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The aim of this essay is to provide an analysis of Foucault's use of the notion of revolution in the reports he wrote for "Il Corriere della Sera" during his two trips to Iran in September and November 1978. Foucault critically frames the historical and philosophical concept of revolution, in order to oppose it to the spreading revolts against the Shah, which embody the simple and negative opening of the possibility of a transformation in history. Yet is it possible to reactivate the notion of revolution in a nonrestrictive sense in order to think about the role and the possibility of political revolts and freedom today?
Reversion: lyric time(s) II
(2019)
Is a 'history' of the lyric even conceivable? What would a 'lyric' temporality look like? With a focus on Rainer Maria Rilke's decision not to translate, but rather to rewrite Dante's "Vita nova" (1293–1295) in the first of his "Duineser Elegien" (1912), the essay deploys 'reversion' (as turning back, return, coming around again), alongside 're-citation', as a keyword that can unlock the transhistorical operations of the lyric as the re-enactment of selected gestures under different circumstances.
Restrain
(2019)
The re- of 'restrain' - not the more common iterative 're-' but a mere, if semantically obscure intensifier - marks a temporal paradox: the restraint that prevents a force from reaching its 'telos' is not only a delay, but the intervention of a separate, autonomous, and anti-teleological regime of time. The article reads the biblical figure of the 'katéchon', 'the withholder', as an expression of this paradox and as symptomatic of a political-theological ambivalence essential to the foundation of Western political thought. If the 'secular order' or 'worldly government' has the function of withholding both the ultimate salvation and the final outbreak of chaos, then it sustains itself only by postponing any determination of its value or effect.
Resolution
(2019)
Many parodies operate through temporal strategies that distort the narrative proportions of their targets. This essay discusses two texts that manipulate time for parodic purposes: the contemporary animated sitcom "Bojack Horseman" and the twelfth-century romance "Ipomedon". Their shared method involves the absurd prolongation of narrative structures of resolution and satisfaction in order to reveal these structures' arbitrary nature. But this method, in turn, shows that resolution - a retrospective determination of shape and meaning - can never be avoided entirely, even if it can be deferred.
Resistance
(2019)
The term 'resistance', as it appears in the writings of Walter Benjamin, marks the attempt to think a politics that emerges out of a certain experience of history and time. This entry shows that 'Widerstand' is conceived here principally as a resistance against the course of a catastrophic history - a desire for time to cease its flow and come to a standstill.
Resistance II
(2019)
Resistance I
(2019)
In an essay on Peter Weiss, W. G. Sebald remarked that 'the grotesque deformities of our inner lives have their background and origin in collective social history'. Weiss's works explore the relationships between writing and action, aesthetics and politics. This short essay discusses some fragments of texts by Weiss, asking how subjects formed and (grotesquely) deformed by history can continue to resist or intervene to alter its course.
Repetition
(2019)
Repetition
(2019)
This article explores the creative value of the notion of 'repetition' in Michel Foucault's texts from the 1960s and early 1970s. Re-enacting Gilles Deleuze's philosophy, Foucault implicitly refers to the Freudian repetition mechanisms in order to distort and reverse them. Foucault's repetition is de-psychologized, affectively de-individualizing, and temporally erratic, using the power of a senseless repetition to create new possibilities for the future.
Repetition
(2019)
Serial texts must repeat, so that they can be recognized, but they must also change, so that they can remain interesting. Unusual temporal manipulations can emerge in such texts in order to balance these contradictory demands. This essay studies two serial texts whose need for self-extension produces a suspension of historical time: the contemporary animated sitcom "The Simpsons", and medieval romance as theorized by the twelfth-century poet Wace. I suggest that we might name this temporal constraint fiction.
Renewal
(2019)
Interruptions and discontinuity are the very essence of Aby Warburg's conception of the temporality that affects art objects. Beneath the seemingly immobilized expressive gesture, the Hamburg scholar recognizes the vitality of the "Pathosformeln" that convey the intricacy of human multi-layered temporality, made of interruptions, resumptions, inversions, regressions, stops, accelerations, and survivals (Nachleben). In this sense, Warburg's idea of 'renewal', which he developed from his well-known investigation of the Italian Renaissance, does not quite overlap with the notion of rebirth: an expressive gesture can re-emerge and be renewed in a different time without dying and being born a second time with a different form.
Rehabilitation II
(2019)
Rehabilitation I
(2019)
By distancing it from historical revival (i.e., 'Living History'), reenactment is here understood as artistic strategy as well as curatorial practice, and therefore as critical method. As artistic strategy it implies the reactivation (over time) and remediation (on different supports) of images stemming from a vast visual repertoire that artists - especially those working with time-based media (film, video, performance) - appropriate in order to give them new meanings. As curatorial practice and critical method, reenactment regards the remaking of impermanent artworks and the restaging of temporary exhibitions to possibly offer an understanding of (art) history that gives preference to a visual and performative, sometimes immersive, approach.
Recovery
(2019)
Despite the increasing incidence of eating disorders, very few films have addressed these conditions in particular. What's more, most of the US-American mainstream fiction films that deal with eating disorders tend to be built on anachronistic clichés, hardly depicting their broad array. Furthermore, the traditional narrative structure of beginning, middle, and (happy) end misrepresents the erratic temporality of eating disorder symptoms as well as the nonlinear phases of recovery and relapse.
Recitation : lyric time(s) I
(2019)
What is the time of the lyric? For Augustine, the recitation of a hymn illustrates the workings of time in the human mind; for Giorgio Agamben, the poem itself exemplifies the structure of what he defines as 'messianic time'. By focusing on Dante's sonnet 'Tanto gentile e tanto onesta pare' and looking at the double act of the recitation of the poem and the "re-citation" of prior gestures, the temporality of both the single poem and lyric discourse will come into focus.
The text considers recirculation as a process through which both visual and cultural imagery are put in motion over and over again in the current information age, especially in the context of post-Internet art. Hito Steyerl's writings and thoughts on the 'poor image', namely the low-resolution digital image bound to a perpetual wandering or 'circulationism', here serve as major reference points for the development of the argument.
Recherche II : anamnesis
(2019)
The temporal loop of Proust's "Recherche" complicates the unidirectional understanding of anamnesis in psychoanalysis, which, in turn, allows for a renewed reading of the temporality of the "Recherche", highlighting the intrinsic link between artistic 'research' and unconscious affect - at the same time origin, motif, and destination.
Recherche I
(2019)
Recherche, (re-)search: do I research to find something not yet found or do I re-search back to find something that has been lost? These two directionalities structure Proust's "À la recherche du temps perdu" and are reflected in its reception. But what if they only seem mutually exclusive, yet really are one and the same thing?
Preface
(2019)
What's in a prefix? How to read a prefix as short as 're-'? Does 're-' really signify? Can it point into a specific direction? Can it reverse? Can it become the shibboleth of a 'postcritical' reboot? At first glance transparent and directional, 're-' complicates the linear and teleological models commonly accepted as structuring the relations between past, present, and future, opening onto errant temporalities.
Albumin, the most abundant plasma protein, not only controls osmotic blood pressure, but also serves as a carrier for various small molecules, including pharmaceuticals. Its impact on pharmacological properties of many drugs has been extensively studied over decades. Here, we focus on its interaction with the following mobilizing agents: Granulocyte-colony stimulating factor (G-CSF) and AMD3100, where such analyses are lacking. These compounds are widely used for hematopoietic stem cell mobilization of healthy donors or patients. Using albumin-deficient (Alb−/−) mice, we studied the contribution of albumin to mobilization outcomes. Mobilization with the bicyclam CXCR4 antagonist AMD3100 was attenuated in Alb−/− mice compared to wild-type littermates. By contrast, mobilization with recombinant human G-CSF (rhG-CSF), administered twice daily over a five-day course, was significantly increased in Alb−/− mice. In terms of a mechanism, we show that rhG-CSF bioavailability in the bone marrow is significantly improved in Alb−/− mice, compared to wild-type (WT) littermates, where rhG-CSF levels dramatically drop within a few hours of the injection. These observations likely explain the favorable mobilization outcomes with split-dose versus single-dose administration of rhG-CSF to healthy donors.
We investigated the implications of string theory in the high-precision regime of quantum mechanics. In particular, we examined a quantum field theoretical propagator which was derived from string theory when compactified at the T-duality self-dual radius and which is closely related to the path integral duality. Our focus was on the hydrogen ground state energy and the 1S1/2−2S1/2 transition frequency, as they are the most precisely explored properties of the hydrogen atom. The T-duality propagator alters the photon field dynamics leading to a modified Coulomb potential. Thus, our study is complementary to investigations where the electron evolution is modified, as in studies of a minimal length in the context of the generalized uncertainty principle. The first manifestation of the T-duality propagator arises at fourth order in the fine-structure constant, including a logarithmic term. For the first time, constraints on the underlying parameter, the zero-point length, are presented. They reach down to 3.9×10−19m and are in full agreement with previous studies on black holes.
Convective shower characteristics simulated with the convection-permitting climate model COSMO-CLM
(2019)
This paper evaluates convective precipitation as simulated by the convection-permitting climate model (CPM) Consortium for Small-Scale Modeling in climate mode (COSMO-CLM) (with 2.8 km grid-spacing) over Germany in the period 2001–2015. Characteristics of simulated convective precipitation objects like lifetime, area, mean intensity, and total precipitation are compared to characteristics observed by weather radar. For this purpose, a tracking algorithm was applied to simulated and observed precipitation with 5-min temporal resolution. The total amount of convective precipitation is well simulated, with a small overestimation of 2%. However, the simulation underestimates convective activity, represented by the number of convective objects, by 33%. This underestimation is especially pronounced in the lowlands of Northern Germany, whereas the simulation matches observations well in the mountainous areas of Southern Germany. The underestimation of activity is compensated by an overestimation of the simulated lifetime of convective objects. The observed mean intensity, maximum intensity, and area of precipitation objects increase with their lifetime showing the spectrum of convective storms ranging from short-living single-cell storms to long-living organized convection like supercells or squall lines. The CPM is capable of reproducing the lifetime dependence of these characteristics but shows a weaker increase in mean intensity with lifetime resulting in an especially pronounced underestimation (up to 25%) of mean precipitation intensity of long-living, extreme events. This limitation of the CPM is not identifiable by classical evaluation techniques using rain gauges. The simulation can reproduce the general increase of the highest percentiles of cell area, total precipitation, and mean intensity with temperature but fails to reproduce the increase of lifetime. The scaling rates of mean intensity and total precipitation resemble observed rates only in parts of the temperature range. The results suggest that the evaluation of coarse-grained (e.g., hourly) precipitation fields is insufficient for revealing challenges in convection-permitting simulations.
Focused electron and ion beam-induced deposition (FEBID/FIBID) are direct-write techniques with particular advantages in three-dimensional (3D) fabrication of ferromagnetic or superconducting nanostructures. Recently, two novel precursors, HCo 3 Fe(CO) 12 and Nb(NMe 3 ) 2 (N-t-Bu), were introduced, resulting in fully metallic CoFe ferromagnetic alloys by FEBID and superconducting NbC by FIBID, respectively. In order to properly define the writing strategy for the fabrication of 3D structures using these precursors, their temperature-dependent average residence time on the substrate and growing deposit needs to be known. This is a prerequisite for employing the simulation-guided 3D computer aided design (CAD) approach to FEBID/FIBID, which was introduced recently. We fabricated a series of rectangular-shaped deposits by FEBID at different substrate temperatures between 5 ∘ C and 24 ∘ C using the precursors and extracted the activation energy for precursor desorption and the pre-exponential factor from the measured heights of the deposits using the continuum growth model of FEBID based on the reaction-diffusion equation for the adsorbed precursor.
To improve and focus preclinical testing, we combine tumor models based on a decellularized tissue matrix with bioinformatics to stratify tumors according to stage-specific mutations that are linked to central cancer pathways. We generated tissue models with BRAF-mutant colorectal cancer (CRC) cells (HROC24 and HROC87) and compared treatment responses to two-dimensional (2D) cultures and xenografts. As the BRAF inhibitor vemurafenib is—in contrast to melanoma—not effective in CRC, we combined it with the EGFR inhibitor gefitinib. In general, our 3D models showed higher chemoresistance and in contrast to 2D a more active HGFR after gefitinib and combination-therapy. In xenograft models murine HGF could not activate the human HGFR, stressing the importance of the human microenvironment. In order to stratify patient groups for targeted treatment options in CRC, an in silico topology with different stages including mutations and changes in common signaling pathways was developed. We applied the established topology for in silico simulations to predict new therapeutic options for BRAF-mutated CRC patients in advanced stages. Our in silico tool connects genome information with a deeper understanding of tumor engines in clinically relevant signaling networks which goes beyond the consideration of single drivers to improve CRC patient stratification.
The sources and critical enrichment processes for granite related tin ores are still not well understood. The Erzgebirge represents one of the classical regions for tin mineralization. We investigated the four largest plutons from the Western Erzgebirge (Germany) for the geochemistry of bulk rocks and autocrystic zircons and relate this information to their intrusion ages. The source rocks of the Variscan granites were identified as high-grade metamorphic rocks based on the comparison of Hf-O isotope data on zircons, the abundance of xenocrystic zircon ages as well as Nd and Hf model ages. Among these rocks, restite is the most likely candidate for later Variscan melts. Based on the evolution with time, we could reconstruct enrichment factors for tin and tungsten starting from the protoliths (575 Ma) that were later converted to high-grade metamorphic rocks (340 Ma) and served as sources for the older biotite granites (323–318 Ma) and the tin granites (315–314 Ma). This evolution involved a continuous enrichment of both tin and tungsten with an enrichment factor of ~15 for tin and ~7 for tungsten compared to the upper continental crust (UCC). Ore level concentrations (>10–100 times enrichment) were achieved only in the greisen bodies and dykes by subsequent hydrothermal processes.
CCR8 leads to eosinophil migration and regulates neutrophil migration in murine allergic enteritis
(2019)
Allergic enteritis (AE) is a gastrointestinal form of food allergy. This study aimed to elucidate cellular and molecular mechanisms of AE using a murine model. To induce AE, BALB/c wild type (WT) mice received intraperitoneal sensitization with ovalbumin (an egg white allergen) plus ALUM and feeding an egg white (EW) diet. Microarray analysis showed enhanced gene expression of CC chemokine receptor (CCR) 8 and its ligand, chemokine CC motif ligand (CCL) 1 in the inflamed jejunum. Histological and FACS analysis showed that CCR8 knock out (KO) mice exhibited slightly less inflammatory features, reduced eosinophil accumulation but accelerated neutrophil accumulation in the jejunums, when compared to WT mice. The concentrations of an eosinophil chemoattractant CCL11 (eotaxin-1), but not of IL-5, were reduced in intestinal homogenates of CCR8KO mice, suggesting an indirect involvement of CCR8 in eosinophil accumulation in AE sites by inducing CCL11 expression. The potential of CCR8 antagonists to treat allergic asthma has been discussed. However, our results suggest that CCR8 blockade may promote neutrophil accumulation in the inflamed intestinal tissues, and not be a suitable therapeutic target for AE, despite the potential to reduce eosinophil accumulation. This study advances our knowledge to establish effective anti-inflammatory strategies in AE treatment.
Glioblastome (GB) sind die häufigsten bösartigen primären Hirntumore im Erwachsenenalter. Das Therapiekonzept bei Erstdiagnose besteht aus einer maximalen Tumorresektion, gefolgt von einer Strahlentherapie mit konkomitanter und anschließend adjuvanter Chemotherapie mit dem Alkylanz Temozolomid in Zyklusform. Zusätzlich zur adjuvanten Chemotherapie werden inzwischen für supratentorielle GBs auch Tumortherapiefelder empfohlen, die über elektromagnetische Wechselfelder die Tumorzellteilung hemmen sollen. Trotz multimodaler Therapiekonzepte und Fortschritte im Verständnis der GB-Biologie ist die Prognose der Patienten bei einer 5-Jahresüberlebensrate von unter 5% sehr ernüchternd. Eine mögliche Ursache für den ausbleibenden Erfolg neuer GB-Medikamente könnten die besonderen metabolischen Bedingungen des Tumormikromilieus sein. Unter diesen kann eine therapeutische zielgerichtete Inhibition bestimmter Kinasen, wie des Epidermalen Wachstumsfaktorrezeptors (EGFR) oder mammalian Target of Rapamycin (mTOR), unerwünschte Tumorzell-protektive Effekte entfalten, da bereits gezeigt werden konnte, dass sich Tumorzellen durch Suppression der mTORC1 abhängigen Signalkaskade an Energiemangelbedingungen, wie sie im Tumormikromilieu zu finden sind, anpassen, um zu überleben. Ziel dieses Projektes war es den physiologischen mTORC1-Inhibitor DNAdamage-inducible transcript 4 (DDIT4) als möglichen intrinsischen Resistenzmechanismus gegenüber Strahlen- und Chemotherapie in GBs zu untersuchen. In verschiedenen GB-Zelllinien konnte eine Induktion von DDIT4 teilweise durch Bestrahlung, Temozolomid und generell durch die im Tumormikromilieu vorherrschende Hypoxie nachgewiesen werden. Dies gelang sowohl auf transkriptioneller Ebene als auch auf Proteinniveau. Zur Beurteilung der Relevanz dieses zellulären Anpassungsmechanismus wurden Zellen mit DDIT4 Gensuppression generiert und charakterisiert. Hier zeigte sich in klonalen Überlebensanalysen eine gesteigerte Sensibilität der Zellen mit verminderter DDIT4 Expression gegenüber Temozolomid und Strahlentherapie. Darüber hinaus waren diese Zellen gegenüber Hypoxie-induziertem Zelltod sensibilisiert. Umgekehrt führte eine stabile oder Doxycyclin- induzierte DDIT4 Überexpression zu einer signifikanten Resistenz gegenüber Strahlentherapie, Temozolomid und Hypoxie-induziertem Zelltod.
Zusammenfassend beschreiben unsere Ergebnisse DDIT4 als Mediator von Therapieresistenz gegenüber den etablierten Komponenten der GBErstlinientherapie und zudem als Anpassungsmechanismus an das hypoxische Tumormikromilieu. DDIT4 stellt somit einen möglichen Angriffspunkt für eine therapeutische Inhibition beim GB dar.
Human beings are supposed to possess an approximate number system (ANS) dedicated to extracting and representing approximate numerical magnitude information as well as an object tracking system (OTS) for the rapid and accurate enumeration of small sets. It is assumed that the OTS and the ANS independently contribute to the acquisition of more elaborate numerical concepts. Chinese children have been shown to exhibit more elaborate numerical concepts than their non-Chinese peers, but it is still an open question whether similar cross-national differences exist with regard to the underlying systems, namely the ANS and the OTS. In the present study, we investigated this question by comparing Chinese and German preschool children with regard to their performance in a non-symbolic numerical magnitude comparison task (assessing the ANS) and in an enumeration task (assessing the OTS). In addition, we compared children’s counting skills. To ensure that possible between-group differences could not be explained by differences in more general performance factors, we also assessed children’s reasoning ability and processing speed. Chinese children showed a better counting performance and a more accurate performance in the non-symbolic numerical magnitude comparison task. These differences in performance could not be ascribed to differences in reasoning abilities and processing speed. In contrast, Chinese and German children did not differ significantly in the enumeration of small sets. The superior counting performance of Chinese children was thus found to be reflected in the ANS but not in the OTS.
Aquesta tesi doctoral estudia la construcció de la notícia sobre esdeveniments del procés polític català en els mitjans de comunicació escrits alemanys. El període d’anàlisi s’estèn del 2010 al 2015, quan el procés ha passat de la societat civil a l’agenda política catalana i s’ha internacionalitzat. En aquest context, l’opinió publicada alemanya es considera un referent.
La tesi analitza dotze fets clau a partir d’una doble metodologia, quantitativa i qualitativa. Es duu a terme una anàlisi d’Agenda i de Frames, també s’aplica una Anàlisi del Discurs i es complementa la recerca amb entrevistes a periodistes i polítics. La metodologia ha estat provada i validada per set analistes germanòfons.
Els resultats de la recerca, exposats a més en quaranta-nou taules i figures, mostren l’establiment de l’agenda i els enquadraments dels temes i actors del procés català, la relació entre discurs, poder i legitimació, així com la construcció de l’opinió publicada alemanya.
In this work we provided additional insights into our understanding of bulk QCD matter through the study of the transport coeffcients which govern the non-equilibrium microscopical processes of statistical ensembles. Specically, we focused on the low energy regime corresponding to the hadron gas, as the properties of this region of the phase diagram are still relatively unknown, and existing calculations for the transport coeffcients are either scarce, contradictory, or somewhat limited in scope; this thesis' main goal was thus to shed some light on this by providing new independent calculations of these quantities.
We subsequently presented two formalisms which can be used to calculate transport coeffcients. The first one (which also was the main tool we used in the following chapters to produce our results) relies on the development of so-called Green-Kubo formulas, which relate non-equilibrium dissipative fluctuations with transport coeffcients; notably, the off-diagonal components of the energy-momentum tensor are shown to be related to the shear viscosity, its diagonal components to the bulk viscosity and fluctuations in the electric current can be related to the electric conductivity. We additionally introduced two new conductivities, namely the baryon-electric and strange electric conductivities, which we dubbed, together with the already known electric one, the "cross-conductivity", which encodes information about how electric fluctuations are correlated to changes in electric, baryonic or strange currents, or vice-versa. The second way of calculating transport coeffcient which we discussed consists in linearizing the collision term of the Boltzmann equation through the Chapman-Enskog formalism. While in principle providing direct semi-analytical results for the transport coeffcients, this approach is complicated to implement when more than a few species are considered, and as such was then mostly used as a tool to calibrate our Green-Kubo calculations.
The hadron gas model that we used for all calculations, namely the transport approach SMASH, was then presented. The main features of the model were explained, such as the collision criterion, the considered degrees of freedom and the specific way in which they microscopically interact with each other. It was verified that SMASH does reproduce analytical results of the Boltzmann equation in an expanding universe scenario, thus showing the equivalence of this transport approach and the associated kinetic theory results. A special care was taken to detail the ways in which a state of thermal and chemical equilibrium (which is necessary for Green-Kubo relations to be valid) can be reached and described using SMASH.
...
Ziel dieser Arbeit war es, eine vergleichende Bewertung der Erkennbarkeit der apikalen Aufhellung in den dreidimensionalen DVT-Aufnahmen und den konventionellen Panoramaschichtaufnahmen im Oberkiefer unter den folgenden Gesichtspunkten vorzunehmen:
Werden die apikalen Aufhellungen sowohl bei zwei- als auch bei dreidimensionalen Aufnahmen gleichermaßen erkannt?
Spielt die Stärke der Kompakta eine Rolle in der radiologischen Diagnose einer apikalen Aufhellung?
Zu diesem Zweck wurden 351 Patienten aus der Datenbank einer privaten Praxis in Stuttgart ausgewählt. Davon erfüllten 199 Patienten die Einschlusskriterien. Es wurden insgesamt 2223 Zähne durch den Untersucher ausgewertet. Es konnten 144 apikale Aufhellungen mittels der DVT diagnostiziert werden, wovon lediglich 23 (15,9 %) mittels der OPT erkannt wurden. Die Ergebnisse dieser Studie zeigen insgesamt einen signifikanten Unterschied zwischen den DVT- und den OPG-Befunden hinsichtlich der Sichtbarkeit der apikalen Aufhellungen im Oberkiefer. Andere Parameter wie die Tiefe, die Breite und die Länge der apikalen Aufhellungen wurden ebenfalls untersucht. Die Messungen erfolgten mittels der Software i-CatVision 2008 für die DVT-Aufnahmen und mittels DBSWIN von Dürr Dental für die OPG- Aufnahmen. Es ergab sich daraus, dass die apikalen Läsionen, die im OPG und in der DVT sichtbar waren, signifikant größere Breiten hatten als die, die nur in der DVT sichtbar waren. Es zeigte sich hierbei ein signifikanter Unterschied (U- Test, p =0,018). Dies weist daraufhin, dass insbesondere schmale apikale Läsionen nicht sicher in OPG-Aufnahmen diagnostiziert werden, während sie in der DVT nachweisbar sind. Des Weiteren wurde in der Studie die Kompaktadicke gemessen. Es bestand kein signifikanter Zusammenhang zwischen der Sichtbarkeit der apikalen Aufhellung und der Kompaktadicke. Zusammenfassend lässt sich anhand der Ergebnisse der vorliegenden Arbeit feststellen, dass die Kompaktadicke keine Rolle bei der Sichtbarkeit der apikalen Läsionen spielt und dass die OPT im Nachweis apikaler Läsionen der DVT eindeutig unterlegen ist. Es wurden dadurch nur 19 % der apikalen 64 Aufhellungen diagnostiziert und damit ist eine Unterdiagnose sehr wahrscheinlich.
Schlussfolgernd scheint die DVT ein zuverlässiges diagnostisches Mittel bezüglich des Erkennens der apikalen Läsionen zu sein. Mehrere Studien bezeichnen die DVT als Goldstandard und ziehen sie für die Diagnose der apikalen Aufhellungen den konventionellen Röntgenbildern vor. Dieses Vorgehen widerspricht jedoch dem Bestreben nach einer möglichst geringen Strahlenexposition gemäß dem ALARA-Prinzips. Damit bleibt die DVT derzeit eine Ergänzung zur konventionellen Bildgebung.
Der VEGF-neutralisierende Antikörper Bevacizumab ist ein wichtiger Bestandteil der modernen Tumortherapie. Auch in der Glioblastom Therapie wird Bevacizumab eingesetzt, da in klinischen Studien eine Verlängerung des progressionsfreien Überlebens beobachtet wurde. Leider entwickeln sich schnell Resistenzen und das Gesamtüberleben konnte durch Bevacizumab in der Erstlinientherapie von Glioblastomen nicht verlängert werden.
Die genaue Wirkungsweise von Bevacizumab und somit auch die Resistenzentwicklung sind nur teilweise bekannt. Es wird vermutet, dass es durch Gefäßveränderungen zu einer Mangelsituation und zu Hypoxie kommt. Einige Studien deuten darauf hin, dass es neben der Wiedererlangung einer VEGF-unabhängigen Gefäßversorgung auch zu Resistenz gegen das durch Bevacizumab hervorgerufene, von Sauerstoffmangel gekennzeichnete Mikromilieu kommt. So konnte gezeigt werden, dass Bevacizumab-resistente Tumoren einen stark glykolytischen, sauerstoff-unabhängigen Zellmetabolismus aufweisen und vermehrt Laktat produzieren. Darüber hinaus wurde in Folge der Bevacizumab-Behandlung eine Fehlfunktion von Mitochondrien beobachtet. Unklar ist noch, ob die beschriebenen metabolischen Veränderungen ein Epiphänomen der Nährstoffmangelsituation sind oder ob sie kausal mit der Resistenzentwicklung in Zusammenhang stehen.
In der vorliegenden Arbeit sollte deshalb geprüft werden, ob die metabolische Umstellung hin zu einem glykolytischen, anaeroben Phänotyp eine hinreichende Bedingung zur Entwicklung einer Hypoxie- und Bevacizumabresistenz darstellt.
Hierzu wurden Glioblastomzellen (LNT229) derart verändert, dass sie keine oxidative Phosphorylierung durchführen konnten und rein auf die glykolytische Energiegewinnung angewiesen waren (rho0-Zellen). Diese Veränderung führte in-vitro zu einer Hypoxieresistenz der Zellen. Außerdem waren rho0-Zellen empfindlicher gegenüber Glukoseentzug und einer Behandlung mit dem Glykolyse-Inhibitor 2-Deoxyglucose (2DG). Des Weiteren waren im Mausmodell intrakranielle rho0-Tumorxenografts resistent gegenüber Bevacizumab. Diese Resistenz konnte durch zusätzliche Therapie mit 2DG wieder aufgehoben werden.
Somit konnte in der vorliegenden Arbeit gezeigt werden, dass die Hemmung der oxidativen Phosphorylierung zu einem glykolytischen Phänotyp führt, der hinreichend ist, um eine Hypoxieresistenz und in Folge dessen eine Bevacizumabresistenz in Glioblastomzellen zu verursachen. Dies lässt einen kausalen Zusammenhang zwischen bereits in anderen Studien beschriebenen metabolischen Veränderungen und einer Bevacizumabresistenz in Tumoren vermuten. Der zelluläre Glukosestoffwechsel ist damit ein vielversprechender therapeutischer Angriffspunkt zur Vermeidung und Überwindung einer Bevacizumabresistenz.
Das Strukturgleichungsmodell (SEM) wird in den Sozial- und Verhaltenswissenschaften oft verwendet, um die Beziehung zwischen latenten Variablen zu modellieren. In der Analyse dieser Modelle spielt die Bewertung der Modellgüte eine wesentliche Rolle, wobei geprüft werden soll, ob das untersuchte Modell (Zielmodell) zu den erhobenen Daten passt. Dafür werden verschiedene inferenzstatistische und deskriptive Gütemaße verwendet. In nichtlinearen SEM, in denen nichtlineare Effekte, wie beispielsweise Interaktionseffekte, modelliert werden, gibt es bisher allerdings keine Verfahren, um die Modellgüte ausreichend prüfen zu können. Insbesondere der χexp2-Test ist für verschiedene nichtlineare SEM nicht geeignet (vgl. Klein & Schermelleh-Engel, 2010; Mooijaart & Satorra, 2009).
In dieser Arbeit werden zwei unterschiedliche nichtlineare SEM betrachtet. Das erste dieser Modelle wird für die Analyse von Interaktions- und quadratischen Effekten verwendet (quadratisches SEM, QSEM). Das zweite Modell ist das Heterogene Wachstumskurvenmodell (HGM; Klein & Muthén, 2006). In diesem Modell wird das latente Wachstumskurvenmodell (LGM), mit dem individuelle Wachstumsverläufe modelliert werden können, um eine heterogene Varianzkomponente des Slope-Faktors erweitert. Diese Heterogenität des Slope-Faktors ist abhängig von den Ausgangswerten und Kovariaten.
Ziel dieser Arbeit war es, die Bewertung der Modellgüte für das QSEM und das HGM zu verbessern. Für das QSEM und das HGM wurde jeweils ein globaler Modelltest entwickelt („Quasi-Likelihood-Ratio-Test“; QLRT). Darüber hinaus wurden Differenztests für diese Art der Modelle diskutiert. Außerdem wurde für beide Modelle je ein Gütemaß bereitgestellt, um fehlende Nichtlinearität, wie fehlende nichtlineare Terme bzw. fehlende Heterogenität der Slope-Varianzen, aufdecken zu können (der Homoscedastic Fit Index, HFI, für das QSEM und der hhet-Test für das HGM).
Die Entwicklung der neuen Gütemaße ist im Wesentlichen von der verwendeten Schätzmethode abhängig. Für beide Modelle, das QSEM und das HGM, wurde in dieser Arbeit die Quasi-Maximum-Likelihood-Methode (Quasi-ML-Methode; Wedderburn, 1974) ausgewählt, mit der für beide betrachteten Modelle geeignete Schätzungen erzielt werden können (Klein & Muthén, 2006, 2007). Die Quasi-ML-Methode ist vergleichbar mit der Maximum-Likelihood-Methode, berücksichtigt allerdings Fehlspezifikationen der LogLikelihood-Funktion, wie beispielsweise kleinere Abweichungen von der angenommenen Verteilung. Für das QSEM wurde im Rahmen der Entwicklung der Modelltests eine zur Schätzung von QSEM entwickelte Quasi-ML-Methode (QML-Methode; Klein & Muthén, 2007) vereinfacht zu der „simplified QML“-Methode (sQML-Methode; Büchner & Klein, 2019). Für die sQML-Methode ist es erheblich einfacher als für die QML-Methode einen globalen Modelltest zu entwickeln. In einer Simulationsstudie konnte gezeigt werden, dass die sQML-Methode ähnlich gute Schätzeigenschaften wie die QML-Methode aufweist.
Die Idee der neuen globalen Modelltests für das QSEM und das HGM besteht darin, statt des für das lineare SEM verwendeten χexp2-Tests, der ein Likelihood-Quotienten-Test („Likelihood Ratio Test“, LRT) ist, einen Quasi-LRT (QLRT) zu verwenden, der auf der Quasi-ML-Methode basiert (Büchner & Klein, 2019; Büchner, Klein & Irmer, 2019). Wie für den χexp2-Test soll das Zielmodell mit einem unbeschränkten Vergleichsmodell verglichen werden. Ist der Unterschied zwischen den Modellen groß, wird darauf geschlossen, dass das Zielmodell nicht gut zu den Daten passt. Die Schwierigkeit bei der Entwicklung solcher QLRT liegt dabei in der Definition eines Vergleichsmodells. Die hier verwendete Idee für solche Vergleichsmodelle besteht darin, wie im χexp2-Test, die Beschränkungen durch das Zielmodell im Vergleichsmodell aufzuheben. Eine weitere Herausforderung ist die Bestimmung der asymptotischen Verteilung der QLRT-Statistiken, die nicht, wie viele LRT-Statistiken, asymptotisch χexp2-verteilt sind. Deshalb wurde die korrekte asymptotische Verteilung dieser Teststatistiken bestimmt, die das Ermitteln von p-Werten ermöglicht.
Globale Modelltests sind zwar geeignet, wichtige Aussagen zur Passung des Modells zu machen, ermöglichen aber keine direkte Aussage über den Vergleich zweier konkurrierender Modelle. Ein solcher Modellvergleich ist aber wichtig, um ein möglichst sparsames Modell zu erhalten. Zum Vergleich ineinander geschachtelter Modelle werden häufig Differenztests verwendet. Diese werden auch in der Arbeit mit dem QSEM und dem HGM empfohlen. Allerdings ist zu beachten, dass die Teststatistiken für mit der Quasi-MLMethode geschätzten Modelle nicht χexp2-verteilt sind. Im Rahmen dieser Arbeit wurde eine korrekte asymptotische Verteilung angegeben. Im Speziellen wurde der Differenztest für den Vergleich zwischen einem HGM und einem LGM vorgestellt, mit dem getestet wird, ob die im HGM modellierten heterogenen Slope-Varianzen notwendig sind.
Ein weiteres Ziel bestand darin, fehlende Nichtlinearität, die nicht in einem Modell berücksichtigt ist, aufzudecken. Dafür wurde ein Test für Regressionsmodelle, der hhet-Test (Klein, Gerhard, Büchner, Diestel & Schermelleh-Engel, 2016), angepasst. Für das SEM wurde dieser Test zu einem Fit-Index, dem HFI (Gerhard, Büchner, Klein & SchermellehEngel, 2017), weiterentwickelt und darin die Verteilung der Residuen der abhängigen Variable bewertet. Der HFI deckt dabei Veränderungen in der Verteilung auf, die durch fehlende nichtlineare Terme verursacht sind. Für das LGM wird der hhet-Test verwendet, um fehlende heterogene Entwicklungsverläufe aufzudecken. Es wird die Verteilung der mit dem LGM standardisierten beobachteten Variablen geprüft.
Für alle vorgeschlagenen Gütemaße wurden Simulationsstudien durchgeführt, um ihre Eignung für die Bewertung des QSEMs bzw. des HGMs zu prüfen. Die α-Fehler-Raten waren meistens nahe an dem erstrebten 5%-Niveau. Für den QLRT für das QSEM bei kleinen Stichproben und für den HFI bei komplexeren Modellen waren sie allerdings erhöht. Darüber hinaus zeigten die Tests insgesamt eine gute Teststärke für das Aufdecken von Fehlspezifikationen. Wie in allen statistischen Tests muss dafür die Stichprobengröße ausreichend groß sein. Die praktische Anwendbarkeit der beiden QLRTs, des hhet-Tests und des Differenztests für das HGM wurde anhand von empirischen Beispielen aufgezeigt.
Background: Approximately every third surgical patient is anemic. The most common form, iron deficiency anemia, results from persisting iron‐deficient erythropoiesis (IDE). Zinc protoporphyrin (ZnPP) is a promising parameter for diagnosing IDE, hitherto requiring blood drawing and laboratory workup.
Study design and methods: Noninvasive ZnPP (ZnPP‐NI) measurements are compared to ZnPP reference determination of the ZnPP/heme ratio by high‐performance liquid chromatography (ZnPP‐HPLC) and the analytical performance in detecting IDE is evaluated against traditional iron status parameters (ferritin, transferrin saturation [TSAT], soluble transferrin receptor–ferritin index [sTfR‐F], soluble transferrin receptor [sTfR]), likewise measured in blood. The study was conducted at the University Hospitals of Frankfurt and Zurich.
Results: Limits of agreement between ZnPP‐NI and ZnPP‐HPLC measurements for 584 cardiac and noncardiac surgical patients equaled 19.7 μmol/mol heme (95% confidence interval, 18.0–21.3; acceptance criteria, 23.2 μmol/mol heme; absolute bias, 0 μmol/mol heme). Analytical performance for detecting IDE (inferred from area under the curve receiver operating characteristics) of parameters measured in blood was: ZnPP‐HPLC (0.95), sTfR (0.92), sTfR‐F (0.89), TSAT (0.87), and ferritin (0.67). Noninvasively measured ZnPP‐NI yielded results of 0.90.
Conclusion: ZnPP‐NI appears well suited for an initial IDE screening, informing on the state of erythropoiesis at the point of care without blood drawing and laboratory analysis. Comparison with a multiparameter IDE test revealed that ZnPP‐NI values of 40 μmol/mol heme or less allows exclusion of IDE, whereas for 65 μmol/mol heme or greater, IDE is very likely if other causes of increased values are excluded. In these cases (77% of our patients) ZnPP‐NI may suffice for a diagnosis, while values in between require analyses of additional iron status parameters.
Glioblastoma (GB) is the most common and aggressive primary brain tumor in adults and currently incurable. Despite multimodal treatment regimens, median survival in unselected patient cohorts is <1 year, and recurrence remains almost inevitable. Escape from immune surveillance is thought to contribute to the development and progression of GB. While GB tumors are frequently infiltrated by natural killer (NK) cells, these are actively suppressed by the GB cells and the GB tumor microenvironment. Nevertheless, ex vivo activation with cytokines can restore cytolytic activity of NK cells against GB, indicating that NK cells have potential for adoptive immunotherapy of GB if potent cytotoxicity can be maintained in vivo. NK cells contribute to cancer immune surveillance not only by their direct natural cytotoxicity which is triggered rapidly upon stimulation through germline-encoded cell surface receptors, but also by modulating T-cell mediated antitumor immune responses through maintaining the quality of dendritic cells and enhancing the presentation of tumor antigens. Furthermore, similar to T cells, specific recognition and elimination of cancer cells by NK cells can be markedly enhanced through expression of chimeric antigen receptors (CARs), which provides an opportunity to generate NK-cell therapeutics of defined specificity for cancer immunotherapy. Here, we discuss effects of the GB tumor microenvironment on NK-cell functionality, summarize early treatment attempts with ex vivo activated NK cells, and describe relevant CAR target antigens validated with CAR-T cells. We then outline preclinical approaches that employ CAR-NK cells for GB immunotherapy, and give an overview on the ongoing clinical development of ErbB2 (HER2)-specific CAR-NK cells currently applied in a phase I clinical trial in glioblastoma patients.
Charge states and energy loss of heavy ions after passing an inductively coupled plasma target
(2019)
In various kinds of fields such as accelerator physics, warm dense matter, high energy density physics, and inertial confinement fusion, heavy ions beam-plasma interaction plays an important role, and abundant investigations have been and are being carried out. Taking advantage of a good level of understanding on the interaction between a swift heavy ions beam and a hydrogen gas discharge plasma, an engineering application of a spherical theta-pinch device as a plasma stripper for FAIR (facility for antiproton and ion research) and a scientific application of a swift heavy ions beam as a novel plasma diagnostic tool are proposed and investigated.
The spherical theta-pinch device is manufactured, improved, and comprehensively tested for its application as a plasma stripper. The device is mainly composed of an evacuated glass vessel that can be filled with gas (for example: hydrogen) and a LRC circuit including a capacitors bank and a set of coils. Discharging the device at an initial hydrogen pressure in the glass vessel and an operation voltage for the capacitors bank, a circuit current oscillates in the LRC circuit. The oscillating circuit current in the set of coils induces a corresponding alternating magnetic field inside the glass vessel to ignite and maintain a hydrogen plasma.
Based on the built setup of circuit and plasma diagnostics, the measurements of circuit current, plasma light emission, plasma shape, and hydrogen Balmer series are carried out. The recorded signals of the circuit current and the plasma light emission of many consecutively repetitive discharges overlap perfectly, which indicate a very good reproducibility of the parameters of the LRC circuit during discharge and the generated plasma. From the measured circuit current, a real energy transfer efficiency is calculated by our proposed new model, which shows its overall tendency varying with the hydrogen pressure and the operation voltage, including the maximum value of 25% occurring at an initial hydrogen pressure of around 25 Pa and a maximum operation voltage of 14 kV. So, the discharge at an initial hydrogen pressure of 20 Pa and an operation voltage of 14 ...
Elucidating the immune evasion mechanisms of borrelia mayonii, the causative agent of lyme disease
(2019)
Borrelia (B.) mayonii sp. nov. has recently been reported as a novel human pathogenic spirochete causing Lyme disease (LD) in North America. Previous data reveal a higher spirochaetemia in the blood compared to patients infected by LD spirochetes belonging to the B. burgdorferi sensu lato complex, suggesting that this novel genospecies must exploit strategies to overcome innate immunity, in particular complement. To elucidate the molecular mechanisms of immune evasion, we utilized various methodologies to phenotypically characterize B. mayonii and to identify determinants involved in the interaction with complement. Employing serum bactericidal assays, we demonstrated that B. mayonii resists complement-mediated killing. To further elucidate the role of the key regulators of the alternative pathway (AP), factor H (FH), and FH-like protein 1 (FHL-1) in immune evasion of B. mayonii, serum adsorption experiments were conducted. The data revealed that viable spirochetes recruit both regulators from human serum and FH retained its factor I-mediated C3b-inactivating activity when bound to the bacterial cells. In addition, two prominent FH-binding proteins of approximately 30 and 18 kDa were detected in B. mayonii strain MN14-1420. Bioinformatics identified a gene, exhibiting 60% identity at the DNA level to the cspA encoding gene of B. burgdorferi. Following PCR amplification, the gene product was produced as a His-tagged protein. The CspA-orthologous protein of B. mayonii interacted with FH and FHL-1, and both bound regulators promoted inactivation of C3b in the presence of factor I. Additionally, the CspA ortholog counteracted complement activation by inhibiting the alternative and terminal but not the classical and Lectin pathways, respectively. Increasing concentrations of CspA of B. mayonii also strongly affected C9 polymerization, terminating the formation of the membrane attack complex. To assess the role of CspA of B. mayonii in facilitating serum resistance, a gain-of-function strain was generated, harboring a shuttle vector allowing expression of the CspA encoding gene under its native promotor. Spirochetes producing the native protein on the cell surface overcame complement-mediated killing, indicating that CspA facilitates serum resistance of B. mayonii. In conclusion, here we describe the molecular mechanism utilized by B. mayonii to resists complement-mediated killing by capturing human immune regulators.
Background: The DIAMOND study of de novo liver transplant patients showed that prolonged-release tacrolimus exposure in the acute post-transplant period maintained renal function over 24 weeks of treatment. To assess these findings further, we performed a post-hoc analysis in patients according to baseline kidney function, Model for End-stage Liver Disease [MELD] scores, and donor age.
Material/Methods: Patients received prolonged-release tacrolimus (initial-dose, Arm 1: 0.2 mg/kg/day, Arm 2: 0.15-0.175 mg/kg/day, Arm 3: 0.2 mg/kg/day delayed until Day 5), mycophenolate mofetil and 1 steroid bolus. Arms 2 and 3 also received basiliximab. The recommended tacrolimus target trough levels to Day 42 post-transplantation were 5-15 ng/mL in all arms. In this post-hoc analysis, change in renal outcome, based on estimated glomerular filtration rate (eGFR), Modified Diet in Renal Disease-4 (MDRD4), values from baseline to Week 24 post-transplantation, were assessed according to baseline patient factors: eGFR (≥60 and ˂60 mL/min/1.73 m²), MELD score (˂25 and ≥25) and donor age (˂50 and ≥50 years).
Results: Baseline characteristics were comparable (Arms 1-3: n=283, n=287, n=274, respectively). Patients with baseline renal function, eGFR ≥60 mL/min/1.73 m², experienced a decrease in eGFR in all tacrolimus treatment arms. In patients with lower baseline renal function (eGFR ˂60 mL/min/1.73 m²), an advantage for renal function was observed with both the early lower-dose and delayed higher-dose tacrolimus regimens compared with the early introduction of higher-dose tacrolimus. At Week 24, renal function was higher in the early-lower tacrolimus arm with older donors, and the delayed higher-dose tacrolimus arm with younger donors, both compared with early higher-dose tacrolimus.
Conclusions: Pre-transplantation factors, such as renal function and donor age, could guide the choice of prolonged-release tacrolimus regimen following liver transplantation.
The thrombopoietin receptor agonist eltrombopag was successfully used against human cytomegalovirus (HCMV)-associated thrombocytopenia refractory to immunomodulatory and antiviral drugs. These effects were ascribed to the effects of eltrombopag on megakaryocytes. Here, we tested whether eltrombopag may also exert direct antiviral effects. Therapeutic eltrombopag concentrations inhibited HCMV replication in human fibroblasts and adult mesenchymal stem cells infected with six different virus strains and drug-resistant clinical isolates. Eltrombopag also synergistically increased the anti-HCMV activity of the mainstay drug ganciclovir. Time-of-addition experiments suggested that eltrombopag interfered with HCMV replication after virus entry. Eltrombopag was effective in thrombopoietin receptor-negative cells, and the addition of Fe3+ prevented the anti-HCMV effects, indicating that it inhibits HCMV replication via iron chelation. This may be of particular interest for the treatment of cytopenias after hematopoietic stem cell transplantation, as HCMV reactivation is a major reason for transplantation failure. Since therapeutic eltrombopag concentrations are effective against drug-resistant viruses, and synergistically increase the effects of ganciclovir, eltrombopag is also a drug-repurposing candidate for the treatment of therapy-refractory HCMV diseas.
We study the Wigner function for massive spin-1/2 fermions in electromagnetic fields. The Wigner function is analytically solved in five cases when electromagnetic fields are constants. For a general space-time dependent field configuration, we use the method of semi-classical expansion and solved the Wigner function at linear order in the Planck's constant. At the same order, we obtained a generalized Boltzmann equation for particle distribution, and a generalized BMT equation for spin polarization. Using the Wigner function, we calculated some physical quantities in a thermal equilibrium system.
Nina Kühnle wendet sich in ihrer Untersuchung in erster Linie sozialgeschichtlichen Fragestellungen zu. Im Eingangskapitel wirft sie die zentrale Ausgangsfrage ihrer Arbeit auf: Handelt es sich bei der sog. "Ehrbarkeit" in Württemberg tatsächlich um eine "ständegeschichtlich einzigartige Sondergruppe" unter den städtischen Oberschichten in Deutschland (8), die man in dieser Form tatsächlich nur in Württemberg antrifft? Und handelt es sich bei dieser "Ehrbarkeit" um einen halbwegs abgrenzbaren stadtbürgerlichen Stand, der sich von den Patriziaten anderer, zumal süddeutscher Städtelandschaften in signifikanter Weise unterscheidet? Eben dies war die mittlerweile allerdings überholte These des württembergischen Landeshistorikers Hansmartin Decker-Hauff: Ihm zufolge bildete die württembergische Ehrbarkeit einen ganz spezifischen Stand, der sich dadurch ausgezeichnet habe, dass bei ihm allein die ausgeübten Ämter und Funktionen die Standeszugehörigkeit begründet hätten. In der eingehenden Auseinandersetzung mit dieser These zeigt die Verf. sodann deren Schwachstellen auf (12–17), wobei sie an die Kritik von Gabriele Haug-Moritz anknüpft, die in ihrer Monographie über die württembergische Ehrbarkeit von Decker-Hauffs Konzept nicht mehr viel übrig gelassen hat: Die Ehrbarkeit bestand nicht – das dürfte mittlerweile feststehen – aus der Gruppe der Amtsinhaber; letztere kamen vielmehr zu Amt und Würden, weil sie aus der Ehrbarkeit stammten (17). "Ehrbarkeit" ergab sich demzufolge nicht aus einem Amt, sondern umgekehrt aus der Zugehörigkeit zu einer bestimmten Gesellschaftsschicht. Angesichts dessen spricht die Verf. in ihrer Arbeit auch nicht von "der Ehrbarkeit", sondern von "städtischen Führungsgruppen" oder der "Stadtelite" (26f.), hier im Anschluss an die neuere Sozialgeschichte, die bekanntlich seit geraumer Zeit eine besondere Vorliebe für das Wort "Elite" entwickelt hat. ...
Neuroblastoma (NB) is the most common solid extracranial tumor in childhood. Despite therapeutic progress, prognosis in high-risk NB is poor and innovative therapies are urgently needed. Therefore, we addressed the potential cytotoxic capacity of interleukin (IL)-activated natural killer (NK) cells compared to cytokine-induced killer (CIK) cells for the treatment of NB. NK cells were isolated from peripheral blood mononuclear cells (PBMCs) by indirect CD56-enrichment or CD3/CD19-depletion and expanded with different cytokine combinations, such as IL-2, IL-15, and/or IL-21 under feeder-cell free conditions. CIK cells were generated from PBMCs by ex vivo stimulation with interferon-γ, IL-2, OKT-3, and IL-15. Comparative analysis of expansion rate, purity, phenotype and cytotoxicity was performed. CD56-enriched NK cells showed a median expansion rate of 4.3-fold with up to 99% NK cell content. The cell product after CD3/CD19-depletion consisted of a median 43.5% NK cells that expanded significantly faster reaching also 99% of NK cell purity. After 10–12 days of expansion, both NK cell preparations showed a significantly higher median cytotoxic capacity against NB cells relative to CIK cells. Remarkably, these NK cells were also capable of efficiently killing NB spheroidal 3D culture in long-term cytotoxicity assays. Further optimization using a novel NK cell culture medium and a prolonged culturing procedure after CD3/CD19-depletion for up to 15 days enhanced the expansion rate up to 24.4-fold by maintaining the cytotoxic potential. Addition of an IL-21 boost prior to harvesting significantly increased the cytotoxicity. The final cell product consisted for the major part of CD16−, NCR-expressing, poly-functional NK cells with regard to cytokine production, CD107a degranulation and antitumor capacity. In summary, our study revealed that NK cells have a significantly higher cytotoxic potential to combat NB than CIK cell products, especially following the synergistic use of IL-15 and IL-21 for NK cell activation. Therefore, the use of IL-15+IL-21 expanded NK cells generated from CD3/CD19-depleted apheresis products seems to be highly promising as an immunotherapy in combination with haploidentical stem cell transplantation (SCT) for high-risk NB patients.
Background: Patients with acutely decompensated cirrhosis (AD) may or may not develop acute-on-chronic liver failure (ACLF). ACLF is characterized by high-grade systemic inflammation, organ failures (OF) and high short-term mortality. Although patients with AD cirrhosis exhibit distinct clinical phenotypes at baseline, they have low short-term mortality, unless ACLF develops during follow-up. Because little is known about the association of profile of systemic inflammation with clinical phenotypes of patients with AD cirrhosis, we aimed to investigate a battery of markers of systemic inflammation in these patients.
Methods: Upon hospital admission baseline plasma levels of 15 markers (cytokines, chemokines, and oxidized albumin) were measured in 40 healthy controls, 39 compensated cirrhosis, 342 AD cirrhosis, and 161 ACLF. According to EASL-CLIF criteria, AD cirrhosis was divided into three distinct clinical phenotypes (AD-1: Creatinine<1.5, no HE, no OF; AD-2: creatinine 1.5–2, and or HE grade I/II, no OF; AD-3: Creatinine<1.5, no HE, non-renal OF).
Results: Most markers were slightly abnormal in compensated cirrhosis, but markedly increased in AD. Patients with ACLF exhibited the largest number of abnormal markers, indicating “full-blown” systemic inflammation (all markers). AD-patients exhibited distinct systemic inflammation profiles across three different clinical phenotypes. In each phenotype, activation of systemic inflammation was only partial (30% of the markers). Mortality related to each clinical AD-phenotype was significantly lower than mortality associated with ACLF (p < 0.0001 by gray test). Among AD-patients baseline systemic inflammation (especially IL-8, IL-6, IL-1ra, HNA2 independently associated) was more intense in those who had poor 28-day outcomes (ACLF, death) than those who did not experience these outcomes.
Conclusions: Although AD-patients exhibit distinct profiles of systemic inflammation depending on their clinical phenotypes, all these patients have only partial activation of systemic inflammation. However, those with the most extended baseline systemic inflammation had the highest the risk of ACLF development and death.
MicroRNAs (miRs) significantly contribute to the regulation of gene expression, by virtue of their ability to interact with a broad, yet specific set of target genes. MiRs are produced and released by almost every cell type and play an important role in horizontal gene regulation in the tumor microenvironment (TME). In the TME, both tumor and stroma cells cross-communicate via diverse factors including miRs, which are taking central stage as a therapeutic target of anti-tumor therapy. One of the immune escape strategies adopted by tumor cells is to release miRs as a Trojan horse to hijack circulating or tumor-localized monocytes/macrophages to tune them for pro-tumoral functions. On the other hand, macrophage-derived miRs exert anti-tumor functions. The transfer of miRs from host to recipient cells depends on the supramolecular structure and composition of miR carriers, which determine the distinct uptake mechanism by recipient cells. In this review, we provide a recent update on the miR-mediated crosstalk between tumor cells and macrophages and their mode of uptake in the TME.
EDTA is commonly used as an efficient chelator of metal ion enzyme cofactors. It is highly soluble, optically inactive and does not interfere with most chemicals used in standard buffers making EDTA a common choice to generate metal-free conditions for biochemical and biophysical investigations. However, the controversy in the literature on metal-free enzyme activities achieved using EDTA or by other means called our attention to a putative effect of EDTA beyond chelation. Here, we show that EDTA competes for the nucleotide binding site of the nucleotide hydrolase dUTPase by developing an interaction network within the active site similar to that of the substrate. To achieve these findings, we applied kinetics and molecular docking techniques using two different dUTPases. Furthermore, we directly measured the binding of EDTA to dUTPases and to two other dNTPases, the Taq polymerase and MutT using isothermal titration calorimetry. EDTA binding proved to be exothermic and mainly enthalpy driven with a submicromolar dissociation constant considerably lower than that of the enzyme:substrate or the Mg:EDTA complexes. Control proteins, including an ATPase, did not interact with EDTA. Our findings indicate that EDTA may act as a selective inhibitor against dNTP hydrolyzing enzymes and urge the rethinking of the utilization of EDTA in enzymatic experiments.
Yellow fever virus (YFV) represents a re-emerging zoonotic pathogen, transmitted by mosquito vectors to humans from primate reservoirs. Sporadic outbreaks of YFV occur in endemic tropical regions, causing a viral hemorrhagic fever (VHF) associated with high mortality rates. Despite a highly effective vaccine, no antiviral treatments currently exist. Therefore, YFV represents a neglected tropical disease and is chronically understudied, with many aspects of YFV biology incompletely defined including host range, host–virus interactions and correlates of host immunity and pathogenicity. In this article, we review the current state of YFV research, focusing on the viral lifecycle, host responses to infection, species tropism and the success and associated limitations of the YFV-17D vaccine. In addition, we highlight the current lack of available treatments and use publicly available sequence and structural data to assess global patterns of YFV sequence diversity and identify potential drug targets. Finally, we discuss how technological advances, including real-time epidemiological monitoring of outbreaks using next-generation sequencing and CRISPR/Cas9 modification of vector species, could be utilized in future battles against this re-emerging pathogen which continues to cause devastating disease.
As the prognosis of invasive aspergillosis remains unacceptably poor in patients undergoing hematopoietic stem cell transplantation (HSCT), there is a growing interest in the adoptive transfer of antifungal effector cells, such as Natural Killer (NK) cells. Because immunosuppressive agents are required in most HSCT recipients, knowledge of the impact of these compounds on the antifungal activity of NK cells is a prerequisite for clinical trials. We, therefore, assessed the effect of methylprednisolone (mPRED), cyclosporin A (CsA) and mycophenolic acid (MPA) at different concentrations on proliferation, apoptosis/necrosis, and the direct and indirect anti-Aspergillus activity of human NK cells. Methylprednisolone decreased proliferation and increased apoptosis of NK cells in a significant manner. After seven days, a reduction of viable NK cells was seen for all three immunosuppressants, which was significant for MPA only. Cyclosporin A significantly inhibited the direct hyphal damage by NK cells in a dose-dependent manner. None of the immunosuppressive compounds had a major impact on the measured levels of interferon-γ, granulocyte-macrophage colony-stimulating factor and RANTES (regulated on activation, normal T cell expressed and secreted; CCL5). Our data demonstrate that commonly used immunosuppressive compounds have distinct effects on proliferation, viability and antifungal activity of human NK cells, which should be considered in designing studies on the use of NK cells for adoptive antifungal immunotherapy.
Objective: Many cancer patients complain about cognitive dysfunction. While cognitive deficits have been attributed to the side effects of chemotherapy, there is evidence for impairment at disease onset, prior to cancer-directed therapy. Further debated issues concern the relationship between self-reported complaints and objective test performance and the role of psychological distress.
Method: We assessed performance on neuropsychological tests of attention and memory and obtained estimates of subjective distress and quality of life in 27 breast cancer patients and 20 healthy controls. Testing in patients took place shortly after the initial diagnosis, but prior to subsequent therapy.
Results: While patients showed elevated distress, cognitive performance differed on a few subtests only. Patients showed slower processing speed and poorer verbal memory than controls. Objective and self-reported cognitive function were unrelated, and psychological distress correlated more strongly with subjective complaints than with neuropsychological test performance.
Conclusion: This study provides further evidence of limited cognitive deficits in cancer patients prior to the onset of adjuvant therapy. Self-reported cognitive deficits seem more closely related to psychological distress than to objective test performance.
Hessen ist ein starker Standort der Friedens- und Konfliktforschung. Dies bestätigt jetzt ein Gutachten des Wissenschaftsrats. Prof. Birgitta Wolff, Präsidentin der Goethe-Universität und Sprecherin der Konferenz der hessischen Hochschulpräsidien, begrüßt die Ergebnisse – und die Empfehlung, in bestimmten Forschungsbereichen noch einen Ausbau anzustreben.
Kryotechnologien bezeichnen Verfahren des Kühlens und Einfrierens. Wie verändert deren Einsatz in immer mehr Feldern unser Verständnis von Lebensprozessen und gesellschaftliche Grundannahmen? Mit welchen Erwartungen werden Menschen heute durch verschiedene Nutzungsformen dieser Technologien konfrontiert? Fragen wie diese versucht das Projekt "Cryosocieties" des Soziologen Prof. Thomas Lemke an der Goethe-Universität zu beantworten. Im Fokus stehen die sozialen, kulturellen und moralischen Dimensionen der Sammlung, Lagerung und Nutzung von menschlichem und nichtmenschlichem organischem Material durch kryotechnologische Verfahren. Seit April 2019 wird das Projekt als ERC Advanced Investigator Grant des Europäischen Forschungsrats gefördert. Die Förderung ist auf fünf Jahre angelegt. ...
In seinem viel beachteten Buch "Das kalte Herz" erzählt der Wirtschaftshistoriker Prof. Werner Plumpe die Geschichte des Kapitalismus, der seiner Ansicht nach eine nüchterne Form des Wirtschaftens darstellt, die sich anderen Systemen gegenüber als überlegen und leistungsfähiger erwiesen habe. Die lange Tradition der Kapitalismuskritik habe bis heute nicht verstanden, dass im Kapitalismus große Vermögen eingesetzt werden, um Güter herzustellen, die in der Regel für Menschen mit kleinem Einkommen erwerbbar sind.
Das "Herz" (arabisch "Qalb") gehört zu den bedeutungsreichsten und vielfältigsten Begriffen im Islam. Seine Bedeutung geht weit über das Herz als "Körperorgan" hinaus: Es ist das Zentrum aller Emotionen, der Ort der kognitiven Fähigkeiten, der Sitz der Seele und die Quelle der "Erkenntnis". Dementsprechend finden wir in den islamischen Quellen verschiedene Begriffe für das Herz: "qalb", "fuʾād", "rūḥ", "sirr", "ṣadr". ...
Das Wissen um die Bedeutung des menschlichen Herzens als zentrales Organ ist den Menschen aller Kulturen und Zeiten gemeinsam. Das Herz bildete den Referenzpunkt anthropologischer Selbstidentifikation und wurde bereits bei den antiken Völkern zu einem existenziellen Symbol, das auch in die christliche Kultur transformiert wurde. Dem Herzen sowie seiner symbolischen Verwendung in Theologie, Mystik und Frömmigkeit kommt in der gesamten Christentumsgeschichte eine herausragende Stellung zu. Ungeachtet des Fokus der modernen medizinischen Forschung auf die physiologische Funktionalität des Herzens hat sich dessen starke Symbolkraft bis in unsere Gegenwart erhalten. Exemplarisch soll hier beleuchtet werden, welche Veränderungen dieses Symbol im Laufe der Christentumsgeschichte erfuhr. ...
Vernarbung stoppen
(2019)
Wie herzig!
(2019)
Doch Vorsicht – dies ist kein Einblick in die Hirnwindungen eines verliebten Teenagers. Vielmehr handelt es sich hier um einen wissenschaftlichen Blick in die Großhirnrinde einer Maus. Die Forscherinnen und Forscher um Prof. Amparo Acker-Palmer vom Buchmann Institut für Molekulare Lebenswissenschaften und dem Institut für Zellbiologie und Neurowissenschaften der Goethe-Universität haben 2018 in der Zeitschrift "Science" darüber berichtet, dass Blutgefäße bei der Entwicklung neuronaler Zellnetzwerke im Gehirn eine bislang unbekannte Rolle spielen ...
Ein Zell-Atlas des kranken Herzens : Einzelzelltechniken ermöglichen neue Einsichten auf Zellebene
(2019)
Herz und Gefäße bilden ein hochkomplexes Organsystem, in dem unterschiedlichste Zellen korrekt zusammenarbeiten müssen, um alle Organe mit Blut zu versorgen. In den vergangenen Jahrzehnten hat die Herzbiologie ganze Gewebe oder Zellisolate in den Blick genommen. Doch jetzt erlauben neue Technologien, die Vielfalt der Zelltypen und ihre individuelle Antwort auf Signale bis auf die Ebene von Proteinen und Genen zu verfolgen. Forscher hoffen, kranken Herzen dadurch besser bei der Regeneration helfen zu können.
Mutationen in Blutstammzellen müssen nicht unbedingt zu Blutkrebs führen. Erst vor Kurzem hat man entdeckt, dass Klone mutierter Blutzellen bei vielen gesunden Menschen im Alter nachweisbar sind. Dennoch stufen Forscher die klonale Hämatopoese inzwischen als Risikofaktor für Herz-Kreislauf-Erkrankungen ein – mit einer ähnlichen Bedeutung wie Rauchen, Übergewicht oder Bluthochdruck.
"Medizin bringt einem den Menschen nahe", sagt Dietmar Schranz. Schon als junger Arzt bereiste er die Welt. Er behandelte Leprakranke in Pakistan und war mit "Cap Anamur – Deutsche Not-Ärzte" in Asien. Dass er schließlich Kinderkardiologe wurde, verdankt er vier geistigen Vätern. Heute ist er selbst für viele Kardiologen weltweit zu einer prägenden Figur geworden.
Klappe - die zweite : Herzklappenaustausch in einer halben Stunde dank modernem Katheter-Verfahren
(2019)
Früher wurde der Brustkorb geöffnet und der Patient künstlich am Leben gehalten, während Chirurgen die Herzklappe austauschten. Heute kommt immer häufiger das TAVI-Verfahren (Transkatheter-AortenklappenImplantation) zur Anwendung: Die Herzklappe wird durch eine Arterie zum Herzen vorgeschoben und dort entfaltet. Das Frankfurter Uniklinikum ist führend in dieser modernen Behandlung.
Uniklinische Forschung
(2019)
"Herzeleid" und "Herzensfreud" – obwohl schon der griechische Philosoph Alkmaion erkannt hat, dass nicht das Herz das Zentralorgan der Wahrnehmung und der Erkenntnis ist, sondern das Gehirn, hält die Alltagssprache daran fest, dass Gefühle "Herzenssache" sind. Ganz falsch liegt sie damit nicht, denn wenn Gefühle verletzt werden, ist eben doch das Herz das Organ, das darunter zu leiden hat. Wie es dazu kommt, damit befassen sich an der Goethe-Universität Psychotherapeuten, Psychosomatiker und Kardiologen.
In einem Wurm wurden sie 1993 zuerst entdeckt: kleine Ribonukleinsäuren (microRNAs), die nicht für ein Protein kodieren, sondern gezielt mit Boten-RNA (mRNA) paaren. Damit stoppen sie die Übersetzung der mRNA in Protein (Translation) oder lösen den Abbau der Ziel-mRNA aus. In den folgenden Jahren wurde deutlich, dass microRNAs auch beim Menschen eine wichtige Rolle spielen. Möglicherweise ist jedes dritte oder vierte Gen durch microRNA reguliert. Nur zwei bis drei Prozent des humanen Genoms kodiert Proteine; die Mehrzahl der gebildeten RNAs (über 80 Prozent) haben unbekannte oder regulatorische Funktionen. ...
Über epigenetische Prozesse können Umweltfaktoren und Lebensstil unsere Entwicklung und Gesundheit beeinflussen – auch über Generationen hinweg –, ohne die Sequenz der DNA zu verändern. Erst in jüngster Zeit ist es möglich, die Mechanismen auf der molekularen Ebene zu entschlüsseln. Für Herz-Kreislauf-Erkrankungen sind erste Ansätze für epigenetische Therapien in Sicht.
Heute weiß fast jeder, dass ein hoher Blutcholesterinspiegel ein Risikofaktor für Herz-Kreislauf-Erkrankungen ist. Inzwischen gibt es wirksame Therapien, die den Cholesterinstoffwechsel wieder in Gang setzen. Doch die Herzgesundheit hängt von so viel mehr ab als von Cholesterin. Zu den bekannten Mediatoren für Herz-Kreislauf-Erkrankungen sind neue hinzugekommen. Alle können durch Ernährung beeinflusst werden.
In der Tat sind Herz-Kreislauf-Erkrankungen häufig multikausal. Neben Risikofaktoren wie Bluthochdruck, Diabetes, Nikotinmissbrauch spielen die genetische Veranlagung, familiäre und soziale Einflüsse sowie Umweltfaktoren eine Rolle, auch eigene psychische Erkrankungen und die Persönlichkeit. Ein einzelner Faktor hat in der Regel nur einen kleinen Einfluss, aber mehrere können durch Akkumulation zur Erkrankung führen. ...
Transforming growth factor-β (TGF-β) suppresses innate and adaptive immune responses via multiple mechanisms. TGF-β also importantly contributes to the formation of an immunosuppressive tumor microenvironment thereby promoting tumor growth. Amongst others, TGF-β impairs tumor recognition by cytotoxic lymphocytes via NKG2D. NKG2D is a homodimeric C-type lectin-like receptor expressed on virtually all human NK cells and cytotoxic T cells, and stimulates their effector functions upon engagement by NKG2D ligands (NKG2DL). While NKG2DL are mostly absent from healthy cells, their expression is induced by cellular stress and malignant transformation, and, accordingly, frequently detected on various tumor cells. Hence, the NKG2D axis is thought to play a decisive role in cancer immunosurveillance and, obviously, often is compromised in clinically apparent tumors. There is mounting evidence that TGF-β, produced by tumor cells and immune cells in the tumor microenvironment, plays a key role in blunting the NKG2D-mediated tumor surveillance. Here, we review the current knowledge on the impairment of NKG2D-mediated cancer immunity through TGF-β and discuss therapeutic approaches aiming at counteracting this major immune escape pathway. By reducing tumor-associated expression of NKG2DL and blinding cytotoxic lymphocytes through down-regulation of NKG2D, TGF-β is acting upon both sides of the NKG2D axis severely compromising NKG2D-mediated tumor rejection. Consequently, novel therapies targeting the TGF-β pathway are expected to reinvigorate NKG2D-mediated tumor elimination and thereby to improve the survival of cancer patients.
Introduction and Objectives: Surgical techniques such as preservation of the full functional-length of the urethral sphincter (FFLU) have a positive impact on postoperative continence rates. Thereby, data on very early continence rates after radical prostatectomy (RP) are scarce. The aim of the present study was to analyze very early continence rates in patients undergoing FFLU during RP.
Materials and Methods: Very early-continence was assessed by using the PAD-test within 24 h after removal of the transurethral catheter. The PAD-test is a validated test that measures the amount of involuntary urine loss while performing predefined physical activities within 1 h (e.g., coughing, walking, climbing stairs). Full continence was defined as a urine loss below 1 g. Mild, moderate, and severe incontinence was defined as urine loss of 1–10 g, 11–50 g, and >50 g, respectively.
Results: 90 patients were prospectively analyzed. Removal of the catheter was performed on the 6th postoperative day. Proportions for no, mild, moderate and severe incontinence were 18.9, 45.5, 20.0, and 15.6%, respectively. In logistic regression younger age was associated with significant better continence (HR 2.52, p = 0.04), while bilateral nerve-sparing (HR 2.56, p = 0.057) and organ-confined tumor (HR 2.22, p = 0.078) showed lower urine loss, although the effect was statistically not significant. In MVA, similar results were recorded.
Conclusion: Overall, 64.4% of patients were continent or suffered only from mild incontinence at 24 h after catheter removal. In general, reduced urine loss was recorded in younger patients, patients with organ-confined tumor and in patients with bilateral nerve sparing. Severe incontinence rates were remarkably low with 15.6%.
Differential games of common resources that are governed by linear accumulation constraints have several applications. Examples include political rent-seeking groups expropriating public infrastructure, oligopolies expropriating common resources, industries using specific common infrastructure or equipment, capital-flight problems, pollution, etc. Most of the theoretical literature employs specific parametric examples of utility functions. For symmetric differential games with linear constraints and a general time-separable utility function depending only on the player’s control variable, we provide an exact formula for interior symmetric Markovian-strategies. This exact solution, (a) serves as a guide for obtaining some new closed-form solutions and for characterizing multiple equilibria, and (b) implies that, if the utility function is an analytic function, then the Markovian strategies are analytic functions, too. This analyticity property facilitates the numerical computation of interior solutions of such games using polynomial projection methods and gives potential to computing modified game versions with corner solutions by employing a homotopy approach.
Protein quality control (PQC) machinery is in charge of ensuring protein homeostasis in the cell, i.e. proteostasis. Chaperones assist polypeptides throughout their maturation until functionality is achieved. This process might be disrupted in the presence of mutations or external damaging agents that affect the folding and stability of proteins. In this case, proteins can be efficiently recognized and targeted for degradation in a controlled manner. Ubiquitylation refers to the covalent attachment of one or more ubiquitin moieties to faulty proteins, thus triggering their degradation by the 26S proteasome.
More than 30% of proteins need cofactor molecules. Lack of cofactors renders proteins non-functional. We wanted to understand how the PQC deals with wild-type proteins in the absence of their cofactors. Several studies have indicated the importance of the riboflavin-derived cofactor FAD in the stability of individual flavoproteins, and hence we assumed that loss of flavin should mediate a targeted degradation of this group of proteins. Indeed, our mass spectrometry experiments showed that flavoproteome levels decreased under riboflavin starvation. The oxidoreductase NQO1 was used as a model enzyme to further investigate the mechanism of flavoproteome targeting by the PQC. We showed that cofactor loading determines ubiquitylation of NQO1 by the co-chaperone CHIP, both in vivo and in vitro. Furthermore, subtle changes in the C-terminus of NQO1 in the absence of FAD seemed to be crucial for this recognition event. ApoNQO1 interactome differed from holoNQO1. Chaperones and degradation factors were enriched on NQO1 upon cofactor withdrawal, probably to support maturation and prevent aggregation of the enzyme.
Loss of protein folding and stability, even to a small extent, can enhance the aggregating behavior of proteins. Proper loading with FAD reduced the co-aggregation of NQO1 with Aβ1-42 peptide. We assumed that the flavoproteome might represent aggregating-prone species under riboflavin deprivation. Supportingly, reversible apoNQO1 aggregates were observed in vivo in the absence of cofactor. General amyloidogenesis in vivo also increased under these conditions, apparently as a result of flavoproteome destabilization. In this context, we think that our data might have important implications considering the onset and development of conformational diseases.
This work has shed some light on the therapeutic implications of riboflavin deficiency as well. The sensitivity of melanoma cells towards the alkylating agent methyl methanesulfonate (MMS) increased under riboflavin starvation. Subsequent analyses indicated that a complex metabolic reorganization, mostly affecting proliferation and energy metabolism, occurs in response to starvation. What we suggest to call “flavoaddiction” can be understood as the dependence of melanoma cells on the flavoproteome structural and functional intactness to survive chemotherapy. Understanding this cellular reprogramming in detail might reveal new possibilities for future therapies.
The marginalization of the hijra identity in postcolonial Pakistan perpetuates the inequalities that have dogged the transgender community since the colonial era. Although Pakistan has since ratified all concerned UN treaties aimed at protecting transgender people and preventing human rights violations against them, the country’s gender-variant population nevertheless remains vulnerable to these transgressions. As such, this study aims to explore the following inquiry: “What are the lifeways of the hijra community and how do hijra people face human rights violations in their daily life activities?”
The identity construction of the hijra is a complex process. Pakistan is a patriarchal society that determines gender based on biological sex. While a genitally ambiguous child is generally recognized as intersexed, the family usually obscures this circumstance or tries to enforce a predominantly male identity onto the child. To some degree, an intersexed child is allowed to perform feminine roles, particularly when compared to a biologically male individual who is inclined toward femininity. They may partake in “girls’ games” or in “women’s chores” like cooking; they may opt to don feminine clothing and jewelry or practice walking and talking “like a girl.” Many family members and relatives consider such actions a threat to family honor and/or an indication of weakness, which in turn renders the child vulnerable to sexual or physical assault. Abuse also causes some gender-variant children to drop out of school. As adults, many hijras do not see childhood sexual encounters as assault, particularly because they considered themselves to be feminine even from a young age. Nevertheless, experiences of isolation, abuse, and exclusion often compel a gender-variant child to seek company outside of his/her family of orientation.
Many transgender individuals see redemption in joining the hijra community: there, a new identity is defined and shaped. New members mirror themselves after more senior hijras. In the community, relationships are solidified through similar childhood experiences and interests as well as a shared freedom to express the outer reflection of an “inner feminine soul.” Here, they accept the childhood label affixed to them by heteronormative society: hijra. In fact, the identity now becomes the key to economic viability and socialization.
The predominant livelihood strategies within the hijra community are dancing and prostitution. New members must adhere to stringent norms and rules; they risk (sometimes severe) punishment if they do not. For example, a new hijra must adopt a very strict feminine appearance; if she does not appear feminine enough she may be socially isolated or physically punished. Similarly, a hijra is required to remain passive during sex. In fact, because hijras are stereotyped as passive and vulnerable, many clients physically exploit or even rape them. If she tries to resist, a hijra may face physical violence and, in extreme circumstances, death. Reporting abuse to law enforcement authorities often leads to further exploitation. As such, whether dancing or performing sexually, hijras are encouraged to do whatever is asked of them.
In the last decade, the Supreme Court of Pakistan has taken significant steps to ensure the rights of transgender people. The Court has similarly compelled local governments to amend existing legislation in order to protect the transgender community. Nevertheless, discrepancies exist in legislative and judicial interpretations of the transgender identity, which continues to impede the struggle for basic rights. Indeed, there is a long way to go in the effort to incorporate transgender people into the folds of mainstream Pakistani society.
Die Extrauteringravidität (EUG) ist eine relativ häufige und bei zu spätem Erkennen schwerwiegende bis tödliche Anomalie der Schwangerschaft. Rund 2 % aller Schwangerschaften befinden sich extrauterin, z. B. im Eileiter, im Eierstock oder in der Bauchhöhle. Das Symptomspektrum kann vielfältig sein und reicht u. a. von Symptomfreiheit bis hin zu Schockzuständen durch innere Blutungen. Die maternale Sterblichkeit lag zu Beginn des letzten Jahrhunderts noch sehr hoch, da die Diagnose nicht oder zu spät gestellt wurde bzw. keine adäquate Therapie verfügbar war. Durch sensible Schwangerschaftstest, welche die β-Untereinheit des hCGs nachweisen, und den transvaginalen Ultraschall können heute pathologische Schwangerschaftsverläufe früh detektiert und ebenso früh interveniert werden. Je nach Fortschritt und Lokalisation der EUG stehen verschiedene Therapiemöglichkeiten zu Verfügung. Ambulant kann eine einmalige Methotrexatinjektion erfolgen. Auch chirurgische Methoden sind eine Therapieoption.
In dieser Arbeit wurden die 8.040 Publikationen, die zwischen 1900 und 2012 zum Thema EUG erschienen sind und ins Web of Science aufgenommen wurden, szientometrisch analysiert, um quantitative und qualitative Aussagen bezüglich der Publikationen und dem Forschungsverhalten treffen zu können. Quantitativ wurden u. a. die Publikationsleistung einzelner Länder, Autoren und Fachzeitschriften sowie verschiedene Kooperationen evaluiert. Die qualitative Beurteilung betrachtete neben Zitationszahlen, Zitationsraten und modifizierten H-Indizes auch Impact-Faktoren (IF). Eine derartige Untersuchung existiert zum jetzigen Zeitpunkt nicht.
Im betrachteten Zeitraum sind die Publikations- und Zitationszahlen stetig gestiegen. Dies lässt auf ein gestiegenes wissenschaftliches Interesse für EUGen schließen. Außerdem ist über die Jahre auch die Anzahl der Autoren pro Publikation gestiegen, was auf eine vermehrte Zusammenarbeit zwischen Autoren, Institutionen und Ländern hindeutet. Als meistpublizierend kristallisierten sich die USA heraus. Auch bezüglich des modifizierten H-Index`, der erhaltenen Zitierungen und der meisten Institutionen, die das Thema EUG beforschen, sind die USA führend. Im Gegensatz dazu ist Israel mit einem weitaus geringeren BIP unter den 5 meistpublizierenden Ländern zu finden. Israels Publikationszahl pro BIP zeigt, dass die Forschung einen hohen Stellen¬wert hat, aus der qualitativ hochwertige Ergebnisse resultieren, was durch die hohe Zitationsrate und den modifizierten H-Index untermauert wird. Unter den Zeitschriften sind Fertility and Sterility, American Journal of Obstetrics & Gynecology und Obstetrics & Gynecology quantitativ die Spitzenreiter. Werden jedoch qualitative Parameter wie der IF betrachtet, siedeln sich die genannten Periodika im hinteren Drittel ein. Im Gegensatz zu Journalen mit hohen IF, wie das New England Journal of Medicine (IF = 51,658) und The Lancet (IF = 39,060) haben die meistpublizierenden Journale ein eingeschränktes Themengebiet, was erheblichen Einfluss auf den IF hat. Unter den 15 meistpublizierenden Fachjournalen werden 14 in englischer Sprache veröffentlicht. Nur die Fachzeitschrift Geburtshilfe und Frauenheilkunde publiziert deutschsprachige Fachbeiträge. Parallel dazu sind mehr als 92 % der Veröffentlichungen in Englisch publiziert worden. Ursächlich hierfür sind unter anderem die Vorauswahl, die vom WoS getroffen wird und die Anerkennung der englischen Sprache als Sprache der Wissenschaft. Mit Abstand die meisten Publikationen wurden im Themengebiet Obstetrics & Gynecology veröffentlicht. Da die EUG ein gynäkologisches Krankheitsbild ist, ist dies wenig verwunderlich. Weltweit führende Institution hinsichtlich der Publikationen ist die University of London. Mit 168 Publikationen reihen sich die weltbekannten amerikanischen Universitäten aus Pennsylvania, Yale und die Harvard University hinter der britischen Einrichtung ein. Hinsichtlich der Zahl der Zitierungen liegt die Londoner Universität hinter dem Center for Disease Control, das in den USA angesiedelt ist. Unter den Autoren genießt der Amerikaner Kurt T. Barnhart (81 Publikationen) großes Ansehen. Diese Veröffentlichungen wurden über 1.000 Mal zitiert. Sein modifizierter H-Index von 19 wird von Hervé Fernandez (mod. H-Index 24) noch übertroffen. Mit 79 Publikationen reiht er sich hinter Barnhart ein. Durch die Genderanalyse wird ersichtlich, dass weitaus weniger Frauen als Autoren in Erscheinung treten, wobei nur ca. 22 % der Autorennamen ihrem Geschlecht zugeordnet werden konnten.
Diese szientometrische Analyse zum Thema EUG liefert einen Überblick über die quantitative und qualitative Entwicklung der internationalen Forschung zeigt die wissenschaftliche Anerkennung auf, interpretiert Ergebnisse und hinterfragt sie kritisch.
The present thesis is primarily concerned with the application of the functional renormalization group (FRG) to spin systems. In the first part, we study the critical regime close to the Berezinskii-Kosterlitz-Thouless (BKT) transition in several systems. Our starting point is the dual-vortex representation of the two-dimensional XY model, which is obtained by applying a dual transformation to the Villain model. In order to deal with the integer-valued field corresponding to the dual vortices, we apply the lattice FRG formalism developed by Machado and Dupuis [Phys. Rev. E 82, 041128 (2010)]. Using a Litim regulator in momentum space with the initial condition of isolated lattice sites, we then recover the Kosterlitz-Thouless renormalization group equations for the rescaled vortex fugacity and the dimensionless temperature. In addition to our previously published approach based on the vertex expansion [Phys. Rev. E 96, 042107 (2017)], we also present an alternative derivation within the derivative expansion. We then generalize our approach to the O(2) model and to the strongly anisotropic XXZ model, which enables us to show that weak amplitude fluctuations as well as weak out-of-plane fluctuations do not change the universal properties of the BKT transition.
In the second part of this thesis, we develop a new FRG approach to quantum spin systems. In contrast to previous works, our spin functional renormalization group (SFRG) does not rely on a mapping to bosonic or fermionic fields, but instead deals directly with the spin operators. Most importantly, we show that the generating functional of the irreducible vertices obeys an exact renormalization group equation, which resembles the Wetterich equation of a bosonic system. As a consequence, the non-trivial structure of the su(2) algebra is fully taken into account by the initial condition of the renormalization group flow. Our method is motivated by the spin-diagrammatic approach to quantum spin system that was developed more than half a century ago in a seminal work by Vaks, Larkin, and Pikin (VLP) [Sov. Phys. JETP 26, 188 (1968)]. By embedding their ideas in the language of the modern renormalization group, we avoid the complicated diagrammatic rules while at the same time allowing for novel approximation schemes. As a demonstration, we explicitly show how VLP's results for the leading corrections to the free energy and to the longitudinal polarization function of a ferromagnetic Heisenberg model can be recovered within the SFRG. Furthermore, we apply our method to the spin-S Ising model as well as to the spin-S quantum Heisenberg model, which allows us to calculate the critical temperature for both a ferromagnetic and an antiferromagnetic exchange interaction. Finally, we present a new hybrid formulation of the SFRG, which combines features of both the pure and the Hubbard-Stratonovich SFRG that were published recently [Phys. Rev. B 99, 060403(R) (2019)].
Epigenetic mechanisms largely influence how genetic information on DNA level is translated into different phenotypes. DNA methylations and histone post-translational modifications make up what is referred to as "epigenetic landscape", an interconnected pattern that regulates access to genes and serves as platform for specific binding partners. The epigenetic landscape is maintained by "writers", which add the modifications, "erasers", which delete the modifications and "readers" which specifically bind modifications and mediate their location to other proteins connected to transcription. In the context of acetylations, which are the focus of this thesis, the writers are called histone acetyl transferases (HATs), the erasers are called histone deacetylases (HDACs) and the readers comprise Bromodomains (BRDs) as well as Yaf9, ENL, AF9, Taf14, Sas5 (YEATS) domains. An aberrant epigenetic landscape and mutated forms of epigenetic readers can lead to diseases including cancer and inflammatory diseases, making epigenetic reader domains attractive drug targets.
The focus of this thesis were YEATS domains and the development of inhibitors for this new class of epigenetic readers. Eleven-nineteen-leukemia protein (ENL) and ALL1-fused gene from chromosome 9 protein (AF9) are also part of the super elongation complex and are common fusion partners of mixed lineage leukemia protein (MLL) in acute myeloid leukemia (AML) (Wan et al., 2017, Erb et al., 2017). In this thesis, the first ligand-free crystal structure of ENL YEATS revealed an inherent flexibility of the Y78 side chain in the aromatic triad and two conserved water molecules. Soaking experiments led to the first co-crystal structures between a YEATS domain and small molecule inhibitors and defined prerequisites for ENL YEATS inhibitor scaffolds. The discovered inhibitory fragments had a central amide bond in common, which replaced one of the two conserved water molecules to form beta-sheet-like hydrogen bonds between the loop 6 backbone and the S58 side chain. The amide bond was flanked by two aromatic moieties, of which one stacks with H56 in the front pocket and the other interacts with the aromatic triad in the rear pocket. The development of the first chemical probe for ENL/AF9, SGC-iMLLT, show that the affinity is increased to low nanomolar levels if the rear flanking aromatic moiety forms additional hydrogen bonds with loop 6 and the side chain of E75 (Moustakim et al., 2018). In case of the probe, this is achieved with a 2-methyl-pyrrolidine-benzimidazole moiety. The probe binds with high affinity to ENL (129 nM) and AF9 (77 nM) and shows no significant affinity towards other human YEATS domains or BRDs. Target engagement was shown by fluorescence recovery after photobleaching (FRAP), cellular thermal shift assay (CETSA) and in case of AF9 also with NanoBRET. The probe changed the expression of three AML-related genes (MYC, dendrin and CD86) in MV4;11 cells, encouraging application of this probe in more AML cell lines.
Eine qualitative und quantitative Studie zum Einsatz der virtuellen Mikroskopie in der Schule
(2019)
Das Mikroskop stellt in der Alltagswelt ein Sinnbild für naturwissenschaftliches Arbeiten dar (Coleman 2009, Paulsen 2010). Im Bereich der Lehre eröffnet dieses Laborgerät das Eintauchen in die mikroskopische Dimension und besitzt eine wesentliche Rolle bei der damit verbundenen Erkenntnisgewinnung, insbesondere von funktionsmorphologischen Konzepten (Gropengießer & Kattmann 2008, Kremer 2002). Jedoch wird die Durchführung der klassischen Mikroskopie und damit die aktive Auseinandersetzung mit mikroskopischen Präparaten im schulischen (Biologie-)Unterricht durch verschiedene Faktoren erschwert. Zu den Limitierungen gehören beispielsweise die Verfügbarkeit geeigneter Mikroskope und Dauerpräparate, die aufwendige Vor- und Nachbereitungszeit sowie der zeitliche Aufwand bei der Herstellung hochwertiger mikroskopischer Frischpräparate. Die virtuelle Mikroskopie könnte diese Schwierigkeiten umgehen. Das virtuelle Mikroskop kann als eine Simulation verstanden werden, bei der die bildanalytischen Vorgehensweisen bei mikroskopischen Präparaten analog zur klassischen Mikroskopie nachvollzogen werden können (Gu & Oglivie 2005, Hentschel 2009). Hierbei umfasst das virtuelle Mikroskop ein Akquisitionssystem zum Einscannen und Digitalisieren mikroskopischer Präparate, einen Server zum Speichern und Bereitstellen der entstandenen virtuellen hochauflösenden Aufnahmen (WSI) sowie eine Bildbetrachtungssoftware auf einem Anwendungsrechner (Kalinski et al. 2006). Basierend auf einer Nutzerbefragung wurde eine Betrachtungssoftware programmiert, die hinsicht¬lich ihrer Benutzerfreundlichkeit und ihren Eigenschaften auf den schulischen Einsatz angepasst wurde. Um die Relevanz in diesem Anwendungsfeld zu testen, wurden die Untersuchungen der vorliegenden Arbeit sowohl im Schülerlabor Goethe BioLab als auch in der universitären Lehre der Abteilung für Didaktik der Biowissen¬schaften der Goethe–Universität Frankfurt am Main durchgeführt. Der Schülerlabortag „Blut und das virtuelle Mikroskop“ wurde entwickelt, um die computerbasierte virtuelle Mikroskopie mit Schülern ergänzend zur klassischen Mikroskopie in einem fachlichen Kontext anzuwenden und zu erforschen.
Beruhend auf der Vergleichbarkeit beider Mikroskopiemethoden (Paulsen et al. 2010) lagen die Forschungsschwerpunkte neben der Nutzung der Software durch Schülerinnen und Schülern auf einer gegenüberstellenden Beurteilung beider mikroskopischer Verfahren von Schülern und Lehramtsstudierenden. Es wurden in diesem Zusammenhang drei zentrale Forschungsfragen formuliert.
Die erste Forschungsfrage untersucht das Nutzerverhalten der Schüler (n = 123) bei der virtuellen Mikroskopie mittels automatisch generierter Datensätze während der Anwendung der Bildbetrachtungssoftware. Die Analyse der Anwendungsdaten zeigt, dass das mikroskopische Sehen, insbesondere das Fokussieren auf relevante Bildbereiche, im virtuellen Humanblutausstrich angewandt wurde.
Die zweite Forschungsfrage untersuchte das aktuelle Interesses bei Schülern (n = 293) im direkten Vergleich zwischen virtueller und klassischer Mikroskopie. Dabei wurde das aktuelle Interesse aufgrund des engen Zusammenhangs zum Lernen (vgl. Krapp 1992a) als Indikator der Lernwirksamkeit gewählt. Die Erhebung erfolgte mittels eines Fragebogens. Die Ergebnisse dieser Untersuchung zeigen, dass der Einsatz beider mikroskopischer Verfahren das aktuelle Interesse fördert, das emotionale und das wertbezogene Merkmal sich jedoch zugunsten der klassischen Mikroskopie signifikant unterscheiden.
Im Rahmen der dritten Forschungsfrage erfolgte eine Beurteilung der Vorteile virtueller Mikroskopie gegenüber der klassischen Mikroskopie von Schülern (n = 504) sowie Lehramtsstudierenden (n = 247). Hierbei diente ebenfalls ein Fragebogen als Grundlage der Erhebung. Die Auswertung zeigt, dass sowohl die Schüler als auch die Studierenden die Vorteile der virtuellen Mikroskopie klar erkennen. Es liegen jedoch signifikante Unterschiede zwischen den Versuchsgruppen vor. Die Schüler bewerten die Vorteile betreffend der Förderung von Lernprozessen, des Erkennens von Strukturen und des mikroskopischen Zeichnens höher.
Zusammenfassend bestärken die Ergebnisse dieser Studie die Ansicht, dass das virtuelle Mikroskop nicht als Ersatz, sondern als sinnvolle Ergänzung zu der klassischen Lichtmikroskopie angesehen werden sollte (Bloodgood et al. 2006, Berg et al. 2016, Braun & Kearns 2008, Hufnagl et al. 2012, Mione et al. 2013, Santiago 2018, Scoville & Buskirk 2007). Dabei sollte die vorliegende Arbeit als Einstieg verstanden werden, um bestehende Forschungslücken zu verkleinern, damit ein Transfer der virtuellen Mikroskopie in den schulischen Kontext möglichst lernwirksam erfolgen kann.
Die Neurowissenschaften sind in Forschungsarbeiten für Schüler und Studierende immer wieder als eines der schwierigsten Teilgebiete der Biologie angeführt. Die Inhalte werden überwiegend nicht verstanden. Als mögliche Ursache gelten die seltenen praktischen Zugänge für die Lernenden aufgrund limitierter Ressourcen. Diese Ursache konnte in der vorliegenden Arbeit durch eine Befragung der Lehrkräfte zu ihren Praxisumsetzungen bestätigt werden. 70 % der Lehrkräfte gaben an, dass sie keine Experimente in der Schule zum Thema Nervenzellen anbieten. Experimente zur Verhaltensbiologie führen 65 % der Lehrkräfte nicht durch.
Um Schülern die Möglichkeit zu geben, sich experimentell mit den Themenfeldern der Neuro- und Verhaltensbiologie auseinanderzusetzen, wurden im Rahmen der vorliegenden Arbeit Schülerlabortage auf dem Feld der Neurowissenschaften konzipiert. Die Konzepte wurden schülerorientiert umgesetzt und neurowissenschaftliche Forschung durch den eigenen Umgang mit modernen Forschungsapparaturen erfahrbar gemacht. Die drei Labortage für die Sekundarstufe II wurden wissenschaftlich begleitet: 1) Verhaltensbiologie, 2) systemische Ebene der Elektrophysiologie, 3) elektrophysiologische Forschungsmethoden. Um die Qualität und Wirksamkeit der Labortage beurteilen zu können, wurden sie mit Feedbackerhebungen begleitet. Die drei Labortage wurden sowohl von den Lehrkräften als auch von den Schülern bezüglich ihrer Qualität positiv bewertet. Für die Schüler konnte gezeigt werden, dass die Beurteilung weitgehend unabhängig von einem zugrunde liegenden Interesse an Biologie und Forschung ausfällt. Anhand einer retrospektiven Erhebung wird außerdem gezeigt, dass alle drei Labortage eine höchst signifikante, selbsteingeschätzte Steigerung des „Wissens“, der „Anwendungszuversicht“ und des „Interesses“ bewirken. Schüler mit niedrigen Ausgangswerten zeigen einen besonders hohen Anstieg. Für das Interesse kann weiter gezeigt werden, dass auch Schüler mit hohem Ausgangswert eine große Interessenssteigerung durch den Labortag aufweisen. Das Interesse für den verhaltensbiologischen Labortag liegt etwas niedriger – die Labortage mit elektrophysiologischen Inhalten zeigen dagegen für die Anwendungszuversicht etwas niedrigere Werte.
Der Fokus der fachdidaktischen Forschung lag auf der Betrachtung des experimentellen Zugangs zur Elektrophysiologie über ein entwickeltes „EPhys-Setup“. Dabei handelt es sich um einen quasi-realen Messaufbau. Die Umsetzung kombiniert dazu Komponenten eines realen Elektrophysiologie-Setups (Hands-on Komponenten) mit einer speziell entwickelten schülerfreundlichen Software (Neurosimulation) und einem virtuellen Nervensystem in Form einer Platine. Als Modellnervensystem werden für diese Umsetzung Ganglien von Hirudo medicinalis verwendet – der Neurosimulation liegen originale elektrophysiologische Messspuren des Ganglions zugrunde. Experimentelle Vermittlungsansätze für die Elektrophysiologie finden sich kaum für den Schulbereich. Dem Bedarf einer entsprechenden Beforschung wurde mit verschiedenen Testinstrumenten nachgegangen, um den Vermittlungsansatz mit dem EPhys-Setup bewerten zu können. Dafür fand eine Wirksamkeitsanalyse über die Erhebung der Motivation der Schüler statt (Lab Motivation Scale; Dohn et al. 2016). Von Bedeutung war auch, inwiefern gegenüber der Umsetzung eine Technologieakzeptanz vorliegt (Technology Acceptance Model; Davis 1989), die im Schulkontext ausgehend von der steigenden Einbindung von Technologien einen entsprechenden Forschungsbedarf aufweist. Weiter wurde untersucht, ob sich die Bewertung des EPhys-Setups von der Bewertung einer Kontrollgruppe unterscheidet. Für die Kontrollgruppe wurde die Neurosimulation von den Hands-on Komponenten gelöst und die Schüler arbeiteten ausschließlich PC-basiert. Die Ergebnisse zeigen, dass beide Umsetzungen die Motivation förderten und eine Technologieakzeptanz bei den Schülern aufwiesen. Der Unterschied der Untersuchungsgruppen fällt gering aus. Die Abhängigkeiten, die für die verwendete Simulationsumsetzung gefunden wurden, beziehen sich ausschließlich auf Komponenten der „Freude“. Somit wird der intrinsische Bereich von den Schülern die am EPhys-Setup gearbeitet haben höher bewertet. Zur weiteren Analyse der Testinstrumente wurde auch eine Abhängigkeit der Bewertung vom zugrunde liegenden Biologieinteresse sowie von den Computerfähigkeiten vergleichend betrachtet. Der Einfluss auf die Bewertungen der drei Testskalen ist in vielen Fällen höher als der Einfluss der verwendeten Simulation. Vom individuellen Biologieinteresse der Schüler zeigen alle untersuchten Komponenten eine Abhängigkeit. Die größeren Effekte beziehen sich auf die Komponenten der „Lernwirksamkeit“ oder der „Freude“. Von den individuellen Computerfähigkeiten der Schüler zeigen Komponenten zur „Zuversicht bezüglich der Methoden und der Inhalte“ eine Abhängigkeit.
Autophagy has important functions in maintaining energy metabolism under conditions of starvation and to alleviate stress by removal of damaged and potentially harmful cellular components. Therefore, autophagy represents a pro-survival stress response in the majority of cases. However, the role of autophagy in cell survival and cell death decisions is highly dependent on its extent, duration, and on the respective cellular context. An alternative pro-death function of autophagy has been consistently observed in different settings, in particular, in developmental cell death of lower organisms and in drug-induced cancer cell death. This cell death is referred to as autophagic cell death (ACD) or autophagy-dependent cell death (ADCD), a type of cellular demise that may act as a backup cell death program in apoptosis-deficient tumors. This pro-death function of autophagy may be exerted either via non-selective bulk autophagy or excessive (lethal) removal of mitochondria via selective mitophagy, opening new avenues for the therapeutic exploitation of autophagy/mitophagy in cancer treatment.
Health-related preferences of older patients with multimorbidity: the protocol for an evidence map
(2019)
Introduction: Interaction of conditions and treatments, complicated care needs and substantial treatment burden make patient–physician encounters involving multimorbid older patients highly complex. To optimally integrate patients’ preferences, define and prioritise realistic treatment goals and individualise care, a patient-centred approach is recommended. However, the preferences of older patients, who are especially vulnerable and frequently multimorbid, have not been systematically investigated with regard to their health status. The purpose of this evidence map is to explore current research addressing health-related preferences of older patients with multimorbidity, and to identify the knowledge clusters and research gaps.
Methods and analysis: To identify relevant research, we will conduct searches in the electronic databases MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL, Social Science Citation Index, Social Science Citation Index Expanded and the Cochrane library from their inception. We will check reference lists of relevant articles and carry out cited reference research (forward citation tracking). Two independent reviewers will screen titles and abstracts, check full texts for eligibility and extract the data. Any disagreement will be resolved and consensus reached with the help of a third reviewer. We will include both qualitative and quantitative studies, and address preferences from the patients’ perspectives in a multimorbid population of 60 years or older. There will be no restrictions on the publication language. Data extraction tables will present study and patient characteristics, aim of study, methods used to identify preferences and outcomes (ie, type of preferences). We will summarise the data using tables and figures (ie, bubble plot) to present the research landscape and to describe clusters and gaps.
Ethics and dissemination: Due to the nature of the proposed evidence map, ethics approval will not be required. Results from our research will be disseminated by means of specifically prepared materials for patients, at relevant (inter)national conferences and via publication in peer-reviewed journals.
Background: Cannabis proofed to be effective in pain relief, but one major side effect is its influence on memory in humans. Therefore, the role of memory on central processing of nociceptive information was investigated in healthy volunteers.
Methods: In a placebo-controlled cross-over study including 22 healthy subjects, the effect of 20 mg oral Δ9-tetrahydrocannabinol (THC) on memory involving nociceptive sensations was studied, using a delayed stimulus discrimination task (DSDT). To control for nociceptive specificity, a similar DSDT-based study was performed in a subgroup of thirteen subjects, using visual stimuli.
Results: For each nociceptive stimulus pair, the second stimulus was associated with stronger and more extended brain activations than the first stimulus. These differences disappeared after THC administration. The THC effects were mainly located in two clusters comprising the insula and inferior frontal cortex in the right hemisphere, and the caudate nucleus and putamen bilaterally. These cerebral effects were accompanied in the DSDT by a significant reduction of correct ratings from 41.61% to 37.05% after THC administration (rm-ANOVA interaction "drug" by "measurement": F (1,21) = 4.685, p = 0.042). Rating performance was also reduced for the visual DSDT (69.87% to 54.35%; rm-ANOVA interaction of "drug" by "measurement": F (1,12) = 13.478, p = 0.003) and reflected in a reduction of stimulus-related brain deactivations in the bilateral angular gyrus.
Conclusions: Results suggest that part of the effect of THC on pain may be related to memory effects. THC reduced the performance in DSDT of nociceptive and visual stimuli, which was accompanied by significant effects on brain activations. However, a pain specificity of these effects cannot be deduced from the data presented.
SAFE Newsletter : 2019, Q4
(2019)
Objectives: The present randomized clinical trial assesses the six-month outcomes following surgical regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC).
Materials and Methods: 24 patients with 24 implants suffering from peri-implantitis with any type of bone defect were randomly treated by EC or PEC. Bone defects were augmented with a mixture of natural bone mineral and autogenous bone and left for submerged healing. The distance from implant shoulder to bone was assessed at six defined points at baseline (T0) and after six months at uncovering surgery (T1) by periodontal probe and standardized x-rays.
Results: One implant had to be removed at T1 because of reinfection and other obstacles. None of the other implants showed signs of inflammation. Bone gain was 2.71 ± 1.70 mm for EC and 2.81 ± 2.15 mm for PEC. No statistically significant difference between EC and PEC was detected. Significant clinical bone fill was observed for all 24 implants. Complete regeneration of bone was achieved in 12 implants. Defect morphology impacted the amount of regeneration.
Conclusion: EC needs no further mechanical cleaning by powder spray. Complete re-osseointegration in peri-implantitis cases is possible.
Background: Critical incident reporting systems (CIRS) can be an important tool for the identification of organisational safety needs and thus to improve patient safety. In German primary care, CIRS use is obligatory but remains rare. Studies on CIRS implementation in primary care are lacking, but those from secondary care recommend involving management personnel.
Objective: This project aimed to increase CIRS use in 69 practices belonging to a local practice network.
Methods: The intervention consisted of the provision of a web-based CIRS, accompanying measures to train practice teams in error management and CIRS, and the involvement of the network’s management. Three measurements were used: (1) number of incident reports and user access rates to the web-based CIRS were recorded, (2) staff were given a questionnaire addressing incident reporting, error management and safety climate and (3) qualitative reflection conferences were held with network management.
Results: Over 20 months, 17 critical incidents were reported to the web-based CIRS. The number of staff intending to report the next incident online decreased from 42% to 20% of participants. In contrast, the number of practices using an offline CIRS (eg, incident book) increased from 23% to 49% of practices. Practices also began proactively approaching network management for help with incidents. After project completion, participants scored higher in the patient safety climate factor ‘perception of causes of errors’. For many practices, the project provided the first contact with structured error management.
Conclusion: Specific measures to improve the use of CIRS in primary care should focus on network management and practice owners. Practices need basic training on safety culture and error management. Continuing, practices should implement an offline CIRS, before they can profit from the exchange of reports via web-based CIRS. It is crucial that practices receive feedback on incidents, and trained network management personnel can provide such support.
Classical Hodgkin lymphoma (cHL) is one of the most common malignant lymphomas in Western Europe. The nodular sclerosing subtype of cHL (NS cHL) is characterized by a proliferation of fibroblasts in the tumor microenvironment, leading to fibrotic bands surrounding the lymphoma infiltrate. Several studies have described a crosstalk between the tumour cells of cHL, the Hodgkin- and Reed-Sternberg (HRS) cells, and cancer-associated fibroblasts. However, to date a deep molecular characterization of these fibroblasts is lacking. Thus, the aim of the present study is a comprehensive characterization of these fibroblasts. Gene expression profiling and methylation profiles of fibroblasts isolated from primary lymph node suspensions revealed persistent differences between fibroblasts obtained from NS cHL and lymphadenitis. NS cHL derived fibroblasts exhibit a myofibroblastic phenotype characterized by myocardin (MYOCD) expression. Moreover, TIMP3, an inhibitor of matrix metalloproteinases, was strongly upregulated in NS cHL fibroblasts, likely contributing to the accumulation of collagen in sclerotic bands of NS cHL. As previously shown for other types of cancer-associated fibroblasts, treatment by luteolin could reverse this fibroblast phenotype and decrease TIMP3 secretion. NS cHL fibroblasts showed enhanced proliferation when they were exposed to soluble factors released from HRS cells. For HRS cells, soluble factors from fibroblasts were not sufficient to protect them from Brentuximab-Vedotin induced cell death. However, HRS cells adherent to fibroblasts were protected from Brentuximab-Vedotin induced injury. In summary, we confirm the importance of fibroblasts for HRS cell survival and identify TIMP3 which probably contributes as a major factor to the typical fibrosis observed in NS cHL.
The title co-crystal, 1,3,5,7-tetraazatricyclo[3.3.1.13,7]decane (HMTA, 1)–4-fluorophenol (4-FP) (1/1), C6H12N4·C6H5FO, shows an unusual asymmetric unit that comprises eight independent molecules (Z′′ = 8), four for each component, with four formula units per asymmetric unit (Z′ = 4). In the molecular packing, each HMTA molecule bridges one 4-FP molecule via an O−H···N hydrogen bond to form a two-molecule aggregate. Differences can be observed between the bond lengths and angles of the independent HMTA and 4-FP molecules and those of the molecules in the aggregate. The C−N bonds exhibit different bond lengths in the tetrahedral cage-like structure of the HMTA molecules, but the largest differences between the molecular aggregates are in the bond lengths in the 4-fluorophenol ring. In the crystal, the HMTA and 4-FP molecules form two hydrogen-bonded (O−H···N, C−H···F and C−H···O) dimers of HMTA and 4-FP molecules, A···D and B···C inversion dimers, which generate enlarged R88(34) ring motifs in both supramolecular structures. In both structures, the crystal packing also features additional C−H···F and C−H···O interactions. The A···D and B···C dimers are linked by additional C−H···F and C−H···O hydrogen bonds, forming columns along the a and b axes, respectively. The importance of the C−H···F interaction to the structure and crystal packing has been demonstrated.
Introduction: Pediatric pneumococcal pneumonia complicated by parapneumonic pleural effusion/empyema (PPE/PE) remains a major concern despite general immunization with pneumococcal conjugate vaccines (PCVs).
Methods: In a nationwide pediatric hospital surveillance study in Germany we identified 584 children <18 years of age with bacteriologically confirmed PPE/PE from October 2010 to June 2018. Streptococcus pneumoniae was identified by culture and/or PCR of blood samples and/or pleural fluid and serotyped.
Results: S. pneumoniae was identified in 256 of 584 (43.8%) children by culture (n = 122) and/or PCR (n = 207). The following pneumococcal serotypes were detected in 114 children: serotype 3 (42.1%), 1 (25.4%), 7F (12.3%), 19A (7.9%), other PCV13 serotypes (4.4%) and non-PCV13 serotypes (7.9%). Between October 2010 and June 2014 serotype 1 (38.1%) and serotype 3 (25.4%) were most prevalent, whereas between July 2014 and June 2018 serotype 3 (62.7%) and non-PCV13 serotypes (15.7%) were dominant. Compared to children with other pneumococcal serotypes, children with serotype 3 associated PPE/PE were younger (median 3.2 years [IQR 2.1–4.3 years] vs. median 5.6 years [IQR 3.8–8.2 years]; p < 0.001) and more frequently admitted to intensive care (43 [89.6%] vs. 48 [73.8%]; p = 0.04). Seventy-six of 114 (66.7%) children with pneumococcal PPE/PE had been vaccinated with pneumococcal vaccines. Thirty-nine of 76 (51.3%) had received a vaccine covering the serotype detected. Thirty of these 39 breakthrough cases were age-appropriately vaccinated with PCV13 and considered vaccine failures, including 26 children with serotype 3, three children with serotype 19A and one child with serotype 1.
Conclusion: Following the introduction of PCV13 in general childhood vaccination we observed a strong emergence of serotype 3 associated PPE/PE in the German pediatric population, including a considerable number of younger children with serotype 3 vaccine breakthrough cases and failures. Future PCVs should not only cover newly emerging serotypes, but also include a more effective component against serotype 3.