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We tested the hypothesis that phonosemantic iconicity––i.e., a motivated resonance of sound and meaning––might not only be found on the level of individual words or entire texts, but also in word combinations such that the meaning of a target word is iconically expressed, or highlighted, in the phonetic properties of its immediate verbal context. To this end, we extracted single lines from German poems that all include a word designating high or low dominance, such as large or small, strong or weak, etc. Based on insights from previous studies, we expected to find more vowels with a relatively short distance between the first two formants (low formant dispersion) in the immediate context of words expressing high physical or social dominance than in the context of words expressing low dominance. Our findings support this hypothesis, suggesting that neighboring words can form iconic dyads in which the meaning of one word is sound-iconically reflected in the phonetic properties of adjacent words. The construct of a contiguity-based phono-semantic iconicity opens many venues for future research well beyond lines extracted from poems.
Weltweit stellt das kolorektale Karzinom die dritthäufigste Krebsdiagnose bei Männern und die zweithäufigste bei Frauen dar. Von den bekannten beeinflussbaren Risikofaktoren sind Ernährung, Rauchen und körperliche Aktivität zu nennen, hingegen gelten Alter, familiäre Belastung und männliches Geschlecht als nicht beeinflussbare Risikofaktoren. Neben Genmutationen, welche beispielsweise bei der Familiären Adenomatösen Polyposis coli und beim “Lynch Syndrom” eine wichtige Rolle spielen, kann auch die pathologisch verstärkte Expression von tumorrelevanten Proteinen wie z.B. induzierbare COX-2, Cyclin A, B und D, c-Fos, EGF, MMP-9, VEGF sowie das ubiquitäre RNA-Bindeprotein HuR maßgeblich zur Entstehung des Kolonkarzinoms beitragen. Viele der bislang identifizierten Zielgene des HuRs sind an der Regulation tumorpromovierender Eigenschaften wie Proliferation, Invasion, Metastasierung und Apoptose beteiligt, was HuR zu einem hochattraktiven Target der molekularen Tumortherapie macht. Bislang ist bekannt, dass eine gesteigerte HuR-Bindung an AREs in der 3’UTR vieler Zielgene entweder zur Stabilisierung und/oder
Translationsveränderung von kurzlebigen mRNAs von tumorrelevanten Genprodukten führen kann. Eine pathologisch erhöhte zytosolische HuR Akkumulation, welche bekanntlich oft mit einer ungünstigen Prognose der Tumorpatienten korreliert, wird jedoch im Wesentlichen als Folge eines fehlerhaft regulierten erhöhten Exportes des überwiegend im Zellkern lokalisierten HuR Proteins ins Zytoplasma (sogenanntes “HuR-Shuttling”) betrachtet, während genomische oder epigenetische Mechanismen vermutlich nur eine untergeordnete Rolle spielen. Der Gegenstand der vorliegenden Arbeit war die Aufklärung der bisher nur wenig bekannten zugrunde liegenden Mechanismen des erhöhten HuR-Shuttlings in der Kolonkarzinom-Zelllinie DLD-1 unter besonderen Berücksichtigung PKCδ-abhängiger Signalwege. Durch Zugabe des pharmakologischen PKCδ-Inhibitors Rottlerin konnte die subzelluläre HuR-Lokalisation in den Kolonkarzinom Zelllinien DLD-1 und SW-620 deutlich reduziert werden, wobei die maximale Wirkung erst nach einer Inhibitionszeit von 16 Stunden erreicht wurde. Diese Beobachtung lässt vermuten, dass Rottlerin die PKCδ Aktivität in DLD-1 Zellen hemmt. Hingegen konnten Inhibitoren von verschiedenen MAPK-Kinasen (SB203580, SP600125, PD98059, Raf-1-Inhibitor) die basale zytoplasmatische HuR Lokalisation nicht beeinflussten, ebensowenig der pharmakologische Inhibitor der Calcium-abhängigen PKCs (PKCα und PKCβ) Gö6976. Auf der anderen Seite bewirkte das Phorbolester PMA eine deutliche Steigerung der PKC-Aktivität. Des Weiteren wurde in dieser Arbeit nach tumorrelevanten Genen gesucht, deren Expression in humanen Kolonkarzinomzellen posttranskriptionell von HuR und gleichzeitig von PKCδ kontrolliert wird. Mit Hilfe von RNA-Pulldown Experimenten konnte gezeigt werden, dass die Hemmung der PKCδ funktionell zu einer starken Reduktion der an HuR-gebundenen mRNAs wie c-myc, cyclin A und D sowie COX-2 führt. Schließlich haben Aktivitätsmessungen der Gesamt-PKC-Aktivität gezeigt, dass diese in Kolonkarzinom-Zelllinien nachweisbar und damit basal aktiv ist. Die Untersuchungsergebnisse dieser Arbeit können zum besseren Verständnis der pathophysiologischen Bedeutung des ubiquitären RNA-Bindeproteins HuR für die Kolonkarzinogenese sowie der prokarzinogenen Rolle der PKCδ im Kolongewebe beitragen.
Zinc finger domains are highly structured and can mediate interactions to DNA, RNA, proteins, lipids, and small molecules. Accordingly, zinc finger proteins are very versatile and involved in many biological functions. Eukaryotes contain a wealth of zinc finger proteins, but zinc finger proteins have also been found in archaea and bacteria. Large zinc finger proteins have been well studied, however, in stark contrast, single domain zinc finger µ-proteins of less than 70 amino acids have not been studied at all, with one single exception. Therefore, 16 zinc finger µ-proteins of the haloarchaeon Haloferax volcanii were chosen and in frame deletion mutants of the cognate genes were generated. The phenotypes of mutants and wild-type were compared under eight different conditions, which were chosen to represent various pathways and involve many genes. None of the mutants differed from the wild-type under optimal or near-optimal conditions. However, 12 of the 16 mutants exhibited a phenotypic difference under at least one of the four following conditions: Growth in synthetic medium with glycerol, growth in the presence of bile acids, biofilm formation, and swarming. In total, 16 loss of function and 11 gain of function phenotypes were observed. Five mutants indicated counter-regulation of a sessile versus a motile life style in H. volcanii. In conclusion, the generation and analysis of a set of deletion mutants demonstrated the high importance of zinc finger µ-proteins for various biological functions, and it will be the basis for future mechanistic insight.
Immune checkpoint modulation in cancer has been demonstrated as a high-value therapeutic strategy in many tumor entities. VISTA is an immune checkpoint receptor regulating T-cell function. To the best of our knowledge, nothing is known about the expression and prognostic impact of VISTA on tumor infiltrating lymphocytes (TILs) in the tumor microenvironment of esophageal adenocarcinoma (EAC). We analyzed in total 393 EACs within a test-cohort (n = 165) and a validation-cohort (n = 228) using a monoclonal antibody (clone D1L2G). These data were statistically correlated with clinical as well as molecular data. 22.2% of the tumor cohort presented with a VISTA expression on TILs. These patients demonstrated an improved median overall survival compared to patients without VISTA expression (202.2 months vs. 21.6 months; p < 0.0001). The favorable outcome of VISTA positive tumors is significant in the entire cohort but mainly driven by the general better prognosis of T1/T2 tumors. However, in the pT1/2 group, VISTA positive tumors show a tremendous survival benefit compared to VISTA negative tumors revealing real long-term survivors in this particular subgroup. The survival difference is independent of the T-stage. This unique characteristic could influence neoadjuvant therapy concepts for EAC, since a profit of therapy could be reduced in the already favorable subgroup of VISTA positive tumors. VISTA emerges as a prognostic biomarker for long-term survival especially in the group of early TNM-stages. Future studies have to show the relevance of VISTA positive TILs within a tumor concerning response to specific immune checkpoint inhibition.
Over the last years non-invasive brain stimulation techniques (NIBS) have become the ultimate tool to gain major insights about the mechanisms responsible for sensory, motor, and cognitive functions. A big issue surrounding transcranial magnetic stimulation (TMS) and transcranial electric stimulation (TES) methods is the disagreement about the aftereffects reported by studies using similar (if not the same) stimulation protocols (Robertson et al., 2003; Horvath et al., 2014). The purpose of this research topic was to collect information regarding different stimulation procedures to assess their capacity to modulate cognition including also, appropriate control and sham conditions. The first part of this report will cover contributions related to TES which were limited to transcranial direct current stimulation methods (tDCS). This will be followed by studies dedicated to real TMS and sham methodology. ...
This paper investigates how the major outcome of a confirmatory factor investigation is preserved when scaling the variance of a latent variable by the various scaling methods. A constancy framework, based upon the underlying factor analysis formula that enables scaling by modifying components through scalar multiplication, is described; a proof is included to demonstrate the constancy property of the framework. It provides the basis for a scaling method that enables the comparison of the contribution of different latent variables of the same confirmatory factor model to observed scores, as for example, the contributions of trait and method latent variables. Furthermore, it is shown that available scaling methods are in line with this constancy framework and that the criterion number included in some scaling methods enables modifications. The impact of the number of manifest variables on the scaled variance parameter can be modified and the range of possible values. It enables the adaptation of scaling methods to the requirements of the field of application.
Congenital lower urinary-tract obstruction (LUTO) is caused by anatomical blockage of the bladder outflow tract or by functional impairment of urinary voiding. About three out of 10,000 pregnancies are affected. Although several monogenic causes of functional obstruction have been defined, it is unknown whether congenital LUTO caused by anatomical blockage has a monogenic cause. Exome sequencing in a family with four affected individuals with anatomical blockage of the urethra identified a rare nonsense variant (c.2557C>T [p.Arg853∗]) in BNC2, encoding basonuclin 2, tracking with LUTO over three generations. Re-sequencing BNC2 in 697 individuals with LUTO revealed three further independent missense variants in three unrelated families. In human and mouse embryogenesis, basonuclin 2 was detected in lower urinary-tract rudiments. In zebrafish embryos, bnc2 was expressed in the pronephric duct and cloaca, analogs of the mammalian lower urinary tract. Experimental knockdown of Bnc2 in zebrafish caused pronephric-outlet obstruction and cloacal dilatation, phenocopying human congenital LUTO. Collectively, these results support the conclusion that variants in BNC2 are strongly implicated in LUTO etiology as a result of anatomical blockage.
Burkitt lymphoma (BL) is the most common B-cell lymphoma in children. Within the International Cancer Genome Consortium (ICGC), we performed whole genome and transcriptome sequencing of 39 sporadic BL. Here, we unravel interaction of structural, mutational, and transcriptional changes, which contribute to MYC oncogene dysregulation together with the pathognomonic IG-MYC translocation. Moreover, by mapping IGH translocation breakpoints, we provide evidence that the precursor of at least a subset of BL is a B-cell poised to express IGHA. We describe the landscape of mutations, structural variants, and mutational processes, and identified a series of driver genes in the pathogenesis of BL, which can be targeted by various mechanisms, including IG-non MYC translocations, germline and somatic mutations, fusion transcripts, and alternative splicing.
Supersaturating formulations are widely used to improve the oral bioavailability of poorly soluble drugs. However, supersaturated solutions are thermodynamically unstable and such formulations often must include a precipitation inhibitor (PI) to sustain the increased concentrations to ensure that sufficient absorption will take place from the gastrointestinal tract. Recent advances in understanding the importance of drug-polymer interaction for successful precipitation inhibition have been encouraging. However, there still exists a gap in how this newfound understanding can be applied to improve the efficiency of PI screening and selection, which is still largely carried out with trial and error-based approaches. The aim of this study was to demonstrate how drug-polymer mixing enthalpy, calculated with the Conductor like Screening Model for Real Solvents (COSMO-RS), can be used as a parameter to select the most efficient precipitation inhibitors, and thus realise the most successful supersaturating formulations. This approach was tested for three different Biopharmaceutical Classification System (BCS) II compounds: dipyridamole, fenofibrate and glibenclamide, formulated with the supersaturating formulation, mesoporous silica. For all three compounds, precipitation was evident in mesoporous silica formulations without a precipitation inhibitor. Of the nine precipitation inhibitors studied, there was a strong positive correlation between the drug-polymer mixing enthalpy and the overall formulation performance, as measured by the area under the concentration-time curve in in vitro dissolution experiments. The data suggest that a rank-order based approach using calculated drug-polymer mixing enthalpy can be reliably used to select precipitation inhibitors for a more focused screening. Such an approach improves efficiency of precipitation inhibitor selection, whilst also improving the likelihood that the most optimal formulation will be realised.
Hydride transfers play a crucial role in a multitude of biological redox reactions and are mediated by flavin, deazaflavin or nicotinamide adenine dinucleotide cofactors at standard redox potentials ranging from 0 to –340 mV. 2-Naphthoyl-CoA reductase, a key enzyme of oxygen-independent bacterial naphthalene degradation, uses a low-potential one-electron donor for the two-electron dearomatization of its substrate below the redox limit of known biological hydride transfer processes at E°’ = −493 mV. Here we demonstrate by X-ray structural analyses, QM/MM computational studies, and multiple spectroscopy/activity based titrations that highly cooperative electron transfer (n = 3) from a low-potential one-electron (FAD) to a two-electron (FMN) transferring flavin cofactor is the key to overcome the resonance stabilized aromatic system by hydride transfer in a highly hydrophobic pocket. The results evidence how the protein environment inversely functionalizes two flavins to switch from low-potential one-electron to hydride transfer at the thermodynamic limit of flavin redox chemistry.
BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders worldwide. As described in the DSM-5, ADHD is clinically heterogeneous with three main subtypes; predominant hyperactive, predominant attention deficit and combined. The severity of symptoms widely differs among the patients and interferes with the person functioning, negatively impacting social and occupational activities (American Psychiatric Association, 2013). Despite the many efforts, the etiology of the disorder is still unclear. Therefore, there is an increasing demand of models that would help elucidating the causative mechanisms of the disorder and, in parallel, would be valuable tools to discover new and effective treatments. The main goal of the study is the identification of disease specific cellular phenotypes related to Attention-Deficit/Hyperactivity Disorder (ADHD) in cellular models from patients carrying rare copy number variants (CNVs) in the PARK2 locus that have been previously associated with ADHD (Elia et al., 2010; Jarick et al., 2014).
METHODS: Human dermal fibroblast (HDF) cultures were obtained from skin punches and reprogrammed into human induced pluripotent stem cells (HiPSC) and successively induced to differentiate into HiPSC-derived dopaminergic neurons. Both HiPSC and HiPSC-derived neurons, were proven to be bona fide models by morphological analysis, RT-PCR, RT-qPCR, immunofluorescence, embryoid body assay, molecular karyotyping and dopamine level quantification. A total of six donors were selected for HiPSC and dopaminergic neuron generation: 3 adult ADHD PARK2 CNV risk carriers (1 duplication and 2 deletion carriers, 1 ADHD non-risk CNV variant carrier and 2 healthy controls).
We conducted stress-response experiments (nutrient deprivation and CCCP administration) that are well known to increase PARK2 expression, on both fibroblasts and HiPSC. After assessing PARK2 gene and protein expression levels, we evaluated the gene expression of genes that are involved with different processes orchestrated by PARK2. We then performed a series of assays with a special focus on mitochondrial function and energy metabolism (ATP production, basal oxygen consumption rates, ROS abundance) and evaluated changing in the mitochondrial network morphology.
To evaluate the effect of nicotine exposure, one of the best replicated prenatal risk factors for having a child later on diagnosed with ADHD, we treated HiPSC-derived dopaminergic neurons with smoking-relevant nicotine concentrations and evaluated PARK2 protein expression after treatment and gene expression by RNA sequencing.
RESULTS: The cell models created in this study passed all the characterization tests required to assess whether the lines can be considered bona fide models without underling genotype differences. The evaluation of patho-phenotypes connected with ADHD/PARK2 CNVs in HDF and HIPSC showed that, although PARK2 gene expression was unchanged, ADHD/PARK2 CNV carriers show different PARK2 protein levels possibly implying the presence of different post-transcriptional processes. ADHD/PARK2 CNV carriers show lower levels of ATP production and basal oxygen consumption rates compared to controls, a result in line with what was already reported in ADHD cybrids cells model (Verma et al., 2016). Our experiments indicate that both the amount of reactive oxygen species (ROS) and the mitochondrial network morphology is influenced by the treatment but not by the genotype. The evaluation of nicotine effects on HiPSC-derived dopaminergic neuron from aADHD patients showed no effects on PARK2 protein levels and gene expression. ADHD/PARK2 CNVs carriers show gene ontology enrichment in modules connected with the regulation of cell growth after nicotine acute treatment. Additionally, genes connected with energy production & oxidative stress response and extracellular matrix & cell adhesion were significantly differentially expressed after nicotine treatments.
CONCLUSIONS: This study points out the presence of impairment of mitochondrial energetics in cellular models derived from adult ADHD patients carrying rare CNVs within the PARK2 locus. In the last years, several studies have linked mitochondrial impairments to the etiology of psychiatric and neurodevelopmental disorders (McCann & Ross, 2018) and reported an overall increase of oxidative stress or insufficient response to oxidative damage both in children and adults with ADHD (Joseph, Zhang-James, Perl, & Faraone, 2015; Lopresti, 2015). Additionally, different groups have underlined an abnormal brain connectivity in ADHD patients in their work (Gehricke et al., 2017). Our preliminary investigation of the effects of a well-known prenatal risk factor for ADHD, nicotine gestation exposure, point out a susceptibility of the PARK2 CNVs carriers in processes involved in regulation of cell growth and in proteins connected with extracellular matrix composition and cell-adhesion molecules, all factors necessary for neuronal maturation and formation of proper neural connections (Washbourne et al., 2004). In conclusion, this study presents novel and fully validated cellular model systems to study the etiopathogenesis of ADHD based on rare CNVs in the PARK2 locus. Moreover, the identification of disease-relevant phenotypes in the model might be helpful in the future for testing new alternative medications.
Introduction: Previous studies have established graph theoretical analysis of functional network connectivity (FNC) as a potential tool to detect neurobiological underpinnings of psychiatric disorders. Despite the promising outcomes in studies that examined FNC aberrancies in bipolar disorder (BD) and major depressive disorder (MDD), there is still a lack of research comparing both mood disorders, especially in a nondepressed state. In this study, we used graph theoretical network analysis to compare brain network properties of euthymic BD, euthymic MDD and healthy controls (HC) to evaluate whether these groups showed distinct features in FNC.
Methods: We collected resting‐state functional magnetic resonance imaging (fMRI) data from 20 BD patients, 15 patients with recurrent MDD as well as 30 age‐ and gender‐matched HC. Graph theoretical analyses were then applied to investigate functional brain networks on a global and regional network level.
Results: Global network analysis revealed a significantly higher mean global clustering coefficient in BD compared to HC. We further detected frontal, temporal and subcortical nodes in emotion regulation areas such as the limbic system and associated regions exhibiting significant differences in network integration and segregation in BD compared to MDD patients and HC. Participants with MDD and HC only differed in frontal and insular network centrality.
Conclusion: In conclusion, our findings indicate that a significantly altered brain network topology in the limbic system might be a trait marker specific to BD. Brain network analysis in these regions may therefore be used to differentiate euthymic BD not only from HC but also from patients with MDD.
Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process.
Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score.
Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases.
Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway.
Trial Registration Number. This trial is registered under number NCT03403946.
The present study aims to clarify the confused taxonomy of Z. schaufussi von Frauenfeld, 1862 and Zospeum suarezi Gittenberger, 1980. Revision of Iberian Zospeum micro snails is severely hindered by uncertainties regarding the identity of the oldest Iberian Zospeum species, Z. schaufussi von Frauenfeld, 1862. In this paper, we clarify its taxonomic status by designating a lectotype from the original syntype series and by describing its internal and external shell morphology. Using SEM-EDX, we attempt to identify the area of the type locality cave more precisely than "a cave in Spain". The shell described and illustrated by Gittenberger (1980) as Z. schaufussi appears not to be conspecific with the lectotype shell, and is considered a separate species, Z. gittenbergeri Jochum, Prieto & De Winter, sp. n.
Zospeum suarezi was described from various caves in NW Spain. Study of the type material reveals that these shells are not homogenous in shell morphology. The holotype shell of Z. suarezi is imaged here for the first time. The paratype shell, illustrated by Gittenberger (1980) from a distant, second cave, is described as Zospeum praetermissum Jochum, Prieto & De Winter, sp. n. The shell selected here as lectotype of Z. schaufussi, was also considered a paratype of Z. suarezi by Gittenberger (1980). Since this specimen is morphologically very similar to topotypic shells of Z. suarezi, the latter species is considered a junior synonym of Z. schaufussi (syn. n.). The internal shell morphology of all these taxa is described and illustrated using X-ray Micro Computer Tomography (Micro-CT).
Background: The incidence of central nervous system (CNS) metastases in breast cancer patients is rising and has become a major clinical challenge. Only few data are published concerning risk factors for the development of CNS metastases as a first site of metastatic disease in breast cancer patients. Moreover, the incidence of CNS metastases after modern neoadjuvant treatment is not clear.
Methods: We analyzed clinical factors associated with the occurrence of CNS metastases as the first site of metastatic disease in breast cancer patients after neoadjuvant treatment in the trials GeparQuinto and GeparSixto (n = 3160) where patients received targeted treatment in addition to taxane and anthracycline-based chemotherapy.
Results: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed CNS metastases as the first site of recurrence and 411 (13%) patients had metastatic disease outside the CNS. Thirty-six patients (1%) developed both CNS metastases and other distant metastases as the first site of metastatic disease. Regarding subtypes of the primary tumor, 1% of luminal A-like (11/954), 2% of luminal B-like (7/381), 4% of HER2-positive (34/809), and 6% of triple-negative patients (56/1008) developed CNS metastases as the first site of metastatic disease.
In multivariate analysis, risk factors for the development of CNS metastases were larger tumor size (cT3–4; HR 1.63, 95% CI 1.08–2.46, p = 0.021), node-positive disease (HR 2.57, 95% CI 1.64–4.04, p < 0.001), no pCR after neoadjuvant chemotherapy (HR 2.29, 95% CI 1.32–3.97, p = 0.003), and HER2-positive (HR 3.80, 95% CI 1.89–7.64, p < 0.001) or triple-negative subtype (HR 6.38, 95% CI 3.28–12.44, p < 0.001).
Conclusions: Especially patients with HER2-positive and triple-negative tumors are at risk of developing CNS metastases despite effective systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
Background: Esophageal cancer (EC) is one of the deadliest cancers worldwide. The contemporary strong increase of the adenocarcinomas in Western countries and the high mortality rates require the intensification of prospective multinational studies.
Methods: Therefore, this global health issue has been chosen for the bibliometric review of the global publication output. As source for meta and citation data, the Web of Science has been used and Density Equalizing Maps were applied for visualization.
Results: 17,387 articles on EC could be identified. The years with publication and citation maxima correspond to the appearance of the most prolific articles. China is the most publishing country, followed by Japan and the USA. Germany and the UK ranked 4th and 5th. The analysis of the ratios articles and socio-economic parameters emphasizes the leading position of the Scandinavian countries and Japan. Here, the high-income countries come out on top. The high incidence regions are mainly represented by Chinese and Japanese research. The association of the publication output and the overall research funding could be shown.
Conclusions: A strengthened international network increasingly consisting of the scientifically best positioned countries as well as more of the high incidence countries worldwide is mandatory for future research. The findings deliver scientists, clinicians and decision makers backgrounds for future decisions all over the world.
Acute deterioration of liver cirrhosis (e.g., infections, acute‐on‐chronic liver failure [ACLF]) requires an increase in cardiac contractility. The insufficiency to respond to these situations could be deleterious. Left ventricular global longitudinal strain (LV‐GLS) has been shown to reflect left cardiac contractility in cirrhosis better than other parameters and might bear prognostic value. Therefore, this retrospective study investigated the role of LV‐GLS in the outcome after transjugular intrahepatic portosystemic shunt (TIPS) and the development of ACLF. We included 114 patients (48 female patients) from the Noninvasive Evaluation Program for TIPS and Their Follow‐Up Network (NEPTUN) cohort. This number provided sufficient quality and structured follow‐up with the possibility of calculating major scores (Child, Model for End‐Stage Liver Disease [MELD], Chronic Liver Failure Consortium acute decompensation [CLIF‐C AD] scores) and recording of the events (development of decompensation episode and ACLF). We analyzed the association of LV‐GLS with overall mortality and development of ACLF in patients with TIPS. LV‐GLS was independently associated with overall mortality (hazard ratio [HR], 1.123; 95% confidence interval [CI],1.010‐1.250) together with aspartate aminotransferase (HR, 1.009; 95% CI, 1.004‐1.014) and CLIF‐C AD score (HR, 1.080; 95% CI, 1.018‐1.137). Area under the receiver operating characteristic curve (AUROC) analysis for LV‐GLS for overall survival showed higher area under the curve (AUC) than MELD and CLIF‐C AD scores (AUC, 0.688 versus 0.646 and 0.573, respectively). The best AUROC‐determined LV‐GLS cutoff was −16.6% to identify patients with a significantly worse outcome after TIPS at 3 months, 6 months, and overall. LV‐GLS was independently associated with development of ACLF (HR, 1.613; 95% CI, 1.025‐2.540) together with a MELD score above 15 (HR, 2.222; 95% CI, 1.400‐3.528). Conclusion: LV‐GLS is useful for identifying patients at risk of developing ACLF and a worse outcome after TIPS. Although validation is required, this tool might help to stratify risk in patients receiving TIPS.
No association between Parkinson disease and autoantibodies against NMDA-type glutamate receptors
(2019)
Background: IgG-class autoantibodies to N-Methyl-D-Aspartate (NMDA)-type glutamate receptors define a novel entity of autoimmune encephalitis. Studies examining the prevalence of NMDA IgA/IgM antibodies in patients with Parkinson disease with/without dementia produced conflicting results. We measured NMDA antibodies in a large, well phenotyped sample of Parkinson patients without and with cognitive impairment (n = 296) and controls (n = 295) free of neuropsychiatric disease. Detailed phenotyping and large numbers allowed statistically meaningful correlation of antibody status with diagnostic subgroups as well as quantitative indicators of disease severity and cognitive impairment.
Methods: NMDA antibodies were analysed in the serum of patients and controls using well established validated assays. We used anti-NMDA antibody positivity as the main independent variable and correlated it with disease status and phenotypic characteristics.
Results: The frequency of NMDA IgA/IgM antibodies was lower in Parkinson patients (13%) than in controls (22%) and higher than in previous studies in both groups. NMDA IgA/IgM antibodies were neither significantly associated with diagnostic subclasses of Parkinson disease according to cognitive impairment, nor with quantitative indicators of disease severity and cognitive impairment. A positive NMDA antibody status was positively correlated with age in controls but not in Parkinson patients.
Conclusion: It is unlikely albeit not impossible that NMDA antibodies play a significant role in the pathogenesis or progression of Parkinson disease e.g. to Parkinson disease with dementia, while NMDA IgG antibodies define a separate disease of its own.
The antitumor effect of curcumin in urothelial cancer cells is enhanced by light exposure in vitro
(2019)
The natural compound curcumin exerts antitumor properties in vitro, but its clinical application is limited due to low bioavailability. Light exposure in skin and skin cancer cells has been shown to improve curcumin bioavailability; thus, the object of this investigation was to determine whether light exposure might also enhance curcumin efficacy in bladder cancer cell lines. RT112, UMUC3, and TCCSUP cells were preincubated with low curcumin concentrations (0.1-0.4 μg/ml) and then exposed to 1.65 J/cm2 visible light for 5 min. Cell growth, cell proliferation, apoptosis, cell cycle progression, and cell cycle regulating proteins along with acetylation of histone H3 and H4 were investigated. Though curcumin alone did not alter cell proliferation or apoptosis, tumor cell growth and proliferation were strongly blocked when curcumin was combined with visible light. Curcumin-light caused the bladder cancer cells to become arrested in different cell phases: G0/G1 for RT112, G2/M for TCCSUP, and G2/M- and S-phase for UMUC3. Proteins of the Cdk-cyclin axis were diminished in RT112 after application of 0.1 and 0.4 μg/ml curcumin. Cell cycling proteins were upregulated in TCCSUP and UMUC3 in the presence of 0.1 μg/ml curcumin-light but were partially downregulated with 0.4 μg/ml curcumin. 0.4 μg/ml (but not 0.1 μg/ml) curcumin-light also evoked late apoptosis in TCCSUP and UMUC3 cells. H3 and H4 acetylation was found in UMUC3 cells treated with 0.4 μg/ml curcumin alone or with 0.1 μg/ml curcumin-light, pointing to an epigenetic mechanism. Light exposure enhanced the antitumor potential of curcumin on bladder cancer cells but by different molecular action modes in the different cell lines. Further studies are necessary to evaluate whether intravesical curcumin application, combined with visible light, might become an innovative tool in combating bladder cancer.