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Seit dem 28. Juni 2019 ist in der hessischen Landeshauptstadt eine der größten privaten Jugendstil-Sammlungen Europas in einer Dauerausstellung zu sehen. Mit seiner großzügigen Schenkung hat der Kunstsammler Ferdinand Wolfgang Neess bereits vor zwei Jahren 570 Werke seiner in einem halben Jahrhundert zusammengetragenen Sammlung von Inkunabeln des internationalen Jugendstils dem Landesmuseum Wiesbaden vermacht. Seitdem wurde an der Präsentation dieser einmaligen Objekte im Südflügel des Museums gearbeitet, die nun seit knapp zwei Monaten der Öffentlichkeit zugänglich sind. ...
Background: Complications after surgery for esophageal cancer are associated with significant resource utilization. The aim of this study was to analyze the economic burden of two frequently used endoscopic treatments for anastomotic leak management after esophageal surgery: Treatment with a Self-expanding Metal Stent (SEMS) and Endoscopic Vacuum Therapy (EVT).
Materials and methods: Between January 2012 and December 2016, we identified 60 German-Diagnosis Related Group (G-DRG) cases of patients who received a SEMS and / or EVT for esophageal anastomotic leaks. Direct costs per case were analyzed according to the Institute for Remuneration System in Hospitals (InEK) cost-accounting approach by comparing DRG payments on the case level, including all extra fees per DRG catalogue.
Results: In total, 60 DRG cases were identified. Of these, 15 patients were excluded because they received a combination of SEMS and EVT. Another 6 cases could not be included due to incomplete DRG data. Finally, N = 39 DRG cases were analyzed from a profit-center perspective. A further analysis of the most frequent DRG code -G03- including InEK cost accounting, revealed almost twice the deficit for the EVT group (N = 13 cases, € - 9.282 per average case) compared to that for the SEMS group (N = 9 cases, € - 5.156 per average case).
Conclusion: Endoscopic treatments with SEMS and EVT for anastomotic leaks following oncological Ivor Lewis esophagectomies are not cost-efficient for German hospitals. Due to longer hospitalization and insufficient reimbursements, EVT is twice as costly as SEMS treatment. An adequate DRG cost compensation is needed for SEMS and EVT.
This article presents an analysis of the police television series A Touch of Frost (Yorkshire Television, 1992) and the crime novels by Rodney Wingfield upon which it is based.
In order to analyse the way the protagonist, Inspector Jack Frost, is characterised in either version, data is drawn from the pilot episode of the series and Wingfield’s debut novel Frost at Christmas (1984). Wingfield was less than impressed with television’s version of Frost, stating, ‘He just isn’t my Frost’. The rationale for this article is to apply established models in stylistics to investigate the differences between the original and the adaptation. A core motivation for stylistics is to ‘support initial impressions in various extracts’ readings’ and to ‘describe the readers’ response with some precision’ (Gregoriou 2007: 19); this article therefore offers a close linguistic explanation for an author’s dissatisfaction with the adaptation of his own work. The famously reticent Wingfield did not elaborate in detail on why he disapproved of the television version of Frost, although several critics observed that Wingfield felt television had ‘softened’ his creation. This article contends that ‘softness’ is represented in language through politeness strategies adopted by speakers whilst impoliteness represents the ‘tougher’ speech of Wingfield’s original iteration of Jack Frost. In order to demonstrate this contention, this study will analyse pragmatic elements of the dialogue of both novel and television versions of Frost through the analytical framework for impoliteness developed by Culpeper (1996; 2010). This framework will be integrated into the model for analysing the elements of narrative outlined by Simpson and Montgomery (1995), in turn suggesting an elaboration of this model. In investigating whether television’s Jack Frost is ‘softer’ than the character envisaged by Wingfield, free direct speech and accompanying physical behaviour in novel and television adaptation are analysed, focussing on whether the perceived softness of the latter has been partly achieved by making the speech of Frost less impolite on television.
Interleukin (IL)-18 and IL-22 are key components of cytokine networks that play a decisive role in (pathological) inflammation, host defense, and tissue regeneration. Tight regulation of cytokine-driven signaling, inflammation, and immunoactivation is supposed to enable nullification of a given deleterious trigger without mediating overwhelming collateral tissue damage or even activating a cancerous face of regeneration. In fact, feedback regulation by specific cytokine opponents is regarded as a major means by which the immune system is kept in balance. Herein, we shine a light on the interplay between IL-18 and IL-22 and their opponents IL-18 binding protein (IL-18BP) and IL-22BP in order to provide integrated information on their biology, pathophysiological significance, and prospect as targets and/or instruments of therapeutic intervention.
Forschen und Kuratieren sind Kerntätigkeitsbereiche von KunsthistorikerInnen. Genau das tun gerade junge NachwuchswissenschaftlerInnen am Kunstgeschichtlichen Institut der Goethe-Universität. In dem auf zwei Jahre angelegten Forschungs- und Ausstellungsprojekt "Die Porträtsammlung der Frankfurter Patrizierfamilie Holzhausen aus kunst- und kulturhistorischer Sicht" haben Masterstudierende der Kunstgeschichte und des Masterstudiengangs Curatorial Studies die Gelegenheit, am Puls der Forschung mitzuarbeiten. Unter der Leitung von Prof. Dr. Jochen Sander erlernen sie in einer Serie von drei Hauptseminaren, worauf es in der wissenschaftlichen Praxis und beim Ausstellungsmachen ankommt. ...
Endometriosis represents nowadays a real burden for the patients as well as for the physicians, as it requires surgical and/or medical treatment, often long – termed and repeated. Moreover, the high costs necessary to diagnose and treat endometriosis represent a real economic burden, being comparable to other chronic diseases like diabetes or rheumatoid arthritis. Therefore, the physicians dealing with this disease should take into account not only the efficacy of the treatment, but also the economic aspects and patients compliance.
The present paper analyses the efficiency of progestins (lynestrenol and medrogestone) in endometriosis as a cost – effective, but forgotten medical therapy of the disease. Our study underlines the good tolerability of progestins, as they have limited side effects, the compliance of patients being high. They are also low-cost medications, which could represent an effective alternative method in the endometriosis treatment, especially in less – developed countries that cannot afford the higher therapeutic costs.
Die Keksfabrik, das alte Backsteingemäuer, dessen Schornstein hinter der Universitätsbibliothek in die Höhe ragt, beherbergt seit vielen Jahrzehnten das Institut für Kunstpädagogik. Auf besondere Weise hat dieser Ort Arbeit und Lehre beeinflusst; nicht zuletzt durch die Aneignung der Räumlichkeiten als Werkstätten und Ateliers. Doch der Umzug auf den Campus Westend rückt näher und noch bevor die Erinnerung an das markante Gebäude verblasst, soll die Geschichte dieses besonderen Standortes, sowie sein Einfluss auf das Institutsleben in einer Ausstellung beleuchtet werden. Eröffnet wird sie an diesem Donnerstag ab 18 Uhr mit einem Rundgang. ...
Background: Patient Reported Outcomes (PRO) are gaining more and more importance in the context of clinical trials. The assessment of PRO is frequently performed by questionnaires where the multiple items of a questionnaire are usually pooled within summarizing scores. These scores are used as variables to measure subjective aspects of treatments and diseases. In clinical research, the calculation of these scores is mostly kept very simple, e.g. by a simple summation of item values. In the medical literature, there is hardly any guidance for performing a refinements of questionnaires and for deducing adequate scores. In contrast, in psychometric literature, there are plenty of more sophisticated methods, which overcome typical assumptions made in traditional (sum) scores, however to the prize of more complicated algorithms, which might be difficult to communicate. When faced with the practical task to refine an existing questionnaire, there exist a clear gap of guidance for applied medical researchers. By this article we try to fill this important gap between psychometric theory and medical application by illustrating our methodological choices on the example of a clinical PRO questionnaire.
Methods: Based on our experiences with the refinement of the BCTOS, a PRO questionnaire to assess aesthetic and function after breast conserving therapy in breast cancer patients, we present the following general steps that we performed by refining the BCTOS questionnaire and its scores: 1. Refinement of the length of the questionnaire and the (item-factor) structure. 2. Selection of the factor score estimation method. 3. Validation of the refined questionnaire and scores with respect to validity, reliability and structure based on a validation cohort.
Results: Our step-step-step procedure helped us to shorten the current form of the BCTOS and to redefine the factor structure. By this, the compliance of patients can be increased and the interpretation of the results becomes more coherent.
Conclusions: We present a step-by-step procedure to refine an existing medical questionnaire along with its scores illustrated and discussed by the refinement of the BCTOS.
Trial registration: Due to the character of the study (no intervention study), no registration was performed.
Early, non-invasive sensing of sustained hyperglycemia in mice using millimeter-wave spectroscopy
(2019)
Diabetes is a very complex condition affecting millions of people around the world. Its occurrence, always accompanied by sustained hyperglycemia, leads to many medical complications that can be greatly mitigated when the disease is treated in its earliest stage. In this paper, a novel sensing approach for the early non-invasive detection and monitoring of sustained hyperglycemia is presented. The sensing principle is based on millimeter-wave transmission spectroscopy through the skin and subsequent statistical analysis of the amplitude data. A classifier based on functional principal components for sustained hyperglycemia prediction was validated on a sample of twelve mice, correctly classifying the condition in diabetic mice. Using the same classifier, sixteen mice with drug-induced diabetes were studied for two weeks. The proposed sensing approach was capable of assessing the glycemic states at different stages of induced diabetes, providing a clear transition from normoglycemia to hyperglycemia typically associated with diabetes. This is believed to be the first presentation of such evolution studies using non-invasive sensing. The results obtained indicate that gradual glycemic changes associated with diabetes can be accurately detected by non-invasively sensing the metabolism using a millimeter-wave spectral sensor, with an observed temporal resolution of around four days. This unprecedented detection speed and its non-invasive character could open new opportunities for the continuous control and monitoring of diabetics and the evaluation of response to treatments (including new therapies), enabling a much more appropriate control of the condition.
An increased expression and cytoplasmic abundance of the ubiquitous RNA binding protein human antigen R (HuR) is critically implicated in the dysregulated control of post-transcriptional gene expression during colorectal cancer development and is frequently associated with a high grade of malignancy and therapy resistance. Regardless of the fact that HuR elicits a broad cell survival program by increasing the stability of mRNAs coding for prominent anti-apoptotic factors, recent data suggest that HuR is critically involved in the regulation of translation, particularly, in the internal ribosome entry site (IRES) controlled translation of cell death regulatory proteins. Accordingly, data from human colon carcinoma cells revealed that HuR maintains constitutively reduced protein and activity levels of caspase-2 through negative interference with IRES-mediated translation. This review covers recent advances in the understanding of mechanisms underlying HuR’s modulatory activity on IRES-triggered translation. With respect to the unique regulatory features of caspase-2 and its multiple roles (e.g., in DNA-damage-induced apoptosis, cell cycle regulation and maintenance of genomic stability), the pathophysiological consequences of negative caspase-2 regulation by HuR and its impact on therapy resistance of colorectal cancers will be discussed in detail. The negative HuR-caspase-2 axis may offer a novel target for tumor sensitizing therapies.
Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.
Aim: To quantify and compare the association between CCDO and ICDO with outcome parameters.
Methods: We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27; atresia type 1-3, annular pancreas) and ICDO (n = 23; annular pancreas, web, Ladd´s bands).
Results: In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%; CCDO vs ICDO, P < 0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P ≤ 0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P < 0.01).
Conclusion: CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.
Electrical stimulation shifts healing/scarring towards regeneration in a rat limb amputation model
(2019)
Different species respond differently to severe injury, such as limb loss. In species that regenerate, limb loss is met with complete restoration of the limbs’ form and function, whereas in mammals the amputated limb’s stump heals and scars. In in vitro studies, electrical stimulation (EStim) has been shown to promote cell migration, and osteo- and chondrogenesis. In in vivo studies, after limb amputation, EStim causes significant new bone, cartilage and vessel growth. Here, in a rat model, the stumps of amputated rat limbs were exposed to EStim, and we measured extracellular matrix (ECM) deposition, macrophage distribution, cell proliferation and gene expression changes at early (3 and 7 days) and later stages (28 days). We found that EStim caused differences in ECM deposition, with less condensed collagen fibrils, and modified macrophage response by changing M1 to M2 macrophage ratio. The number of proliferating cells was increased in EStim treated stumps 7 days after amputation, and transcriptome data strongly supported our histological findings, with activated gene pathways known to play key roles in embryonic development and regeneration. In conclusion, our findings support the hypothesis that EStim shifts injury response from healing/scarring towards regeneration. A better understanding of if and how EStim controls these changes, could lead to strategies that replace scarring with regeneration.
Cheilostome Bryozoa Anoteropora latirostris, a colonial marine invertebrate, constructs its skeleton from calcite and aragonite. This study presents firstly correlated multi-scale electron microscopy, micro-computed tomography, electron backscatter diffraction and NanoSIMS mapping. We show that all primary, coarse-grained platy calcitic lateral walls are covered by fine-grained fibrous aragonite. Vertical lateral walls separating autozooid chambers have aragonite only on their distal side. This type of asymmetric mineralization of lateral walls results from the vertical arrangement of the zooids at the growth margins of the colony and represents a type of biomineralization previously unknown in cheilostome bryozoans. NanoSIMS mapping across the aragonite-calcite interface indicates an organic layer between both mineral phases, likely representing an organic template for biomineralization of aragonite on the calcite layer. Analysis of crystallographic orientations show a moderately strong crystallographic preferred orientation (CPO) for calcite (7.4 times random orientation) and an overall weaker CPO for aragonite (2.4 times random orientation) with a high degree of twinning (45%) of the aragonite grains. The calculated Young’s modulus for the CPO map shows a weak mechanical direction perpendicular to the colony’s upper surface facilitating this organism’s strategy of clonal reproduction by fragmentation along the vertical zooid walls.
Künstliche Intelligenz als Ende des Strafrechts? Zur algorithmischen Transformation der Gesellschaft
(2019)
Does Artificial Intelligence (AI) imply the end of criminal law and justice as we know it? This article submits that AI is a transformative technology that seemingly assumes and optimizes the rationalities of criminal law (the effective prevention of crime; the objective, neutral and coherent application of the law etc.), namely by replacing the counterfactual guarantees of the law with the factual guarantees of technology. As a consequence, AI must not be trivialized by criminal law theory. Likewise, it is not enough to subversively criticize the current weaknesses of AI (e.g. vis-à-vis the “bias in, bias out” problem). Rather, criminal law theory should draw on the highflying promises of AI to reflect upon the foundational premises of criminal law. For a criminal law that is mostly a governance tool in the administrative and/or welfare state, AI applications promise the culmination of the law’s very objectives (like the effective inhibition and prevention of crime, e.g. by means of predictive policing; or the political determination of fuzzy sentencing rationales in sentencing algorithms that ensure equal sentences for comparable crimes). For a criminal law, however, that protects liberal freedoms and rests on inter-personal trust, AI may well lead to the passing of the law’s very ideals (e.g. of the presumption of innocence, which can no longer be upheld once everyone, ordinary citizens and judges alike, is deemed a possible risk). The question about “AI as the end of criminal law?” thus eventually raises the two-pronged question “Which criminal law for which society?”. Indeed, what is the status of freedom (esp. in a surveillance society needed to power Big Data driven algorithms), trust (esp. under the zero trust paradigm that underlies many risk assessment algorithms) and future (esp. when algorithms make predictions based on past data) once AI enters into the administration of criminal justice? These are the questions, or so I respectfully submit, that criminal law theory needs to address today in order to come up with a criminal law that is both (for pragmatic reasons) open to technology as well as (for humane reasons) sensible. In all of this, we must take to heart Joachim Hruschka’s great legacy and remain intellectually honest.
Gegenstand aller natürlichen Sprachen, die Menschen hervorgebracht haben, ist das Sprechen. Die Schrift einer solchen Sprache kann insofern als sekundäre Errungenschaft bezeichnet werden. Sorten und Gattungen der menschlichen Sprachen und Schriften sind historisch wie auch heute von großer Vielfalt und krassen Gegensätzen geprägt: z.B. die indoeuropäischen Sprachen mit flektierendem Grammatikbau versus der vielen sinotibetischen Sprachen mit analytischem Bau oder das lateinische Alphabet versus die logographische chinesische Schrift. In dieser Arbeit wird gezeigt, welche Faktoren die Korrespondenz der schriftlichen Repräsentation auf eine Sprache entscheiden und in welcher Art und Weise die Schrift die sprachlichen Entwicklungen beeinflussen kann.
IL-1 family member IL-33 exerts a variety of immune activating and regulating properties and has recently been proposed as a prognostic biomarker for cancer diseases, although its precise role in tumor immunity is unclear. Here we analyzed in vitro conditions influencing the function of IL-33 as an alarmin and a co-factor for the activity of cytotoxic CD8+ T cells in order to explain the widely discussed promiscuous behavior of IL-33 in vivo. Circulating IL-33 detected in the serum of healthy human volunteers was biologically inactive. Additionally, bioactivity of exogenous recombinant IL-33 was significantly reduced in plasma, suggesting local effects of IL-33, and inactivation in blood. Limited availability of nutrients in tissue causes necrosis and thus favors release of IL-33, which—as described before—leads to a locally high expression of the cytokine. The harsh conditions however influence T cell fitness and their responsiveness to stimuli. Nutrient deprivation and pharmacological inhibition of mTOR mediated a distinctive phenotype characterized by expression of IL-33 receptor ST2L on isolated CD8+ T cells, downregulation of CD8, a transitional CD45RAlowROlow phenotype and high expression of secondary lymphoid organ chemokine receptor CCR7. Under nutrient deprivation, IL-33 inhibited an IL-12 induced increase in granzyme B protein expression and increased expression of GATA3 and FOXP3 mRNA. IL-33 enhanced the TCR-dependent activation of CD8+ T cells and co-stimulated the IL-12/TCR-dependent expression of IFNγ. Respectively, GATA3 and FOXP3 mRNA were not regulated during TCR-dependent activation. TCR-dependent stimulation of PBMC, but not LPS, initiated mRNA expression of soluble IL-33 decoy receptor sST2, a control mechanism limiting IL-33 bioactivity to avoid uncontrolled inflammation. Our findings contribute to the understanding of the compartment-specific activity of IL-33. Furthermore, we newly describe conditions, which promote an IL-33-dependent induction of pro- or anti-inflammatory activity in CD8+ T cells during nutrient deprivation.
Background: The nature of perceptual-cognitive expertise in interactive sports has gained more and more scientific interest over the last two decades. Research to understand how this expertise can be developed has not been addressed profoundly yet. In approaches to study this with interventional designs, only few studies have scrutinized several levels of transfer such as to the field. Therefore, the aim of this study was to examine the efficacy of a generic off-court perceptual-cognitive training in elite volleyball players on three different levels: task-specific, near-transfer, and far-transfer effects. Based on overlapping cognitive processes between training and testing, we hypothesized task-specific improvements as well as positive near- and far-transfer effects after a multiple-object tracking training intervention.
Methods: Twenty-two volleyball experts completed a 8-week three-dimensional (3D) multiple-object tracking (3D-MOT) training intervention. A control group (n = 21; volleyball experts also) participated in regular ball practice only. Before and after training, both groups performed tests on the 3D-MOT, four near-transfer tests in cognitive domains, and a far-transfer, lab-based, and volleyball-specific blocking test.
Results: The results of the 2 × 2 analysis of variance (ANOVA) (group, time) showed significant interaction effects in the 3D-MOT task [F(1,40) = 93.10; p < 0.001; η2p = 0.70] and in two near-transfer tests [sustained attention: F(1,40) = 15.45; p < 0.001; η2p = 0.28; processing speed: F(1,40) = 12.15; p = 0.001; η2p = 0.23]. No significant interaction effects were found in the far-transfer volleyball test.
Conclusions: Our study suggests positive effects in task-specific and two near-transfer tests of a perceptual-cognitive intervention in elite volleyball athletes. This supports a partial overlap in cognitive processing between practice and tests with the result of positive near-transfer. However, there are no significant effects in far-transfer testing. Although these current results are promising, it is still unclear how far-transfer effects of a generic perceptual-cognitive training intervention can be assured.
One of the most difficult challenges in clinical hepatology is the diagnosis of a drug-induced liver injury (DILI). The timing of the events, exclusion of alternative causes, and taking into account the clinical context should be systematically assessed and scored in a transparent manner. RUCAM (Roussel Uclaf Causality Assessment Method) is a well-established diagnostic algorithm and scale to assess causality in patients with suspected DILI. First published in 1993 and updated in 2016, RUCAM is now the worldwide most commonly used causality assessment method (CAM) for DILI. The following manuscript highlights the recent implementation of RUCAM around the world, by reviewing the literature for publications that utilized RUCAM, and provides a review of “best practices” for the use of RUCAM in cases of suspected DILI. The worldwide appreciation of RUCAM is substantiated by the current analysis of 46,266 DILI cases, all tested for causality using RUCAM. These cases derived from 31 reports published from 2014 to early 2019. Their first authors came from 10 countries, with China on top, followed by the US, and Germany on the third rank. Importantly, all RUCAM-based DILI reports were published in high profile journals. Many other reports were published earlier from 1993 up to 2013 in support of RUCAM. Although most of the studies were of high quality, the current case analysis revealed shortcomings in few studies, not at the level of RUCAM itself but rather associated with the work of the users. To ensure in future DILI cases a better performance by the users, a list of essential elements is proposed. As an example, all suspected DILI cases should be evaluated 1) by the updated RUCAM to facilitate result comparisons, 2) according to a prospective study protocol to ensure complete data sets, 3) after exclusion of cases with herb induced liver injury (HILI) from a DILI cohort to prevent confounding variables, and 4) according to inclusion of DILI cases with RUCAM-based causality gradings of highly probable or probable, in order to increase the specificity of the results. In conclusion, RUCAM benefits from its high appreciation and performs well provided the users adhere to published recommendations to prevent confounding variability.
Microenvironmental regulation of tumor progression and therapeutic response in brain metastasis
(2019)
Cellular and non-cellular components of the tumor microenvironment (TME) are emerging as key regulators of primary tumor progression, organ-specific metastasis, and therapeutic response. In the era of TME-targeted- and immunotherapies, cancer-associated inflammation has gained increasing attention. In this regard, the brain represents a unique and highly specialized organ. It has long been regarded as an immunological sanctuary site where the presence of the blood brain barrier (BBB) and blood cerebrospinal fluid barrier (BCB) restricts the entry of immune cells from the periphery. Consequently, tumor cells that metastasize to the brain were thought to be shielded from systemic immune surveillance and destruction. However, the detailed characterization of the immune landscape within border-associated areas of the central nervous system (CNS), such as the meninges and the choroid plexus, as well as the discovery of lymphatics and channels that connect the CNS with the periphery, have recently challenged the dogma of the immune privileged status of the brain. Moreover, the presence of brain metastases (BrM) disrupts the integrity of the BBB and BCB. Indeed, BrM induce the recruitment of different immune cells from the myeloid and lymphoid lineage to the CNS. Blood-borne immune cells together with brain-resident cell-types, such as astrocytes, microglia, and neurons, form a highly complex and dynamic TME that affects tumor cell survival and modulates the mode of immune responses that are elicited by brain metastatic tumor cells. In this review, we will summarize recent findings on heterotypic interactions within the brain metastatic TME and highlight specific functions of brain-resident and recruited cells at different rate-limiting steps of the metastatic cascade. Based on the insight from recent studies, we will discuss new opportunities and challenges for TME-targeted and immunotherapies for BrM.