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Up to 50% of patients initially treated for prostate cancer in a curative intent experience biochemical recurrence, possibly requiring adjuvant treatment. However, salvage treatment decisions, such as lymph node dissection or radiation therapy, are typically based on prostate specific antigen (PSA) recurrence. Importantly, common imaging modalities (e.g., computed tomography [CT], magnetic resonance imaging, and bone scan) are limited and the detection of recurrent disease is particularly challenging if PSA is low. Prostate specific membrane antigen (PSMA) positron-emission tomography/computed tomography (PET/CT) is a novel and promising imaging modality which aims to overcome the incapability of early identification of distant and regional metastases. Within this review, we summarize the current evidence related to PSMA-PET/CT in prostate cancer men diagnosed with biochemical recurrence after local treatment with curative intent. We discuss detection rates of PSMA-PET/CT stratified by PSA-levels and its impact on clinical decision making. Furthermore, we compare different imagefusion techniques such as PSMA-PET vs. F-/C-Choline-PET scans vs. PSMA-single photon emission computed tomography/CT. Finally, we touch upon the contemporary role of radio-guided-PSMA salvage lymphadenectomy.
After removal of a dental implant or extraction of a tooth in the upper jaw, the closure of an oroantral fistula (OAF) or oroantral communication (OAC) can be a difficult problem confronting the dentist and surgeon working in the oral and maxillofacial region. Oroantral communication (OAC) acts as a pathological pathway for bacteria and can cause infection of the antrum, which further obstructs the healing process as it is an unnatural communication between the oral cavity and the maxillary sinus. There are different ways to perform the surgical closure of the OAC. The decision-making in closure of oroantral communication and fistula is influenced by many factors. Consequently, it requires a combination of knowledge, experience, and information gathering. Previous narrative research has focused on assessments and comparisons of various surgical techniques for the closure of OAC/OAF. Thus, the decision-making process has not yet been described comprehensively.
The present study aims to illustrate all the factors that have to be considered in the management of OACs and OAFs that determine optimal treatment.
5-lipoxygenase (5-LO) is the key enzyme in the biosynthesis of leukotrienes and specialized proresolving lipid mediators (SPM). It is mainly expressed in leukocytes and is part of the innate immune system. 5-LO can shuttle between the cytosol and the nucleus. Upon cell activation the protein translocates from soluble cellular compartments to the nuclear membrane. Besides FLAP which is required for cellular leukotriene and SPM formation, 5-LO interacts with other proteins like coactosin-like protein (CLP), Dicer, β-catenin and p53. In this review, the factors involved in the regulation of 5-LO expression, the role of 5-LO in the regulation of stem cell proliferation and differentiation and its biological functions apart from leukotriene and SPM formation are summarized.
Chirality is omnipresent in living nature. On the single molecule level, the response of a chiral species to a chiral probe depends on their respective handedness. A prominent example is the difference in the interaction of a chiral molecule with left or right circularly polarized light. In the present study, we show by Coulomb explosion imaging that circularly polarized light can also induce a chiral fragmentation of a planar and thus achiral molecule. The observed enantiomer strongly depends on the orientation of the molecule with respect to the light propagation direction and the helicity of the ionizing light. This finding might trigger new approaches to improve laser-driven enantioselective chemical synthesis.
CRFVoter : gene and protein related object recognition using a conglomerate of CRF-based tools
(2019)
Background: Gene and protein related objects are an important class of entities in biomedical research, whose identification and extraction from scientific articles is attracting increasing interest. In this work, we describe an approach to the BioCreative V.5 challenge regarding the recognition and classification of gene and protein related objects. For this purpose, we transform the task as posed by BioCreative V.5 into a sequence labeling problem. We present a series of sequence labeling systems that we used and adapted in our experiments for solving this task. Our experiments show how to optimize the hyperparameters of the classifiers involved. To this end, we utilize various algorithms for hyperparameter optimization. Finally, we present CRFVoter, a two-stage application of Conditional Random Field (CRF) that integrates the optimized sequence labelers from our study into one ensemble classifier.
Results: We analyze the impact of hyperparameter optimization regarding named entity recognition in biomedical research and show that this optimization results in a performance increase of up to 60%. In our evaluation, our ensemble classifier based on multiple sequence labelers, called CRFVoter, outperforms each individual extractor’s performance. For the blinded test set provided by the BioCreative organizers, CRFVoter achieves an F-score of 75%, a recall of 71% and a precision of 80%. For the GPRO type 1 evaluation, CRFVoter achieves an F-Score of 73%, a recall of 70% and achieved the best precision (77%) among all task participants.
Conclusion: CRFVoter is effective when multiple sequence labeling systems are to be used and performs better then the individual systems collected by it.
Congenitally blind individuals have been shown to activate the visual cortex during non-visual tasks. The neuronal mechanisms of such cross-modal activation are not fully understood. Here, we used an auditory working memory training paradigm in congenitally blind and in sighted adults. We hypothesized that the visual cortex gets integrated into auditory working memory networks, after these networks have been challenged by training. The spectral profile of functional networks was investigated which mediate cross-modal reorganization following visual deprivation. A training induced integration of visual cortex into task-related networks in congenitally blind individuals was expected to result in changes in long-range functional connectivity in the theta-, beta- and gamma band (imaginary coherency) between visual cortex and working memory networks. Magnetoencephalographic data were recorded in congenitally blind and sighted individuals during resting state as well as during a voice-based working memory task; the task was performed before and after working memory training with either auditory or tactile stimuli, or a control condition. Auditory working memory training strengthened theta-band (2.5-5 Hz) connectivity in the sighted and beta-band (17.5-22.5 Hz) connectivity in the blind. In sighted participants, theta-band connectivity increased between brain areas typically involved in auditory working memory (inferior frontal, superior temporal, insular cortex). In blind participants, beta-band networks largely emerged during the training, and connectivity increased between brain areas involved in auditory working memory and as predicted, the visual cortex. Our findings highlight long-range connectivity as a key mechanism of functional reorganization following congenital blindness, and provide new insights into the spectral characteristics of functional network connectivity.
Purpose: Prisoners have a higher risk of suicide compared to non-incarcerated individuals. One aim of suicide prevention for prisoners is to identify risk factors in order to put stronger support mechanisms in place for the more vulnerable detainees. This study investigates the suicide risk (SR) in offence-related sub-populations in a representative German sample and differentiates between SR for adolescent and adult prisoners.
Methods: Conducting a national study with data from public German records on the entire prison population from 2000 to 2016 and suicide numbers in German prisons in the same period, SR was calculated for the total male prison population as well as for both subgroups, adolescent and adult male prisoners.
Results: In the study period, male prisoners spent 959.584 life years (LY) in German criminal detention. Among those, 524 prisoners died of suicide. SR was higher for detainees imprisoned for an offence resulting in extensive physical harm for another person, e.g. homicide (suicide rate = 134,8 suicides per 100.000 LY; OR = 2,47; CI95%: 1,98–3,08), bodily injury (suicide rate = 87,3; OR = 1,60; CI95%: 1,29–1,99), and sexual offences (suicide rate = 84,2; OR = 1,54; CI95%: 1,18–2,01) compared with the SR of the total prison population (suicide rate = 54.6). Age differences between offence-related SR were found for theft, with adolescents (suicide rate = 69,3; OR = 1,25; CI95%: 0,85–1,84) showing higher SR than adults (suicide rate = 38,2; OR = 0,7; CI95%: 0,54–0,92).
Conclusion: The index offence of detainees is associated with SR and age-related differences exist. Suicide prevention in prisons should take both into account to determine populations at risk.
Twilight, Tintenherz, The Hunger Games und – auch 20 Jahre nach Erstpublikation des ersten Bandes ist an ihm kein Vorbeikommen – Harry Potter: Wir kennen sie alle, die großen kommerziellen Erfolge der Literaturbranche der Gegenwart. Seit dem durchschlagenden Erfolg von J.K. Rowlings Romanserie um den Zauberlehrling ist der Markt geradezu überschwemmt von seriellen Erzählungen, die im öffentlichen Diskurs als Fantasyerzählungen wahrgenommen beziehungsweise beschrieben werden. Deren Popularität dokumentieren seit nunmehr 20 Jahren in Deutschland die Jahresbestsellerlisten des Spiegel: Während im Jahr 2000 die deutschen Übersetzungen der ersten drei Harry Potter-Bände die Plätze 1 bis 3 belegen (vgl. Der Spiegel 2000, S. 206), ist auch das postHarry Potter-Deutschland diese Art von Romanserien nicht leid. Im Jahr 2008 finden sich unter den meistverkauften Romanen unter anderem Cornelia Funkes TintenherzTrilogie (2003–2007), Stephenie Meyers Bis(s)-Romane (2005–2009), Bände von Christopher Paolinis Eragon (2004–2011), der Romanserie House of Night (2009–2014) des Mutter-und-Tochter-Teams Casts, Kerstin Giers Liebe geht durch alle Zeiten- (2009–2010) und Silber-Serien (2013–2015) und Suzanne Collins’ Die Tribute von Panem (2008–2010) (vgl. Der Spiegel 2009, S. 131). Die ehemals der Allgemeinliteratur vorbehaltene Belletristik-Bestsellerliste des Spiegel kann sich Romanen nicht länger erwehren, die LeserInnen in den Kinder- und Jugendbuchabteilungen ihrer Buchhandlungen finden können. ...
Bilderbücher verfügen über einen Körper im Raum. Sie haben ein bestimmtes Format und Gewicht, bestehen aus Papier, einem Rücken, Vorsatzblättern und Knickkanten. Wie Druckmedien generell sind sie jeweils auf eine bestimmte Art gemacht und konstituieren sich durch eine Form, Gestalt und Oberfläche. BüchermacherInnen weisen in ästhetischen Reflexionen auf die verwandte Struktur der Architektur mit ihrem Metier und Medium hin. Der Typograph Jan Tschichold etwa versteht Druckwerke als eigene architektonische Ausdrucksform von Linie, Fläche und Raum und fasst seine Rolle bei der Reform der Penguin Books »als verantwortlicher Architekt der Bücher« auf (zitiert in Fleischmann 2013, S. 49). Dass Ideen nicht einfach in der Luft liegen und Künstlerisches der Konstruktion bedarf, hebt der Autor Hermann Burger in Die allmähliche Verfertigung der Idee beim Schreiben hervor. In seiner Poetik-Vorlesung geht Burger darauf ein, wie der Autor eine Situation entwirft, einen Gegenstand mit Wörtern anpackt, dreht und wendet, und schreibt, dass er während seines abgebrochenen Architekturstudiums, »im architektonischen Entwerfen[,] mehr für das spätere Schreiben gelernt habe als während der ganzen Germanistikausbildung« (Burger 1986, S. 12). ...
This article examines three novels by the popular Flemish youth author Gie Laenen, written between 1975 and 1982, in which the theories and practices associated with progressive education in the 1970s are key elements of the narrative. It argues that Laenen, who was convicted in 1973 and again in 2008 of serial sexual abuse of teenage boys, used progressive education as a narrative trope both to suggest to his young readers that close attachments between young boys and adult men were harmless and to provide an exculpatory defence for his own acts. Through narratological analysis and a contextualisation of the novels within the educational culture of the time, the article shows how Laenen – by drawing upon the ideas of progressive education, using these ideas to shape his narratives, and suggesting parallels between himself (as author) and several main characters – effectively appropriated the ideals of progressive education for ulterior purposes to justify his own abusive behaviour.
The rebellious spirit of 1968 was characterised, among other things, by a strong aversion to authority of any form. In Dutch children’s literature, this spirit is personified by the author Miep Diekmann. From the end of the 1950s until the end of the 1980s, Diekmann contested all kinds of social injustice, both in her children’s books and in her critical work. This article discusses how she challenged the status quo in Dutch children’s literature, firstly through her efforts to improve the cultural status of children’s literature, and secondly through writing books with a different view of the world than the one with which children were then familiar. In interviews, reviews, and discussions with politicians, she successfully appealed for more academic and critical attention for books for young readers. With her children’s books she wanted to make her readers think independently about all kinds of social injustice. Whereas in her first books a tension can be observed between her ambition to make children aware of forms of inequality and her intention to let her reading audience judge for themselves, in her later novels, in particular in De dagen van olim, [The Days of Yore] (1971), she presents social injustice in a way that leaves more to the imagination of her readers.
In der Theatergeschichte wurde von Aristoteles bis Brecht immer wieder angenommen, dass ein Bühnengeschehen das Publikum beeinflussen kann. Entsprechend nahe liegt der Gedanke, das Theater als Erziehungsinstrument einzusetzen, wie es z. B. im Jesuitentheater der Renaissance oder den didaktischen Dramen der Aufklärung der Fall war. Stand bei Ersteren die Vermittlung der christlichen Heilslehre im Mittelpunkt, können Letztere als »Einübung in gesellschaftliche Verhaltensnormen« (Schedler 1974, S. 23) verstanden werden. Auch das emanzipatorische Kindertheater der 1960er Jahre verfolgt erzieherische Ziele, obgleich diese sich signifikant von den oben genannten unterscheiden. Hier sollen Kinder nicht lernen, indem neue Ängste erzeugt, »sondern alte benannt [und] sprachlich faßbar« gemacht werden (Reisner 1983, S. 116). ...
Setzt man bei der Darstellung revolutionärer Prozesse im Kindertheater in den 1960/70er Jahren an, so liegt der Fokus auf einer Zeit gesellschaftlicher Umbrüche und politisch-sozialer Bewegungen, die für die Geschichte des Kinder- und Jugendtheaters von besonderer Bedeutung ist (vgl. Schneider 1984). Wie andere Intellektuelle und KünstlerInnen auch wurden Theaterschaffende von den Protesten und dem Klima der Veränderung und des Aufbruchs vielfältig angeregt. Auch im Theater wurden Autoritäten hinterfragt, traditionelle Repertoirestücke einer kritischen Revision unterzogen und neue Spielformen erprobt. Das Revolutionäre erscheint hier zunächst als eine Hinwendung zum Politischen, die auch bestehende und neu gegründete Kindertheater erfasste. Erkennbar wird eine gesellschaftlich engagierte Theaterarbeit, die Formen der Unterdrückung (z. B. von Kindern) dokumentierte und mit großem Engagement bekämpfte. Mit den Mitteln des Theaters sollten kulturelle und gesellschaftliche Veränderungen durchgesetzt werden und die Theaterbühne sollte ein Ort der Revolution gegen gesellschaftliche Missstände sein. Theaterarbeit war politische Arbeit und Kindertheater ein »Mittel, auf gesellschaftliche Zustände einzuwirken« (Ludwig 1994, S. 24). ...
Kaum eine Zeit steht so sehr für die sexuelle Befreiung und Sprengung familialer Strukturen wie die 1968er (vgl. Herzog 2005). Kaum ein Märchen steht in der psychoanalytischen Deutung so sehr für den sexuellen Reifungsprozess und das Unabhängigwerden eines Kindes wie Der Froschkönig. Der vorliegende Artikel greift diese Verbindung auf, da gerade während der 68er-Bewegung verschiedene Wasser- und Amphibienfiguren in der Kinder- und Jugendliteratur (KJL) vorkommen, die stark an die Motive des Märchens erinnern. Besonders prominente Beispiele hierfür sind: Christine Nöstlingers Wir pfeifen auf den Gurkenkönig von 1972 sowie Mirjam Presslers Erzählung Goethe in der Kiste, die zwar erst 1987 erschienen ist, jedoch deutliche Züge des anti-autoritären Gedankenguts der Protestkultur aufweist. Diesen Texten ist gemein, dass ihre Motive augenscheinlich von einem Märchen geprägt sind, das von der Psychoanalyse als Sinnbild für den Reifungsvorgang eines Kindes bewertet wird, welches sich aus seiner inzestuösen Verstricktheit mit dem Vater lösen muss. Während Presslers Buch den Froschkönig explizit anzitiert, kann Nöstlingers Gurkenkönig als eine Schwell- und Schwellenfigur gelesen werden, die ähnliche Prozesse in Gang setzt wie die Märchengestalt. ...
The years around May ’68 (c. 1965 – c. late-1970s) are widely understood to represent a watershed moment for children’s books in France. An important factor was the influence of a new fringe of avant-garde publishers that attracted attention across their trade in and beyond France. Using archives and interviews and accounts of some of the books produced and their reception, this article presents case studies of the most influential publishing houses as a series of three snapshots of the areas of movement in the field. At the same time, it evaluates the extent to which the social, cultural and political upheavals in France in the wake of May ’68 helped to alter the shape of book production for children and to bring about a ›radical revolution‹ in the children’s publishing trade.
This article, based on extensive source material from Denmark, Sweden and Norway, is about the changing norms for children’s media, childhood and art in Scandinavia in the late 1960s and early 1970s. The analysis demonstrates how changes within welfare state institutions converged with the youth rebellion’s wider criticism of children’s low status in traditional power hierarchies, and contributed to new definitions of the role of media in children’s lives. After establishing a wider historical contextualisation, the article moves on to show how the criticism of existing norms in the realm of children’s literature in the mid-1960s grew into a critique of the prevailing ideologies and existing narratives in all children’s media (including film, theatre and television) at the end of the decade. A key figure in the redefinition of norms for children’s media was the Swede, Gunilla Ambjörnsson. Her 1968 book, Trash Culture for Children, led to discussions about the role of media in children’s lives all over Scandinavia. Her core belief in the innate social and political interests of children had a great impact on the ways in which the possibilities for an explicit political agenda in children’s media were conceptualised in Scandinavia at large.
Fünfzig Jahre nach 1968. Fünfzig Jahre nach der Studentenrevolte.
Was hat sie in Deutschland bewirkt? Was ist geblieben? Wo haben sich die 68er geirrt? Fragen, mit denen man seit Beginn des Jahres konfrontiert wird. Namen und Fakten, die erinnert werden: Benno Ohnesorg, Rudi Dutschke, Alice Schwarzer, Rainer Langhans, Kommune 1. – Die Jugend, aber nicht nur die, ging auf die Straße, protestierte gegen Alt-Nazis in Führungspositionen oder juristischen und öffentlichen Institutionen, forderte Gleichberechtigung für die Frauen und vieles mehr. Der Protest richtete sich gegen verkrustete Strukturen und falsche Selbstverständlichkeiten. ...
We study the well-known resonance ψ(4040), corresponding to a 33S1 charm–anticharm vector state ψ(3S), within a QFT approach, in which the decay channels into DD, D∗D, D∗D∗, DsDs and D∗s Ds are considered. The spectral function shows sizable deviations from a Breit–Wigner shape (an enhancement, mostly generated by DD∗loops, occurs); moreover, besides the c ¯ c pole of ψ(4040), a second dynamically generated broad pole at 4 GeV emerges. Naively, it is tempting to identify this new pole with the unconfirmed state Y (4008). Yet, this state was not seen inthe reaction e+e− → ψ(4040) → DD∗, but in processes with π+π−J/ψ in the final state. A detailed study shows a related but different mechanism: a broad peak at 4GeV in the process e+e− → ψ(4040) → DD∗ → π+π−J/ψ appears when DD∗ loops are considered. Its existence in this reaction is not necessarily connected to the existence of a dynamically generated pole, but the underlying mechanism – the strong coupling of c ¯ c to DD∗ loops – can generate both of them. Thus, the controversial state Y (4008) may not be a genuine resonance, but a peak generated by the ψ(4040) and D∗D loops with π+π−J/ψ in the final state.
Editorial
(2018)
»Under the pavement lies the beach« or »Power to the imagination« – these slogans characterise the movement of ’68, which publicised its social and political demands in a creative and programmatic fashion. The year 1968 not only marks a significant upheaval in what was then West Germany, it also has strong East and West European as well as international dimensions. ’68 can be understood as a cipher for protest movements which re-evaluated and challenged institutional structures, revolutionised gender and intergenerational relations and radiated into daily life, family life as well as individual lifestyles. Literature and the media, too, were subjected to critical revision, new formats and writing styles established, traditions either abandoned or continued within new paradigms.
Children’s literature and media were significantly shaped by these developments. Their contents were influenced by the anti-authoritarian discourse in education and by the demands of emancipation movements, their themes and aesthetics by politicised concerns and a new orientation towards sociopolitical reality. Children’s literature scholars have studied and identified ’68 as a paradigm shift. Recent studies, however, have also looked at developments in the late 1950s and early 1960s, pointing out that changes on the literary-aesthetic and content levels actually started much earlier.
Fifty years after this ›paradigmatic‹ caesura, the second volume of the Yearbook of the German Children’s Literature Research Society brings the cipher »’68« into focus to discuss historical and contemporary dimensions of this junction. Articles from a variety of European perspectives examine the manifold implications of this topic from theoretical and subject-oriented angles and in its different medial forms, and discuss these in the context of their significance for today’s children’s and young adult culture.
Beyond this focus theme, and in line with the concept of the Yearbook, two fundamental theoretical and historical articles on questions of children’s literature and media present current avenues and perspectives. And the ten articles are followed by book reviews. Thanks to the involvement of the members of the German Children’s Literature Research Society (GKJF), over 30 relevant publications from the past year are discussed in individual and collective book reviews.
Editorial
(2018)
»Unter dem Pflaster liegt der Strand« oder »Die Phantasie an die Macht« – diese Slogans charakterisieren die ’68er-Bewegung, die kreativ, programmatisch und parolenreich ihre (gesamt)gesellschaftlichen Forderungen in die Öffentlichkeit trug. Nicht nur für die bundesrepublikanische Gesellschaft stellt das Jahr 1968 einen bedeutsamen Umbruch dar; vielmehr hat ’68 ebenso eine ost- wie westeuropäische und darüber hinausführende internationale Dimension. ’68 kann als Chiffre für Protestbewegungen (Kraushaar) verstanden werden, die in sehr unterschiedliche gesellschaftliche Bereiche ausgestrahlt haben. Die damit einhergehende Politisierung führte zur kritischen Bestandsaufnahme und Infragestellung bestehender staatlicher und institutioneller Ordnungen, revolutionierte die Geschlechter- und Generationsverhältnisse und reichte weit hinein in den Alltag, das Familienleben und die individuellen Lebensstile. Auch Literatur und Medien wurden einer kritischen Revision unterzogen und neue Themen, Schreibweisen und Genres etabliert, Traditionslinien wurden aufgebrochen bzw. unter neuen Vorzeichen weitergeführt.
Diese Entwicklungen bestimmten auch die Kinder- und Jugendliteratur und ihre Medien in entscheidender Weise: inhaltlich beeinflusst durch die antiautoritären Diskurse, wie sie im Bildungs- und Erziehungswesen geführt wurden, und die Forderungen der Emanzipationsbewegung(en), thematisch und ästhetisch orientiert an den politischen und gesellschaftskritischen Fragestellungen, einem neuen Realitätsbezug verpflichtet. Die Kinder- und Jugendliteraturforschung hat diese Reformen als Paradigmenwechsel benannt und erforscht; neuere Untersuchungen beziehen aber erkennbar auch die Entwicklungen der späten 1950er und frühen 1960er Jahre mit ein und weisen darauf hin, dass die Veränderungen literarästhetisch, aber auch inhaltlich bereits sehr viel früher einsetzten.
50 Jahre nach dieser ›paradigmatischen‹ Zäsur nimmt der zweite Jahrgang des Jahrbuchs der Gesellschaft für Kinder- und Jugendliteraturforschung 2018 die Chiffre ’68 in den Blick, um historische wie gegenwärtige Dimensionen dieser Schnittstelle zu diskutieren. Die Aufsätze greifen die vielfältigen Implikationen dieses Themenkomplexes sowohl aus theoretischer wie gegenstandsorientierter Perspektive in seinen unterschiedlichen medialen Gestaltungsformen auf, stellen sie, dank der internationalen Beiträge, in europäische Kontexte und reflektieren ihre Bedeutung für die heutige Kinder- und Jugendkultur. Dabei wird erforschtes Terrain weiter ausgeleuchtet, werden neue Fragestellungen entwickelt sowie bekannte Positionen und Texte einer kritischen Re-Lektüre unterzogen.
Entsprechend der Konzeption des Jahrbuchs stehen über das Schwerpunktthema ’68 hinaus grundlegende kinder- und jugendmediale Fragestellungen aus historischer wie theoretischer Perspektive im Fokus. Zwei Beiträge stellen aktuelle Forschungszugänge und -perspektiven vor.
Rezensionen zur Fachliteratur schließen sich den zehn Beiträgen an. Insgesamt konnten, dank der großen Beteiligung der Mitglieder der GKJF, über 30 Titel gesichtet und besprochen werden.
Background: Posttraumatic stress disorder (PTSD) after childhood abuse (CA) is often related to severe co-occurring psychopathology, such as symptoms of borderline personality disorder (BPD). The ICD-11 has included Complex PTSD as a new diagnosis, which is defined by PTSD symptoms plus disturbances in emotion regulation, self-concept, and interpersonal relationships. Unfortunately, the empirical database on psychosocial treatments for survivors of CA is quite limited. Furthermore, the few existing studies often have either excluded subjects with self-harm behaviour and suicidal ideation — which is common behaviour in subjects suffering from Complex PTSD. Thus, researchers are still trying to identify efficacious treatment programmes for this group of patients.
We have designed DBT-PTSD to meet the specific needs of patients with Complex PTSD. The treatment programme is based on the rules and principles of dialectical behavioural therapy (DBT), and adds interventions derived from cognitive behavioural therapy, acceptance and commitment therapy and compassion-focused therapy. DBT-PTSD can be provided as a comprehensive residential programme or as an outpatient programme. The effects of the residential programme were evaluated in a randomised controlled trial. Data revealed significant reduction of posttraumatic symptoms, with large between-group effect sizes when compared to a treatment-as-usual wait list condition (Cohen’s d = 1.5).
The first aim of this project on hand is to evaluate the efficacy of the outpatient DBT-PTSD programme. The second aim is to identify the major therapeutic variables mediating treatment efficacy. The third aim is to study neural mechanisms and treatment sensitivity of two frequent sequelae of PTSD after CA: intrusions and dissociation.
Methods: To address these questions, we include female patients who experienced CA and who fulfil DSM-5 criteria for PTSD plus borderline features, including criteria for severe emotion dysregulation. The study is funded by the German Federal Ministry of Education and Research, and started in 2014. Participants are randomised to outpatient psychotherapy with either DBT-PTSD or Cognitive Processing Therapy. Formal power analysis revealed a minimum of 180 patients to be recruited. The primary outcome is the change on the Clinician-Administered PTSD Scale for DSM-5.
Discussion: The expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD.
Trial registration: German Clinical Trials Register: registration number DRKS00005578, date of registration 19 December 2013.
Synthesis and SAR of the antistaphylococcal natural product nematophin from Xenorhabdus nematophila
(2019)
The repeated and improper use of antibiotics had led to an increased number of multiresistant bacteria. Therefore, new lead structures are needed. Here, the synthesis and an expanded structure–activity relationship of the simple and antistaphylococcal amide nematophin from Xenorhabdus nematophila and synthetic derivatives are described. Moreover, the synthesis of intrinsic fluorescent derivatives, incorporating azaindole moieties was achieved for the first time.
Background: While the incidence and aspects of pneumonia in ICU patients has been extensively discussed in the literature, studies on the occurrence of pneumonia in severely injured patients are rare. The aim of the present study is to elucidate factors associated with the occurrence of pneumonia in severely injured patients with thoracic trauma.
Setting: Level-I University Trauma Centres associated with the TraumaRegister DGU®.
Methods: A total of 1162 severely injured adult patients with thoracic trauma documented in the TraumaRegister DGU® (TR-DGU) were included in this study. Demographic data, injury severity, duration of mechanical ventilation (MV), duration of ICU stay, occurrence of pneumonia, bronchoalveolar lavage, aspiration, pathogen details, and incidences of mortality were evaluated. Statistical evaluation was performed using SPSS (Version 25.0, SPSS, Inc.) software.
Results: The overall incidence of pneumonia was 27.5%. Compared to patients without pneumonia, patients with pneumonia had sustained more severe injuries (mean ISS: 32.6 vs. 25.4), were older (mean age: 51.3 vs. 47.5) and spent longer periods under MV (mean: 368.9 h vs. 114.9 h). Age, sex (male), aspiration, and duration of MV were all independent predictors for pneumonia occurrence in a multivariate analysis. The cut-off point for duration of MV that best discriminated between patients who would and would not develop pneumonia during their hospital stay was 102 h. The extent of thoracic trauma (AISthorax), ISS, and presence of pulmonary comorbidities did not show significant associations to pneumonia incidence in our multivariate analysis. No significant difference in mortality between patients with and without pneumonia was observed.
Conclusions: Likelihood of pneumonia increases with age, aspiration, and duration of MV. These parameters were not found to be associated with differences in outcomes between patients with and without pneumonia. Future studies should focus on independent parameters to more clearly identify severely injured subgroups with a high risk of developing pneumonia.
Level of evidence: Level II - Retrospective medical record review.
Glioblastoma is one of the deadliest malignancies and is virtually incurable. Accumulating evidence indicates that a small population of cells with a stem-like phenotype is the major culprit of tumor recurrence. Enhanced DNA repair capacity and expression of stemness marker genes are the main characteristics of these cells. Elimination of this population might delay or prevent tumor recurrence following radiochemotherapy. The aim of this study was to analyze whether interference with the Hedgehog signaling (Hh) pathway or combined Hh/Notch blockade using small-molecule inhibitors can efficiently target these cancer stem cells and sensitize them to therapy. Using tumor sphere lines and primary patient-derived glioma cultures we demonstrate that the Hh pathway inhibitor GANT61 (GANT) and the arsenic trioxide (ATO)-mediated Hh/Notch inhibition are capable to synergistically induce cell death in combination with the natural anticancer agent (−)-Gossypol (Gos). Only ATO in combination with Gos also strongly decreased stemness marker expression and prevented sphere formation and recovery. These synergistic effects were associated with distinct proteomic changes indicating diminished DNA repair and markedly reduced stemness. Finally, using an organotypic brain slice transplantation model, we show that combined ATO/Gos treatment elicits strong growth inhibition or even complete elimination of tumors. Collectively, our data show for the first time that ATO and Gos, two drugs that can be used in the clinic, represent a promising targeted therapy approach for the synergistic elimination of glioma stem-like cells.
Phytotoxic dioxolanones from Guignardia bidwellii can be described as potential virulence factors which cause the formation of lesions upon an infection by G. bidwellii. The toxin guignardic acid was found in planta of G. bidwellii-infected Vitis vinifera leaves, whereas no phytotoxic dioxolanones were detected in uninfected leaf material. Secondary metabolism analyses of further phytopathogenic fungi from the genus Guignardia led to the observation that all species investigated can produce the phytotoxins known from G. bidwellii. In addition to these studies, it was demonstrated that phenguignardic acid is biosynthetically derived from two molecules of phenylalanine and that phenylalanine is a key precursor in the biosynthesis of the two other phytotoxins – alaguignardic acid and guignardic acid.
Current technologies used to generate CRISPR/Cas gene perturbation reagents are labor intense and require multiple ligation and cloning steps. Furthermore, increasing gRNA sequence diversity negatively affects gRNA distribution, leading to libraries of heterogeneous quality. Here, we present a rapid and cloning-free mutagenesis technology that can efficiently generate covalently-closed-circular-synthesized (3Cs) CRISPR/Cas gRNA reagents and that uncouples sequence diversity from sequence distribution. We demonstrate the fidelity and performance of 3Cs reagents by tailored targeting of all human deubiquitinating enzymes (DUBs) and identify their essentiality for cell fitness. To explore high-content screening, we aimed to generate the largest up-to-date gRNA library that can be used to interrogate the coding and noncoding human genome and simultaneously to identify genes, predicted promoter flanking regions, transcription factors and CTCF binding sites that are linked to doxorubicin resistance. Our 3Cs technology enables fast and robust generation of bias-free gene perturbation libraries with yet unmatched diversities and should be considered an alternative to established technologies.
The paper outlines a method for investigating the speed effect due to a time limit in testing. It is assumed that the time limit enables latent processing speed to influence responses by causing omissions in the case of insufficient speed. Because of processing speed as additional latent source, the customary confirmatory factor model is enlarged by a second latent variable representing latent processing speed. For distinguishing this effect from other method effects, the factor loadings are fixed according to the cumulative normal distribution. With the second latent variable added, confirmatory factor analysis of reasoning data (N=518) including omissions because of a time limit yielded good model fit and discriminated the speed effect from other possible effects due to the item difficulty, the homogeneity of an item subset and the item positions. Because of the crucial role of the cumulative normal distribution for fixing the factor loadings a check of the normality assumption is also reported.
Discovery of key whole-brain transitions and dynamics during human wakefulness and non-REM sleep
(2019)
The modern understanding of sleep is based on the classification of sleep into stages defined by their electroencephalography (EEG) signatures, but the underlying brain dynamics remain unclear. Here we aimed to move significantly beyond the current state-of-the-art description of sleep, and in particular to characterise the spatiotemporal complexity of whole-brain networks and state transitions during sleep. In order to obtain the most unbiased estimate of how whole-brain network states evolve through the human sleep cycle, we used a Markovian data-driven analysis of continuous neuroimaging data from 57 healthy participants falling asleep during simultaneous functional magnetic resonance imaging (fMRI) and EEG. This Hidden Markov Model (HMM) facilitated discovery of the dynamic choreography between different whole-brain networks across the wake-non-REM sleep cycle. Notably, our results reveal key trajectories to switch within and between EEG-based sleep stages, while highlighting the heterogeneities of stage N1 sleep and wakefulness before and after sleep.
Background: Peritonitis is responsible for thousands of deaths annually in Germany alone. Even source control (SC) and antibiotic treatment often fail to prevent severe sepsis or septic shock, and this situation has hardly improved in the past two decades. Most experimental immunomodulatory therapeutics for sepsis have been aimed at blocking or dampening a specific pro-inflammatory immunological mediator. However, the patient collective is large and heterogeneous. There are therefore grounds for investigating the possibility of developing personalized therapies by classifying patients into groups according to biomarkers. This study aims to combine an assessment of the efficacy of treatment with a preparation of human immunoglobulins G, A, and M (IgGAM) with individual status of various biomarkers (immunoglobulin level, procalcitonin, interleukin 6, antigen D-related human leucocyte antigen (HLA-DR), transcription factor NF-κB1, adrenomedullin, and pathogen spectrum).
Methods/design: A total of 200 patients with sepsis or septic shock will receive standard-of-care treatment (SoC). Of these, 133 patients (selected by 1:2 randomization) will in addition receive infusions of IgGAM for 5 days. All patients will be followed for approximately 90 days and assessed by the multiple-organ failure (MOF) score, by the EQ QLQ 5D quality-of-life scale, and by measurement of vital signs, biomarkers (as above), and survival.
Discussion: This study is intended to provide further information on the efficacy and safety of treatment with IgGAM and to offer the possibility of correlating these with the biomarkers to be studied. Specifically, it will test (at a descriptive level) the hypothesis that patients receiving IgGAM who have higher inflammation status (IL-6) and poorer immune status (low HLA-DR, low immunoglobulin levels) have a better outcome than patients who do not receive IgGAM. It is expected to provide information that will help to close the knowledge gap concerning the association between the effect of IgGAM and the presence of various biomarkers, thus possibly opening the way to a personalized medicine.
Trial registration: EudraCT, 2016–001788-34; ClinicalTrials.gov, NCT03334006. Registered on 17 Nov 2017.
Trial sponsor: RWTH Aachen University, represented by the Center for Translational & Clinical Research Aachen (contact Dr. S. Isfort).
Glaubt man Hermann Parzinger, entsteht in Berlin das würdige Zentrum einer Art Welthauptstadt: "Das Humboldt Forum: 'So viel Welt mit sich verbinden als möglich'"– das ist der Titel des 2011 herausgegebenen Folianten der Stiftung Preußischer Kulturbesitz, deren Präsident Parzinger ist. Die markigen Worte umreißen das Ziel des "wichtigsten Kulturprojekts in Deutschland zu Beginn des 21. Jahrhunderts", wie es im Untertitel heißt. "So viel Welt mit sich verbinden als möglich". Von wem stammt dieses werbewirksame Schlagwort? Und: Wie ist dieses Verbinden zu denken? [...] Mich interessiert hier und im Folgenden der erste Kontakt, der sich im Verb "ergreifen" ausdrückt. Offensichtlich setzt die Etablierung einer möglichst engen Verbindung von 'Mensch' und 'Welt' ein initiales Moment voraus, ein aktives Zupacken durch das Subjekt, das in der Folge die Fusion beider allererst ermöglicht. Das Ergreifen von "so viel Welt, als möglich" bildet das Fundament für humanistische Allgemeinbildung im Humboldt’schen Sinne: "[D]iese Aufgabe löst sich allein durch die Verknüpfung unsres Ich mit der Welt zu der allgemeinsten, regesten und freiesten Wechselwirkung." Angesichts der kontrovers geführten Kolonialismus-Debatte um das Humboldt-Forum ist es bemerkenswert, dass Parzingers Werbetext das Ergreifen tilgt, negiert er doch damit auch ein mögliches Gewaltmoment. Schließlich wurden Kolonien zuerst ergriffen, gewaltsam ein-genommen, bevor es zu einem zumindest einseitig produktiven Austausch von Waren, Kunst und dergleichen, zu einer "Verknüpfung" kommen konnte. Indem der Text die Kontaktanbahnung, das Ausgreifen verschweigt, kaschiert er damit auch das preußisch-imperiale Erbe. Wie sehr aber wirkt in jener Humboldt’schen Verbindung von Bildungssubjekt und Welt die initiale Gewalt fort, die an ihrem Anfang steht? Wie ist das Verhältnis von der "freiesten Wechselwirkung", also einer reziproken Interaktion, zum aggressiven, aktiven Ergreifen? Diese Fragen und der imperiale Wunsch, Berlin möge mit dem Humboldt-Forum nun zur "Angelegenheit der gesamten Welt werden", führen zu 'dem' Modell und Phantasma einer Welthauptstadt – zu Rom, genauer zum Rom Johann Wolfgang von Goethes.
In der Erinnerungskultur der Goethezeit spielt das haptische Erleben von Souvenirs eine entscheidende Rolle – im taktilen Umgang mit Andenken werden über Form, Materialität und Funktion Abwesende vergegenwärtigt, Erinnerungen und Gefühle evoziert. Nachvollziehbar wird die Kultivierung und Reflexion dieser Praktik der Erinnerungskultur in dem sehr gut überlieferten Nachlass von Johann Wolfgang von Goethe, der von der Klassik Stiftung Weimar bewahrt wird. Obwohl Goethe dem Tastsinn jegliche Erkenntnisfähigkeit abspricht und ihn als den niedersten der Sinne diskreditiert, werden das Berühren und Berührtwerden von Körpern und Dingen in seinen literarischen Werken sowie insbesondere in seinen privaten Korrespondenzen variantenreich verhandelt. Eingebettet in empfindsame Liebessemantik, assoziiert mit religiösen Praktiken und medizinischen Diskursen oder verknüpft mit erotischen Momenten ist die Berührung ein wiederkehrender Gegenstand expliziter und impliziter Auseinandersetzungen.
Für Aristoteles gleicht das Drama einem 'zóon', einem Lebewesen mit Anfang, Mitte und Ende. Gemeint sind Entstehung, Ausgestaltung und Abschluss der Handlungsstruktur, und zwar als 'psyché', als Seele, des Dramas. Aus einem Blickwinkel, der weniger am 'dráma' und mehr an den körperlichen Dimensionen des Theaters orientiert ist, ließe sich Aristoteles’ Vergleich auch zur Frage nach einer Organologie des Theaters und ihrer politischen und sinnesphysiologischen Implikationen wenden. Darum geht es mir im Folgenden – für ein unterschätztes Organ: für die Füße.
During the past 15 years there have been dramatic changes in the medical landscape, particularly in oncology and regenerative medicine. Cell therapies have played a substantial part in this progress. Cellular immunotherapies can use immune cells, such as T cells or natural killer cells that, after functional modification ex vivo, exert powerful anti-cancer effects when given to the patient. Innovative technologies, such as re-programming terminally differentiated cells into pluripotent stem cells or into other cell types and applying specific enzymes to more precisely edit the human genome, are paving the way towards more potent cell and gene therapies.
Mesenchymal stromal cells are promising cellular immunotherapeutics, which also have potential for use in tissue engineering strategies and other regenerative medicine applications. However, substantial gaps in our knowledge of their biology and therapeutic efficacy present major challenges to their sustainable implementation in the clinical routine.
In this article, progress in the field of cell therapeutics during the past 15 years will be briefly discussed, with a focus on mesenchymal stromal cells, highlighting the impact of this field on patient care.
Background: Prevention of persistent pain following breast cancer surgery, via early identification of patients at high risk, is a clinical need. Supervised machine-learning was used to identify parameters that predict persistence of significant pain.
Methods: Over 500 demographic, clinical and psychological parameters were acquired up to 6 months after surgery from 1,000 women (aged 28–75 years) who were treated for breast cancer. Pain was assessed using an 11-point numerical rating scale before surgery and at months 1, 6, 12, 24, and 36. The ratings at months 12, 24, and 36 were used to allocate patents to either "persisting pain" or "non-persisting pain" groups. Unsupervised machine learning was applied to map the parameters to these diagnoses.
Results: A symbolic rule-based classifier tool was created that comprised 21 single or aggregated parameters, including demographic features, psychological and pain-related parameters, forming a questionnaire with "yes/no" items (decision rules). If at least 10 of the 21 rules applied, persisting pain was predicted at a cross-validated accuracy of 86% and a negative predictive value of approximately 95%.
Conclusions: The present machine-learned analysis showed that, even with a large set of parameters acquired from a large cohort, early identification of these patients is only partly successful. This indicates that more parameters are needed for accurate prediction of persisting pain. However, with the current parameters it is possible, with a certainty of almost 95%, to exclude the possibility of persistent pain developing in a woman being treated for breast cancer.
Memory impairments are a major characteristic of schizophrenia (SZ). In the current study, we used an associative memory task to test the hypothesis that SZ patients and first-degree relatives have altered functional patterns in comparison to healthy controls. We analyzed the fMRI activation pattern during the presentation of a face-name task in 27 SZ patients, 23 first-degree relatives, and 27 healthy controls. In addition, we performed correlation analyses between individual psychopathology, accuracy and reaction time of the task and the beta scores of the functional brain activations. We observed a lower response accuracy and increased reaction time during the retrieval of face-name pairs in SZ patients compared with controls. Deficient performance was accompanied by abnormal functional activation patterns predominantly in DMN regions during encoding and retrieval. No significant correlation between individual psychopathology and neuronal activation during encoding or retrieval of face-name pairs was observed. Findings of first-degree relatives indicated slightly different functional pattern within brain networks in contrast to controls without significant differences in the behavioral task. Both the accuracy of memory performance as well as the functional activation pattern during retrieval revealed alterations in SZ patients, and, to a lesser degree, in relatives. The results are of potential relevance for integration within a comprehensive model of memory function in SZ. The development of a neurophysiological model of cognition in psychosis may help to clarify and improve therapeutic options to improve memory and functioning in the illness.
Numerous cell–cell and cell–matrix interactions within the bone marrow microenvironment enable the controlled lifelong self-renewal and progeny of hematopoietic stem and progenitor cells (HSPCs). On the cellular level, this highly mutual interaction is granted by cell adhesion molecules (CAMs) integrating differentiation, proliferation, and pro-survival signals from the surrounding microenvironment to the inner cell. However, cell–cell and cell–matrix interactions are also critically involved during malignant transformation of hematopoietic stem/progenitor cells. It has become increasingly apparent that leukemia-associated gene products, such as activated tyrosine kinases and fusion proteins resulting from chromosomal translocations, directly regulate the activation status of adhesion molecules, thereby directing the leukemic phenotype. These observations imply that interference with adhesion molecule function represents a promising treatment strategy to target pre-leukemic and leukemic lesions within the bone marrow niche. Focusing on myeloid leukemia, we provide a current overview of the mechanisms by which leukemogenic gene products hijack control of cellular adhesion to subsequently disturb normal hematopoiesis and promote leukemia development.
Background: Human genetic research has implicated functional variants of more than one hundred genes in the modulation of persisting pain. Artificial intelligence and machine‐learning techniques may combine this knowledge with results of genetic research gathered in any context, which permits the identification of the key biological processes involved in chronic sensitization to pain.
Methods: Based on published evidence, a set of 110 genes carrying variants reported to be associated with modulation of the clinical phenotype of persisting pain in eight different clinical settings was submitted to unsupervised machine‐learning aimed at functional clustering. Subsequently, a mathematically supported subset of genes, comprising those most consistently involved in persisting pain, was analysed by means of computational functional genomics in the Gene Ontology knowledgebase.
Results: Clustering of genes with evidence for a modulation of persisting pain elucidated a functionally heterogeneous set. The situation cleared when the focus was narrowed to a genetic modulation consistently observed throughout several clinical settings. On this basis, two groups of biological processes, the immune system and nitric oxide signalling, emerged as major players in sensitization to persisting pain, which is biologically highly plausible and in agreement with other lines of pain research.
Conclusions: The present computational functional genomics‐based approach provided a computational systems‐biology perspective on chronic sensitization to pain. Human genetic control of persisting pain points to the immune system as a source of potential future targets for drugs directed against persisting pain. Contemporary machine‐learned methods provide innovative approaches to knowledge discovery from previous evidence.
Significance: We show that knowledge discovery in genetic databases and contemporary machine‐learned techniques can identify relevant biological processes involved in Persitent pain.
Oxidative stress plays a fundamental role in many conditions. Specifically, redox imbalance inhibits endothelial cell (EC) growth, inducing cell death and senescence. We used global transcriptome profiling to investigate the involvement of noncoding-RNAs in these phenotypes. By RNA-sequencing, transcriptome changes were analyzed in human ECs exposed to H2O2, highlighting a pivotal role of p53-signaling. Bioinformatic analysis and validation in p53-silenced ECs, identified several p53-targets among both mRNAs and long noncoding-RNAs (lncRNAs), including MALAT1 and NEAT1. Among microRNAs (miRNAs), miR-192-5p was the most induced by H2O2 treatment, in a p53-dependent manner. Down-modulated mRNA-targets of miR-192-5p were involved in cell cycle, DNA repair and stress response. Accordingly, miR-192-5p overexpression significantly decreased EC proliferation, inducing cell death. A central role of the p53-pathway was also confirmed by the analysis of differential exon usage: Upon H2O2 treatment, the expression of p53-dependent 5’-isoforms of MDM2 and PVT1 increased selectively. The transcriptomic alterations identified in H2O2-treated ECs were also observed in other physiological and pathological conditions where redox control plays a fundamental role, such as ECs undergoing replicative senescence, skeletal muscles of critical limb-ischemia patients and the peripheral-blood mononuclear cells of long-living individuals. Collectively, these findings indicate a prominent role of noncoding-RNAs in oxidative stress response.
IKZF1 deletion (ΔIKZF1) is an important predictor of relapse in both childhood and adult B-cell precursor acute lymphoblastic leukemia (B-ALL). Previously, we revealed that COBL is a hotspot for breakpoints in leukemia and could promote IKZF1 deletions. Through an international collaboration, we provide a detailed genetic and clinical picture of B-ALL with COBL rearrangements (COBL-r). Patients with B-ALL and IKZF1 deletion (n = 133) were included. IKZF1 ∆1-8 were associated with large alterations within chromosome 7: monosomy 7 (18%), isochromosome 7q (10%), 7p loss (19%), and interstitial deletions (53%). The latter included COBL-r, which were found in 12% of the IKZF1 ∆1-8 cohort. Patients with COBL-r are mostly classified as intermediate cytogenetic risk and frequently harbor ETV6, PAX5, CDKN2A/B deletions. Overall, 56% of breakpoints were located within COBL intron 5. Cryptic recombination signal sequence motifs were broadly distributed within the sequence of COBL, and no enrichment for the breakpoint cluster region was found. In summary, a diverse spectrum of alterations characterizes ΔIKZF1 and they also include deletion breakpoints within COBL. We confirmed that COBL is a hotspot associated with ΔIKZF1, but these rearrangements are not driven by RAG-mediated recombination.
Background: Posaconazole (POS) is a potent triazole antifungal agent approved in adults for treatment and prophylaxis of invasive fungal infections (IFIs). The objectives of this study were to evaluate the pharmacokinetics (PK), safety, and tolerability of POS oral suspension in pediatric subjects with neutropenia.
Methods: This was a prospective, multicenter, sequential dose-escalation study. Enrolled subjects were divided into 3 age groups: AG1, 7 to <18 years; AG2, 2 to <7 years; and AG3, 3 months to <2 years. AG1 and AG2 were divided into 3 dosage cohorts: DC1, 12 mg/kg/day divided twice daily (BID); DC2, 18 mg/kg/day BID; and DC3, 18 mg/kg/day divided thrice daily (TID). AG3 was also divided into DC1 and DC2; however, no subjects were enrolled in DC2. Subjects received 7–28 days of POS oral suspension. PK samples were collected at predefined time points. The POS PK target was predefined as ~90% of subjects with Cavg (AUC /dosing interval) between 500 and 2500 ng/mL, with an anticipated mean steady state Cavg exposure of ~1200 ng/mL.
Results: The percentage of subjects meeting the PK target was <90% across all age groups and dosage cohorts (range: 31% to 80%). The percentage of subjects that achieved the Cavg target of 500 to 2500 ng/mL on Day 7 ranged from 31% to 80%, with the lowest proportion in subjects 2 to <7 years receiving 12 mg/kg/day BID (AG2/DC1) and the highest proportion in subjects 7 to <18 years receiving 18 mg/kg/day TID (AG1/DC3). At all three dose levels (12 mg/kg/day BID, 18 mg/kg/day BID and 18 mg/kg/day TID), subjects in AG1 (7 to <18 years old) had higher mean PK exposures at steady state than those in AG2. High variability in exposures was observed in all groups. POS oral suspension was generally well tolerated and most of the reported adverse events were related to the subjects’ underlying diseases.
Conclusion: The POS PK target of 90% of subjects with Cavg between 500 and 2500 ng/mL was not achieved in any of the age groups across the different dosage cohorts. New formulations of the molecule with a greater potential to achieve the established PK target are currently under investigation.
Trial registration: ClinicalTrials.gov identifier: NCT01716234
Purpose: To review the role of radiotherapy (RT) in the treatment of renal cell cancer (RCC) in the curative and palliative setting.
Content: Details related to the clinical outcomes of primary, preoperative, postoperative and palliative RT are discussed, along with a presentation of the established role of surgery and systemic therapy. An overview of data derived from mono- and multi-institutional trials is provided.
Conclusion: Radiotherapy has been shown to provide good symptom palliation and local control in RCC depending on the dose that can be delivered. There is emerging data suggesting that with the use of high-precision RT methods the indication spectrum of RT can be exploited covering different clinical situations particularly for unresectable local recurrences and oligometastatic disease.
The interdependence of selective cues during development of regulatory T cells (Treg cells) in the thymus and their suppressive function remains incompletely understood. Here, we analyzed this interdependence by taking advantage of highly dynamic changes in expression of microRNA 181 family members miR-181a-1 and miR-181b-1 (miR-181a/b-1) during late T-cell development with very high levels of expression during thymocyte selection, followed by massive down-regulation in the periphery. Loss of miR-181a/b-1 resulted in inefficient de novo generation of Treg cells in the thymus but simultaneously permitted homeostatic expansion in the periphery in the absence of competition. Modulation of T-cell receptor (TCR) signal strength in vivo indicated that miR-181a/b-1 controlled Treg-cell formation via establishing adequate signaling thresholds. Unexpectedly, miR-181a/b-1–deficient Treg cells displayed elevated suppressive capacity in vivo, in line with elevated levels of cytotoxic T-lymphocyte–associated 4 (CTLA-4) protein, but not mRNA, in thymic and peripheral Treg cells. Therefore, we propose that intrathymic miR-181a/b-1 controls development of Treg cells and imposes a developmental legacy on their peripheral function.
In the current study we compared the molecular signature of expanded mesenchymal stromal cells (MSCs) derived from selected CD271+ bone marrow mononuclear cells (CD271-MSCs) and MSCs derived from non-selected bone marrow mononuclear cells by plastic adherence (PA-MSCs). Transcriptome analysis demonstrated for the first time the upregulation of 115 and downregulation of 131 genes in CD271-MSCs. Functional enrichment analysis showed that the upregulated genes in CD271-MSCs are significantly enriched for extracellular matrix (tenascin XB, elastin, ABI family, member 3 (NESH) binding protein, carboxypeptidase Z, laminin alpha 2 and nephroblastoma overexpressed) and cell adhesion (CXCR7, GPNMB, MYBPH, SVEP1, ARHGAP6, TSPEAR, PIK3CG, ABL2 and NCAM1). CD271-MSCs expressed higher gene transcript levels that are involved in early osteogenesis/chondrogenesis/adipogenesis (ZNF145, FKBP5). In addition, increased transcript levels for early and late osteogenesis (DPT, OMD, ID4, CRYAB, SORT1), adipogenesis (CTNNB1, ZEB, LPL, FABP4, PDK4, ACDC), and chondrogenesis (CCN3/NOV, CCN4/WISP1, CCN5/WISP2 and ADAMTS-5) were detected. Interestingly, CD271-MSCs expressed increased levels of hematopoiesis associated genes (CXCL12, FLT3L, IL-3, TPO, KITL). Down-regulated genes in CD271-MSCs were associated with WNT and TGF-beta signaling, and cytokine/chemokine signaling pathways. In addition to their capacity to support hematopoiesis, these results suggest that CD271-MSCs may contain more osteo/chondro progenitors and/or feature a greater differentiation potential.
Application of blood flow restriction to optimize exercise countermeasures for human space flight
(2019)
In recent years there has been a strong increase in publications on blood flow restriction (BFR) training. In particular, the fact that this type of training requires only low resistance to induce muscle strength and mass gains, makes BFR training interesting for athletes and scientists alike. For the same reason this type of training is particularly interesting for astronauts working out in space. Lower resistance during training would have the advantage of reducing the risk of strain-induced injuries. Furthermore, strength training with lower resistances would have implications for the equipment required for training under microgravity conditions, as significantly lower resistances have to be provided by the training machines. Even though we are only about to understand the effects of blood flow restriction on exercise types other than low-intensity strength training, the available data indicate that BFR of leg muscles is also able to improve the training effects of walking or running at slow speeds. The underlying mechanisms of BFR-induced functional and structural adaptations are still unclear. An essential aspect seems to be the premature fatigue of Type-I muscle fibers, which requires premature recruitment of Type-II muscle fibers to maintain a given force output. Other theories assume that cell swelling, anabolic hormones, myokines and reactive oxygen species are involved in the mediation of BFR training-related effects. This review article is intended to summarize the main advantages and disadvantages, but also the potential risks of such training for astronauts.
We present a study of the elliptic flow and RAA of D and D¯ mesons in Au+Au collisions at FAIR energies. We propagate the charm quarks and the D mesons following a previously applied Langevin dynamics. The evolution of the background medium is modeled in two different ways: (I) we use the UrQMD hydrodynamics + Boltzmann transport hybrid approach including a phase transition to QGP and (II) with the coarse-graining approach employing also an equation of state with QGP. The latter approach has previously been used to describe di-lepton data at various energies very successfully. This comparison allows us to explore the effects of partial thermalization and viscous effects on the charm propagation. We explore the centrality dependencies of the collisions, the variation of the decoupling temperature and various hadronization parameters. We find that the initial partonic phase is responsible for the creation of most of the D/D¯ mesons elliptic flow and that the subsequent hadronic interactions seem to play only a minor role. This indicates that D/D¯ mesons elliptic flow is a smoking gun for a partonic phase at FAIR energies. However, the results suggest that the magnitude and the details of the elliptic flow strongly depend on the dynamics of the medium and on the hadronization procedure, which is related to the medium properties as well. Therefore, even at FAIR energies the charm quark might constitute a very useful tool to probe the quark–gluon plasma and investigate its physics.
Interferons (IFNs) are key players in the tumor immune response and act by inducing the expression of IFN-stimulated genes (ISGs). Here, we identify the mixed-lineage kinase domain-like pseudokinase (MLKL) as an ISG in various cancer cell lines. Both type I and type II IFNs increase the expression of MLKL indicating that MLKL up-regulation is a general feature of IFN signaling. IFNγ up-regulates mRNA as well as protein levels of MLKL demonstrating that IFNγ transcriptionally regulates MLKL. This notion is further supported by Actinomycin D chase experiments showing that IFNγ-stimulated up-regulation of MLKL is prevented in the presence of the transcriptional inhibitor Actinomycin D. Also, knockdown of the transcription factor IFN-regulatory factor 1 (IRF1) and signal transducer and activator of transcription (STAT) 1 as well as knockout of IRF1 significantly attenuate IFNγ-mediated induction of MLKL mRNA levels. Up-regulation of MLKL by IFNγ provides a valuable tool to sensitize cells towards necroptotic cell death and to overcome apoptosis resistance of cancer cells.
High seroprevalence of Babesia antibodies among Borrelia burgdorferi-infected humans in Sweden
(2018)
In northern Europe, tick-borne diseases such as Lyme borreliosis (LB) and tick-borne encephalitis (TBE) are well known. The actual incidence of Babesia infections, however, has remained elusive. In this study, the prevalence of antibodies against two Babesia spp. was investigated in a cohort of patients that were seropositive for Borrelia (B.) burgdorferi sensu lato (s.l.). Data were compared to a control group of healthy individuals. Sera were collected from 283 individuals residing in the southernmost region of Sweden, Skåne County. Almost one third of the sera were from patients with a confirmed seropositive reaction against B. burgdorferi s.l. All sera samples were assessed for IgG antibodies against Babesia (Ba.) microti and Ba. divergens by indirect fluorescent antibody (IFA) assays. Seropositive IgG titers for at least one of the Babesia spp. was significantly more common (p < 0.05) in individuals seropositive for Borrelia (16.3%) compared to the healthy control group (2.5%). Our findings suggest that Babesia infections may indeed be quite common among individuals who have been exposed to tick bites. Furthermore, the results indicate that human babesiosis should be considered in patients that show relevant symptoms; particularly for splenectomized and other immunocompromised individuals. Finally, the data challenges current blood transfusion procedures and highlights the current lack of awareness of the parasite in northern Europe.
Recent progress in the synaptic pathophysiology of brain diseases is reviewed. To emphasize the emergence of common motifs in synapse dysfunctions across neurodevelopmental, psychiatric and neurological disorders, conventional clinical boundaries are disregarded and a decidedly trans-diagnostic, potentially unifying view of altered synapse function is promoted. Based on the overlapping genetic architecture of brain disorders, which often converges on genes related to synaptic functions, disease-related changes in basic pre-synaptic and post-synaptic communication, neuromodulation-gated changes in Hebbian plasticity, dynamic interactions between Hebbian and homeostatic plasticity, and changes in synaptic maintenance by autophagy and glial-mediated phagocytosis are highlighted.