo ; Menatti, Elisabetta ; Trotta, Tullio ; Coiro, Gabriella ; Lena, Fabio ; Martinelli, Enrico ; Mancarella, Sandro ; Gabbi, Chiara ; Maggiolo, Franco ; Ripamonti, Diego ; Bachetti, Tiziana ; Suardi, Claudia ; Parati, Gianfranco ; Bottà, Giordano ; Di Domenico, Paolo ; Rancan, Ilaria ; Bianchi, Francesco ; Colombo, Riccardo ; van Heel, David A. ; Hunt, Karen A. ; Trembath, Richard C. ; Huang, Qin Qin ; Martin, Hilary C. ; Mason, Dan ; Trivedi, Bhavi ; Wright, John ; Finer, Sarah ; Griffiths, Christopher J. ; Akhtar, Shaheen ; Anwar, Mohammad ; Arciero, Elena ; Ashraf, Samina ; Breen, Gerome ; Chung, Raymond ; Curtis, Charles J. ; Chowdhury, Maharun ; Colligan, Grainne ; Deloukas, Panos ; Durham, Ceri ; Finer, Sarah ; Griffiths, Chris ; Huang, Qin Qin ; Hurles, Matt ; Hunt, Karen A. ; Hussain, Shapna ; Islam, Kamrul ; Khan, Ahsan ; Khan, Amara ; Lavery, Cath ; Lee, Sang Hyuck ; Lerner, Robin ; MacArthur, Daniel ; MacLaughlin, Bev ; Martin, Hilary ; Mason, Dan ; Miah, Shefa ; Newman, Bill ; Safa, Nishat ; Tahmasebi, Farah ; Trembath, Richard C. ; Trivedi, Bhavi ; van Heel, David A. ; Wright, John ; Smith, Albert V. ; Boughton, Andrew P. ; Li, Kevin W. ; LeFaive, Jonathon ; Annis, Aubrey ; Jannes, Cinthia E. ; Krieger, Jose E. ; Pereira, Alexandre C. ; Velho, Mariliza ; Marques, Emanuelle ; Lima, Isabella Ramos ; Tada, Mauricio Teruo ; Valino, Karina ; McCarthy, Mark ; Rosenberger, Carrie ; Lee, Jong Eun ; Chang, Diana ; Hammer, Christian ; Hunkapiller, Julie ; Mahajan, Anubha ; Pendergrass, Sarah ; Sucheston-Campbell, Lara ; Yaspan, Brian ; Lee, Hyun Soo ; Shin, Eunsoon ; Jang, Hye Yoon ; Kim, Sunmie ; Kym, Sungmin ; Kim, Yeon-Sook ; Jeong, Hyeongseok ; Kwon, Ki Tae ; Kim, Shin-Woo ; Kim, Jin Yong ; Jang, Young Rock ; Kim, Hyun ah ; Lee, Ji Yeon ; Lee, Jeong Eun ; Lee, Shinwon ; Choe, Kang-Won ; Kang, Yu Min ; Jee, Sun Ha ; Jung, Keum Ji ; Parikh, Victoria ; Ashley, Euan ; Wheeler, Matthew ; Rivas, Manuel ; Bustamante, Carlos ; Pinksy, Benjamin ; Febbo, Phillip ; Farh, Kyle ; Schroth, Gary P. ; deSouza, Francis ; Dalton, Karen ; Christle, Jeff ; Deboever, Christopher ; Szalma, Sándor ; Tanigawa, Yosuke ; Rubinacci, Simone ; Delaneau, Olivier ; Gorzynski, John ; de Jong, Hannah ; Sutton, Shirley ; Youlton, Nathan ; Joshi, Ruchi ; Jimenez-Morales, David ; Hughes, Christopher ; Amar, David ; Ioannidis, Alex ; Hershman, Steve ; Kirillova, Anna ; Seo, Kinya ; Huang, Yong ; Shoura, Massa ; Hammond, Nathan ; Watson, Nathaniel ; Raja, Archana ; Huang, ChunHong ; Sahoo, Malaya ; Wang, Hannah ; Zhen, Jimmy ; Rakitko, Alexander ; Ilinsky, Valery ; Yermakovich, Danat ; Popov, Iaroslav ; Chernitsov, Alexander ; Kovalenko, Elena ; Krasnenko, Anna ; Plotnikov, Nikolay ; Stetsenko, Ivan ; Kim, Anna ; Cirulli, Elizabeth T. ; Schiabor Barrett, Kelly M. ; Bolze, Alexandre ; White, Simon ; Washington, Nicole L. ; Lu, James T. ; Riffle, Stephen ; Tanudjaja, Francisco ; Wang, Xueqing ; Ramirez, Jimmy M. ; Leonetti, Nicole ; Sandoval, Efren ; Neveux, Iva ; Dabe, Shaun ; Grzymski, Joseph J. ; Esteban Miñano, Juan Ignacio ; Aguirre, Luis A. ; López-Collazo, Eduardo ; de la Mata Pazos, Manuel ; Cerrato, Luciano ; Folkersen, Lasse ; Lozano-Rodríguez, Roberto ; Avendaño-Ortiz, José ; Arcos, Verónica Terrón ; Montalbán-Hernández, Karla Marina ; Quiroga, Jaime Valentín ; Pascual-Iglesias, Alejandro ; Maroun-Eid, Charbel ; Martín-Quirós, Alejandro ; Namkoong, Ho ; Okada, Yukinori ; Imoto, Seiya ; Katayama, Kazuhiko ; Fukunaga, Koichi ; Kitagawa, Yuko ; Sato, Toshiro ; Hasegawa, Naoki ; Kumanogoh, Atsushi ; Kimura, Akinori ; Ai, Masumi ; Tokunaga, Katsushi ; Kanai, Takanori ; Miyano, Satoru ; Ogawa, Seishi ; Edahiro, Ryuya ; Sonehara, Kyuto ; Shirai, Yuya ; Kanai, Masahiro ; Ishii, Makoto ; Kabata, Hiroki ; Masaki, Katsunori ; Kamata, Hirofumi ; Ikemura, Shinnosuke ; Chubachi, Shotaro ; Okamori, Satoshi ; Terai, Hideki ; Tanaka, Hiromu ; Morita, Atsuho ; Lee, Ho ; Asakura, Takanori ; Sasaki, Junichi ; Morisaki, Hiroshi ; Uwamino, Yoshifumi ; Nanki, Kosaku ; Mikami, Yohei ; Tomono, Kazunori ; Kato, Kazuto ; Matsuda, Fumihiko ; Takahashi, Meiko ; Hizawa, Nobuyuki ; Takeda, Yoshito ; Hirata, Haruhiko ; Shiroyama, Takayuki ; Miyawaki, Satoru ; Suzuki, Ken ; Maeda, Yuichi ; Nii, Takuro ; Noda, Yoshimi ; Niitsu, Takayuki ; Adachi, Yuichi ; Enomoto, Takatoshi ; Amiya, Saori ; Hara, Reina ; Takahashi, Kunihiko ; Anzai, Tatsuhiko ; Hasegawa, Takanori ; Ito, Satoshi ; Koike, Ryuji ; Endo, Akifumi ; Uchimura, Yuji ; Miyazaki, Yasunari ; Honda, Takayuki ; Tateishi, Tomoya ; Tohda, Shuji ; Ichimura, Naoya ; Sonobe, Kazunari ; Sassa, Chihiro ; Nakajima, Jun ; Nannya, Yasuhito ; Omae, Yosuke ; Takahashi, Kazuhisa ; Harada, Norihiro ; Hiki, Makoto ; Takagi, Haruhi ; Nakamura, Ai ; Tagaya, Etsuko ; Kawana, Masatoshi ; Arimura, Ken ; Ishiguro, Takashi ; Takayanagi, Noboru ; Isono, Taisuke ; Takaku, Yotaro ; Takano, Kenji ; Anan, Ryusuke ; Nakajima, Yukiko ; Nakano, Yasushi ; Nishio, Kazumi ; Ueda, Soichiro ; Hayashi, Reina ; Tateno, Hiroki ; Hase, Isano ; Yoshida, Shuichi ; Suzuki, Shoji ; Mitamura, Keiko ; Saito, Fumitake ; Ueda, Tetsuya ; Azuma, Masanori ; Nagasaki, Tadao ; Yasui, Yoshinori ; Hasegawa, Yoshinori ; Mutoh, Yoshikazu ; Yoshiyama, Takashi ; Shoko, Tomohisa ; Kojima, Mitsuaki ; Adachi, Tomohiro ; Ishikawa, Motonao ; Takahashi, Kenichiro ; Watanabe, Kazuyoshi ; Manabe, Tadashi ; Ito, Fumimaro ; Fukui, Takahiro ; Funatsu, Yohei ; Koh, Hidefumi ; Hirai, Yoshihiro ; Kawashima, Hidetoshi ; Narita, Atsuya ; Niwa, Kazuki ; Sekikawa, Yoshiyuki ; Saito, Fukuki ; Yoshiya, Kazuhisa ; Yoshihara, Tomoyuki ; Suzuki, Yusuke ; Nakayama, Sohei ; Masuzawa, Keita ; Nishi, Koichi ; Nishitsuji, Masaru ; Tani, Maiko ; Inoue, Takashi ; Hirano, Toshiyuki ; Kobayashi, Keigo ; Miyazawa, Naoki ; Kimura, Yasuhiro ; Sado, Reiko ; Ogura, Takashi ; Kitamura, Hideya ; Murohashi, Kota ; Nakachi, Ichiro ; Baba, Rie ; Arai, Daisuke ; Fuke, Satoshi ; Saito, Hiroshi ; Kuwahara, Naota ; Fujiwara, Akiko ; Okada, Takenori ; Baba, Tomoya ; Noda, Junya ; Mashimo, Shuko ; Yagi, Kazuma ; Shiomi, Tetsuya ; Hashiguchi, Mizuha ; Odani, Toshio ; Mochimaru, Takao ; Oyamada, Yoshitaka ; Mori, Nobuaki ; Izumi, Namiki ; Nagata, Kaoru ; Taki, Reiko ; Murakami, Koji ; Yamada, Mitsuhiro ; Sugiura, Hisatoshi ; Hayashi, Kentaro ; Shimizu, Tetsuo ; Gon, Yasuhiro ; Fujitani, Shigeki ; Tsuchida, Tomoya ; Yoshida, Toru ; Kagaya, Takashi ; Kita, Toshiyuki ; Sakagami, Satoru ; Kimizuka, Yoshifumi ; Kawana, Akihiko ; Nakamura, Yoshihiko ; Ishikura, Hiroyasu ; Takata, Tohru ; Kikuchi, Takahide ; Taniyama, Daisuke ; Nakamura, Morio ; Kodama, Nobuhiro ; Kaneyama, Yasunari ; Maeda, Shunsuke ; Nagasaki, Yoji ; Okamoto, Masaki ; Ishihara, Sayoko ; Ito, Akihiro ; Chihara, Yusuke ; Takeuchi, Mayumi ; Onoi, Keisuke ; Hashimoto, Naozumi ; Wakahara, Keiko ; Ando, Akira ; Masuda, Makoto ; Wakabayashi, Aya ; Watanabe, Hiroki ; Sageshima, Hisako ; Nakada, Taka-Aki ; Abe, Ryuzo ; Shimada, Tadanaga ; Kawamura, Kodai ; Ichikado, Kazuya ; Nishiyama, Kenta ; Yamasaki, Masaki ; Hashimoto, Satoru ; Kusaka, Yu ; Ohba, Takehiko ; Isogai, Susumu ; Takada, Minoru ; Kanda, Hidenori ; Komase, Yuko ; Sano, Fumiaki ; Asano, Koichiro ; Oguma, Tsuyoshi ; Harada, Masahiro ; Takahashi, Takeshi ; Shibusawa, Takayuki ; Abe, Shinji ; Kono, Yuta ; Togashi, Yuki ; Izumo, Takehiro ; Inomata, Minoru ; Awano, Nobuyasu ; Ogawa, Shinichi ; Ogata, Tomouki ; Ishihara, Shoichiro ; Kanehiro, Arihiko ; Ozaki, Shinji ; Fuchimoto, Yasuko ; Kitagawa, Yuichiro ; Yoshida, Shozo ; Ogura, Shinji ; Nishiyama, Kei ; Yoshida, Kousuke ; Beppu, Satoru ; Fukuyama, Satoru ; Eriguchi, Yoshihiro ; Yonekawa, Akiko ; Inoue, Yoshiaki ; Yamagata, Kunihiro ; Chiba, Shigeru ; Narumoto, Osamu ; Nagai, Hideaki ; Ooshima, Nobuharu ; Motegi, Mitsuru ; Sagara, Hironori ; Tanaka, Akihiko ; Ohta, Shin ; Shibata, Yoko ; Tanino, Yoshinori ; Sato, Yuki ; Yamada, Yuichiro ; Hashino, Takuya ; Shinoki, Masato ; Iwagoe, Hajime ; Imamura, Tomonori ; Umeda, Akira ; Shimada, Hisato ; Endo, Mayu ; Hayashi, Shinichi ; Takahashi, Mai ; Nakano, Shigefumi ; Yatomi, Masakiyo ; Maeno, Toshitaka ; Ishii, Tomoo ; Utsugi, Mitsuyoshi ; Ono, Akihiro ; Kanaoka, Kensuke ; Ihara, Shoichi ; Komuta, Kiyoshi ; Franke, Lude ; Boezen, Marike ; Claringbould, Annique ; Lopera, Esteban ; Warmerdam, Robert ; Vonk, Judith. M. ; van Blokland, Irene ; Lanting, Pauline ; Ori, Anil P. S. ; Obeidat, Ma’en ; Hernández Cordero, Ana I. ; Sin, Don D. ; Bossé, Yohan ; Joubert, Philippe ; Hao, Ke ; Nickle, David ; Timens, Wim ; van den Berge, Maarten ; Feng, Yen-Chen Anne ; Mercader, Josep ; Weiss, Scott T. ; Karlson, Elizabeth W. ; Smoller, Jordan W. ; Murphy, Shawn N. ; Meigs, James B. ; Woolley, Ann E. ; Green, Robert C. ; Perez, Emma F. ; Wolford, Brooke ; Zöllner, Sebastian ; Wang, Jiongming ; Beck, Andrew ; Sloofman, Laura G. ; Ascolillo, Steven ; Sebra, Robert P. ; Collins, Brett L. ; Levy, Tess ; Sealfon, Stuart C. ; Jordan, Daniel M. ; Thompson, Ryan C. ; Gettler, Kyle ; Chaudhary, Kumardeep ; Belbin, Gillian M. ; Preuss, Michael ; Hoggart, Clive ; Choi, Sam ; Underwood, Slayton J. ; Salib, Irene ; Britvan, Bari ; Keller, Katherine ; Tang, Lara ; Peruggia, Michael ; Hiester, Liam L. ; Niblo, Kristi ; Aksentijevich, Alexandra ; Labkowsky, Alexander ; Karp, Avrohom ; Zlatopolsky, Menachem ; Zyndorf, Marissa ; Charney, Alexander W. ; Beckmann, Noam D. ; Schadt, Eric E. ; Abul-Husn, Noura S. ; Cho, Judy H. ; Itan, Yuval ; Kenny, Eimear E. ; Loos, Ruth J. F. ; Nadkarni, Girish N. ; Do, Ron ; O’Reilly, Paul ; Huckins, Laura M. ; Ferreira, Manuel A. R. ; Abecasis, Goncalo R. ; Leader, Joseph B. ; Cantor, Michael N. ; Justice, Anne E. ; Carey, Dave J. ; Chittoor, Geetha ; Josyula, Navya Shilpa ; Kosmicki, Jack A. ; Horowitz, Julie E. ; Baras, Aris ; Gass, Matthew C. ; Yadav, Ashish ; Mirshahi, Tooraj ; Jan Hottenga, Jouke ; Bartels, Meike ; de Geus, Eco J. C. ; Nivard, Michel G. ; Verma, Anurag ; Ritchie, Marylyn D. ; Rader, Daniel ; Li, Binglan ; Verma, Shefali S. ; Lucas, Anastasia ; Bradford, Yuki ; Zara, Federico ; Salpietro, Vincenzo ; Scala, Marcello ; Iacomino, Michele ; Scudieri, Paolo ; Bocciardi, Renata ; Minetti, Carlo ; Riva, Antonella ; Vari, Maria Stella ; Rahier, Jean-François ; Giorgio, Elisa ; Carli, Diana ; Louis, Edouad ; Bulik, Cynthia M. ; Landén, Mikael ; Brusco, Alfredo ; Ferrero, Giovanni Battista ; Madia, Francesca ; Fundín, Bengt ; Ismail, Said I. ; Saad, Chadi ; Al-Sarraj, Yaser ; Badji, Radja Messai ; Al-Muftah, Wadha ; Al Thani, Asma ; Afifi, Nahla ; Klovins, Janis ; Rovite, Vita ; Rescenko, Raimonds ; Peculis, Raitis ; Ustinova, Monta ; Zeberg, Hugo ; Frithiof, Robert ; Hultström, Michael ; Lipcsey, Miklos ; Johnson, Ruth ; Geschwind, Daniel H. ; Freimer, Nelson ; Butte, Manish J. ; Geschwind, Daniel H. ; Pasaniuc, Bogdan ; Ding, Yi ; Chiu, Alec ; Chang, Timothy S. ; Boutros, Paul ; Moutsianas, Loukas ; Caulfield, Mark J. ; Scott, Richard H. ; Walker, Susan ; Stuckey, Alex ; Odhams, Christopher A. ; Rhodes, Daniel ; Fowler, Tom ; Rendon, Augusto ; Chan, Georgia ; Arumugam, Prabhu ; Karczewski, Konrad J. ; Wilson, Daniel J. ; Spencer, Chris A. ; Crook, Derrick W. ; Wyllie, David H. ; O’Connell, Anne Marie ; Atkinson, Elizabeth G. ; Kanai, Masahiro ; Tsuo, Kristin ; Baya, Nikolas ; Turley, Patrick ; Gupta, Rahul ; Walters, Raymond K. ; Palmer, Duncan S. ; Sarma, Gopal ; Solomonson, Matthew ; Cheng, Nathan ; Lu, Wenhan ; Churchhouse, Claire ; Goldstein, Jacqueline I. ; King, Daniel ; Seed, Cotton ; Daly, Mark J. ; Neale, Benjamin M. ; Bryant, Sam ; Satterstrom, F. Kyle ; Band, Gavin ; Earle, Sarah G. ; Lin, Shang-Kuan ; Arning, Nicolas ; Armstrong, Jacob ; Rudkin, Justine K. ; Callier, Shawneequa ; Bryant, Sam ; Cusick, Caroline ; Soranzo, Nicole ; Zhao, Jing Hua ; Danesh, John ; Di Angelantonio, Emanuele ; Butterworth, Adam S. ; Sun, Yan V. ; Huffman, Jennifer E. ; Cho, Kelly ; O’Donnell, Christopher J. ; Tsao, Phil ; Gaziano, J. Michael ; Peloso, Gina ; Ho, Yuk-Lam ; Mian, Michael ; Scaggiante, Federica ; Chang, Xiao ; Glessner, Joseph R. ; Hakonarson, Hakon ; McGuigan, Peter J. ; Prockter Moore, Luke Stephen ; Vizcaychipi, Marcela Paola ; Hall, Kathryn ; Campbell, Andy ; Nichol, Ailstair ; Ward, Geraldine ; Page, Valerie Joan ; Semple, Malcolm G. ; Adeniji, Kayode ; Agranoff, Daniel ; Agwuh, Ken ; Ail, Dhiraj ; Aldera, Erin L. ; Alegria, Ana ; Angus, Brian ; Ashish, Abdul ; Atkinson, Dougal ; Bari, Shahedal ; Barlow, Gavin ; Barnass, Stella ; Barrett, Nicholas ; Bassford, Christopher ; Basude, Sneha ; Baxter, David ; Beadsworth, Michael ; Bernatoniene, Jolanta ; Berridge, John ; Best, Nicola ; Bothma, Pieter ; Chadwick, David ; Brittain-Long, Robin ; Bulteel, Naomi ; Burden, Tom ; Burtenshaw, Andrew ; Caruth, Vikki ; Chambler, Duncan ; Chee, Nigel ; Child, Jenny ; Chukkambotla, Srikanth ; Clark, Tom ; Collini, Paul ; Cosgrove, Catherine ; Cupitt, Jason ; Cutino-Moguel, Maria-Teresa ; Dark, Paul ; Dawson, Chris ; Dervisevic, Samir ; Donnison, Phil ; Douthwaite, Sam ; Drummond, Andrew ; DuRand, Ingrid ; Dushianthan, Ahilanadan ; Dyer, Tristan ; Evans, Cariad ; Eziefula, Chi ; Fegan, Christopher ; Finn, Adam ; Fullerton, Duncan ; Garg, Sanjeev ; Garg, Atul ; Gkrania-Klotsas, Effrossyni ; Godden, Jo ; Goldsmith, Arthur ; Graham, Clive ; Hardy, Elaine ; Hartshorn, Stuart ; Harvey, Daniel ; Havalda, Peter ; Hawcutt, Daniel B. ; Hobrok, Maria ; Hodgson, Luke ; Hormis, Anil ; Jacobs, Michael ; Jain, Susan ; Jennings, Paul ; Kaliappan, Agilan ; Kasipandian, Vidya ; Kegg, Stephen ; Kelsey, Michael ; Kendall, Jason ; Kerrison, Caroline ; Kerslake, Ian ; Koch, Oliver ; Koduri, Gouri ; Koshy, George ; Laha, Shondipon ; Laird, Steven
The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
Ratzinger, Ulrich ; Basten, Markus ; Chau, Long Phi ; Dinter, Hannes ; Droba, Martin ; Heilmann, Manuel ; Lotz, Marcel ; Mäder, Dominik ; Meusel, Oliver ; Müller, Ilja ; Nie, Yuancun ; Noll, Daniel ; Podlech, Holger ; Schempp, Alwin ; Schweizer, Waldemar ; Volk, Klaus ; Wiesner, Christoph ; Zhang, Chuan
This novel kind of neutron beam facility will provide 1 ns short neutron pulses with an approximately thermal energy distribution around 30 keV. The pulse repetition rate will be up to 250 kHz, the total proton number per pulse will be up to 6×1010 in the final stage, starting with a p – source current of 200 mA. A second target station will allow n – activation experiments by cw beam operation. An intense 2 MeV proton beam will drive a neutron source by the 7 Li (p,n) 7 Be reaction. The facility is under construction at the physics experimental hall of the J.W. Goethe – University. The 1m thick concrete tunnel was installed in 2009. In 2011 all rf amplifiers will be delivered and installed. Successful 200 mA proton source experiments in 2010 at a test stand will be followed by experiments on the 120 kV FRANZ terminal in 2011. The 250 kHz, 100 ns chopper in front of the rf linac is under construction, while the 2 MeV bunch compressor design was finished and the technical design of all components has started. The main accelerator cavity is under construction. First 2 MeV beam tests are expected for end of 2012.
Kröhler, Tarek ; Keßler, Sonja ; Hosseini, Kevan ; List, Markus ; Barghash, Ahmad ; Patial, Sonika ; Laggai, Stephan ; Gemperlein, Katja ; Haybäck, Johannes ; Müller, Rolf ; Helms, Volkhard ; Schulz, Marcel Holger ; Hoppstädter, Jessica ; Blackshear, Perry J. ; Kiemer, Alexandra Kathrin
Hepatic lipid deposition and inflammation represent risk factors for hepatocellular carcinoma (HCC). The mRNA-binding protein tristetraprolin (TTP, gene name ZFP36) has been suggested as a tumor suppressor in several malignancies, but it increases insulin resistance. The aim of this study was to elucidate the role of TTP in hepatocarcinogenesis and HCC progression. Employing liver-specific TTP-knockout (lsTtp-KO) mice in the diethylnitrosamine (DEN) hepatocarcinogenesis model, we observed a significantly reduced tumor burden compared to wild-type animals. Upon short-term DEN treatment, modelling early inflammatory processes in hepatocarcinogenesis, lsTtp-KO mice exhibited a reduced monocyte/macrophage ratio as compared to wild-type mice. While short-term DEN strongly induced an abundance of saturated and poly-unsaturated hepatic fatty acids, lsTtp-KO mice did not show these changes. These findings suggested anti-carcinogenic actions of TTP deletion due to effects on inflammation and metabolism. Interestingly, though, investigating effects of TTP on different hallmarks of cancer suggested tumor-suppressing actions: TTP inhibited proliferation, attenuated migration, and slightly increased chemosensitivity. In line with a tumor-suppressing activity, we observed a reduced expression of several oncogenes in TTP-overexpressing cells. Accordingly, ZFP36 expression was downregulated in tumor tissues in three large human data sets. Taken together, this study suggests that hepatocytic TTP promotes hepatocarcinogenesis, while it shows tumor-suppressive actions during hepatic tumor progression.
Meybohm, Patrick ; Lindau, Simone ; Treskatsch, Sascha ; Francis, Roland ; Spies, Claudia ; Velten, Markus ; Wittmann, Maria ; Güresir, Erdem Özer ; Stoppe, Christian ; Kowark, Ana ; Coburn, Mark ; Selleng, Sixten ; Baschin, Marcel ; Jenichen, Gregor ; Meersch, Melanie ; Ermert, Thomas ; Zarbock, Alexander ; Kranke, Peter ; Kredel, Markus ; Helf, Antonia ; Laufenberg-Feldmann, Rita ; Ferner, Marion ; Wittenmeier, Eva ; Gürtler, Karl-Heinz ; Kienbaum, Peter ; Abreu, Marcelo Gama de ; Sander, Michael ; Bauer, Michael ; Seyfried, Timo ; Grünewald, Matthias Lars ; Choorapoikayil, Suma ; Müller, Markus M. ; Seifried, Erhard ; Brosteanu, Oana ; Bogatsch, Holger ; Hasenclever, Dirk ; Zacharowski, Kai
Background: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and age-related decline of functional reserves. The purpose of the study is to evaluate whether elderly surgical patients may benefit from a liberal red blood cell (RBC) transfusion strategy compared to a restrictive transfusion strategy.
Methods: The LIBERAL Trial is a prospective, randomized, multicentre, controlled clinical phase IV trial randomising 2470 elderly (≥ 70 years) patients undergoing intermediate- or high-risk non-cardiac surgery. Registered patients will be randomised only if Haemoglobin (Hb) reaches ≤9 g/dl during surgery or within 3 days after surgery either to the LIBERAL group (transfusion of a single RBC unit when Hb ≤ 9 g/dl with a target range for the post-transfusion Hb level of 9–10.5 g/dl) or the RESTRICTIVE group (transfusion of a single RBC unit when Hb ≤ 7.5 g/dl with a target range for the post-transfusion Hb level of 7.5–9 g/dl). The intervention per patient will be followed until hospital discharge or up to 30 days after surgery, whichever occurs first. The primary efficacy outcome is defined as a composite of all-cause mortality, acute myocardial infarction, acute ischaemic stroke, acute kidney injury (stage III), acute mesenteric ischaemia and acute peripheral vascular ischaemia within 90 days after surgery. Infections requiring iv antibiotics with re-hospitalisation are assessed as important secondary endpoint. The primary endpoint will be analysed by logistic regression adjusting for age, cancer surgery (y/n), type of surgery (intermediate- or high-risk), and incorporating centres as random effect.
Discussion: The LIBERAL-Trial will evaluate whether a liberal transfusion strategy reduces the occurrence of major adverse events after non-cardiac surgery in the geriatric population compared to a restrictive strategy within 90 days after surgery.
Trial registration: ClinicalTrials.gov (identifier: NCT03369210).
Pflüger‑Müller, Beatrice ; Oo, James A. ; Heering, Jan Peter ; Warwick, Timothy ; Proschak, Ewgenij ; Günther, Stefan ; Looso, Mario ; Rezende Felipe, Flávia Figueiredo de ; Fork, Christian ; Geisslinger, Gerd ; Thomas, Dominique Jeanette ; Gurke, Robert ; Steinhilber, Dieter ; Schulz, Marcel Holger ; Leisegang, Matthias ; Brandes, Ralf
Endocannabinoids are important lipid-signaling mediators. Both protective and deleterious effects of endocannabinoids in the cardiovascular system have been reported but the mechanistic basis for these contradicting observations is unclear. We set out to identify anti-inflammatory mechanisms of endocannabinoids in the murine aorta and in human vascular smooth muscle cells (hVSMC). In response to combined stimulation with cytokines, IL-1β and TNFα, the murine aorta released several endocannabinoids, with anandamide (AEA) levels being the most significantly increased. AEA pretreatment had profound effects on cytokine-induced gene expression in hVSMC and murine aorta. As revealed by RNA-Seq analysis, the induction of a subset of 21 inflammatory target genes, including the important cytokine CCL2 was blocked by AEA. This effect was not mediated through AEA-dependent interference of the AP-1 or NF-κB pathways but rather through an epigenetic mechanism. In the presence of AEA, ATAC-Seq analysis and chromatin-immunoprecipitations revealed that CCL2 induction was blocked due to increased levels of H3K27me3 and a decrease of H3K27ac leading to compacted chromatin structure in the CCL2 promoter. These effects were mediated by recruitment of HDAC4 and the nuclear corepressor NCoR1 to the CCL2 promoter. This study therefore establishes a novel anti-inflammatory mechanism for the endogenous endocannabinoid AEA in vascular smooth muscle cells. Furthermore, this work provides a link between endogenous endocannabinoid signaling and epigenetic regulation.
Roick, Julia ; Berner, Reinhard ; Bernig, Toralf ; Erdlenbruch, Bernhard ; Escherich, Gabriele ; Faber, Jörg ; Klein, Christoph ; Bochennek, Konrad ; Kratz, Christian ; Kühr, Joachim ; Längler, Alfred ; Lode, Holger ; Metzler, Markus ; Müller, Hermann ; Reinhardt, Dirk ; Sauerbrey, Axel ; Schepper, Florian ; Scheurlen, Wolfram ; Schneider, Dominik ; Schwabe, Georg Christof ; Richter, Matthias
Background: About 2000 children and adolescents under the age of 18 are diagnosed with cancer each year in Germany. Because of current medical treatment methods, a high survival rate can be reached for many types of the disease. Nevertheless, patients face a number of long-term effects related to the treatment. As a result, physical and psychological consequences have increasingly become the focus of research in recent years. Social dimensions of health have received little attention in health services research in oncology so far. Yet, there are no robust results that allow an estimation of whether and to what extent the disease and treatment impair the participation of children and adolescents and which factors mediate this effect. Social participation is of great importance especially because interactions with peers and experiences in different areas of life are essential for the development of children and adolescents.
Methods: Data are collected in a longitudinal, prospective, observational multicenter study. For this purpose, all patients and their parents who are being treated for cancer in one of the participating clinics throughout Germany will be interviewed within the first month after diagnosis (t1), after completion of intensive treatment (t2) and half a year after the end of intensive treatment (t3) using standardized questionnaires. Analysis will be done by descriptive and multivariate methods.
Discussion: The results can be used to identify children and adolescents in high-risk situations at an early stage in order to be able to initiate interventions tailored to the needs. Such tailored interventions will finally reduce the risk of impairments in the participation of children and adolescents and increase quality of life.
Trial registration: ClinicalTrials.gov: NCT04101123.
Müller, Beate ; Klaaßen-Mielke, Renate ; González-González, Ana I. ; Grandt, Daniel ; Hammerschmidt, Reinhard ; Köberlein-Neu, Juliane ; Kellermann-Mühlhoff, Petra ; Trampisch, Hans Joachim ; Beckmann, Till ; Düvel, Lara ; Surmann, Bastian ; Flaig, Benno ; Ihle, Peter ; Söling, Sara ; Grandt, Simone ; Dinh, Truc Sophia ; Piotrowski, Alexandra ; Meyer, Ingo ; Karbach, Ute ; Harder, Sebastian ; Perera, Rafael ; Glasziou, Paul ; Pfaff, Holger ; Greiner, Wolfgang ; Gerlach, Ferdinand M. ; Timmesfeld, Nina ; Muth, Christiane
Introduction: Clinically complex patients often require multiple medications. Polypharmacy is associated with inappropriate prescriptions, which may lead to negative outcomes. Few effective tools are available to help physicians optimise patient medication. This study assesses whether an electronic medication management support system (eMMa) reduces hospitalisation and mortality and improves prescription quality/safety in patients with polypharmacy. Methods and analysis: Planned design: pragmatic, parallel cluster-randomised controlled trial; general practices as randomisation unit; patients as analysis unit. As practice recruitment was poor, we included additional data to our primary endpoint analysis for practices and quarters from October 2017 to March 2021. Since randomisation was performed in waves, final study design corresponds to a stepped-wedge design with open cohort and step-length of one quarter. Scope: general practices, Westphalia-Lippe (Germany), caring for BARMER health fund-covered patients. Population: patients (≥18 years) with polypharmacy (≥5 prescriptions). Sample size: initially, 32 patients from each of 539 practices were required for each study arm (17 200 patients/arm), but only 688 practices were randomised after 2 years of recruitment. Design change ensures that 80% power is nonetheless achieved. Intervention: complex intervention eMMa. Follow-up: at least five quarters/cluster (practice). recruitment: practices recruited/randomised at different times; after follow-up, control group practices may access eMMa. Outcomes: primary endpoint is all-cause mortality and hospitalisation; secondary endpoints are number of potentially inappropriate medications, cause-specific hospitalisation preceded by high-risk prescribing and medication underuse. Statistical analysis: primary and secondary outcomes are measured quarterly at patient level. A generalised linear mixed-effect model and repeated patient measurements are used to consider patient clusters within practices. Time and intervention group are considered fixed factors; variation between practices and patients is fitted as random effects. Intention-to-treat principle is used to analyse primary and key secondary endpoints.
We consider an imperfectly competitive loan market in which a local relationship lender has an information advantage vis-à-vis distant transaction lenders. Competitive pressure from the transaction lenders prevents the local lender from extracting the full surplus from projects, so that she inefficiently rejects marginally profitable projects. Collateral mitigates the inefficiency by increasing the local lender’s payoff from precisely those marginal projects that she inefficiently rejects. The model predicts that, controlling for observable borrower risk, collateralized loans are more likely to default ex post, which is consistent with the empirical evidence. The model also predicts that borrowers for whom local lenders have a relatively smaller information advantage face higher collateral requirements, and that technological innovations that narrow the information advantage of local lenders, such as small business credit scoring, lead to a greater use of collateral in lending relationships. JEL classification: D82; G21 Keywords: Collateral; Soft infomation; Loan market competition; Relationship lending
This article shows that investors financing a portfolio of projects may use the depth of their financial pockets to overcome entrepreneurial incentive problems. Competition for scarce informed capital at the refinancing stage strengthens investors’ bargaining positions. And yet, entrepreneurs’ incentives may be improved, because projects funded by investors with ‘‘shallow pockets’’ must have not only a positive net present value at the refinancing stage, but one that is higher than that of competing portfolio projects. Our article may help understand provisions used in venture capital finance that limit a fund’s initial capital and make it difficult to add more capital once the initial venture capital fund is raised. (JEL G24, G31)
This paper shows that investors financing a portfolio of projects may use the depth of their financial pockets to overcome entrepreneurial incentive problems. Competition for scarce informed capital at the refinancing stage strengthens investors’ bargaining positions. And yet, entrepreneurs’ incentives may be improved, because projects funded by investors with “shallow pockets” must have not only a positive net present value at the refinancing stage, but one that is higher than that of competing portfolio projects. Our paper may help to understand provisions used in venture capital finance that limit a fund’s initial capital and make it difficult to add more capital once the initial venture capital fund is raised.
This paper shows that active investors, such as venture capitalists, can affect the speed at which new ventures grow. In the absence of product market competition, new ventures financed by active investors grow faster initially, though in the long run those financed by passive investors are able to catch up. By contrast, in a competitive product market, new ventures financed by active investors may prey on rivals that are financed by passive investors by “strategically overinvesting” early on, resulting in long-run differences in investment, profits, and firm growth. The value of active investors is greater in highly competitive industries as well as in industries with learning curves, economies of scope, and network effects, as is typical for many “new economy” industries. For such industries, our model predicts that start-ups with access to venture capital may dominate their industry peers in the long run. JEL Classifications: G24; G32 Keywords: Venture capital; dynamic investment; product market competition
We study a model of “information-based entrenchment” in which the CEO has private information that the board needs to make an efficient replacement decision. Eliciting the CEO’s private information is costly, as it implies that the board must pay the CEO both higher severance pay and higher on-the-job pay. While higher CEO pay is associated with higher turnover in our model, there is too little turnover in equilibrium. Our model makes novel empirical predictions relating CEO turnover, severance pay, and on-the-job pay to firm-level attributes such as size, corporate governance, and the quality of the firm’s accounting system.
This paper argues that banks must be sufficiently levered to have first-best incentives to make new risky loans. This result, which is at odds with the notion that leverage invariably leads to excessive risk taking, derives from two key premises that focus squarely on the role of banks as informed lenders. First, banks finance projects that they do not own, which implies that they cannot extract all the profits. Second, banks conduct a credit risk analysis before making new loans. Our model may help understand why banks take on additional unsecured debt, such as unsecured deposits and subordinated loans, over and above their existing deposit base. It may also help understand why banks and finance companies have similar leverage ratios, even though the latter are not deposit takers and hence not subject to the same regulatory capital requirements as banks.
Noll, Frederik ; Behnke, Jonas ; Leiting, Silke ; Troidl, Kerstin ; Teixeira Alves, Gustavo ; Müller-Redetzky, Holger ; Preissner, Klaus T. ; Fischer, Silvia
Self-extracellular RNA (eRNA), released from stressed or injured cells upon various pathological situations such as ischemia-reperfusion-injury, has been shown to act as an alarmin by inducing procoagulatory and proinflammatory responses. In particular, M1-polarization of macrophages by eRNA resulted in the expression and release of a variety of cytokines, including tumor necrosis factor (TNF)-α or interleukin-6 (IL-6). The present study now investigates in which way self-eRNA may influence the response of macrophages towards various Toll-like receptor (TLR)-agonists. Isolated agonists of TLR2 (Pam2CSK4), TLR3 (PolyIC), TLR4 (LPS), or TLR7 (R848) induced the release of TNF-α in a concentration-dependent manner in murine macrophages, differentiated from bone marrow-derived stem cells by mouse colony stimulating factor. Here, the presence of eRNA shifted the dose-response curve for Pam2CSK4 (Pam) considerably to the left, indicating that eRNA synergistically enhanced the cytokine liberation from macrophages even at very low Pam-levels. The synergistic activation of TLR2 by eRNA/Pam was duplicated by other TLR2-agonists such as FSL-1 or Pam3CSK4. In contrast, for TLR4-agonists such as LPS a synergistic effect of eRNA was much weaker, and was not existent for TLR3-, or TLR7-agonists. The synergistic eRNA/Pam action was dependent on the NFκB-signaling pathway as well as on p38MAP- and MEK1/ERK-kinases and was prevented by predigestion of eRNA with RNase1 or by antibodies against TLR2. Thus, the presence of self-eRNA as alarming molecule sensitizes innate immune responses towards pathogen-associated molecular patterns (PAMPs) in a synergistic way and may thereby contribute to the differentiated outcome of inflammatory responses.
Friedmann, Franziska ; Santangelo, Philip ; Ebner-Priemer, Ulrich ; Hill, Holger ; Neubauer, Andreas B. ; Rausch, Sophie ; Steil, Regina ; Müller-Engelmann, Meike ; Kleindienst, Nikolaus ; Bohus, Martin ; Fydrich, Thomas ; Priebe, Kathlen
Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic stress disorder (PTSD) and healthy individuals with and without a history of child abuse were investigated. We used global positioning system (GPS) tracking to study temporal and spatial limitations in the participants’ real-life activity space over the course of one week. The sample consisted of 228 female participants: 150 women with PTSD and emotional instability with a history of child abuse, 35 mentally healthy women with a history of child abuse (healthy trauma controls, HTC) and 43 mentally healthy women without any traumatic experiences in their past (healthy controls, HC). Both traumatized groups—i.e. the PTSD and the HTC group—had smaller movement radii than the HC group on the weekends, but neither spent significantly less time away from home than HC. Some differences between PTSD and HC in movement radius seem to be related to correlates of PTSD psychopathology, like depression and physical health. Yet group differences between HTC and HC in movement radius remained even when contextual and individual health variables were included in the model, indicating specific effects of traumatic experiences on activity space. Experiences of child abuse could limit activity space later in life, regardless of whether PTSD develops.
Wilde, Anne-Christin ; Lieb, Charlotte ; Leicht, Elise ; Greverath, Lena Maria ; Steinhagen, Lara Marleen ; Wald de Chamorro, Nina ; Petersen, Jörg ; Hofmann, Wolf-Peter ; Hinrichsen, Holger ; Heyne, Renate ; Berg, Thomas ; Naumann, Uwe ; Schwenzer, Jeannette ; Vermehren, Johannes ; Geier, Andreas ; Tacke, Frank ; Müller, Tobias
Background: Clinical practice guidelines for patients with primary biliary cholangitis (PBC) have been recently revised and implemented for well-established response criteria to standard first-line ursodeoxycholic acid (UDCA) therapy at 12 months after treatment initiation for the early identification of high-risk patients with inadequate treatment responses who may require treatment modification. However, there are only very limited data concerning the real-world clinical management of patients with PBC in Germany. Objective: The aim of this retrospective multicenter study was to evaluate response rates to standard first-line UDCA therapy and subsequent Second-line treatment regimens in a large cohort of well-characterized patients with PBC from 10 independent hepatological referral centers in Germany prior to the introduction of obeticholic acid as a licensed second-line treatment option. Methods: Diagnostic confirmation of PBC, standard first-line UDCA treatment regimens and response rates at 12 months according to Paris-I, Paris-II, and Barcelona criteria, the follow-up cut-off alkaline phosphatase (ALP) ≤ 1.67 × upper limit of normal (ULN) and the normalization of bilirubin (bilirubin ≤ 1 × ULN) were retrospectively examined between June 1986 and March 2017. The management and hitherto applied second-line treatment regimens in patients with an inadequate response to UDCA and subsequent response rates at 12 months were also evaluated. Results: Overall, 480 PBC patients were included in this study. The median UDCA dosage was 13.2 mg UDCA/kg bodyweight (BW)/d. Adequate UDCA treatment response rates according to Paris-I, Paris-II, and Barcelona criteria were observed in 91, 71.3, and 61.3% of patients, respectively. In 83.8% of patients, ALP ≤ 1.67 × ULN were achieved. A total of 116 patients (24.2%) showed an inadequate response to UDCA according to at least one criterion. The diverse second-line treatment regimens applied led to significantly higher response rates according to Paris-II (35 vs. 60%, p = 0.005), Barcelona (13 vs. 34%, p = 0.0005), ALP ≤ 1.67 × ULN and bilirubin ≤ 1 × ULN (52.1 vs. 75%, p = 0.002). The addition of bezafibrates appeared to induce the strongest beneficial effect in this cohort (Paris II: 24 vs. 74%, p = 0.004; Barcelona: 50 vs. 84%, p = 0.046; ALP < 1.67 × ULN and bilirubin ≤ 1 × ULN: 33 vs. 86%, p = 0.001). Conclusion: Our large retrospective multicenter study confirms high response rates following UDCA first-line standard treatment in patients with PBC and highlights the need for close monitoring and early treatment modification in high-risk patients with an insufficient response to UDCA since early treatment modification significantly increases subsequent response rates of these patients.
Bingemer, Heinz ; Klein, Holger ; Ebert, Martin ; Haunold, Werner ; Bundke, Ulrich ; Herrmann, Thomas ; Kandler, Konrad ; Müller-Ebert, Dörthe ; Weinbruch, Stephan ; Judt, Anna ; Ardon-Dryer, Karin ; Levin, Zev ; Curtius, Joachim
Explosive volcanism affects weather and climate. Primary volcanic ash particles which act as ice nuclei (IN) can modify the phase and properties of cold tropospheric clouds. During the Eyjafjallajökull volcanic eruption we have measured the highest ice nucleus number concentrations (>600 L) in our record of 2 years of daily IN measurements in central Germany. Even in Israel, located about 5000 km away from Iceland, IN were as high as otherwise only during desert dust storms. These measurements are the only ones available on the properties of IN in the Eyjafjallajökull plume. The measured high concentrations and high activation temperature (−8 °C) point to an important impact of volcanic ash on microphysical and radiative properties of clouds through enhanced glaciation.
Bingemer, Heinz ; Klein, Holger ; Ebert, Martin ; Haunold, Werner ; Bundke, Ulrich ; Herrmann, Thomas ; Kandler, Konrad ; Müller-Ebert, Dörthe ; Weinbruch, Stephan ; Judt, Anna ; Weber, A. ; Nillius, Björn ; Ardon-Dryer, Karin ; Levin, Zev ; Curtius, Joachim
We have sampled atmospheric ice nuclei (IN) and aerosol in Germany and in Israel during spring 2010. IN were analyzed by the static vapor diffusion chamber FRIDGE, as well as by electron microscopy. During the Eyjafjallajökull volcanic eruption of April 2010 we have measured the highest ice nucleus number concentrations (>600 l−1) in our record of 2 yr of daily IN measurements in central Germany. Even in Israel, located about 5000 km away from Iceland, IN were as high as otherwise only during desert dust storms. The fraction of aerosol activated as ice nuclei at −18 °C and 119% rhice and the corresponding area density of ice-active sites per aerosol surface were considerably higher than what we observed during an intense outbreak of Saharan dust over Europe in May 2008.
Pure volcanic ash accounts for at least 53–68% of the 239 individual ice nucleating particles that we collected in aerosol samples from the event and analyzed by electron microscopy. Volcanic ash samples that had been collected close to the eruption site were aerosolized in the laboratory and measured by FRIDGE. Our analysis confirms the relatively poor ice nucleating efficiency (at −18 °C and 119% ice-saturation) of such "fresh" volcanic ash, as it had recently been found by other workers. We find that both the fraction of the aerosol that is active as ice nuclei as well as the density of ice-active sites on the aerosol surface are three orders of magnitude larger in the samples collected from ambient air during the volcanic peaks than in the aerosolized samples from the ash collected close to the eruption site. From this we conclude that the ice-nucleating properties of volcanic ash may be altered substantially by aging and processing during long-range transport in the atmosphere, and that global volcanism deserves further attention as a potential source of atmospheric ice nuclei.