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he Influence of trehalose-based glycolipids in the virulence of Mycobacterium tuberculosis (Mtb) is recognised; however, the actual role of these cell-wall glycolipids in latent infection is unknown. As an initial approach, we determined by two-dimensional thin-layer chromatography the sulfolipid (SL) and diacyltrehalose/polyacyltrehalose (DAT/PAT) profile of the cell wall of hypoxic Mtb. Then, qRT-PCR was extensively conducted to determine the transcription profile of genes involved in the biosynthesis of these glycolipids in non-replicating persistent 1 (NRP1) and anaerobiosis (NRP2) models of hypoxia (Wayne model), and murine models of chronic and progressive pulmonary tuberculosis. A diminished content of SL and increased amounts of glycolipids with chromatographic profile similar to DAT were detected in Mtb grown in the NRP2 stage. A striking decrease in the transcription of mmpL8 and mmpL10 transporter genes and increased transcription of the pks (polyketidesynthase) genes involved in SL and DAT biosynthesis were detected in both the NRP2 stage and the murine model of chronic infection. All genes were found to be up-regulated in the progressive disease. These results suggest that SL production is diminished during latent infection and the DAT/PAT precursors can be accumulated inside tubercle bacilli and are possibly used in reactivation processes.
Few sequence alignment methods have been designed specifically for integral membrane proteins, even though these important proteins have distinct evolutionary and structural properties that might affect their alignments. Existing approaches typically consider membrane-related information either by using membrane-specific substitution matrices or by assigning distinct penalties for gap creation in transmembrane and non-transmembrane regions. Here, we ask whether favoring matching of predicted transmembrane segments within a standard dynamic programming algorithm can improve the accuracy of pairwise membrane protein sequence alignments. We tested various strategies using a specifically designed program called AlignMe. An updated set of homologous membrane protein structures, called HOMEP2, was used as a reference for optimizing the gap penalties. The best of the membrane-protein optimized approaches were then tested on an independent reference set of membrane protein sequence alignments from the BAliBASE collection. When secondary structure (S) matching was combined with evolutionary information (using a position-specific substitution matrix (P)), in an approach we called AlignMePS, the resultant pairwise alignments were typically among the most accurate over a broad range of sequence similarities when compared to available methods. Matching transmembrane predictions (T), in addition to evolutionary information, and secondary-structure predictions, in an approach called AlignMePST, generally reduces the accuracy of the alignments of closely-related proteins in the BAliBASE set relative to AlignMePS, but may be useful in cases of extremely distantly related proteins for which sequence information is less informative. The open source AlignMe code is available at https://sourceforge.net/projects/alignme/, and at http://www.forrestlab.org, along with an online server and the HOMEP2 data set.
Purpose: Metabolic changes upon antiangiogenic therapy of recurrent glioblastomas (rGBMs) may provide new biomarkers for treatment efficacy. Since in vitro models showed that phospholipid membrane metabolism provides specific information on tumor growth we employed in-vivo MR-spectroscopic imaging (MRSI) of human rGBMs before and under bevacizumab (BVZ) to measure concentrations of phosphocholine (PCho), phosphoethanolamine (PEth), glycerophosphocholine (GPC), and glyceroethanolamine (GPE).
Methods: 1H and 31P MRSI was prospectively performed in 32 patients with rGBMs before and under BVZ therapy at 8 weeks intervals until tumor progression. Patients were dichotomized into subjects with long overall survival (OS) (>median OS) and short OS (<median OS) survival time from BVZ-onset. Metabolite concentrations from tumor tissue and their ratios were compared to contralateral normal-appearing tissue (control).
Results: Before BVZ, 1H-detectable choline signals (total GPC and PCho) in rGBMs were elevated but significance failed after dichotomizing. For metabolite ratios obtained by 31P MRSI, the short-OS group showed higher PCho/GPC (p = 0.004) in rGBMs compared to control tissue before BVZ while PEth/GPE was elevated in rGBMs of both groups (long-OS p = 0.04; short-OS p = 0.003). Under BVZ, PCho/GPC and PEth/GPE in the tumor initially decreased (p = 0.04) but only PCho/GPC re-increased upon tumor progression (p = 0.02). Intriguingly, in normal-appearing tissue an initial PEth/GPE decrease (p = 0.047) was followed by an increase at the time of tumor progression (p = 0.031).
Conclusion: An elevated PCho/GPC ratio in the short-OS group suggests that it is a negative predictive marker for BVZ efficacy. These gliomas may represent a malignant phenotype even growing under anti-VEGF treatment. Elevated PEth/GPE may represent an in-vivo biomarker more sensitive to GBM infiltration than MRI.
In complex networks such as gene networks, traffic systems or brain circuits it is important to understand how long it takes for the different parts of the network to effectively influence one another. In the brain, for example, axonal delays between brain areas can amount to several tens of milliseconds, adding an intrinsic component to any timing-based processing of information. Inferring neural interaction delays is thus needed to interpret the information transfer revealed by any analysis of directed interactions across brain structures. However, a robust estimation of interaction delays from neural activity faces several challenges if modeling assumptions on interaction mechanisms are wrong or cannot be made. Here, we propose a robust estimator for neuronal interaction delays rooted in an information-theoretic framework, which allows a model-free exploration of interactions. In particular, we extend transfer entropy to account for delayed source-target interactions, while crucially retaining the conditioning on the embedded target state at the immediately previous time step. We prove that this particular extension is indeed guaranteed to identify interaction delays between two coupled systems and is the only relevant option in keeping with Wiener’s principle of causality. We demonstrate the performance of our approach in detecting interaction delays on finite data by numerical simulations of stochastic and deterministic processes, as well as on local field potential recordings. We also show the ability of the extended transfer entropy to detect the presence of multiple delays, as well as feedback loops. While evaluated on neuroscience data, we expect the estimator to be useful in other fields dealing with network dynamics.
The Behavioral Inhibition System (BIS) as defined within the Reinforcement Sensitivity Theory (RST) modulates reactions to stimuli indicating aversive events. Gray’s trait Anxiety determines the extent to which stimuli activate the BIS. While studies have identified the amygdala-septo-hippocampal circuit as the key-neural substrate of this system in recent years and measures of resting-state dynamics such as randomness and local synchronization of spontaneous BOLD fluctuations have recently been linked to personality traits, the relation between resting-state dynamics and the BIS remains unexplored. In the present study, we thus examined the local synchronization of spontaneous fMRI BOLD fluctuations as measured by Regional Homogeneity (ReHo) in the hippocampus and the amygdala in twenty-seven healthy subjects. Correlation analyses showed that Gray’s trait Anxiety was significantly associated with mean ReHo in both the amygdala and the hippocampus. Specifically, Gray’s trait Anxiety explained 23% and 17% of resting-state ReHo variance in the left amygdala and the left hippocampus, respectively. In summary, we found individual differences in Gray’s trait Anxiety to be associated with ReHo in areas previously associated with BIS functioning. Specifically, higher ReHo in resting-state neural dynamics corresponded to lower sensitivity to punishment scores both in the amygdala and the hippocampus. These findings corroborate and extend recent findings relating resting-state dynamics and personality while providing first evidence linking properties of resting-state fluctuations to Gray’s BIS.
Background: To compare the effect of aprotinin with the effect of lysine analogues (tranexamic acid and ε-aminocaproic acid) on early mortality in three subgroups of patients: low, intermediate and high risk of cardiac surgery.
Methods and Findings: We performed a meta-analysis of randomised controlled trials and observational with the following data sources: Medline, Cochrane Library, and reference lists of identified articles. The primary outcome measure was early (in-hospital/30-day) mortality. The secondary outcome measures were any transfusion of packed red blood cells within 24 hours after surgery, any re-operation for bleeding or massive bleeding, and acute renal dysfunction or failure within the selected cited publications, respectively.
Out of 328 search results, 31 studies (15 trials and 16 observational studies) included 33,501 patients. Early mortality was significantly increased after aprotinin vs. lysine analogues with a pooled risk ratio (95% CI) of 1.58 (1.13–2.21), p<0.001 in the low (n = 14,297) and in the intermediate risk subgroup (1.42 (1.09–1.84), p<0.001; n = 14,427), respectively. Contrarily, in the subgroup of high risk patients (n = 4,777), the risk for mortality did not differ significantly between aprotinin and lysine analogues (1.03 (0.67–1.58), p = 0.90).
Conclusion: Aprotinin may be associated with an increased risk of mortality in low and intermediate risk cardiac surgery, but presumably may has no effect on early mortality in a subgroup of high risk cardiac surgery compared to lysine analogues. Thus, decisions to re-license aprotinin in lower risk patients should critically be debated. In contrast, aprotinin might probably be beneficial in high risk cardiac surgery as it reduces risk of transfusion and bleeding complications.
The FK506-binding protein 51 (FKBP51) is an Hsp90-associated co-chaperone which regulates steroid receptors and kinases. In pancreatic cancer cell lines, FKBP51 was shown to recruit the phosphatase PHLPP to facilitate dephosphorylation of the kinase Akt, which was associated with reduced chemoresistance. Here we show that in addition to FKBP51 several other members of the FKBP family bind directly to Akt. FKBP51 can also form complexes with other AGC kinases and mapping studies revealed that FKBP51 interacts with Akt via multiple domains independent of their activation or phosphorylation status. The FKBP51-Akt1 interaction was not affected by FK506 analogs or Akt active site inhibitors, but was abolished by the allosteric Akt inhibitor VIII. None of the FKBP51 inhibitors affected AktS473 phosphorylation or downstream targets of Akt. In summary, we show that FKBP51 binds to Akt directly as well as via Hsp90. The FKBP51-Akt interaction is sensitive to the conformation of Akt1, but does not depend on the FK506-binding pocket of FKBP51. Therefore, FKBP inhibitors are unlikely to inhibit the Akt-FKBP-PHLPP network.
The membrane proximal external region (MPER) of the HIV-1 glycoprotein gp41 is targeted by the broadly neutralizing antibodies 2F5 and 4E10. To date, no immunization regimen in animals or humans has produced HIV-1 neutralizing MPER-specific antibodies. We immunized llamas with gp41-MPER proteoliposomes and selected a MPER-specific single chain antibody (VHH), 2H10, whose epitope overlaps with that of mAb 2F5. Bi-2H10, a bivalent form of 2H10, which displayed an approximately 20-fold increased affinity compared to the monovalent 2H10, neutralized various sensitive and resistant HIV-1 strains, as well as SHIV strains in TZM-bl cells. X-ray and NMR analyses combined with mutagenesis and modeling revealed that 2H10 recognizes its gp41 epitope in a helical conformation. Notably, tryptophan 100 at the tip of the long CDR3 is not required for gp41 interaction but essential for neutralization. Thus bi-2H10 is an anti-MPER antibody generated by immunization that requires hydrophobic CDR3 determinants in addition to epitope recognition for neutralization similar to the mode of neutralization employed by mAbs 2F5 and 4E10.
The inner structural Gag proteins and the envelope (Env) glycoproteins of human immunodeficiency virus (HIV-1) traffic independently to the plasma membrane, where they assemble the nascent virion. HIV-1 carries a relatively low number of glycoproteins in its membrane, and the mechanism of Env recruitment and virus incorporation is incompletely understood. We employed dual-color super-resolution microscopy visualizing Gag assembly sites and HIV-1 Env proteins in virus-producing and in Env expressing cells. Distinctive HIV-1 Gag assembly sites were readily detected and were associated with Env clusters that always extended beyond the actual Gag assembly site and often showed enrichment at the periphery and surrounding the assembly site. Formation of these Env clusters depended on the presence of other HIV-1 proteins and on the long cytoplasmic tail (CT) of Env. CT deletion, a matrix mutation affecting Env incorporation or Env expression in the absence of other HIV-1 proteins led to much smaller Env clusters, which were not enriched at viral assembly sites. These results show that Env is recruited to HIV-1 assembly sites in a CT-dependent manner, while Env(ΔCT) appears to be randomly incorporated. The observed Env accumulation surrounding Gag assemblies, with a lower density on the actual bud, could facilitate viral spread . Keeping Env molecules on the nascent virus low may be important for escape from the humoral immune response, while cell-cell contacts mediated by surrounding Env molecules could promote HIV-1 transmission through the virological synapse.
Juvenile Neuronal Ceroid Lipofuscinosis (JNCL) is a rare inherited childhood neurodegenerative disease that is caused by a mutation in the gene CLN3. The function of the protein produced by the gene has remained elusive, and therefore the disease mechanism of JNCL is as of yet unknown. The disease is fatal, and no cure is currently available. We believe that simvastatin shows promise as a possible treatment. Simvastatin is well tolerated in children, and as currently no other viable, less invasive treatment for JNCL exists, at least pilot-scale clinical trials for this new off-label use of simvastatin are warranted.
The protein CLN3 has been indicated to have several different subcellular localizations and functions, but conclusive evidence about its role in cellular metabolism is lacking. It is also unclear why the mutation causes the distinct phenotype of the JNCL disease. In order to bring lucidity to the issue, we set out to identify metabolic pathways related to the phenotype of JNCL by using Multi-Epitope Ligand Cartography (MELC) and the related field of toponomics. Toponomic methods are required to process the massive amount of data generated by the MELC runs in order to extract information from them.
Our disease model of choice was the CLN3Δex7/8 knock-in mouse. To separate cause from effect, we compared embryonal wild type and mutant mouse brains to their adult counterparts. The first analyses revealed progressively abnormal Combinatorial Molecular Patterns (CMPs, an unit of toponomic data) related to cholera toxin/ganglioside 1 (Ctx/GM1), which is a membrane microdomain marker.
Cholesterol is an essential part of microdomains, so we utilized filipin staining to see if there were actual changes in cholesterol concentration and localization between healthy and diseased animals. After the disturbance in cholesterol metabolism was verified, we investigated the metabolic pathway that synthesizes cholesterol, the mevalonate pathway. Simvastatin is a drug that specifically down-regulates the mevalonate pathway. Fish oil affects lipid homeostasis and has some effects similar to those of simvastatin, and both of these drugs have previously been studied for their effects on neurodegenerative diseases. After treatment of mice with these drugs, highperformance liquid chromatography (HPLC) measurements on the brain homogenate showed a decrease in levels of farnesyl pyrophosphate (FPP) and geranyl-geranyl pyrophosphate (GGPP), products of the mevalonate pathway, confirming the effect of these drugs on the brains of the animals. Analyses of motor function of the mice further supported the notion that simvastatin had a positive effect on the condition of the diseased animals.
CMP analyses from the simvastatin treated mice showed a rescue of the Ctx/GM1 CMPs, suggesting at least a partial restoration of membrane microdomain homeostasis. Filipin staining revealed reversion of the apparent cholesterol depletion in the adult mutant mouse hippocampus by simvastatin. Interestingly, an additional effect of the treatment was found: simvastatin also affected glutamate receptor homeostasis, especially as regarding to N-methyl-D-aspartate (NMDA) and alphaamino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) receptors. This finding suggested that excitotoxicity could be a part of the disease process, and pointed towards glutamate receptors as possible therapy targets. This is in line with previous studies that have shown that attenuation of AMPA receptors and L voltage-dependent channels improve the phenotype of a JNCL mouse and cell model, respectively.
Simvastatin mediates many of its effects via downregulation of the mevalonate pathway products, such as isoprenoids and cholesterol. However, simvastatin also has multiple pleiotropic effects that include suppression of excitotoxicity and granting neuroprotection. It is apparent that simvastatin treatment has a positive effect on JNCL mice, but if its effects are mediated via cholesterol (and membrane microdomains), isoprenoids (and isoprenylated proteins) or via a fully cholesterol independent mechanism remains to be solved.
In this study we have shown that with the MELC method and toponomics it is possible to approach rare diseases with confounded disease mechanisms with a hypothesis-free approach, to identify possible drug targets, and to monitor the effects of the drugs on treated individuals. This should open up a new avenue in the research of the many diseases that so far have avoided all attempts at discerning their nature.
Introduction: Acute kidney injury (AKI) can evolve quickly and clinical measures of function often fail to detect AKI at a time when interventions are likely to provide benefit. Identifying early markers of kidney damage has been difficult due to the complex nature of human AKI, in which multiple etiologies exist. The objective of this study was to identify and validate novel biomarkers of AKI.
Methods: We performed two multicenter observational studies in critically ill patients at risk for AKI - discovery and validation. The top two markers from discovery were validated in a second study (Sapphire) and compared to a number of previously described biomarkers. In the discovery phase, we enrolled 522 adults in three distinct cohorts including patients with sepsis, shock, major surgery, and trauma and examined over 300 markers. In the Sapphire validation study, we enrolled 744 adult subjects with critical illness and without evidence of AKI at enrollment; the final analysis cohort was a heterogeneous sample of 728 critically ill patients. The primary endpoint was moderate to severe AKI (KDIGO stage 2 to 3) within 12 hours of sample collection.
Results: Moderate to severe AKI occurred in 14% of Sapphire subjects. The two top biomarkers from discovery were validated. Urine insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2), both inducers of G1 cell cycle arrest, a key mechanism implicated in AKI, together demonstrated an AUC of 0.80 (0.76 and 0.79 alone). Urine [TIMP-2].[IGFBP7] was significantly superior to all previously described markers of AKI (P <0.002), none of which achieved an AUC >0.72. Furthermore, [TIMP-2].[IGFBP7] significantly improved risk stratification when added to a nine-variable clinical model when analyzed using Cox proportional hazards model, generalized estimating equation, integrated discrimination improvement or net reclassification improvement. Finally, in sensitivity analyses [TIMP-2].[IGFBP7] remained significant and superior to all other markers regardless of changes in reference creatinine method.
Conclusions: Two novel markers for AKI have been identified and validated in independent multicenter cohorts. Both markers are superior to existing markers, provide additional information over clinical variables and add mechanistic insight into AKI. Trial registration: ClinicalTrials.gov number NCT01209169.
Background: The students' perception of working conditions in hospitals hasn't been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians.
Methods: The perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey.
Discussion: The iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions.
In dieser Arbeit wurde die physiologische Funktion der Klasse I Methyltransferase Rrp8 bei der Ribosomen-Biogenese der Hefe Saccharomyces cerevisiae untersucht. Ziel war es, die Bedeutung des Proteins für die rRNA-Prozessierungsschritte besser zu verstehen und das Substratmolekül zu identifizieren, das durch die katalytische Aktivität von Rrp8p modifiziert wird.
In einer rrp8-ΔC Mutante, bei der die für die C-terminale Methyltransferase-Domäne codierende Sequenz deletiert vorlag, konnte eine leichte Mengenreduktion der 40S Untereinheit gefunden werden, was für eine Beteiligung von Rrp8p an der Biogenese der kleinen Untereinheit sprach. Unter Anwendung eines artifiziellen Tetrazyklin-Aptamer-Systems, das die Regulation der Expression eines spezifischen Gens erlaubt, wurde eine bereits vorher bekannte synthetische Interaktion mit der essentiellen 90SKomponente Nep1p bestätigt. Mit Hilfe dieses Expressionssystems konnte auch für eine reduzierte Expression von Nop14p, einem Interaktionspartner des Nep1-Proteins, eine synthetisch kranke Beziehung mit rrp8-ΔC festgestellt werden. Zusammen mit der Untersuchung des Sedimentationsverhaltens eines markierten Rrp8-Proteins und bekannten Daten aus der Literatur wiesen die genetischen Analysen darauf hin, dass Rrp8p neben dem Einfluss auf späte Reifungsschritte des 90S prä-Ribosoms auch für die frühen Reifungsschritte der 60S Untereinheit wichtig ist. Weitere Interaktionen mit Faktoren, die an der Translation beteiligt sind (TIF4631, DOM34) und die Messung der Translationsaktivität zeigten, dass der Ausfall von Rrp8p nicht nur die Biogenese verzögert, sondern gleichfalls die Funktionsfähigkeit des Ribosoms beeinflusst.
Die in dieser Arbeit durchgeführte phänotypische Analyse einer rrp8-ΔC tc-GAR1 Doppelmutante unterstützte die Vermutung, dass Rrp8p auch frühe Reifungsschritte der 60S Untereinheit beeinflusst. Mit einem in vitro Experiment konnte die Bindung von SAM an Rrp8p gezeigt werden und RP-HPLC Analysen der 25S rRNA verdeutlichten, dass Rrp8p neben dem Einfluss auf die Prozessierungsstelle A2 für die m1A645 Modifikation in Helix 25.1 verantwortlich ist. Die phänotypische Untersuchung einer von P. Kötter und S. Lamberth angefertigten rRNA Mutante (A645U) zeigte, dass die Sequenzveränderung innerhalb der Helix 25.1 der 25S rRNA, die zugleich zum Verlust der Modifikation führt, eine deutliche Auswirkung auf das Zellwachstum und auf das Polysomenprofil hat. Ähnliche Polysomenprofile wurden in den Mutanten rrp8-G209R und rrp8-G209A beobachtet, die ein punktmutiertes Rrp8-Protein exprimieren. Eine reduzierte SAM-Bindungsaktivität des mutierten Proteins führte ebenfalls zu einer reduzierten Menge an m1A645 modifizierter 25S rRNA. Eine im Unterschied zur rrp8-ΔC Mutante auftretende Reduktion der 60S Untereinheit in den Punktmutanten spricht für einen bisher noch unbekannten Einfluss von Rrp8p auf die Biogenese der 60S Untereinheit.
In Zusammenarbeit mit S. Sharma durchgeführte 2D-DIGE Experimente und quantitative Messungen von Transkriptmengen zeigten, dass im Vergleich zu einem Wildtyp-Stamm in einer rrp8-ΔC Mutante einige glykolytische Enzyme in geringerem Maße exprimiert werden, was in Zusammenhang mit einer in höheren Eukaryoten bekannten nukleolären Stressantwort gebracht werden kann. Dies verdeutlicht die komplexe Wechselwirkung zwischen der Ribosomenfunktion und dem Energiemetabolismus.
Im Rahmen einer prospektiven Kohortenstudie wurde in der vorliegenden Arbeit die Epidemiologie und Ätiologie von Fieber während chemotherapiebedingter Neutropenie bei Patienten mit hämatologischen Neoplasien untersucht. Das diagnostische und therapeutische Vorgehen wurde beschrieben und die Übereinstimmung mit den Vorgaben einer hausinternen Leitlinie wurde evaluiert und der Verbrauch an antimikrobiellen Substanzen dokumentiert. Febrile Episoden konnten in 74% der Neutropenieepisoden dokumentiert werden; in 51% der Neutropenieepisoden kam es zu persistierendem Fieber ≥ 3 Tage. Eine dem Fieber zugrunde liegende Infektion wurde in 55% der Chemotherapiezyklen (Neutropeniedauer Median 16 Tage) mittels klinischer, apparativer und mikrobiologischer Diagnostik gefunden. Die häufigsten infektiösen Komplikationen waren Enteritiden mit Nachweis von C. difficile (11%), Enteritiden ohne Nachweis von C. difficile (29%), Pneumonien mit pilztypischen Infiltraten (12%) und Pneumonien mit unspezifischen Infiltraten (11%), sowie mikrobiologisch bestätigte Septikämien (18%). Im Vergleich zu Angaben in der Literatur wurde FUO in der vorliegenden Untersuchung häufiger diagnostiziert (11,8 Tage pro 1000 Patiententage vs. 8,2 Tage pro 1000 Patiententage). Die Gesamtmortalität des Kollektivs lag bei 7%. Die häufigste Todesursache war der septische Schock (8 von 5 Patienten; 63%), welcher sich auf dem Boden einer gramnegativen Septikämie mit multiresistenten Keimen entwickelt hatte (3 von 5 Septikämien; 60%). Die Mortalitätsrate war ähnlich hoch wie im Literaturvergleich bei Studien mit akuten myeloischen Leukämien. Prognoserelevante Faktoren, welche im Rahmen der vorliegenden Studie evaluiert wurden, sind durch schwer therapierbare Grunderkrankungen hervorgerufene prolongierte Neutropeniezeiten, sowie infektiöse Komplikationen, vor allem bei Nachweis multiresistenter Erreger.
Die Compliance bezüglich des diagnostischen und therapeutischen Vorgehens bei persistierendem Fieber betrug in der vorliegenden Arbeit zwischen 47% und 82%. Die Compliance mit den in der Leitlinie vorgeschlagenen antimikrobiellen prophylaktischen und initialen empirischen Therapien lag zwischen 83% und 85%. Der Gesamtverbrauch an antibiotischen und antimykotischen Substanzen war in der vorliegenden Studie höher als im Literaturvergleich (1647 DDD vs. 1140 DDD und 650 DDD vs. 430 DDD). Dabei fällt insbesondere der hohe Verbrauch an Reservemedikamenten gegen grampositive Bakterien auf. Allerdings fehlen aktuelle Vergleichsdaten vergleichbarer Patientenkollektive.
Bezüglich der Optimierung der diagnostischen Maßnahmen ist vor allem die Erhöhung der Sensitivität der Bronchoalveolären Lavage bei Pilzinfektionen, rechtzeitig und regelmäßig durchgeführte Surveillanceabstriche bei febriler Neutropenie, sowie die Diskussion der diagnostischen Ergebnisse und des weiteren therapeutischen Vorgehens mit infektiologischen Experten zu fordern. Patienten mit persistierendem Fieber - vor allem bei positivem Blutkulturnachweis - sollten, aufgrund des positiven prädiktiven Wertes erregerpositiver Blutkulturen für die Notwendigkeit einer intensivmedizinischen Betreuung und einer erhöhten Mortalität, Anlass sein, diagnostische und therapeutische Maßnahmen zu verbessern. Ziel ist es, durch verstärkten Einsatz diagnostischer Maßnahmen und Diskussion mikrobiologischer Befunde im Einzelfall, Reservesubstanzen seltener einzusetzen, gegebenenfalls Breitspektrum-Antibiotika oder ihre Kombinationen zu deeskalieren und somit die Kolonisation mit resistenten Erregern positiv zu beeinflussen, sowie das Ansprechen auf antimikrobielle Therapien zu optimieren.
Die Teilnahme an multizentrischen Surveillancestudien zur Inzidenzerfassung wichtiger, eindeutig definierter neutropener nosokomialer Infektionen wie radiologisch detektierter Pneumonien, mikrobiologisch bestätigter Septikämien und C. difficilepositiver Enteritiden, sowie zur Generierung von Antiinfektivaverbrauchszahlen, könnte helfen, die Beratung und Entscheidungsfindung am Krankenbett zu unterstützen. Auch könnten in diesem Rahmen Zahlen generiert werden, welche bisher zum Vergleich fehlten.
Die vorliegende Arbeit versteht sich im Rahmen der Erfassung von Ätiologie, Diagnostik und antimikrobieller Therapien bei febriler Neutropenie als Teil eines solchen Surveillanceprogrammes und hat somit eine Grundlagen für zukünftige Datenerhebungen geliefert.
This research was conducted in the Rwenzori Region of the Western Branch, East African Rift System (EARS). The EARS is a tectonic structure extending over a length of more than 3000 km from the Afar Triple Junction, in Ethiopia, to Lake Malawi in the south. The Western Rift System is a roughly NE to ENE trending sector of the EARS, which runs along the western boundary of Uganda and the neighboring Democratic Republic of Congo (D.R.C). It stretches 2100 km from Nimule, NW on Uganda-Sudan border, extending to Lake Malawi in the SE of Africa. The unusual uplift of the Rwenzori Mountains within an extensional regime and the mechanisms associated with the high frequency of seismic activity in the region was hardly understood and therefore, had remained a subject of contention that needed to be critically addressed in detail. To my knowledge, this was probably the first study to be performed and documented in great depth within the domains of seismic noise variation, seismic anisotropy and b value analyses beneath the Rwenzori Region. After about six years of operation (2006-2012), the seismology group of the RIFTLINK Research Project (www.riftlink.org) acquired a vast amount of high-quality, digital data that were collected using a seismic network of well calibrated seismic equipment. The project was divided into two phases. Phase I, that operated between February 2006 - September 2007, consisted of thirty-two temporary seismic stations, which were selectively spread out in the Rwenzori Region on the Ugandan side, to detect and record extremely weak as well as strong naturally occurring earthquakes. The seismic equipment used included EDL and REFTEK digitizers, which were coupled with Güralp and MARK sensors respectively (REFTEKS: only short-period MARK sensors, EDLs: short-period MARK plus few broadband Güralp Sensors). Exactly 22375 earthquakes were recorded. The data were processed using the SEISAN software package. About 14413 earthquakes were carefully localized using the velocity model of Bram (1975) that implements a Vp=Vs ratio fixed at 1.74. Phase II, that extended between 2009-2012 consisted of thirty-two seismic stations, which were spread out around the Rwenzori Mountains, both on the Ugandan side and the neighboring D.R.C. Only Taurus digitizers that were coupled with Trillium sensors were used in the D.R.C. On the Ugandan side however, both EDL and Taurus digitizers, which were coupled with Trillium and Güralp sensors were used. ...
Between the 12th and 16th centuries the Hanseatic merchants obtained extremely important privileges from the rulers of the countries with whom they traded. These secured their commercial and legal status and the autonomy of their staples in Flanders, England, Norway, Denmark and Russia. Within these privileges no other subject receives so extensive a treatment as court procedure. Here, the single most important concern of the Hanseatic merchants was their position in front of alien courts. The article analyses the great attention given to court procedure in the twenty main Hanseatic privileges: What did the merchants require? Which procedural rules were necessary to encourage them to submit their disputes to alien public court instead of taking the matter into their own hands and turning to extra-judicial methods to resolve matters, e.g. cancellation of business relations, boycotts or even trade wars? This analysis suggests that the two most important concerns reflected in the procedural rules were to avoid delay to the next trading trip and to ensure a rational law of proof. The former was addressed by pressing for short-term scheduling and swift judgment and by the dispensation from appearing before the court in person. The latter included avoidance of duels and other ordeals and the attempt to obtain parity by appointing half of the jurors from Hanseatic cities.
In der modernen Hochschullehre haben sich eLearning-Elemente als ein Teil des Lehrrepertoires etabliert. Der Einsatz interaktiver webbasierter Selbstlernmodule (Web Based Trainings (WBT)) ist dabei eine Option. Hochschulen und Unternehmen versprechen sich dadurch neue Möglichkeiten des Lehrens und Lernens, um z. B. einen Ausgleich heterogener Vorerfahrungen sowie eine stärkere aktive Beteiligung der Lernenden zu bewirken. Damit die Erstellung und Strukturierung dieser Inhalte mit möglichst geringem Aufwand erfolgen kann, bieten Autorensysteme Unterstützung.
Zu den Grundfunktionen von Autorensystemen gehören unter anderem, das Einbinden gebräuchlicher Medienformate, die einfache Erstellung von Fragen sowie verschiedene Auswertungs- und Feedbackmöglichkeiten. Obwohl Autorensysteme schon vor vielen Jahren ihre erste praktische Anwendung fanden, gibt es nach wie vor Schwachstellen, die sich auf den gesamten Erstellungsprozess wie auch auf einzelne Funktionen beziehen. Im Detail wird bemängelt, dass die Werkzeuge zu komplex und unflexibel sind. Darüber hinaus fehlt häufig eine zufriedenstellende Verknüpfung der vielen Werkzeuge entlang der Prozesskette zu einer Gesamtlösung.
Des Weiteren wird die Konzentration auf die Produktionsphase kritisiert, wodurch andere wichtige Prozesse in den Hintergrund treten bzw. außer Acht gelassen werden.
Im Rahmen der Zusammenarbeit mit einem Automobilhersteller, für den die erste Version des Autorensystems LernBar weiterentwickelt wurde, spielte der Begriff „Lean Production“ inhaltlich in der Umsetzung der WBTs eine wesentliche Rolle. Die Lean Production, die über viele Jahre für die Automobilindustrie entwickelt, verbessert und angepasst wurde, liefert Optimierungsansätze für den Produktionsbereich. Ein wirtschaftlicher Nutzen des Lean-Ansatzes wird auch in anderen Bereichen gesehen wie z. B. in der Softwareentwicklung („Lean Software Development“) oder im Management („Lean Management“). Dabei bietet die Wertschöpfungsorientierung Lösungen für die widersprüchlichen Ziele mehr Leistungen zu geringeren Kosten, schneller und in höherer Qualität zugleich zu liefern. Aus der Grundidee der Lean Production entwickelte sich vorliegendes Dissertationsthema in Bezug darauf, inwiefern sich diese Prinzipien auf den WBT-Produktionsprozess übertragen lassen und die LernBar (das hierfür weiterentwickelnde Autorensystem) dabei Unterstützung bieten kann.
Zunächst wurde analysiert, welche Werkzeuge und Hilfestellungen benötigt werden, um unter dem Aspekt der Lean Production WBTs im universitären Umfeld erstellen zu können. In diesem Zusammenhang wurden Merkmale einer „Lean Media Production“ definiert sowie konzeptionell und technisch umgesetzt. Zur Verbesserung der Prozesse flossen Ergebnisse aus empirischer und praktischer Forschung ein. Im Vergleich zu anderen Entwicklungen bei denen häufig das Hauptziel eine umfangreiche Funktionalität ist, werden u.a. folgende übertragbare Ziele bei der Umsetzung verfolgt: Verschwendung vermeiden, eine starke Einbeziehung der Kunden, Werkzeuge die nahtlos ineinandergreifen, eine hohe Flexibilität und eine stetige Qualitätsverbesserung.
Zur Erreichung dieser Zielsetzungen wurden alle Prozesse kontinuierlich verbessert, sich auf das Wesentliche und die Wertschöpfung konzentriert sowie überflüssige Schritte eliminiert. Demnach ist unter dem Begriff „Lean Media Production“ ein skalierbarer, effizienter und effektiver Produktionsprozess zu verstehen, in dem alle Werkzeuge ineinandergreifen.
Die Realisierung der „Lean Media Production“ erfolgte anhand des Autorensystems LernBar, wobei die typischen Softwareentwicklungsphasen Entwurf, Implementierung und Evaluierung mehrfach durchlaufen wurden. Ausschlaggebend dabei war, dass der „Lean“-Aspekt berücksichtigt wurde und dies somit eine neue Vorgehensweise bei der Umsetzung eines Autorensystems darstellt. Im Verlauf der Entwicklungen ergaben sich, durch eine formative Evaluation, den Einsatz in Projekten und eine empirische Begleitforschung, neue Anforderungen an das System. Ein Vergleich der zwei Produktionssysteme, Automobil vs. WBT-Produktion, zeigt und bestätigt die Erwartung, dass nicht alle Prinzipien der Lean Production übertragbar sind.
Dennoch war diese Untersuchung notwendig, da sie Denkanstöße zur Entwicklung und Optimierung des Erstellungsprozesses eines WBTs gab. Auch die Ergebnisse der abschließenden Online-Befragung ergaben, dass die Ziele der Arbeit erreicht wurden, dass aber weiterer Optimierungsbedarf besteht. Die LernBar Release 3 bietet für alle Produktionsphasen Werkzeuge an, durch die eine effektive und effiziente Erstellung von WBTs von der Idee bis zur Distribution möglich ist.
Stand noch vor fünf Jahren zu Beginn dieser Arbeit das Endprodukt bei der LernBar Entwicklung im Vordergrund, verlagerte sich durch den Einfluss dieser Dissertation der Schwerpunkt auf den gesamten Produktionsprozess. Unter Berücksichtigung der in diesem Zusammenhang entwickelten Prinzipien einer „Lean Media Production“, nehmen bspw. die Wirtschaftlichkeit und die starke Kundenorientierung während des Produktionsprozesses einen wichtigen Stellenwert ein. Dieser Ansatz ist eine neue Vorgehensweise im Bereich der Entwicklung von Autorensystemen, der seine Anerkennung und Professionalität durch die Ergebnisse des selbstentwickelten Evaluationsbogens sowie dem stetig wachsenden Einsatz in Schulen, Hochschulen und Unternehmen belegen kann.
In weiteren Forschungsarbeiten ist zu untersuchen, welche Lean Production Prinzipien zu verwenden oder anzupassen sind, wenn z. B. in größeren Teams oder mobil produziert wird. Des Weiteren sollte überprüft werden, inwieweit die Lernenden mit dem Endprodukt zufrieden sind und in ihrem Lernprozess unterstützt werden. Durch diese Forschungsarbeit wurde ein Beitrag dazu geleistet, die Lehre und Ausbildung zu optimieren, indem die Autoren/Lehrende in der Erstellung ihrer digitalen Lerninhalte im gesamten Prozess von aufeinander abgestimmten Werkzeugen unterstützt werden.
kurz und kn@pp news : Nr. 27
(2013)
In dieser Arbeit wurde eine Messmethode entwickelt, die es ermöglicht, mittels Infrarotspektroskopie quantitative Aussagen über bestimmte Inhaltsstoffe in Körperflüssigkeiten zu machen. Hierfür wurden sowohl selektierte Blutplasma- und Vollblutproben gemessen als auch selektierte Urinproben. Die richtige Selektion des Probensatzes ist von großer Wichtigkeit, um für jede Komponente eine große, unabhängige Varianz der Absorptionswerte zu erhalten. Hierfür wurden sowohl physiologische als auch pathologische Proben in den Datensatz integriert. Um Referenzwerte für diese ausgewählten Proben zu erhalten, wurden konventionelle klinische Methoden verwendet. Grundsätzlich ist die Genauigkeit dieser Methode durch die Genauigkeit der jeweiligen Referenzmethode, also den konventionellen klinischen Methoden, beschränkt. Mit der neu entwickelten Methode besteht nun die Möglichkeit, die wichtigsten Parameter im Blut und Urin schnell, einfach und reagenzienfrei quantitativ zu bestimmen. Zusätzlich zu den in dieser Arbeit angegebenen Inhaltsstoffen ist es möglich, für weitere Komponenten oberhalb eines bestimmten Schwellenwerts quantitative Angaben zu machen. Hierbei könnten z.B. für Albumin oder Glukose im Urin pathologische Proben identifiziert werden und somit Rückschlüsse auf bestimmte Krankheitsbilder ermöglicht werden. ...
In the absence of apparent mutations, alteration of gene expression patterns represents the key mechanism by which normal cells evolve to cancer cells.
Gene expression is tightly regulated by posttranscriptional processes. Within this context, RNA-binding proteins (RBPs) represent fundamental factors, since they control mechanisms, such as mRNA-stabilization, -translation and -degradation. Human antigen R (HuR) was among the first RBPs that have been directly associated to carcinogenesis. HuR modulates the stability and translation of mRNAs which encode proteins facilitating various ‘hallmarks of cancer’, namely proliferation, evasion of growth suppression, angiogenesis, cell death resistance, invasion and metastasis. Furthermore, it is well established that tumor-promoting inflammation contributes to tumorigenesis. In this process, monocytes are attracted to the site of the tumor and educated towards a tumor-promoting macrophage phenotype. While HuR has been extensively studied in various tumor cell types, little is known about HuR in hepatocellular carcinoma (HCC). Thus, the aim of my work was to characterize the contribution of HuR to the development of cancer characteristics in HCC. I was particularly interested to investigate if HuR facilitates tumor-promoting inflammation, since a role for HuR has not been described in this context. To this end, I depleted HuR in HepG2 cells (HuR k/d) and used a co-culture model of HepG2 tumor spheroids and infiltrating monocytes to study the impact of HuR on the tumor microenvironment. I could show that depletion of HuR resulted in the reduction of cell numbers. Additionally, the expression of proliferation marker KI-67 and proto-oncogene c-Myc was reduced, supporting a proliferative role of HuR. Furthermore, exposure to cytotoxic staurosporine elevated apoptosis in HuR k/d cells compared to control cells. Concomitantly, the expression of the anti-apoptotic mediator B-cell lymphoma protein-2 (Bcl-2) was markedly reduced in the HuR k/d cells, pointing to an involvement of HuR in cell survival processes.
Accordingly, a pro-survival function of HuR was also observed in tumor spheroids, since HuR k/d spheroids exhibited a larger necrotic core region at earlier time points and showed elevated numbers of dead cells compared to control (Ctr.) spheroids. Interestingly, HuR k/d spheroids isplayed reduced numbers of infiltrated macrophages, suggesting that HuR contributes to a tumor-promoting, inflammatory microenvironment by recruiting monocytes/macrophages to the tumor site. Aiming at identifying HuR-regulated factors responsible for the recruitment of monocytes, I found reduced levels of the chemokine interleukin 8 (IL-8) in supernatants of HuR k/d spheroids, supporting a critical involvement of HuR in the chemoattraction of monocytes. Analyzing supernatants of co-cultures of macrophages and HuR k/d or Ctr. spheroids revealed additional differences in chemokine secretion patterns. Interestingly, protein levels of many chemokines were elevated in co-cultures of HuR k/d spheroids compared to control co-cultures. Albeit enhanced chemokine secretion was observed, less monocytes are recruited into HuR k/d spheroids, further underlining the necessity of HuR in cancer related monocyte/macrophage attraction and infiltration. Differences between chemokine profiles of mono- and co-cultured spheroids could be attributable to changes in spheroid-derived chemokines as a result of the crosstalk with the immune cells. Provided the chemokines originate from monocytes/macrophages, the different secretion patterns suggest that HuR contributes to the modulation of the functional phenotype of infiltrated macrophages, since the tumorenvironment is critically involved in the shaping of macrophage phenotypes. Regions of low-oxygen (hypoxia) represent another critical feature of tumors. Therefore, I next analyzed the impact of HuR on the hypoxic response. Loss of HuR attenuated hypoxia-inducible factor (HIF) 2α expression after exposure to hypoxia, while HIF-1α protein levels remained unaltered. Considering previous results of our group, showing that HIF-2α depletion (HIF-2α k/d) resulted in the enhanced expression of HIF-1α protein, I aimed to determine the involvement of HuR in the compensatory upregulation of HIF-1α protein in HIF-2α k/d cells. I could demonstrate that not only total HuR protein levels, but specifically cytoplasmic HuR was elevated in HIF-2α depleted cells pointing to enhanced HuR activity. Silencing HuR in HIF-2α deficient cells attenuated enhanced HIF-1α protein expression, thus confirming a direct role of HuR in the compensatory upregulation of HIF-1α. This as also reflected on HIF-1α target gene expression. I further investigated the mechanism underlying the compensatory HIF-1α expression in HIF-2α deficient cells. Analyzing HIF-1α mRNA expression, I excluded enhanced HIF1-α transcription and stability to account for elevated HIF-1α expression in HIF-2α k/d cells. HIF-1α promoter activity assays confirmed the mRNA data. Furthermore, HIF-1α protein half-life was not elevated in HIF-2α k/d cells compared to control cells, indicating that HIF-1α protein stability is not altered in HIF-2α k/d cells. Analysis of the association of HIF-1α with the translational machinery using polysomal fractionation finally revealed an increased istribution of HIF-1α mRNA in the heavier polysomal fractions in HIF-2α k/d cells compared to control cells. Since augmented ribosome occupancy is an indicator for more efficient translation, I propose enhanced HIF-1α translation as underlying principle of the compensatory increase in HIF-1α protein levels in HIF-2α k/d cells. In summary, my results demonstrate that HuR is critical for the development of cancer characteristics in HCC. Future work analyzing the impact of HuR on tumor-promoting inflammation, specifically macrophage attraction and activation could provide new trategies to inhibit macrophage-driven tumor progression. Furthermore, I provide evidence that HuR contributes to the hypoxic response by regulating the expression of HIF-1α and HIF-2α. Targeting single HIF-isoforms for tumor therapy should be carefully considered, because of their compensatory regulation when one α-subunit is depleted. Thus, therapeutic strategies targeting factors such as HuR that control both α-subunits and at the same time prevent compensation might be more promising.
Since most anticancer therapies including immunotherapy trigger programmed cell death in cancer cells, defective cell death programs can lead to treatment resistance and tumor immune escape. Therefore, evasion of programmed cell death may provide one possible explanation as to why cancer immunotherapy has so far only shown modest clinical benefits for children with cancer. A better understanding of the molecular mechanisms that regulate sensitivity and resistance to programmed cell death is expected to open new perspectives for the development of novel experimental treatment strategies to enhance the efficacy of cancer immunotherapy in the future.
Cataract surgery is one of the oldest and the most frequent outpatient clinic operations in medicine performed worldwide. The clouded human crystalline lens is replaced by an artificial intraocular lens implanted into the capsular bag. During the last six decades, cataract surgery has undergone rapid development from a traumatic, manual surgical procedure with implantation of a simple lens to a minimally invasive intervention increasingly assisted by high technology and a broad variety of implants customized for each patient’s individual requirements. This review discusses the major advances in this field and focuses on the main challenge remaining – the treatment of presbyopia. The demand for correction of presbyopia is increasing, reflecting the global growth of the ageing population. Pearls and pitfalls of currently applied methods to correct presbyopia and different approaches under investigation, both in lens implant technology and in surgical technology, are discussed.
Projections of future changes in runoff can have important implications for water resources and flooding. In this study, runoff projections from ISI-MIP (Inter-sectoral Impact Model Intercomparison Project) simulations forced with HadGEM2-ES bias-corrected climate data under the Representative Concentration Pathway 8.5 have been analysed. Projections of change from the baseline period (1981–2010) to the future (2070–2099) from a number of different ecosystems and hydrological models were studied. The differences between projections from the two types of model were looked at globally and regionally. Typically, across different regions the ecosystem models tended to project larger increases and smaller decreases in runoff than the hydrological models. However, the differences varied both regionally and seasonally. Sensitivity experiments were also used to investigate the contributions of varying CO2 and allowing vegetation distribution to evolve on projected changes in runoff. In two out of four models which had data available from CO2 sensitivity experiments, allowing CO2 to vary was found to increase runoff more than keeping CO2 constant, while in two models runoff decreased. This suggests more uncertainty in runoff responses to elevated CO2 than previously considered. As CO2 effects on evapotranspiration via stomatal conductance and leaf-area index are more commonly included in ecosystems models than in hydrological models, this may partially explain some of the difference between model types. Keeping the vegetation distribution static in JULES runs had much less effect on runoff projections than varying CO2, but this may be more pronounced if looked at over a longer timescale as vegetation changes may take longer to reach a new state.
Die Gattung Tragopogon (Bocksbart) gehört zu den zungenblütigen Korbblütlern (Asteraceae Unterfamilie Cichorioideae). In diesem Verwandtschaftskreis fällt sie durch schmale, parallelnervige, grasartige Blätter auf (Abb. 3). In Kultur und im Mittelmeerraum gibt es neben gelb blühenden Arten (wie in dieser Arbeit besprochen) auch Arten mit rötlichen bis lilafarbenen Blüten. Ein Beispiel ist der als Wurzelgemüse kultivierte T. porrifolius (Gemüse- Haferwurz). In Nordrhein-Westfalen sind drei Tragopogon-Arten etabliert: der Große Bocksbart (T. dubius) sowie die nah verwandten Wiesen-Bocksbart (T. pratensis) und Orientalischer Bocksbart (T. orientalis). Neben diesen Arten wird in dieser Arbeit noch der Kleine Bocksbart (T. minor) besprochen, für den abweichende Pflanzen von T. pratensis immer wieder gehalten werden.
Der Kaffeestrauch gehört zu der großen, weltweit verbreiteten Pflanzenfamilie der Rubiaceae (Rötegewächse) und hier zur Gattung Coffea. Die am häufigsten kultivierten Arten sind C. arabica (Arabica-Kaffee), ursprünglich aus Äthiopien und Sudan, und C. canephora (Robusta-Kaffee), der ursprünglich aus West- und Zentral-Afrika, Sudan, Uganda und Angola stammt.
Der Beitrag stellt im Überblick dar, welche Bedeutung das Immaterialgüterrecht (IP) für die Entwicklung einzelner Volkswirtschaften und die globale Wissensgesellschaft hat. In einem ersten Abschnitt wird erläutert, dass in der Geschichte des Immaterialgüterrechts die Vorstellung dominierte, dass Immaterialgüterrechte technologischem und sonstigem Fortschritt zuträglich sind. Im zweiten Abschnitt wird gezeigt, dass dieses lineare Expansions-Narrativ aus ökonomischer und wirtschaftshistorischer Sicht als widerlegt gelten muss. Dazu werden die Argumente der IP-Optimisten und die Gegenargumente der IP-Pessimisten anhand empirischer Studien bewertet. Der Beitrag schließt mit sozialwissenschaftlichen und normativen Schlussfolgerungen im Hinblick auf die künftige Ausgestaltung des internationalen Immaterialgüterrechts.
Artificial environments for the co-translational stabilization of cell-free expressed proteins
(2013)
An approach for designing individual expression environments that reduce or prevent protein aggregation and precipitation is described. Inefficient folding of difficult proteins in unfavorable translation environments can cause significant losses of overexpressed proteins as precipitates or inclusion bodies. A number of chemical chaperones including alcohols, polyols, polyions or polymers are known to have positive effects on protein stability. However, conventional expression approaches can use such stabilizing agents only post-translationally during protein extraction and purification. Proteins that already precipitate inside of the producer cells cannot be addressed. The open nature of cell-free protein expression systems offers the option to include single chemicals or cocktails of stabilizing compounds already into the expression environment. We report an approach for systematic screening of stabilizers in order to improve the solubility and quality of overexpressed proteins co-translationally. A comprehensive list of representative protein stabilizers from the major groups of naturally occurring chemical chaperones has been analyzed and their concentration ranges tolerated by cell-free expression systems have been determined. As a proof of concept, we have applied the method to improve the yield of proteins showing instability and partial precipitation during cell-free synthesis. Stabilizers that co-translationally improve the solubility and functional folding of human glucosamine 6-phosphate N-acetyltransferase have been identified and cumulative effects of stabilizers have been studied.
Ambrosia artemisiifolia L., native to North America, is a problematic invasive species, because of its highly allergenic pollen. The species is expected to expand its range due to climate change. By means of ecological niche modelling (ENM), we predict habitat suitability for A. artemisiifolia in Europe under current and future climatic conditions. Overall, we compared the performance and results of 16 algorithms commonly applied in ENM. As occurrence records of invasive species may be dominated by sampling bias, we also used data from the native range. To assess the quality of the modelling approaches we assembled a new map of current occurrences of A. artemisiifolia in Europe. Our results show that ENM yields a good estimation of the potential range of A. artemisiifolia in Europe only when using the North American data. A strong sampling bias in the European Global Biodiversity Information Facility (GBIF) data for A. artemisiifolia causes unrealistic results. Using the North American data reflects the realized European distribution very well. All models predict an enlargement and a northwards shift of potential range in Central and Northern Europe during the next decades. Climate warming will lead to an increase and northwards shift of A. artemisiifolia in Europe.
Introduction. Cancellous bone is frequently used for filling bone defects in a clinical setting. It provides favourable conditions for regenerative cells such as MSC and early EPC. The combination of MSC and EPC results in superior bone healing in experimental bone healing models. Materials and Methods. We investigated the influence of osteogenic culture conditions on the endothelial properties of early EPC and the osteogenic properties of MSC when cocultured on cancellous bone. Additionally, cell adhesion, metabolic activity, and differentiation were assessed 2, 6, and 10 days after seeding.
Results. The number of adhering EPC and MSC decreased over time; however the cells remained metabolically active over the 10-day measurement period. In spite of a decline of lineage specific markers, cells maintained their differentiation to a reduced level. Osteogenic stimulation of EPC caused a decline but not abolishment of endothelial characteristics and did not induce osteogenic gene expression. Osteogenic stimulation of MSC significantly increased their metabolic activity whereas collagen-1α and alkaline phosphatase gene expressions declined. When cocultured with EPC, MSC’s collagen-1α gene expression increased significantly. Conclusion. EPC and MSC can be cocultured in vitro on cancellous bone under osteogenic conditions, and coculturing EPC with MSC stabilizes the latter’s collagen-1α gene expression.
The purpose of the present study was to examine the effects of cooperative training strategies to enhance students' socioscientific decision making as well as their metacognitive skills in the science classroom. Socioscientific decision making refers to both “describing socioscientific issues” as well as “developing and evaluating solutions” to socioscientific issues. We investigated two cooperative training strategies which differed with respect to embedded metacognitive instructions that were developed on the basis of the IMPROVE method. Participants were 360 senior high school students who studied either in a cooperative learning setting (COOP), a cooperative learning setting with embedded metacognitive questions (COOP+META), or a nontreatment control group. Results indicate that students in the two training conditions outperformed students in the control group on both processes of socioscientific decision making. However, students in the COOP+META condition did not outperform students in the COOP condition. With respect to students' learning outcomes on the regulation facet of metacognition, results indicate that all conditions improved over time. Students in the COOP+META condition exhibited highest mean scores at posttest measures, but again, results were not significant. Implications for integrating metacognitive instructions into science classrooms are discussed.
While necroptosis has for long been viewed as an accidental mode of cell death triggered by physical or chemical damage, it has become clear over the last years that necroptosis can also represent a programmed form of cell death in mammalian cells. Key discoveries in the field of cell death research, including the identification of critical components of the necroptotic machinery, led to a revised concept of cell death signaling programs. Several regulatory check and balances are in place in order to ensure that necroptosis is tightly controlled according to environmental cues and cellular needs. This network of regulatory mechanisms includes metabolic pathways, especially those linked to mitochondrial signaling events. A better understanding of these signal transduction mechanisms will likely contribute to open new avenues to exploit our knowledge on the regulation of necroptosis signaling for therapeutic application in the treatment of human diseases.
CSF and serum biomarkers focusing on cerebral vasospasm and ischemia after subarachnoid hemorrhage
(2013)
Delayed cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) remain severe complications after subarachnoid hemorrhage (SAH). Although focal changes in cerebral metabolism indicating ischemia are detectable by microdialysis, routinely used biomarkers are missing. We therefore sought to evaluate a panel of possible global markers in serum and cerebrospinal fluid (CSF) of patients after SAH.
CSF and serum of SAH patients were analyzed retrospectively. In CSF, levels of inhibitory, excitatory, and structural amino acids were detected by high-performance liquid chromatography (HPLC). In serum, neuron-specific enolase (NSE) and S100B level were measured and examined in conjunction with CVS and DCI. CVS was detected by arteriography, and ischemic lesions were assessed by computed tomography (CT) scans.
All CSF amino acids were altered after SAH. CSF glutamate, glutamine, glycine, and histidine were significantly correlated with arteriographic CVS. CSF glutamate and serum S100B were significantly correlated with ischemic events after SAH; however, NSE did not correlate neither with ischemia nor with vasospasm. Glutamate, glutamine, glycine, and histidine might be used in CSF as markers for CVS. Glutamate also indicates ischemia. Serum S100B, but not NSE, is a suitable marker for ischemia. These results need to be validated in larger prospective cohorts.
Background: This phase I/II-trial assessed the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of neoadjuvant radiochemotherapy (RCT) with docetaxel and oxaliplatin in patients with locally advanced adenocarcinoma of the oesophagogastric junction.
Methods: Patients received neoadjuvant radiotherapy (50.4 Gy) together with weekly docetaxel (20 mg/m2 at dose level (DL) 1 and 2, 25 mg/m2 at DL 3) and oxaliplatin (40 mg/m2 at DL 1, 50 mg/m2 at DL 2 and 3) over 5 weeks. The primary endpoint was the DLT and the MTD of the RCT regimen. Secondary endpoints included overall response rate (ORR) and progression-free survival (PFS).
Results: A total of 24 patients were included. Four patients were treated at DL 1, 13 patients at DL 2 and 7 patients at DL 3. The MTD of the RCT was considered DL 2 with docetaxel 20 mg/m2 and oxaliplatin 50 mg/m2. Objective response (CR/PR) was observed in 32% (7/22) of patients. Eighteen patients (75%) underwent surgery after RCT. The median PFS for all patients (n = 24) was 6.5 months. The median overall survival for all patients (n = 24) was 16.3 months. Patients treated at DL 2 had a median overall survival of 29.5 months.
Conclusion: Neoadjuvant RCT with docetaxel 20 mg/m2 and oxaliplatin 50 mg/m2 was effective and showed a good toxicity profile. Future studies should consider the addition of targeted therapies to current neoadjuvant therapy regimens to further improve the outcome of patients with advanced cancer of the oesophagogastric junction.
Trial Registration: NCT00374985
Background: Interferon and ribavirin therapy for chronic hepatitis C virus (HCV) infection yields sustained virological response (SVR) rates of 50–80%. Several factors such as non-1 genotype, beneficial IL28B genetic variants, low baseline IP-10, and the functionality of HCV-specific T cells predict SVR. With the pending introduction of new therapies for HCV entailing very rapid clearance of plasma HCV RNA, the importance of baseline biomarkers likely will increase in order to tailor therapy. CD26 (DPPIV) truncates the chemokine IP-10 into a shorter antagonistic form, and this truncation of IP-10 has been suggested to influence treatment outcome in patients with chronic HCV infection patients. In addition, previous reports have shown CD26 to be a co-stimulator for T cells. The aim of the present study was to assess the utility of CD26 as a biomarker for treatment outcome in chronic hepatitis C and to define its association with HCV-specific T cells.
Methods: Baseline plasma from 153 genotype 1 and 58 genotype 2/3 infected patients enrolled in an international multicenter phase III trial (DITTO-HCV) and 36 genotype 1 infected patients participating in a Swedish trial (TTG1) were evaluated regarding baseline soluble CD26 (sCD26) and the functionality of HCV-specific CD8+ T cells.
Results: Genotype 1 infected patients achieving SVR in the DITTO (P = 0.002) and the TTG1 (P = 0.02) studies had lower pretreatment sCD26 concentrations compared with non-SVR patients. Sixty-five percent of patients with sCD26 concentrations below 600 ng/mL achieved SVR compared with 39% of the patients with sCD26 exceeding 600 ng/mL (P = 0.01). Patients with sCD26 concentrations below 600 ng/mL had significantly higher frequencies of HCV-specific CD8+ T cells (P = 0.02).
Conclusions: Low baseline systemic concentrations of sCD26 predict favorable treatment outcome in chronic HCV infection and may be associated with higher blood counts of HCV-specific CD8+ T cells.
Apoptosis represents one of the most important forms of cell death in higher organisms and is typically dysregulated in human cancers, including pediatric tumors. This implies that ineffective engagement of cell death programs can contribute to tumor formation as well as tumor progression. In addition, the majority of cytotoxic therapeutic principles rely on the activation of cell death signaling pathways in cancer cells. Blockade of signaling networks that lead to cell death can therefore confer treatment resistance. A variety of genetic and epigenetic events as well as dysfunctional regulation of signaling networks have been identified as underlying causes of cell death resistance in childhood malignancies. Apoptosis pathways can be therapeutically exploited by enhancing proapoptotic signals or by neutralizing antiapoptotic programs. The challenge in the coming years will be to successfully transfer this knowledge into the development of innovative treatment approaches for children with cancer.
Radiation damage following the ionising radiation of tissue has different scenarios and mechanisms depending on the projectiles or radiation modality. We investigate the radiation damage effects due to shock waves produced by ions. We analyse the strength of the shock wave capable of directly producing DNA strand breaks and, depending on the ion's linear energy transfer, estimate the radius from the ion's path, within which DNA damage by the shock wave mechanism is dominant. At much smaller values of linear energy transfer, the shock waves turn out to be instrumental in propagating reactive species formed close to the ion's path to large distances, successfully competing with diffusion.
Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: a case-control study
(2013)
Background: Despite advances in HIV treatment, bacterial pneumonia continues to cause considerable morbidity and mortality in patients with HIV infection. Studies of biomarker associations with bacterial pneumonia risk in treated HIV-infected patients do not currently exist.
Methods: We performed a nested, matched, case-control study among participants randomized to continuous combination antiretroviral therapy (cART) in the Strategies for Management of Antiretroviral Therapy trial. Patients who developed bacterial pneumonia (cases) and patients without bacterial pneumonia (controls) were matched 1:1 on clinical center, smoking status, age, and baseline cART use. Baseline levels of Club Cell Secretory Protein 16 (CC16), Surfactant Protein D (SP-D), C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer were compared between cases and controls.
Results: Cases (n = 72) and controls (n = 72) were 25.7% female, 51.4% black, 65.3% current smokers, 9.7% diabetic, 36.1% co-infected with Hepatitis B/C, and 75.0% were on cART at baseline. Median (IQR) age was 45 (41, 51) years with CD4+ count of 553 (436, 690) cells/mm3. Baseline CC16 and SP-D were similar between cases and controls, but hsCRP was significantly higher in cases than controls (2.94 µg/mL in cases vs. 1.93 µg/mL in controls; p = 0.02). IL-6 and d-dimer levels were also higher in cases compared to controls, though differences were not statistically significant (p-value 0.06 and 0.10, respectively).
Conclusions: In patients with cART-treated HIV infection, higher levels of systemic inflammatory markers were associated with increased bacterial pneumonia risk, while two pulmonary-specific inflammatory biomarkers, CC16 and SP-D, were not associated with bacterial pneumonia risk.
Introduction: We aimed at dissociating the neural correlates of memory disorders in Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD).
Methods: We included patients with AD (n = 19, 11 female, mean age 61 years) and FTLD (n = 11, 5 female, mean age 61 years) in early stages of their diseases. Memory performance was assessed by means of verbal and visual memory subtests from the Wechsler Memory Scale (WMS-R), including forgetting rates. Brain glucose utilization was measured by [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and brain atrophy by voxel-based morphometry (VBM) of T1-weighted magnetic resonance imaging (MRI) scans. Using a whole brain approach, correlations between test performance and imaging data were computed separately in each dementia group, including a group of control subjects (n = 13, 6 female, mean age 54 years) in both analyses. The three groups did not differ with respect to education and gender.
Results: Patients in both dementia groups generally performed worse than controls, but AD and FTLD patients did not differ from each other in any of the test parameters. However, memory performance was associated with different brain regions in the patient groups, with respect to both hypometabolism and atrophy: Whereas in AD patients test performance was mainly correlated with changes in the parieto-mesial cortex, performance in FTLD patients was correlated with changes in frontal cortical as well as subcortical regions. There were practically no overlapping regions associated with memory disorders in AD and FTLD as revealed by a conjunction analysis.
Conclusion: Memory test performance may not distinguish between both dementia syndromes. In clinical practice, this may lead to misdiagnosis of FTLD patients with poor memory performance. Nevertheless, memory problems are associated with almost completely different neural correlates in both dementia syndromes. Obviously, memory functions are carried out by distributed networks which break down in brain degeneration.
Background: The ability of stroke volume variation (SVV), pulse pressure variation (PPV) and global end-diastolic volume (GEDV) for prediction of fluid responsiveness in presence of pleural effusion is unknown. The aim of the present study was to challenge the ability of SVV, PPV and GEDV to predict fluid responsiveness in a porcine model with pleural effusions.
Methods: Pigs were studied at baseline and after fluid loading with 8 ml kg−1 6% hydroxyethyl starch. After withdrawal of 8 ml kg−1 blood and induction of pleural effusion up to 50 ml kg−1 on either side, measurements at baseline and after fluid loading were repeated. Cardiac output, stroke volume, central venous pressure (CVP) and pulmonary occlusion pressure (PAOP) were obtained by pulmonary thermodilution, whereas GEDV was determined by transpulmonary thermodilution. SVV and PPV were monitored continuously by pulse contour analysis.
Results: Pleural effusion was associated with significant changes in lung compliance, peak airway pressure and stroke volume in both responders and non-responders. At baseline, SVV, PPV and GEDV reliably predicted fluid responsiveness (area under the curve 0.85 (p<0.001), 0.88 (p<0.001), 0.77 (p = 0.007). After induction of pleural effusion the ability of SVV, PPV and GEDV to predict fluid responsiveness was well preserved and also PAOP was predictive. Threshold values for SVV and PPV increased in presence of pleural effusion.
Conclusions: In this porcine model, bilateral pleural effusion did not affect the ability of SVV, PPV and GEDV to predict fluid responsiveness.
Despite the availability of new antifungal compounds, invasive fungal infection remains a significant cause of morbidity and mortality in children and adults undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Allogeneic HSCT recipients suffer from a long lasting defect of different arms of the immune system, which increases the risk for and deteriorates the prognosis of invasive fungal infections. In turn, advances in understanding these immune deficits have resulted in promising strategies to enhance or restore critical immune functions in allogeneic HSCT recipients. Potential approaches include the administration of granulocytes, since neutropenia is the single most important risk factor for invasive fungal infection, and preliminary clinical results suggest a benefit of adoptively transferred donor-derived antifungal T cells. In vitro data and animal studies demonstrate an antifungal effect of natural killer cells, but clinical data are lacking to date. This review summarizes and critically discusses the available data of immunotherapeutic strategies in allogeneic HSCT recipients suffering from invasive fungal infection.
Mitochondrial maintenance crucially depends on the quality control of proteins by various chaperones, proteases and repair enzymes. While most of the involved components have been studied in some detail, little is known on the biological role of the CLPXP protease complex located in the mitochondrial matrix. Here we show that deletion of PaClpP, encoding the CLP protease proteolytic subunit CLPP, leads to an unexpected healthy phenotype and increased lifespan of the fungal ageing model organism Podospora anserina. This phenotype can be reverted by expression of human ClpP in the fungal deletion background, demonstrating functional conservation of human and fungal CLPP. Our results show that the biological role of eukaryotic CLP proteases can be studied in an experimentally accessible model organism.
Interleukin (IL)-10 and IL-22 are key members of the IL-10 cytokine family that share characteristic properties such as defined structural features, usage of IL-10R2 as one receptor chain, and activation of signal transducer and activator of transcription (STAT)-3 as dominant signaling mode. IL-10, formerly known as cytokine synthesis inhibitory factor, is key to deactivation of monocytes/macrophages and dendritic cells. Accordingly, pre-clinical studies document its anti-inflammatory capacity. However, the outcome of clinical trials assessing the therapeutic potential of IL-10 in prototypic inflammatory disorders has been disappointing. In contrast to IL-10, IL-22 acts primarily on non-leukocytic cells, in particular epithelial cells of intestine, skin, liver, and lung. STAT3-driven proliferation, anti-apoptosis, and anti-microbial tissue protection is regarded a principal function of IL-22 at host/environment interfaces. In this hypothesis article, hidden/underappreciated pro-inflammatory characteristics of IL-10 and IL-22 are outlined and related to cellular priming by type I interferon. It is tempting to speculate that an inherent inflammatory potential of IL-10 and IL-22 confines their usage in tissue protective therapy and beyond that determines in some patients efficacy of type I interferon treatment.
Background: Candida spp. are a frequent cause of nosocomial bloodstream infections worldwide.
Objective: To evaluate the use patterns and outcomes associated with intravenous (IV) fluconazole therapy in intensive care units in Spain and Germany.
Patients and methods: The research reported here was a prospective multicenter longitudinal observational study in adult intensive care unit patients receiving IV fluconazole. Demographic, microbiologic, therapy success, length of hospital stay, adverse event, and all-cause mortality data were collected at 14 sites in Spain and five in Germany, from February 2004 to November 2005.
Results: Patients (n = 303) received prophylaxis (n = 29), empiric therapy (n = 140), preemptive therapy (n = 85), or definitive therapy (n = 49). A total of 298 patients (98.4%) were treated with IV fluconazole as first-line therapy. The treating physicians judged therapy successful in 66% of prophylactic, 55% of empiric, 45% of preemptive, and 43% of definitive group patients. In the subgroup of 152 patients with proven and specified Candida infection only, 32% suffered from Candida specified as potentially resistant to IV fluconazole. The overall mortality rate was 42%.
Conclusion: Our study informs treatment decision makers that approximately 32% of the patients with microbiological results available suffered from Candida specified as potentially resistant to IV fluconazole, highlighting the importance of appropriate therapy.
In the current event-related potential (ERP) study, we investigated how speech rhythm impacts speech segmentation and facilitates the resolution of syntactic ambiguities in auditory sentence processing. Participants listened to syntactically ambiguous German subject- and object-first sentences that were spoken with either regular or irregular speech rhythm. Rhythmicity was established by a constant metric pattern of three unstressed syllables between two stressed ones that created rhythmic groups of constant size. Accuracy rates in a comprehension task revealed that participants understood rhythmically regular sentences better than rhythmically irregular ones. Furthermore, the mean amplitude of the P600 component was reduced in response to object-first sentences only when embedded in rhythmically regular but not rhythmically irregular context. This P600 reduction indicates facilitated processing of sentence structure possibly due to a decrease in processing costs for the less-preferred structure (object-first). Our data suggest an early and continuous use of rhythm by the syntactic parser and support language processing models assuming an interactive and incremental use of linguistic information during language processing.