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Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.
Aim: To quantify and compare the association between CCDO and ICDO with outcome parameters.
Methods: We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27; atresia type 1-3, annular pancreas) and ICDO (n = 23; annular pancreas, web, Ladd´s bands).
Results: In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%; CCDO vs ICDO, P < 0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P ≤ 0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P < 0.01).
Conclusion: CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.
Electrical stimulation shifts healing/scarring towards regeneration in a rat limb amputation model
(2019)
Different species respond differently to severe injury, such as limb loss. In species that regenerate, limb loss is met with complete restoration of the limbs’ form and function, whereas in mammals the amputated limb’s stump heals and scars. In in vitro studies, electrical stimulation (EStim) has been shown to promote cell migration, and osteo- and chondrogenesis. In in vivo studies, after limb amputation, EStim causes significant new bone, cartilage and vessel growth. Here, in a rat model, the stumps of amputated rat limbs were exposed to EStim, and we measured extracellular matrix (ECM) deposition, macrophage distribution, cell proliferation and gene expression changes at early (3 and 7 days) and later stages (28 days). We found that EStim caused differences in ECM deposition, with less condensed collagen fibrils, and modified macrophage response by changing M1 to M2 macrophage ratio. The number of proliferating cells was increased in EStim treated stumps 7 days after amputation, and transcriptome data strongly supported our histological findings, with activated gene pathways known to play key roles in embryonic development and regeneration. In conclusion, our findings support the hypothesis that EStim shifts injury response from healing/scarring towards regeneration. A better understanding of if and how EStim controls these changes, could lead to strategies that replace scarring with regeneration.
Cheilostome Bryozoa Anoteropora latirostris, a colonial marine invertebrate, constructs its skeleton from calcite and aragonite. This study presents firstly correlated multi-scale electron microscopy, micro-computed tomography, electron backscatter diffraction and NanoSIMS mapping. We show that all primary, coarse-grained platy calcitic lateral walls are covered by fine-grained fibrous aragonite. Vertical lateral walls separating autozooid chambers have aragonite only on their distal side. This type of asymmetric mineralization of lateral walls results from the vertical arrangement of the zooids at the growth margins of the colony and represents a type of biomineralization previously unknown in cheilostome bryozoans. NanoSIMS mapping across the aragonite-calcite interface indicates an organic layer between both mineral phases, likely representing an organic template for biomineralization of aragonite on the calcite layer. Analysis of crystallographic orientations show a moderately strong crystallographic preferred orientation (CPO) for calcite (7.4 times random orientation) and an overall weaker CPO for aragonite (2.4 times random orientation) with a high degree of twinning (45%) of the aragonite grains. The calculated Young’s modulus for the CPO map shows a weak mechanical direction perpendicular to the colony’s upper surface facilitating this organism’s strategy of clonal reproduction by fragmentation along the vertical zooid walls.
Künstliche Intelligenz als Ende des Strafrechts? Zur algorithmischen Transformation der Gesellschaft
(2019)
Does Artificial Intelligence (AI) imply the end of criminal law and justice as we know it? This article submits that AI is a transformative technology that seemingly assumes and optimizes the rationalities of criminal law (the effective prevention of crime; the objective, neutral and coherent application of the law etc.), namely by replacing the counterfactual guarantees of the law with the factual guarantees of technology. As a consequence, AI must not be trivialized by criminal law theory. Likewise, it is not enough to subversively criticize the current weaknesses of AI (e.g. vis-à-vis the “bias in, bias out” problem). Rather, criminal law theory should draw on the highflying promises of AI to reflect upon the foundational premises of criminal law. For a criminal law that is mostly a governance tool in the administrative and/or welfare state, AI applications promise the culmination of the law’s very objectives (like the effective inhibition and prevention of crime, e.g. by means of predictive policing; or the political determination of fuzzy sentencing rationales in sentencing algorithms that ensure equal sentences for comparable crimes). For a criminal law, however, that protects liberal freedoms and rests on inter-personal trust, AI may well lead to the passing of the law’s very ideals (e.g. of the presumption of innocence, which can no longer be upheld once everyone, ordinary citizens and judges alike, is deemed a possible risk). The question about “AI as the end of criminal law?” thus eventually raises the two-pronged question “Which criminal law for which society?”. Indeed, what is the status of freedom (esp. in a surveillance society needed to power Big Data driven algorithms), trust (esp. under the zero trust paradigm that underlies many risk assessment algorithms) and future (esp. when algorithms make predictions based on past data) once AI enters into the administration of criminal justice? These are the questions, or so I respectfully submit, that criminal law theory needs to address today in order to come up with a criminal law that is both (for pragmatic reasons) open to technology as well as (for humane reasons) sensible. In all of this, we must take to heart Joachim Hruschka’s great legacy and remain intellectually honest.
Gegenstand aller natürlichen Sprachen, die Menschen hervorgebracht haben, ist das Sprechen. Die Schrift einer solchen Sprache kann insofern als sekundäre Errungenschaft bezeichnet werden. Sorten und Gattungen der menschlichen Sprachen und Schriften sind historisch wie auch heute von großer Vielfalt und krassen Gegensätzen geprägt: z.B. die indoeuropäischen Sprachen mit flektierendem Grammatikbau versus der vielen sinotibetischen Sprachen mit analytischem Bau oder das lateinische Alphabet versus die logographische chinesische Schrift. In dieser Arbeit wird gezeigt, welche Faktoren die Korrespondenz der schriftlichen Repräsentation auf eine Sprache entscheiden und in welcher Art und Weise die Schrift die sprachlichen Entwicklungen beeinflussen kann.
IL-1 family member IL-33 exerts a variety of immune activating and regulating properties and has recently been proposed as a prognostic biomarker for cancer diseases, although its precise role in tumor immunity is unclear. Here we analyzed in vitro conditions influencing the function of IL-33 as an alarmin and a co-factor for the activity of cytotoxic CD8+ T cells in order to explain the widely discussed promiscuous behavior of IL-33 in vivo. Circulating IL-33 detected in the serum of healthy human volunteers was biologically inactive. Additionally, bioactivity of exogenous recombinant IL-33 was significantly reduced in plasma, suggesting local effects of IL-33, and inactivation in blood. Limited availability of nutrients in tissue causes necrosis and thus favors release of IL-33, which—as described before—leads to a locally high expression of the cytokine. The harsh conditions however influence T cell fitness and their responsiveness to stimuli. Nutrient deprivation and pharmacological inhibition of mTOR mediated a distinctive phenotype characterized by expression of IL-33 receptor ST2L on isolated CD8+ T cells, downregulation of CD8, a transitional CD45RAlowROlow phenotype and high expression of secondary lymphoid organ chemokine receptor CCR7. Under nutrient deprivation, IL-33 inhibited an IL-12 induced increase in granzyme B protein expression and increased expression of GATA3 and FOXP3 mRNA. IL-33 enhanced the TCR-dependent activation of CD8+ T cells and co-stimulated the IL-12/TCR-dependent expression of IFNγ. Respectively, GATA3 and FOXP3 mRNA were not regulated during TCR-dependent activation. TCR-dependent stimulation of PBMC, but not LPS, initiated mRNA expression of soluble IL-33 decoy receptor sST2, a control mechanism limiting IL-33 bioactivity to avoid uncontrolled inflammation. Our findings contribute to the understanding of the compartment-specific activity of IL-33. Furthermore, we newly describe conditions, which promote an IL-33-dependent induction of pro- or anti-inflammatory activity in CD8+ T cells during nutrient deprivation.
Background: The nature of perceptual-cognitive expertise in interactive sports has gained more and more scientific interest over the last two decades. Research to understand how this expertise can be developed has not been addressed profoundly yet. In approaches to study this with interventional designs, only few studies have scrutinized several levels of transfer such as to the field. Therefore, the aim of this study was to examine the efficacy of a generic off-court perceptual-cognitive training in elite volleyball players on three different levels: task-specific, near-transfer, and far-transfer effects. Based on overlapping cognitive processes between training and testing, we hypothesized task-specific improvements as well as positive near- and far-transfer effects after a multiple-object tracking training intervention.
Methods: Twenty-two volleyball experts completed a 8-week three-dimensional (3D) multiple-object tracking (3D-MOT) training intervention. A control group (n = 21; volleyball experts also) participated in regular ball practice only. Before and after training, both groups performed tests on the 3D-MOT, four near-transfer tests in cognitive domains, and a far-transfer, lab-based, and volleyball-specific blocking test.
Results: The results of the 2 × 2 analysis of variance (ANOVA) (group, time) showed significant interaction effects in the 3D-MOT task [F(1,40) = 93.10; p < 0.001; η2p = 0.70] and in two near-transfer tests [sustained attention: F(1,40) = 15.45; p < 0.001; η2p = 0.28; processing speed: F(1,40) = 12.15; p = 0.001; η2p = 0.23]. No significant interaction effects were found in the far-transfer volleyball test.
Conclusions: Our study suggests positive effects in task-specific and two near-transfer tests of a perceptual-cognitive intervention in elite volleyball athletes. This supports a partial overlap in cognitive processing between practice and tests with the result of positive near-transfer. However, there are no significant effects in far-transfer testing. Although these current results are promising, it is still unclear how far-transfer effects of a generic perceptual-cognitive training intervention can be assured.
One of the most difficult challenges in clinical hepatology is the diagnosis of a drug-induced liver injury (DILI). The timing of the events, exclusion of alternative causes, and taking into account the clinical context should be systematically assessed and scored in a transparent manner. RUCAM (Roussel Uclaf Causality Assessment Method) is a well-established diagnostic algorithm and scale to assess causality in patients with suspected DILI. First published in 1993 and updated in 2016, RUCAM is now the worldwide most commonly used causality assessment method (CAM) for DILI. The following manuscript highlights the recent implementation of RUCAM around the world, by reviewing the literature for publications that utilized RUCAM, and provides a review of “best practices” for the use of RUCAM in cases of suspected DILI. The worldwide appreciation of RUCAM is substantiated by the current analysis of 46,266 DILI cases, all tested for causality using RUCAM. These cases derived from 31 reports published from 2014 to early 2019. Their first authors came from 10 countries, with China on top, followed by the US, and Germany on the third rank. Importantly, all RUCAM-based DILI reports were published in high profile journals. Many other reports were published earlier from 1993 up to 2013 in support of RUCAM. Although most of the studies were of high quality, the current case analysis revealed shortcomings in few studies, not at the level of RUCAM itself but rather associated with the work of the users. To ensure in future DILI cases a better performance by the users, a list of essential elements is proposed. As an example, all suspected DILI cases should be evaluated 1) by the updated RUCAM to facilitate result comparisons, 2) according to a prospective study protocol to ensure complete data sets, 3) after exclusion of cases with herb induced liver injury (HILI) from a DILI cohort to prevent confounding variables, and 4) according to inclusion of DILI cases with RUCAM-based causality gradings of highly probable or probable, in order to increase the specificity of the results. In conclusion, RUCAM benefits from its high appreciation and performs well provided the users adhere to published recommendations to prevent confounding variability.
Microenvironmental regulation of tumor progression and therapeutic response in brain metastasis
(2019)
Cellular and non-cellular components of the tumor microenvironment (TME) are emerging as key regulators of primary tumor progression, organ-specific metastasis, and therapeutic response. In the era of TME-targeted- and immunotherapies, cancer-associated inflammation has gained increasing attention. In this regard, the brain represents a unique and highly specialized organ. It has long been regarded as an immunological sanctuary site where the presence of the blood brain barrier (BBB) and blood cerebrospinal fluid barrier (BCB) restricts the entry of immune cells from the periphery. Consequently, tumor cells that metastasize to the brain were thought to be shielded from systemic immune surveillance and destruction. However, the detailed characterization of the immune landscape within border-associated areas of the central nervous system (CNS), such as the meninges and the choroid plexus, as well as the discovery of lymphatics and channels that connect the CNS with the periphery, have recently challenged the dogma of the immune privileged status of the brain. Moreover, the presence of brain metastases (BrM) disrupts the integrity of the BBB and BCB. Indeed, BrM induce the recruitment of different immune cells from the myeloid and lymphoid lineage to the CNS. Blood-borne immune cells together with brain-resident cell-types, such as astrocytes, microglia, and neurons, form a highly complex and dynamic TME that affects tumor cell survival and modulates the mode of immune responses that are elicited by brain metastatic tumor cells. In this review, we will summarize recent findings on heterotypic interactions within the brain metastatic TME and highlight specific functions of brain-resident and recruited cells at different rate-limiting steps of the metastatic cascade. Based on the insight from recent studies, we will discuss new opportunities and challenges for TME-targeted and immunotherapies for BrM.
The development of multimodal sensor-based applications designed to support learners with the improvement of their skills is expensive since most of these applications are tailor-made and built from scratch. In this paper, we show how the Presentation Trainer (PT), a multimodal sensor-based application designed to support the development of public speaking skills, can be modularly extended with a Virtual Reality real-time feedback module (VR module), which makes usage of the PT more immersive and comprehensive. The described study consists of a formative evaluation and has two main objectives. Firstly, a technical objective is concerned with the feasibility of extending the PT with an immersive VR Module. Secondly, a user experience objective focuses on the level of satisfaction of interacting with the VR extended PT. To study these objectives, we conducted user tests with 20 participants. Results from our test show the feasibility of modularly extending existing multimodal sensor-based applications, and in terms of learning and user experience, results indicate a positive attitude of the participants towards using the application (PT+VR module).
The quest for new and improved therapies for glioblastoma (GB) has been mostly unsuccessful in more than a decade despite significant efforts. The few exceptions include the optimization of classical alkylating chemotherapy by including lomustine in the first line regimen for GB with a methylated MGMT promoter and tumor treating fields. The GB signaling network has been well-characterized and genetic alterations resulting in activation of receptor tyrosine kinases and especially epidermal growth factor receptor (EGFR) and downstream mammalian target of rapamycin complex 1 (mTORC1) signaling were found in the majority of GBs. ...
Dieses Zitat von Sperone Speroni aus dem "Dialogo d’Amore" (1542) beschreibt eindrücklich die herausragende Stellung des Malers Tizian. Die Hochachtung, die aus diesen Worten hervorgeht, spiegelt sich in der Ausstellung Tizian und die Renaissance in Venedig wieder, die vom 13. Februar bis zum 26. Mai 2019 im Frankfurter Städel Museum zu sehen ist. Die Sonderausstellung mit über 100 Meisterwerken widmet sich nicht nur Tizian, sondern auch anderen wichtigen Vertretern der venezianischen Malerei der Renaissance. So werden unter anderem Gemälde und Zeichnungen von Giovanni Bellini, Jacopo Palma il Vecchio, Sebastiano del Piombo, Lorenzo Lotto, Jacopo Tintoretto, Jacopo Bassano und Paolo Veronese gezeigt. In einer Folge von acht Kapiteln führt die Präsentation dieser Meisterwerke durch ausgewählte Themenfelder, die für die venezianische Malerei im 16. Jahrhundert charakteristisch sind. ...
Background: Obesity impairs a variety of cell types including adipose-derived mesenchymal stem cells (ASCs). ASCs are indispensable for tissue homeostasis/repair, immunomodulation, and cell renewal. It has been demonstrated that obese ASCs are defective in differentiation, motility, immunomodulation, and replication. We have recently reported that some of these defects are linked to impaired primary cilia, which are unable to properly convey and coordinate a variety of signaling pathways. We hypothesized that the rescue of the primary cilium in obese ASCs would restore their functional properties.
Methods: Obese ASCs derived from subcutaneous and visceral adipose tissues were treated with a specific inhibitor against Aurora A or with an inhibitor against extracellular signal-regulated kinase 1/2 (Erk1/2). Multiple molecular and cellular assays were performed to analyze the altered functionalities and their involved pathways.
Results: The treatment with low doses of these inhibitors extended the length of the primary cilium, restored the invasion and migration potential, and improved the differentiation capacity of obese ASCs. Associated with enhanced differentiation ability, the cells displayed an increased expression of self-renewal/stemness-related genes like SOX2, OCT4, and NANOG, mediated by reduced active glycogen synthase kinase 3 β (GSK3β).
Conclusion: This work describes a novel phenomenon whereby the primary cilium of obese ASCs is rescuable by the low-dose inhibition of Aurora A or Erk1/2, restoring functional ASCs with increased stemness. These cells might be able to improve tissue homeostasis in obese patients and thereby ameliorate obesity-associated diseases. Additionally, these functionally restored obese ASCs could be useful for novel autologous mesenchymal stem cell-based therapies.
Die Welt ist im Wandel, der Globalisierungsprozess weit fortgeschritten. Inwiefern spielen dann Kolonialismus und Unterdrückung noch eine Rolle? Sind diese Zeitgeschehnisse nicht wie man so schön sagt "Geschichte"? Dieser Frage gehen der britisch-ghanaische Künstler John Akomfrah und das Black Audio Film Collective im gemeinsamen Werk "Expeditions 1 – Signs of Empire" (1983) nach. Die zweiteilige Videoarbeit zeigt mithilfe dokumentarischer Fotografien, Textfragmenten und Tonaufzeichnungen des British Empire ein Bild, welches die Potenz heutiger nationalstaatlicher Strukturen des Okzidents in der Unterdrückung und Ausbeutung kolonialisierter Länder verortet – und so den Mythos der moralischen Überlegenheit des Westens dekonstruiert. ...
Der technische Fortschritt ermöglicht die Auswertung großer Datenmengen mittels Algorithmen zur Feststellung bislang unbekannter Korrelationen. Schlagwortartig werden solche Analysen unter dem Begriff Big Data zusammengefasst. Häufig sind personenbezogene Daten Gegenstand von Big-Data-Anwendungen, sei es als Grundlage oder Ergebnis einer Auswertung. In diesen Fällen ist das Datenschutzrecht zu beachten.
Der Zweckbindungsgrundsatz fordert die Angabe eines Verarbeitungszwecks bereits bei Erhebung der Daten und eine Bindung des weiteren Datenumgangs an diesen Zweck. Damit besteht ein Spannungsverhältnis zu Big-Data-Anwendungen, die zu Verarbeitungsbeginn den Zweck allenfalls unspezifisch anzugeben vermögen. Auf Grundlage des alten Bundesdatenschutzgesetzes mit einzelnen Ausblicken auf die Datenschutzgrundverordnung untersucht die Arbeit die datenschutzrechtlichen Anforderungen an die Zweckfestlegung und welche Bindungen aus ihr folgen. Zudem nimmt der Autor mögliche Lösungen des Konflikts zwischen Big-Data-Anwendungen und dem Zweckbindungsgrundsatz in den Blick.
The sphingolipid sphingosine-1-phosphate (S1P) is produced by sphingosine kinases to either signal through intracellular targets or to activate a family of specific G-protein-coupled receptors (S1PR). S1P levels are usually low in peripheral tissues compared to the vasculature, forming a gradient that mediates lymphocyte trafficking. However, S1P levels rise during inflammation in peripheral tissues, thereby affecting resident or recruited immune cells, including macrophages. As macrophages orchestrate initiation and resolution of inflammation, the sphingosine kinase/S1P/S1P-receptor axis emerges as an important determinant of macrophage function in the pathogenesis of inflammatory diseases such as cancer, atherosclerosis, and infection. In this review, we therefore summarize the current knowledge how S1P affects macrophage biology.
Canada’s geographic centre lies in the Territory Nunavut. From here the distance to the geographic North Pole is as far as to the US border. Nunavut takes up about 1/5 of the Canadian land mass but has by far the smallest population with currently about 38,000 residents. 85% of its population are Inuit whose culture dramatically changed within the last 70 years.
As a result, the territory is dealing with several generations of Inuit that are traumatized or at least severely affected by cultural and economic changes that started after World War 2 with the resettlement from the land into permanent communities. No matter if we are talking about the actual elders, mid-age adults or pre-teenagers, each of this generation experienced and still experiences various personal and cultural challenges of identity, financial and housing insecurity, food insecurity, substance abuse education, change of social values ranging from inter-generational and gender relationships to the introduction of a foreign political and legal system.
On the other side, a lot of the traditional societal values are still being practiced in Inuit families. Despite all the tragedies that several generations of Inuit have experienced by now, the society keeps generating the strength and cultural pride that allows many Inuit both, as individuals and as a collective under the umbrella of either Inuit Land Claims or not for profit organizations to advocate on behalf of Inuit culture, to fight for more acknowledgement of Inuit culture and to enhance pride in the historic and present day cultural achievements of Nunavut’s indigenous population.
The social issues, inter- and intra-cultural processes described in my thesis are not exclusive to the situation in Nunavut or to Inuit. Studies from other regions, in Canada or from around the world (LaPrairie 1987; Jensen 1986; Nunatsiaq News 6/30/2010) reveal similar challenges.
Though many structural similarities can be identified by comparing these studies with each other, e.g. marginalization of the indigenous local population, colonization, paternalism and resulting issues like personal and cultural identity loss, it is important to have a more in depth look into the single cases to determine which individual events and developments causes and maybe still cause such a devastating social situation as it is found among many indigenous peoples across the world. From my perspective effective improvements of the situation of a group, a respective community or region can only happen when particularities of socialization, communication and philosophy in the single cultural entities are being considered.
That is why my thesis will exclusively focus on developments in Nunavut and use various case studies of communities. The case studies shall help to identify local differences in historic and recent developments and thus provide starting points for explanations of different developments in different Nunavut communities.
The thesis is looking at both, historic and recent root causes for the many issues in Nunavut.
The data that my my thesis is based on are a combination of literature and about 60 formal and informal interviews that I conducted in three Nunavut communities (Iqaluit, Whale Cove, Kugluktuk) during my 18 months of field work between October 2008 and March 2010. Many more spontaneous unstructured conversations between me and community members added to the pool of first-hand information that I gathered.
Since my field work is limited to those three communities it has a very strong qualitative character. The quantitative side, which allows me to confidently apply my research analyses to entire Nunavut, comes from literature research as well as many informal conversations and a few formal interviews that I conducted with people who had some experience in other communities than Iqaluit, Kugluktuk and Whale Cove.
Furthermore, while I was living at the old residence of the Nunavut Arctic College in Iqaluit, I spend time with college students from across Nunavut. Through them, I obtained „case studies “from following communities: Iqaluit, Qikiqtarjuaq, Kimmirut, Pangnirtung, Clyde River, Pond Inlet, Igloolik, Repulse Bay, Cape Dorset, Chesterfield Inlet, Baker Lake, Rankin Inlet, Whale Cove, Arviat, Taloyoak, Kugluktuk.
My general categorization of “early contact period”, “contact”, “1st generation” and “2nd generation” is very similar to Damas’ terms of “early contact phase”, “contact – traditional”, “resettlement” that he uses to create a timeline that describes the major phases of impact for Inuit society (Damas 2002: 7, 17).
Chapters 2 is meant to provide an inventory of the key aspects of current social issues in Nunavut. In this context I am looking at the four major aspects that in my opinion shape Nunavut’s society:
1) violence and other forms of social dysfunctions
2) the associated services and delivering agencies that try to address those matters
3) Education
4) Inuit cultural particularities in communication and socialization
Those four areas are forming the foundation for the rest of my work. The following chapters will guide the reader through the historic transformation process of Inuit pre-colonial semi-nomadic society to a society that is living in permanent settlements, strongly influenced if not in many ways dominated by Euro-Canadian culture. Each of those chapters will be referring to the social and cultural changes that happened in the different time periods that I labeled with “Pre-settlement, First, Second, and Third Generation”. The relevance of violence and other social dysfunctions, their context and strategies how each generation dealt with those matters will be analyzed while I will be also referring to the impacts that non-Inuit, primarily Euro-Canadians and Euro-Americans had and have on Inuit society.
...
Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs.
Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel.
Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy.
Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
Die vorliegende Arbeit behandelt einen Rechtsvergleich zwischen dem Neutralitätsgebot in der Bundesrepublik Deutschland und die Laizität in der Türkei aus der Perspektive des Religionsverwaltungsrechts im Referenzgebiet Medienrecht. Der Schwerpunkt liegt in der Darstellung des Türkischen Rechts.
Zu Beginn werden die beiden Begriffe des Neutralitätsgebots und der Laizität als Analyseinstrumente näher erörtert. Insbesondere erfolgt eine historische Begriffsgenese der Laizität im türkischen Rechtssystem in Bezug auf die Verfassungen der Türkei von Kanun-i Esasi 1876 bis hin zur aktuellen Verfassung von 1982. Darüber hinaus wird sowohl in der Rechtsprechung als auch in der Literatur erforscht, welchen Wandel der Laizitätsbegriff seit seiner Aufnahme in die Verfassung erfahren hat.
Es wird festgestellt, dass beide Begriffe einer Begriffskategorie angehören, wobei sie sich überwiegend durch ihre Intensität bei der Trennung vom Sakralem und Säkularem gerade hinsichtlich Kooperationen derselben und der vorherrschenden Koexistenz unterscheiden.
Zusätzlich wird auf die Funktion und die Auswirkungen des Diyanet sowohl auf den Laizitätsbegriff selbst als auch auf das Medienrecht eingegangen.
Im Folgenden wird das Medienrecht in beiden Ländern aus der Perspektive der öffentlichen Medien, insbesondere der Rundfunkanstalten untersucht. Hierbei werden in der Bundesrepublik Deutschland alle öffentlich-rechtlichen Rundfunkanstalten, ihre Organisationsstruktur und Regelungen zur Vertretung der Religionsgemeinschaften behandelt, die gängigen Regelungen diesbezüglich ausführlich erörtert und aktuelle Unterschiede derselben bei der Vertretung der Religionsgemeinschaften im jeweiligen Rundfunkrat mitunter auch tabellarisch aufgezeigt. Durch die Behandlung der Vertretungsregelungen werden Mängel aufgewiesen. Diese ergeben sich beispielsweise in Hessen bei der Auswahl der vertretungsberechtigten Organisationen, da bei den parlamentarischen Überlegungen hierzu möglicherweise nicht hinreichend sachdienliche Gutachten herangezogen wurden. Eine andere Quelle für Fehler wird in der Anwendung von bestimmten Rechtsbegriffen als Parameter für die Eignung der Religionsgemeinschaften zur Vertretung gesehen, die ihrerseits auf christliche Religionsgemeinschaften zugeschnitten sind, jedoch gerade die innerhalb der Bevölkerung am stärksten vertretene Minderheitengruppe, nämlich die Muslime, mangels Körperschaftsstatus, außen vor lässt. Letztendlich werden auch gerade für die Bundesrepublik Deutschland Lösungsansätze herausgearbeitet.
Im türkischen Recht erfolgt eine ebensolche Darstellung, wobei als Besonderheit auch der TMSF als Einlagensicherungsfonds, sowie die These behandelt werden, dass durch die Eingriffe des TMSF öffentlich-rechtliche Printmedien vorhanden seien. Speziell werden die Entstehung und Entwicklung des Medienrechts, der Aufbau und die Kompetenzen der öffentlich-rechtlichen Medien und die Eingriffe auf diese dargestellt.
In der Türkei werden bereits in der verwaltungsrechtlichen Normierung der Kompetenzen einzelner Institutionen und erst Recht in der verwaltungsrechtlichen Praxis gravierende Mängel festgestellt.
Over the last years, many microRNAs (miRNAs) have been identified that regulate the formation of bioactive lipid mediators such as prostanoids and leukotrienes. Many of these miRNAs are involved in complex regulatory circuits necessary for the fine-tuning of biological functions including inflammatory processes or cell growth. A better understanding of these networks will contribute to the development of novel therapeutic strategies for the treatment of inflammatory diseases and cancer. In this review, we provide an overview of the current knowledge of miRNA regulation in eicosanoid pathways with special focus on novel miRNA functions and regulatory circuits of leukotriene and prostaglandin biosynthesis.
The lateralization of neuronal processing underpinning hearing, speech, language, and music is widely studied, vigorously debated, and still not understood in a satisfactory manner. One set of hypotheses focuses on the temporal structure of perceptual experience and links auditory cortex asymmetries to underlying differences in neural populations with differential temporal sensitivity (e.g., ideas advanced by Zatorre et al. (2002) and Poeppel (2003). The Asymmetric Sampling in Time theory (AST) (Poeppel, 2003), builds on cytoarchitectonic differences between auditory cortices and predicts that modulation frequencies within the range of, roughly, the syllable rate, are more accurately tracked by the right hemisphere. To date, this conjecture is reasonably well supported, since – while there is some heterogeneity in the reported findings – the predicted asymmetrical entrainment has been observed in various experimental protocols. Here, we show that under specific processing demands, the rightward dominance disappears. We propose an enriched and modified version of the asymmetric sampling hypothesis in the context of speech. Recent work (Rimmele et al., 2018b) proposes two different mechanisms to underlie the auditory tracking of the speech envelope: one derived from the intrinsic oscillatory properties of auditory regions; the other induced by top-down signals coming from other non-auditory regions of the brain. We propose that under non-speech listening conditions, the intrinsic auditory mechanism dominates and thus, in line with AST, entrainment is rightward lateralized, as is widely observed. However, (i) depending on individual brain structural/functional differences, and/or (ii) in the context of specific speech listening conditions, the relative weight of the top-down mechanism can increase. In this scenario, the typically observed auditory sampling asymmetry (and its rightward dominance) diminishes or vanishes.
The three major autoimmune diseases (ADs) of the liver are primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH). All of those diseases show an aggressive immune reaction resulting in the destruction of liver tissue and finally to the development of hepatic fibrosis.
PSC is an autoimmune mediated disease of unknown etiology. It is characterized by inflammation of intra- and extrahepatic bile ducts. The progressive destruction of the bile ducts can lead to liver cirrhosis and finally to liver failure. Clinical signs for PSC are increased alkaline phosphatase (AP) and gamma glutamyltransferase (GGT) levels, presence of perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) and bile ducts with characteristic strictures and dilations of the biliary tree as well as onion skin fibrosis surrounding the damaged bile ducts. Currently, there is no established treatment for PSC patients. The administration of ursodeoxycholic acid (UDCA) is being use as a therapy. However, it merely serves a symptomatic treatment to reduce serum AP and GGT as well as the formation of gallstones. In the advanced stage of PSC, liver transplantation is the last therapeutic option. Mdr2-/- mice are an excepted mouse model for human PSC. Such mice show lymphocytes infiltration into the liver, bile duct lesions, as well as the presence of the typical onion skin-like pericholangitis and periductal fibrosis.
AIH is a rare chronic autoimmune disease of the liver that results from the loss of self-tolerance to hepatocytes and leads to destruction of the hepatic parenchyma with the onset of cirrhosis. Clinical signs for AIH are elevated alanine aminotransferase (ALT) and aspartate transaminase (AST) levels, hypergammaglobulinemia and different types of autoantibodies. In addition, interphase hepatitis with lymphocytic and plasmacellular infiltrates in the periportal field are characteristic for AIH. Two different subtypes of AIH exist and depending on their autoantibody profile they can be distinguished into AIH type 1 which is characterized by the presence of anti-nuclear (ANA) and/or anti-smooth muscular (SMA) autoantibodies, and AIH type 2 showing liver/kidney microsomal autoantibodies (LKM-1). LKM-1 recognizes the major autoantigen, the 2D6 isoform of the cytochrome P450 enzyme family (CYP2D6). One mouse model for AIH is the CYP2D6 model in which the injection of Ad-2D6 leads to a breakdown of the immune tolerance by the destruction of hepatocytes.
There are some patients with autoimmune diseases of the liver who have both cholestatic and hepatic liver enzymes and histological features suggestive of two different liver diseases. These patients are diagnosed with an overlap syndrome (OS).
In my thesis I generated an animal model with characteristics of both diseases, which would mimic features of human PSC-AIH OS. Mdr2-/- mice which spontaneously develop PSC were infected with Ad-2D6 to trigger the autoimmune-driven hepatic injury. Pathogenesis of PSC-AIH OS mice was compared to mice with solitary PSC or AIH. Naïve FVB wild type mice have been used as healthy controls. The characterization of the PSC-AIH OS model was done by analyzing serological parameters like ALT, AP, different antibodies like pANCA, LKM-1 like CYP2D6 and total IgG. Additionally, fibrosis and cholangitis were analyzed by immunohistochemistry and Western blotting. Moreover, cellular infiltrations of CD4+ and CD8+ T cells, dendritic cells (DCs), monocytes/macrophages and neutrophils were determined with immunohistochemistry. Finally, the overall immune balance in the liver and the frequency of CYP specific T cells were analyzed via flow cytometry. Our new mouse model indeed represents the characteristics of both PSC and AIH and mimics features of the human PSC-AIH OS. It allows studying the development of a PSC-AIH OS and how the two overlapping diseases are influencing one another. In a second approach I wanted to induce CYP2D6-specific tolerance in AIH mice. Therefore, I tried four different approaches, namely intranasal peptide administration, injection of tolerogenic DCs, antigen-coupled splenocytes, and Ag-coupled nanoparticles (NP) and evaluated their potential to induce CYP2D6 specific Treg with the capacity to prevent AIH in mice. Unfortunately, the intranasal peptide administration and also the injection of tolerogenic DCs did not increase the amount of CYP2D6 specific Treg which would lead to a reduction of the frequency of inflammatory T cells. Surprisingly, the injection of antigen-coupled splenocytes showed the opposite effect characterized by a very strong cytokine secretion in the tolerized mice. The use of NPs led to an increase in CYP2D6 specific Treg as well as in decrease in the frequency of inflammatory T cells and finally has the potential for a therapeutic approach.
In summary, the generated PSC-AIH OS model represents many clinical signs which can also be observed in PSC-AIH OS patients. This model can be used to study the etiology of this overlap syndrome and further to test potential therapeutic approaches. The different immune tolerance induction pathways which I tried in the AIH model show that NPs have to potential to induce immune tolerance but this approach has to be refined and the outcome has to be characterized in more detail.
The paper analyses the linkages from financial developments to public finances. It maps and discusses the transmission channels to fiscal variables. These channels include asset prices, financing conditions, balance sheets of banks, non-banks and central banks and international linkages. The study argues that the fiscal effects via each and all these channels can be very serious in magnitude and can put the sustainability of public finances at risk. However, there is an only limited in-depth analysis of these channels and risks.
Im Frühjahr 2018 wurde innerhalb des vom Bundesministerium für Bildung und Forschung geförderten Projektes „QuartierMobil“ eine Haushaltsbefragung im innenstadtnahen Stadtteil Frankfurt-Bornheim durchgeführt (N = 1027). Für die Stichprobenauswahl wurden das Random-Route-Verfahren und die Last-Birthday-Methode angewendet. Der Fragebogen wurde in Abstimmung mit den Projektpartner*innen, dem Referat Mobilitäts- und Verkehrsplanung der Stadt Frankfurt sowie dem Planungsbüro Planersocietät, entwickelt. Ziel der Befragung war es, die Dynamiken und Präferenzen der Bewohnenden des Quartiers hinsichtlich ihrer Alltagsmobilität, Verkehrsmittelnutzung und Einstellungen zu Konfliktsituationen zu erhalten. Der Schwerpunkt der Befragung lag auf dem Parken im urbanen Quartier und möglichen Gestaltungsoptionen des städtischen Parkraummanagements hin zu einer nachhaltigeren Mobilität und einer Erhöhung der Aufenthalts- und Lebensqualität im Quartier.
We present a model for the autonomous and simultaneous learning of active binocular and motion vision. The model is based on the Active Efficient Coding (AEC) framework, a recent generalization of classic efficient coding theories to active perception. The model learns how to efficiently encode the incoming visual signals generated by an object moving in 3-D through sparse coding. Simultaneously, it learns how to produce eye movements that further improve the efficiency of the sensory coding. This learning is driven by an intrinsic motivation to maximize the system's coding efficiency. We test our approach on the humanoid robot iCub using simulations. The model demonstrates self-calibration of accurate object fixation and tracking of moving objects. Our results show that the model keeps improving until it hits physical constraints such as camera or motor resolution, or limits on its internal coding capacity. Furthermore, we show that the emerging sensory tuning properties are in line with results on disparity, motion, and motion-in-depth tuning in the visual cortex of mammals. The model suggests that vergence and tracking eye movements can be viewed as fundamentally having the same objective of maximizing the coding efficiency of the visual system and that they can be learned and calibrated jointly through AEC.
Fährt man in den Urlaub, weiß man eigentlich schon vorab, dass man als Reisende ob der eigenen Unwissenheit mehr bezahlt als die ortskundigen Locals. Man weiß, dass die meisten europäischen Urlaubsorte vom Tourismus leben und drückt im Stillen sein Einverständnis damit aus, indem man überhaupt reist. Gelegentlich aber zahlt man nicht nur etwas mehr, sondern wird beim Rückweg zum Flughafen von einem Taxifahrer, der kein Englisch spricht oder auch nur so tut, um die halbe Insel gefahren, obwohl man vom Beifahrersitz in sein Handy schaut und einem Google Maps einen wesentlich kürzeren Weg angezeigt hat. Man könnte sich aufregen, mit Hand und Fuß mit dem Taxifahrer schimpfen, die Türen des Wagens zuknallen und so dem eigenen Unmut Ausdruck verschaffen. Man kann aber auch ruhig bleiben, dem Taxifahrer thank you for showing us the whole island zurufen, zurückfliegen und eine Ausstellung organisieren, wie Cemile Deniz Alibas, Dominika Bednarsky, Un-Zu Ha-Nul Lee und Lena Stewens es getan haben. ...
Hypomethylating agents decitabine and azacytidine are regarded as interchangeable in the treatment of acute myeloid leukemia (AML). However, their mechanisms of action remain incompletely understood, and predictive biomarkers for HMA efficacy are lacking. Here, we show that the bioactive metabolite decitabine triphosphate, but not azacytidine triphosphate, functions as activator and substrate of the triphosphohydrolase SAMHD1 and is subject to SAMHD1-mediated inactivation. Retrospective immunohistochemical analysis of bone marrow specimens from AML patients at diagnosis revealed that SAMHD1 expression in leukemic cells inversely correlates with clinical response to decitabine, but not to azacytidine. SAMHD1 ablation increases the antileukemic activity of decitabine in AML cell lines, primary leukemic blasts, and xenograft models. AML cells acquire resistance to decitabine partly by SAMHD1 up-regulation. Together, our data suggest that SAMHD1 is a biomarker for the stratified use of hypomethylating agents in AML patients and a potential target for the treatment of decitabine-resistant leukemia.
Causes of maladaptation
(2019)
Evolutionary biologists tend to approach the study of the natural world within a framework of adaptation, inspired perhaps by the power of natural selection to produce fitness advantages that drive population persistence and biological diversity. In contrast, evolution has rarely been studied through the lens of adaptation's complement, maladaptation. This contrast is surprising because maladaptation is a prevalent feature of evolution: population trait values are rarely distributed optimally; local populations often have lower fitness than imported ones; populations decline; and local and global extinctions are common. Yet we lack a general framework for understanding maladaptation; for instance in terms of distribution, severity, and dynamics. Similar uncertainties apply to the causes of maladaptation. We suggest that incorporating maladaptation‐based perspectives into evolutionary biology would facilitate better understanding of the natural world. Approaches within a maladaptation framework might be especially profitable in applied evolution contexts – where reductions in fitness are common. Toward advancing a more balanced study of evolution, here we present a conceptual framework describing causes of maladaptation. As the introductory article for a Special Feature on maladaptation, we also summarize the studies in this Issue, highlighting the causes of maladaptation in each study. We hope that our framework and the papers in this Special Issue will help catalyze the study of maladaptation in applied evolution, supporting greater understanding of evolutionary dynamics in our rapidly changing world.
Multitasking is ubiquitous in our everyday life. Accordingly, situations in which two or more tasks need to be handled concurrently or in close temporal succession have been studied intensely. Different paradigms have been developed in that context (Koch et al., 2018). Over the last decades, the psychological refractory period (PRP) paradigm has dominated dual-task research, because it allows quantitative predictions of reaction time increases coupled to stimulus onset asynchrony. Part of the success of this paradigm is grounded in the fact that most of the studies are run under strict experimental control with very elementary tasks, mostly characterized by a definite start and ending. However, it remains unclear whether these limited settings sufficiently reflect the range of eventualities we find in real life. Rather, there is accumulating evidence that important factors modulating multitask performance are not sufficiently captured by the PRP approach. Here we focus on evidence that motor responses that involve continuous interaction with the environment may engage processes that alter the coordination of concurrently performed tasks in fundamental ways. ...
Among the causality assessment methods used for the diagnosis of drug-induced liver injury (DILI), Roussel Uclaf Causality Assessment Method (RUCAM) remains the most widely used not only for individual cases but also for prospective and retrospective studies worldwide. This first place is justified by the characteristics of the method such as precise definition and classification of the liver injury, which determines the right scale in the scoring system, precise definition of the seven criteria, and the validation approach based on cases with positive rechallenge. RUCAM is used not only for any types of drugs but also for herbal medicines causing herb-induced liver injury, (HILI) and dietary supplements. In 2016, the updated RUCAM provided further specifications of criteria and instructions to improve interobserver variability. Although this method was criticized for criteria such as the age and alcohol consumption, recent consensus meeting of experts has recognized their value and recommended their incorporation into any method. While early studies searching for DILI in large databases especially in electronic medical records were based on codes of diseases or natural language without causality assessment, the recommendation is now to include RUCAM in the search for DILI/HILI. There are still studies on DILI detection or the identification of biomarkers that take into consideration the cases assessed as “possible,” although it is well known that these cases reduce the strength of the association between the cases and the offending compound or the new biomarker to be validated. Attempts to build electronic RUCAM or automatized application of this method were successful despite some weaknesses to be corrected. In the future, more reflections are needed on an expert system to standardize the exclusion of alternative causes according to the clinical context. Education and training on RUCAM should be encouraged to improve the results of the studies and the day-to-day work in pharmacovigilance departments in companies or in regulatory agencies. It is also expected to improve RUCAM with biomarkers or other criteria provided that the validation process replaces expert opinion by robust standards such as those used for the original method.