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Background: It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. We investigated whether depressive mood mediates the influence of social support on health-related quality of life.
Methods: Cross-sectional data of 3,189 multimorbid patients from the baseline assessment of the German MultiCare cohort study were used. Mediation was tested using the approach described by Baron and Kenny based on multiple linear regression, and controlling for socioeconomic variables and burden of multimorbidity.
Results: Mediation analyses confirmed that depressive mood mediates the influence of social support on health-related quality of life (Sobel's p < 0.001). Multiple linear regression showed that the influence of depressive mood (beta = -0.341, p < 0.01) on health-related quality of life is greater than the influence of multimorbidity (beta = -0.234, p < 0.01).
Conclusion: Social support influences health-related quality of life, but this association is strongly mediated by depressive mood. Depression should be taken into consideration in research on multimorbidity, and clinicians should be aware of its importance when caring for multimorbid patients.
Ultraviolet-B (UVB)-induced inflammation produces a dose-dependent mechanical and thermal hyperalgesia in both humans and rats, most likely via inflammatory mediators acting at the site of injury. Previous work has shown that the gene expression of cytokines and chemokines is positively correlated between species and that these factors can contribute to UVB-induced pain. In order to investigate other potential pain mediators in this model we used RNA-seq to perform genome-wide transcriptional profiling in both human and rat skin at the peak of hyperalgesia. In addition we have also measured transcriptional changes in the L4 and L5 DRG of the rat model. Our data show that UVB irradiation produces a large number of transcriptional changes in the skin: 2186 and 3888 genes are significantly dysregulated in human and rat skin, respectively. The most highly up-regulated genes in human skin feature those encoding cytokines (IL6 and IL24), chemokines (CCL3, CCL20, CXCL1, CXCL2, CXCL3 and CXCL5), the prostanoid synthesising enzyme COX-2 and members of the keratin gene family. Overall there was a strong positive and significant correlation in gene expression between the human and rat (R = 0.8022). In contrast to the skin, only 39 genes were significantly dysregulated in the rat L4 and L5 DRGs, the majority of which had small fold change values. Amongst the most up-regulated genes in DRG were REG3B, CCL2 and VGF. Overall, our data shows that numerous genes were up-regulated in UVB irradiated skin at the peak of hyperalgesia in both human and rats. Many of the top up-regulated genes were cytokines and chemokines, highlighting again their potential as pain mediators. However many other genes were also up-regulated and might play a role in UVB-induced hyperalgesia. In addition, the strong gene expression correlation between species re-emphasises the value of the UVB model as translational tool to study inflammatory pain.
Hypoxia enhances the antiglioma cytotoxicity of b10, a glycosylated derivative of betulinic acid
(2014)
B10 is a glycosylated derivative of betulinic acid with promising activity against glioma cells. Lysosomal cell death pathways appear to be essential for its cytotoxicity. We investigated the influence of hypoxia, nutrient deprivation and current standard therapies on B10 cytotoxicity. The human glioma cell lines LN-308 and LNT-229 were exposed to B10 alone or together with irradiation, temozolomide, nutrient deprivation or hypoxia. Cell growth and viability were evaluated by crystal violet staining, clonogenicity assays, propidium iodide uptake and LDH release assays. Cell death was examined using an inhibitor of lysosomal acidification (bafilomycin A1), a cathepsin inhibitor (CA074-Me) and a short-hairpin RNA targeting cathepsin B. Hypoxia substantially enhanced B10-induced cell death. This effect was sensitive to bafilomycin A1 and thus dependent on hypoxia-induced lysosomal acidification. Cathepsin B appeared to mediate cell death because either the inhibitor CA074-Me or cathepsin B gene silencing rescued glioma cells from B10 toxicity under hypoxia. B10 is a novel antitumor agent with substantially enhanced cytotoxicity under hypoxia conferred by increased lysosomal cell death pathway activation. Given the importance of hypoxia for therapy resistance, malignant progression, and as a result of antiangiogenic therapies, B10 might be a promising strategy for hypoxic tumors like malignant glioma.
Treatment with inhibitors of the receptor tyrosine kinase FLT3 are currently studied as promising therapies in acute myeloid leukemia (AML). However, only a subset of patients benefit from these treatments and the presence of activating mutations within FLT3 can predict response to a certain extent only. ...
Background: Health Authorities recommend influenza vaccination of healthcare personnel (HCP) to decrease the transmission of influenza to vulnerable patients. Recent studies have almost exclusively used quantitative questionnaires in order to identify determinants of vaccination behaviour. Interviews enable HCP to express freely why they think they are (not) willing to get vaccinated against influenza.
Methods: By means of semi-structured one-on-one interviews with 123 Belgian, Dutch and German HCP, reasons for and against vaccination, experiences with influenza vaccination, intention to get vaccinated and possible barriers, as well as willingness to advice influenza vaccination to patients were investigated. Data were processed with QSR NVivo 8.0 and analysed using a combination of a deductive and a general inductive approach.
Results: Across countries, self-protection, patient protection, and protection of family members were reported as most important reasons to get vaccinated against influenza. Reasons to not get vaccinated against influenza were fear of side effects caused by the vaccine, a low risk-perception, the disbelief in the effectiveness of influenza vaccination, organizational barriers, misconceptions, and undefined negative emotions.
Conclusions: The social cognitive variables underlying the decision of HCP to get vaccinated against influenza (or not) seem to be similar in Belgium, Germany, and the Netherlands, even though some differences surfaced. A quantitative investigation of those social cognitive variables is needed in order to determine the importance of the social cognitive variables in explaining the intention to get vaccinated and the importance of the similarities and differences between countries that have been found in this study.
Poster presentation at 1st International Workshop on Odor Spaces.
Mice are exceptional in their ability to capture their chemical environment, mapping the olfactory world into a basic sensory representation with over one thousand different types of chemical sensors, that is, olfactory sensory neurons (OSNs). OSNs of each type converge in the olfactory bulb onto exclusive distinct physiological areas called glomeruli. The glomeruli constitute the first relay station of olfactory stimulus representation in the mouse brain. Thus, the stimulus induced glomerular input pattern spatially embodies an important part of the sensory representation in the olfactory bulb. Still, topographic organization principles (chemotopy, tunotopy) are under debate. One reason might be that investigation are, due to experimental limitations, only performed on stimuli sets in the size of one hundred odors. But this represents only a tiny snapshot of the vast amount of molecules in the olfactory world and topographic relationships might be disguised in the incomplete representation of molecular receptive ranges (MRR). Therefore we investigated the problem with the MOR18-2 glomerulus as point of reference: First we determined it's MRR. Then, based on a measurement set covering this MRR, we elucidated the topographic embedding. It shows that MOR18-2 is embedded in a hierarchy of patchy tunotopic domains.
Background: Chronic particulate matter (PM) exposure is correlated to various health effects, even at low amounts. WHO has defined PM concentration limits as daily and annual mean values which were made legally binding in the European Union. While many studies have focused on PM concentrations in special environments, little is known about the average PM- exposure for both employees and passengers in the German public transportation system.
Methods: Particulate matter (PM10, PM2.5, PM1) - concentrations were monitored for 30 minutes at 15 different areas in Frankfurt am Main with major public traffic. Maximum and mean concentrations and, as a surrogate for the inhaled dosage, the Area Under the Curve (AUC) for 15 minutes of exposure were calculated.
Results: The WHO limits for PM10 and PM2.5 were exceeded at nearly all times and areas. Highest maximum concentrations were found at underground stations, subterranean railway stations and subterranean shopping arcades with much lower values obtained at surface points. In one measurement at a surface test point smokers who neglected the non-smoking policy could be identified as a major cause for a at least temporary strong increase of PM-load as seen in high maximum values and normal averages.
Conclusions: Subterranean areas have high particulate matter contamination exceeding WHO limits. Improvement may be achieved by increased ventilation. Subterranean shops and kiosks, being workplaces with long term exposure, should be equipped with external air supply. The non- smoking policy of the "Deutsche Bahn" for public spaces should be enforced.
Die zentralen Objekte der Dissertation sind Translationsflächen. Dabei handelt es sich um Riemann’sche Flächen, die aus in die euklidische Ebene eingebetteten Polygonen durch Verkleben von parallelen gleichlangen Seiten entstehen. Zwei Translationsflächen sind gleich, wenn es möglich ist, die Polygone durch ”Zerschneiden und mittels Translationen neu Zusammenkleben“ ineinander zu überführen. Die Gruppe GL_2(R) operiert auf der Menge der Translationsflächen via der linearen Abbildungen auf den Polygonen. Der Stabilisator einer Translationsfläche X unter dieser Operation wird die Veech-Gruppe von X genannt und mit SL(X) bezeichnet. Die Veech-Gruppe ist eine diskrete Untergruppe von SL_2(R) und damit eine Fuchs’sche Gruppe.
Fuchs’sche Gruppen werden je nach ihrer Limesmenge in elementare und nicht-elementare Gruppen eingeteilt. Letztere wiederum unterteilt man in Gruppen erster oder zweiter Art. Fuchs’sche Gruppen mit endlichem co-Volumen heißen Gitter und sind genau die endlich erzeugten Gruppen erster Art. Translationsflächen, deren Veech-Gruppe ein Gitter ist, heißen Veech-Flächen und sind von besonderem Interesse, da für sie die Veech Alternative gilt.
Ein feineres Maß für die Größe einer Fuchs’schen Gruppe ist der kritische Exponent. Er ist definiert als das Infimum aller reellen Zahlen, für die die Poincaré Reihe konvergiert und liegt für alle unendlichen Fuchs’schen Gruppen zwischen 0 und 1. Hauptziel der Dissertation ist der Beweis von Theorem 1. Es gibt Translationsflächen, für die der kritische Exponent ihrer Veech-Gruppe echt zwischen 1/2 und 1 liegt.
Der kritische Exponent von elementaren Gruppen ist höchstens 1/2, Translationsflächen mit elementaren Veech-Gruppen sind also als Kandidaten für das Theorem ausgeschlossen. Der kritische Exponent von Gittern ist 1. Also scheiden auch Veech-Flächen für das Theorem aus.
Bis zum Jahr 2003 waren Gitter die einzigen bekannten nicht-elementaren Veech-Gruppen. McMullen klassifizierte die Veech-Flächen vom Geschlecht 2 und zeigte, dass jede solche Fläche, die nur eine Singularität besitzt, in der GL_2(R)-Bahn der Fläche L_D liegt, die aus einem L-förmigen Polygon mit geeigneten von D abhängigen Seitenlängen entsteht.
Während auch heute noch keine Translationsfläche mit Veech-Gruppe zweiter Art bekannt ist, fanden McMullen und unabhängig davon Hubert und Schmidt Konstruktionen unendlich erzeugter Veech-Gruppen erster Art. Eine Abschätzung des kritischen Exponenten dieser Gruppen war 10 Jahre lang eine wichtige offene Frage, die nun durch Theorem 1 beantwortet wird.
Zentral in der Konstruktion von Hubert und Schmidt sind spezielle Punkte, nämlich Verbindungspunkte. Hubert und Schmidt konstruieren Translationsflächen, deren Veech-Gruppen kommensurabel zum Stabilisator SL(X;P) von P sind und damit den gleichen kritischen Exponenten haben. Für Verbindungspunkte mit unendlicher SL(X)- Bahn (diese Punkte heißen nicht-periodisch) ist SL(X;P) unendlich erzeugt und von erster Art.
Wir zeigen Theorem 1, indem wir zeigen, dass für jedes D kongruent 0 mod 4, (kein Quadrat), und jeden nicht-periodischen Verbindungspunkt P in L_D der kritische Exponent der Gruppe SL(L_D;P) echt zwischen 1/2 und 1 liegt.
Eine natürliche Frage in diesem Zusammenhang ist die Abhängigkeit von P: Punkte Q in der SL(L_D)-Bahn von P sind auch er nicht-periodische Verbindungspunkte und die zugehö̈rigen Gruppen SL(L_D;P) und SL(L_D;Q) sind konjugiert zueinander. Daher widmen wir uns in Kapitel 4 der Bestimmung der Bahnen nicht-periodischer Verbindungspunkte.
Die Verbindungspunkte haben die Form P=(x_r+x_iw;y_r+y_iw) mit x_r,x_i,y_r,y_i aus Q. Wir zeigen, dass der Hauptnenner N(P) dieser (gekürzten) Brüche eine Invariante der Bahn ist. Daraus folgt:
Theorem 2. Es gibt unendlich viele verschiedene Bahnen von Verbindungspunkten von L_D.
Wir kennen die Operation der horizontalen und der vertikalen Scherungen A und B aus SL(L_D). Im Spezialfall D=8 erzeugen diese beiden Elemente die ganze Gruppe und wir geben je ein Verfahren an, um eine untere und eine obere Schranke an die Anzahl der Bahnen von nicht-periodischen Verbindungspunkten P mit fixiertem Hauptnenner N(P) zu finden. Damit zeigen wir:
Theorem 3. Die Menge der Verbindungspunkte P mit festem Wert N(P) zerfällt in eine endliche Anzahl von SL(L_8)-Bahnen.
Im Beweis von Theorem 1 ist es nötig, die Nicht-Mittelbarkeit eines Graphen zu zeigen. Da wir nur sehr wenige Informationen über dessen Struktur in unserer konkreten Situation haben, entwickeln wir in Kapitel 1 die folgende Methode:
Theorem 4. Sei G ein Graph, den man durch Weglassen von Kanten in einen Wald G′ ohne Blätter überführen kann, bei dem das Supremum der Längen von zusammenhängenden Valenz-2-Teilgraphen von G′ beschränkt ist. Dann ist G nicht mittelbar.
Um diese Methode anzuwenden, ordnen wir jeder Ecke P von G ein Komplexitätsmaß s(P) zu und weisen nach, dass dieser Wert für die Operation von Worten in A- und B-Potenzen mit wachsender Wortlänge ”tendenziell wächst“.
Acute kidney injury (AKI) is one of the most important complications in hospitalized patients and its pathomechanisms are not completely elucidated. We hypothesize that signaling via toll-like receptor (TLR)-3, a receptor that is activated upon binding of double-stranded nucleotides, might play a crucial role in the pathogenesis of AKI following ischemia and reperfusion (IR). Male adult C57Bl6 wild-type (wt) mice and TLR-3 knock-out (-/-) mice were subjected to 30 minutes bilateral selective clamping of the renal artery followed by reperfusion for 30 min 2.5h and 23.5 hours or subjected to sham procedures. TLR-3 down-stream signaling was activated already within 3 h of ischemia and reperfusion in post-ischemic kidneys of wt mice lead to impaired blood perfusion followed by a strong pro-inflammatory response with significant neutrophil invasion. In contrast, this effect was absent in TLR-3-/- mice. Moreover, the quick TLR-3 activation resulted in kidney damage that was histomorphologically associated with significantly increased apoptosis and necrosis rates in renal tubules of wt mice. This finding was confirmed by increased kidney injury marker NGAL in wt mice and a better preserved renal perfusion after IR in TLR-3-/- mice than wt mice. Overall, the absence of TLR-3 is associated with lower cumulative kidney damage and maintained renal blood perfusion within the first 24 hours of reperfusion. Thus, we conclude that TLR-3 seems to participate in the pathogenesis of early acute kidney injury.