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Wöckel, Achim ; Festl, Jasmin ; Stüber, Tanja ; Brust, Katharina ; Stangl, Stephanie ; Heuschmann, Peter Ulrich ; Albert, Ute Susann ; Budach, Wilfried ; Follmann, Markus ; Janni, Wolfgang ; Kopp, Ina ; Kreienberg, Rolf ; Kühn, Thorsten ; Langer, Thomas ; Nothacker, Monika ; Scharl, Anton ; Schreer, Ingrid ; Link, Hartmut ; Engel, Jutta ; Fehm, Tanja ; Weis, Joachim ; Welt, Anja ; Steckelberg, Anke ; Feyer, Petra ; König, Klaus ; Hahne, Andrea ; Kreipe, Hans H. ; Knoefel, Wolfram Trudo ; Denkinger, Michael ; Brucker, Sara ; Lüftner, Diana ; Kubisch, Christian ; Gerlach, Christina ; Lebeau, Annette ; Siedentopf, Friederike ; Petersen, Cordula ; Bartsch, Hans Helge ; Schulz-Wendtland, Rüdiger ; Hahn, Markus ; Hanf, Volker ; Müller-Schimpfle, Markus ; Henscher, Ulla ; Roncarati, Renza ; Katalinic, Alexander ; Heitmann, Christoph ; Honegger, Christoph ; Paradies, Kerstin ; Bjelic-Radisic, Vesna ; Degenhardt, Friedrich ; Wenz, Frederik ; Rick, Oliver ; Hölzel, Dieter ; Zaiss, Matthias ; Kemper, Gudrun ; Budach, Volker ; Denkert, Carsten Michael ; Gerber, Bernd ; Tesch, Hans ; Hirsmüller, Susanne ; Sinn, Hans-Peter ; Dunst, Jürgen ; Münstedt, Karsten ; Bick, Ulrich ; Fallenberg, Eva ; Tholen, Reina ; Hung, Roswita ; Baumann, Freerk T. ; Beckmann, Matthias Wilhelm ; Blohmer, Jens-Uwe ; Fasching, Peter Andreas ; Lux, Michael Patrick ; Harbeck, Nadia ; Hadji, Peyman ; Hauner, Hans ; Heywang-Köbrunner, Sylvia H. ; Huober, Jens ; Hübner, Jutta ; Jackisch, Christian ; Loibl, Sibylle ; Lück, Hans-Jürgen ; Minckwitz, Gunter von ; Möbus, Volker ; Müller, Volkmar ; Nöthlings, Ute ; Schmidt, Marcus ; Schmutzler, Rita Katharina ; Schneeweiss, Andreas ; Schütz, Florian ; Stickeler, Elmar ; Thomssen, Christoph ; Untch, Michael ; Wesselmann, Simone ; Bücker, Arno ; Krockenberger, Mathias Heinric
Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren.
Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden.
Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.
Wöckel, Achim ; Festl, Jasmin ; Stüber, Tanja ; Brust, Katharina ; Stangl, Stephanie ; Heuschmann, Peter Ulrich ; Albert, Ute Susann ; Budach, Wilfried ; Follmann, Markus ; Janni, Wolfgang ; Kopp, Ina ; Kreienberg, Rolf ; Kühn, Thorsten ; Langer, Thomas ; Nothacker, Monika ; Scharl, Anton ; Schreer, Ingrid ; Link, Hartmut ; Engel, Jutta ; Fehm, Tanja ; Weis, Joachim ; Welt, Anja ; Steckelberg, Anke ; Feyer, Petra ; König, Klaus ; Hahne, Andrea ; Kreipe, Hans H. ; Knoefel, Wolfram Trudo ; Denkinger, Michael ; Brucker, Sara ; Lüftner, Diana ; Kubisch, Christian ; Gerlach, Christina ; Lebeau, Annette ; Siedentopf, Friederike ; Petersen, Cordula ; Bartsch, Hans Helge ; Schulz-Wendtland, Rüdiger ; Hahn, Markus ; Hanf, Volker ; Müller-Schimpfle, Markus ; Henscher, Ulla ; Roncarati, Renza ; Katalinic, Alexander ; Heitmann, Christoph ; Honegger, Christoph ; Paradies, Kerstin ; Bjelic-Radisic, Vesna ; Degenhardt, Friedrich ; Wenz, Frederik ; Rick, Oliver ; Hölzel, Dieter ; Zaiss, Matthias ; Kemper, Gudrun ; Budach, Volker ; Denkert, Carsten Michael ; Gerber, Bernd ; Tesch, Hans ; Hirsmüller, Susanne ; Sinn, Hans-Peter ; Dunst, Jürgen ; Münstedt, Karsten ; Bick, Ulrich ; Fallenberg, Eva ; Tholen, Reina ; Hung, Roswita ; Baumann, Freerk T. ; Beckmann, Matthias Wilhelm ; Blohmer, Jens-Uwe ; Fasching, Peter Andreas ; Lux, Michael Patrick ; Harbeck, Nadia ; Hadji, Peyman ; Hauner, Hans ; Heywang-Köbrunner, Sylvia H. ; Huober, Jens ; Hübner, Jutta ; Jackisch, Christian ; Loibl, Sibylle ; Lück, Hans-Jürgen ; Minckwitz, Gunter von ; Möbus, Volker ; Müller, Volkmar ; Nöthlings, Ute ; Schmidt, Marcus ; Schmutzler, Rita Katharina ; Schneeweiss, Andreas ; Schütz, Florian ; Stickeler, Elmar ; Thomssen, Christoph ; Untch, Michael ; Wesselmann, Simone ; Bücker, Arno ; Krockenberger, Mathias Heinric
Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer.
Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure.
Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease.
Clemen, Christoph Stephan ; Schmidt, Andreas ; Winter, Lilli ; Canneva, Fabio ; Wittig, Ilka ; Becker, Lore ; Coras, Roland ; Berwanger, Carolin ; Hofmann, Andreas ; Eggers, Britta ; Marcus, Katrin ; Gailus-Durner, Valerie ; Fuchs, Helmut ; Hrabe de Angelis, Martin ; Krüger, Marcus ; Hörsten, Stephan von ; Eichinger, Ludwig ; Schröder, Rolf
Aims: We investigated N471D WASH complex subunit strumpellin (Washc5) knock-in and Washc5 knock-out mice as models for hereditary spastic paraplegia type 8 (SPG8). Methods: We generated heterozygous and homozygous N471D Washc5 knock-in mice and subjected them to a comprehensive clinical, morphological and laboratory parameter screen, and gait analyses. Brain tissue was used for proteomic analysis. Furthermore, we generated heterozygous Washc5 knock-out mice. WASH complex subunit strumpellin expression was determined by qPCR and immunoblotting. Results: Homozygous N471D Washc5 knock-in mice showed mild dilated cardiomyopathy, decreased acoustic startle reactivity, thinner eye lenses, increased alkaline phosphatase and potassium levels and increased white blood cell counts. Gait analyses revealed multiple aberrations indicative of locomotor instability. Similarly, the clinical chemistry, haematology and gait parameters of heterozygous mice also deviated from the values expected for healthy animals, albeit to a lesser extent. Proteomic analysis of brain tissue depicted consistent upregulation of BPTF and downregulation of KLHL11 in heterozygous and homozygous knock-in mice. WASHC5-related protein interaction partners and complexes showed no change in abundancies. Heterozygous Washc5 knock-out mice showing normal WASHC5 levels could not be bred to homozygosity. Conclusions: While biallelic ablation of Washc5 was prenatally lethal, expression of N471D mutated WASHC5 led to several mild clinical and laboratory parameter abnormalities, but not to a typical SPG8 phenotype. The consistent upregulation of BPTF and downregulation of KLHL11 suggest mechanistic links between the expression of N471D mutated WASHC5 and the roles of both proteins in neurodegeneration and protein quality control, respectively.
Hornung, Claudia ; Poehlein, Anja ; Haack, Frederike Svenja ; Schmidt, Martina ; Dierking, Katja ; Pohlen, Andrea ; Schulenburg, Hinrich ; Blokesch, Melanie ; Plener, Laure ; Jung, Kirsten ; Bonge, Andreas ; Krohn-Molt, Ines ; Utpatel, Christian ; Timmermann, Gabriele ; Spieck, Eva ; Pommerening-Röser, Andreas ; Bode, Edna ; Bode, Helge Björn ; Daniel, Rolf ; Schmeißer, Christel ; Streit, Wolfgang R.
Janthinobacteria commonly form biofilms on eukaryotic hosts and are known to synthesize antibacterial and antifungal compounds. Janthinobacterium sp. HH01 was recently isolated from an aquatic environment and its genome sequence was established. The genome consists of a single chromosome and reveals a size of 7.10 Mb, being the largest janthinobacterial genome so far known. Approximately 80% of the 5,980 coding sequences (CDSs) present in the HH01 genome could be assigned putative functions. The genome encodes a wealth of secretory functions and several large clusters for polyketide biosynthesis. HH01 also encodes a remarkable number of proteins involved in resistance to drugs or heavy metals. Interestingly, the genome of HH01 apparently lacks the N-acylhomoserine lactone (AHL)-dependent signaling system and the AI-2-dependent quorum sensing regulatory circuit. Instead it encodes a homologue of the Legionella- and Vibrio-like autoinducer (lqsA/cqsA) synthase gene which we designated jqsA. The jqsA gene is linked to a cognate sensor kinase (jqsS) which is flanked by the response regulator jqsR. Here we show that a jqsA deletion has strong impact on the violacein biosynthesis in Janthinobacterium sp. HH01 and that a jqsA deletion mutant can be functionally complemented with the V. cholerae cqsA and the L. pneumophila lqsA genes.
Thill, Marc ; Friedrich, Michael ; Kolberg-Liedtke, Cornelia ; Albert, Ute-Susann ; Banys-Paluchowski, Maggie ; Bauerfeind, Ingo ; Blohmer, Jens-Uwe ; Budach, Wilfried ; Dall, Peter ; Fallenberg, Eva Maria ; Fasching, Peter Andreas ; Fehm, Tanja ; Gerber, Bernd ; Gluz, Oleg ; Harbeck, Nadia ; Heil, Jörg ; Huober, Jens ; Jackisch, Christian ; Kreipe, Hans-H. ; Krug, David ; Kühn, Thorsten ; Kümmel, Sherko ; Loibl, Sibylle ; Lüftner, Diana ; Lux, Michael Patrick ; Maass, Nicolai ; Mundhenke, Christoph ; Nitz, Ulrike ; Park-Simon, Tjoung-Won ; Reimer, Toralf ; Rhiem, Kerstin ; Rody, Achim ; Schmidt, Marcus ; Schneeweiss, Andreas ; Schütz, Florian ; Sinn, Peter ; Solbach, Christine ; Solomayer, Erich-Franz ; Stickeler, Elmar ; Thomssen, Christoph ; Untch, Michael ; Witzel, Isabell ; Wöckel, Achim ; Müller, Volkmar ; Janni, Wolfgang ; Ditsch, Nina
Slik, J. W. Ferry ; Franklin, Janet ; Arroyo-Rodríguez, Víctor ; Field, Richard ; Aguilar, Salomon ; Aguirre, Nikolay ; Ahumada, Jorge ; Aiba, Shin-Ichiro ; Alves, Luciana F. ; Anitha, Kamalakumari ; Avella, Andres ; Mora, Francisco ; Aymard, Gerardo A. ; Báez, Selene ; Balvanera, Patricia ; Bastian, Meredith L. ; Bastin, Jean-François ; Bellingham, Peter ; van den Berg, Eduardo ; da Conceição Bispo, Polyanna ; Boeckx, Pascal ; Böhning-Gaese, Katrin ; Bongers, Frans ; Boyle, Brad ; Brambach, Fabian ; Brearley, Francis Q. ; Brown, Sandra ; Chai, Shauna-Lee ; Chazdon, Robin L. ; Chen, Shengbin ; Chhang, Phourin ; Chuyong, George ; Ewangog, Corneille ; Coronado, Indiana ; Cristóbal-Azkarate, Jurgi ; Culmsee, Heike ; Damas, Kipiro ; Dattaraja, Handanakere Shivaramaiah ; Davidar, Priya ; DeWalt, Saara J. ; Din, Hazimah ; Drake, Donald R. ; Duque, Alvaro ; Durigan, Giselda ; Eichhorn, Karl ; Schmidt Eler, Eduardo ; Enoki, Tsutomu ; Ensslin, Andreas ; Fandohan, Adandé Belarmain ; Farwig, Nina ; Feeley, Kenneth J. ; Fischer, Markus ; Forshed, Olle ; Garcia, Queila Souza ; Garkoti, Satish Chandra ; Gillespie, Thomas William ; Gillet, Jean-Francois ; Gonmadje, Christelle ; Granzow-de la Cerda, Iñigo ; Griffith, Daniel M. ; Grogan, James ; Hakeem, Khalid Rehman ; Harris, David J. ; Harrison, Rhett D. ; Hector, Andy ; Hemp, Andreas ; Homeier, Jürgen ; Hussain, M. Shah ; Ibarra Manríquez, Guillermo ; Hanum, I. Faridah ; Imai, Nobuo ; Jansen, Patrick A. ; Joly, Carlos Alfredo ; Joseph, Shijo ; Kartawinata, Kuswata ; Kearsley, Elizabeth ; Kelly, Daniel L. ; Kessler, Michael ; Killeen, Timothy J. ; Kooyman, Robert ; Laumonier, Yves ; Laurance, Susan G. ; Laurance, William F. ; Lawes, Michael J. ; Letcher, Susan G. ; Lindsell, Jeremy ; Lovett, Jon ; Lozada, Jose ; Lu, Xinghui ; Lykke, Anne Mette ; Bin Mahmud, Khairil ; Mahayani, Ni Putu Diana ; Mansor, Asyraf ; Marshall, Andrew R. ; Martin, Emanuel H. ; Leal Matos, Darley Calderado ; Meave, Jorge A. ; Melo, Felipe P. L. ; Aguirre Mendoza, Zhofre ; Metali, Faizah ; Medjibe, Vincent P. ; Metzger, Jean Paul ; Metzker, Thiago ; Mohandass, Dharmalingam ; Munguía-Rosas, Miguel A. ; Muñoz, Rodrigo ; Nurtjahy, Eddy ; Lenza de Oliveira, Eddie ; Onrizal, Onrizal ; Parolin, Pia ; Parren, Marc ; Parthasarathy, Narayanaswamy ; Paudel, Ekananda ; Perez, Rolando ; Pérez-García, Eduardo A. ; Pommer, Ulf ; Poorter, Lourens ; Qi, Lan ; F. Piedade, Maria Teresa ; Rodrigues Pinto, José Roberto ; Dalberg Poulsen, Axel ; Poulsen, John R. ; Powers, Jennifer S. ; Prasad, Rama Chandra ; Puyravaud, Jean-Philippe ; Rangel, Orlando ; Reitsma, Jan ; S. B. Rocha, Diogo ; Rolim, Samir ; Rovero, Francesco ; Rozak, Andes ; Ruokolainen, Kalle ; Rutishauser, Ervan ; Rutten, Gemma ; Mohd. Said, Mohd. Nizam ; Saiter, Felipe Z. ; Saner, Philippe ; Santos, Braulio ; dos Santos, João Roberto ; Sarker, Swapan Kumar ; Schmitt, Christine B. ; Schöngart, Jochen ; Schulze, Mark ; Sheil, Douglas ; Sist, Plinio ; Souza, Alexandre F. ; Spironello, Wilson Roberto ; Sposito, Tereza ; Steinmetz, Robert ; Stevart, Tariq ; Suganuma, Marcio Seiji ; Sukri, Rahayu ; Sultana, Aisha ; Sukumar, Raman ; Sunderland, Terry ; Supriyadi, Agus ; Suresh, Hebbalalu S. ; Suzuki, Eizi ; Tabarelli, Marcelo ; Tang, Jianwei ; Tanner, Edmund V. J. ; Targhetta, Natalia ; Theilade, Ida ; Thomas, Duncan ; Timberlake, Jonathan ; de Morisson Valeriano, Márcio ; Valkenburg, Johan van ; Do, Tran Van ; Sam, Hoang Van ; Vandermeer, John H. ; Verbeeck, Hans ; Vetaas, Ole Reidar ; Adekunle, Victor ; Vieira, Simone A. ; Webb, Campbell O. ; Webb, Edward L. ; Whitfeld, Timothy ; Wich, Serge ; Williams, John ; Wiser, Susan ; Wittmann, Florian ; Yang, Xiaobo ; Adou Yao, C. Yves ; Yap, Sandra L. ; Zahawie, Rakan A. ; Zakaria, Rahmad ; Zang, Runguo
Knowledge about the biogeographic affinities of the world’s tropical forests helps to better understand regional differences in forest structure, diversity, composition, and dynamics. Such understanding will enable anticipation of region-specific responses to global environmental change. Modern phylogenies, in combination with broad coverage of species inventory data, now allow for global biogeographic analyses that take species evolutionary distance into account. Here we present a classification of the world’s tropical forests based on their phylogenetic similarity. We identify five principal floristic regions and their floristic relationships: (i) Indo-Pacific, (ii) Subtropical, (iii) African, (iv) American, and (v) Dry forests. Our results do not support the traditional neo- versus paleotropical forest division but instead separate the combined American and African forests from their Indo-Pacific counterparts. We also find indications for the existence of a global dry forest region, with representatives in America, Africa, Madagascar, and India. Additionally, a northern-hemisphere Subtropical forest region was identified with representatives in Asia and America, providing support for a link between Asian and American northern-hemisphere forests.
Reifarth, René ; Altstadt, Sebastian ; Göbel, Kathrin ; Heftrich, Tanja ; Heil, Michael ; Koloczek, Alexander ; Langer, Christoph ; Plag, Ralf ; Pohl, M. ; Sonnabend, Kerstin ; Weigand, Mario ; Adachi, T. ; Aksouh, Farouk ; Al-Khalili, J. ; AlGarawi, M. ; AlGhamdi, S. ; Alkhazov, G. ; Alkhomashi, N. ; Alvarez-Pol, Héctor ; Alvarez-Rodriguez, R. ; Andreev, V. ; Andrei, B. ; Atar, Leyla ; Aumann, Thomas ; Avdeichikov, Vladimir ; Bacri, C. ; Bagchi, S. ; Barbieri, Carlo ; Beceiro, Saul ; Beck, C. ; Beinrucker, Clemens ; Belier, Gilbert ; Bemmerer, Daniel ; Bendel, M. ; Benlliure Anaya, Jose Fernando ; Benzoni, G. ; Berjillos, R. ; Bertini, D. ; Bertulani, Carlos A. ; Bishop, S. ; Blasi, N. ; Bloch, T. ; Blumenfeld, Y. ; Bonaccorso, A. ; Boretzky, Konstanze ; Botvina, Alexander ; Boudard, A. ; Boutachkov, P. ; Boztosun, I. ; Bracco, A. ; Brambilla, S. ; Monago, J.Briz ; Caamano, Manuel ; Caesar, Christoph ; Camera, F. ; Casarejos Ruiz, Enrique ; Catford, Wilton N. ; Cederkäll, Joakim ; Cederwall, B. ; Chartier, Marielle ; Chatillon, Audrey ; Cherciu, M. ; Chulkov, Leonid V. ; Coleman-Smith, P. ; Cortina Gil, Dolores ; Crespi, F. ; Crespo, Raquel ; Cresswell, J. ; Csatlós, Margit ; Déchery, F. ; Davids, B. ; Davinson, Thomas ; Derya, Vera ; Detistov, P. ; Díaz Fernández, Paloma ; DiJulio, D. ; Dmitry, S. ; Doré, D. ; Dueñas, J. ; Dupont, Emmeric ; Egelhof, Peter ; Egorova, I. ; Elekes, Zoltán ; Enders, Joachim ; Endres, Janis ; Ershov, S. ; Ershova, Olga ; Fernández Domínguez, Beatriz ; Fetisov, A. ; Fiori, Enrico ; Fomichev, A. ; Fonseca, M. ; Fraile, L. ; Freer, Martin ; Friese, Jürgen ; Garcia Borge, Maria José ; Galaviz Redondo, Daniel ; Gannon, S. ; Garg, U. ; Gašparić, Igor ; Gasques, L. ; Gastineau, B. ; Geissel, Hans ; Gernhäuser, Roman ; Ghosh, T. ; Gilbert, M. ; Glorius, Jan ; Golubev, Pavel ; Gorshkov, Alexander ; Gourishetty, A. ; Grigorenko, Leonid V. ; Gulyas, J. ; Haiduc, Maria ; Hammache, F. ; Harakeh, Muhsin N. ; Hass, M. ; Heine, Marcel ; Hennig, Andreas ; Henriques, Ana ; Herzberg, Rolf-Dietmar ; Holl, Matthias ; Ignatov, Alexander ; Ignatyuk, A. ; Ilieva, Stoyanka ; Ivanov, Marian ; Iwasa, N. ; Jakobsson, B. ; Johansson, Håkan T. ; Jonson, Björn ; Joshi, P. ; Junghans, Arnd Rudolf ; Jurado Apruzzese, Beatriz ; Körner, G. ; Kalantar, N. ; Kanungo, Rituparna ; Kelic-Heil, Aleksandra ; Kezzar, K. ; Khan, E. ; Khanzadeev, Alexei ; Kiselev, Oleg A. ; Kogimtzis, M. ; Körper, D. ; Kräckmann, S. ; Kröll, Thorsten ; Krücken, Reiner ; Krasznahorkay, Attila ; Kratz, Jens-Volker ; Kresan, Dmytro ; Krings, Thomas ; Krumbholz, A. ; Krupko, S. ; Kulessa, Reinhard ; Kumar, Shyam ; Kurz, Nikolaus ; Kuzmin, E. ; Labiche, Marc ; Langanke, Karlheinz ; Lazarus, I. ; Bleis, T.Le ; Lederer, Claudia ; Lemasson, A. ; Lemmon, Roy Crawford ; Liberati, V. ; Litvinov, Yuri A. ; Löher, Bastian ; Herraiz, J.Lopez ; Münzenberg, G. ; Machado, Jorge ; Maev, E. ; Mahata, Kripamay ; Mancusi, D. ; Marganiec, Justyna ; Perez, M.Martinez ; Marusov, V. ; Mengoni, D. ; Million, B. ; Morcelle, V. ; Moreno, O. ; Movsesyan, Alina ; Nácher González, Enrique ; Najafi, Mohammad Ali ; Nakamura, T. ; Naqvi, F. ; Nikolski, E. ; Nilsson, Thomas ; Nociforo, Chiara ; Nolan, P. ; Novatsky, B. ; Nyman, Göran Hugo ; Ornelas, A. ; Palit, R. ; Pandit, S. ; Panin, Valerii ; Paradela Dobarro, Carlos ; Parkar, V. ; Paschalis, Stefanos ; Pawłowski, P. ; Perea Martinez, Angel ; Pereira, J. ; Petrache, C. ; Petri, Marina ; Pickstone, Simon Glynn ; Pietralla, Norbert ; Pietri, Stephane ; Pivovarov, Y. ; Potlog, P. ; Prokofiev, Andrey ; Rastrepina, G. ; Rauscher, Thomas ; Ribeiro Jimenez, Guillermo ; Ricciardi, Maria Valentina ; Richter, Achim ; Rigollet, Catherine ; Riisager, Karsten ; Rios, A. ; Ritter, C. ; Rodríguez Frutos, Tomás Raúl ; Rodríguez Vignote, Javier ; Röder, Marko ; Romig, Christopher ; Rossi, Dominic M. ; Roussel-Chomaz, P. ; Rout, Prakash Chandra ; Roy, S. ; Söderström, P. ; Saha Sarkar, Maitreyee ; Sakuta, S. ; Salsac, M. ; Sampson, J. ; Sanchez, J. ; Saez, del Rio ; Rosado, J.Sanchez ; Sanjari, Mohammad Shahab ; Sarriguren, P. ; Sauerwein, Anne ; Savran, Deniz ; Scheidenberger, Christoph ; Scheit, Heiko ; Schmidt, Stefan ; Schmitt, C. ; Schnorrenberger, Linda ; Schrock, P. ; Schwengner, R. ; Seddon, D. ; Sherrill, B. ; Shrivastava, A. ; Sidorchuk, S. ; Silva, Joel ; Simon, Haik ; Simpson, E. ; Singh, P. ; Slobodan, D. ; Sohler, D. ; Spieker, Mark-Christoph ; Stach, D. ; Stan, E. ; Stanoiu, M. ; Stepantsov, S. ; Stevenson, P. ; Strieder, F. ; Stuhl, László ; Suda, T. ; Sümmerer, Klaus ; Streicher, Branislav ; Taieb, Julien ; Takechi, M. ; Tanihata, I. ; Taylor, J. ; Tengblad, Olof ; Ter-Akopian, G. ; Terashima, S. ; Teubig, P. ; Thies, Ronja ; Thoennessen, M. ; Thomas, T. ; Thornhill, J. ; Thungstrom, G. ; Timar, J. ; Togano, Yasuhiro ; Tomohiro, U. ; Tornyi, T. ; Tostevin, J. ; Townsley, C. ; Trautmann, Wolfgang ; Trivedi, T. ; Typel, Stefan ; Uberseder, E. ; Udias, J. ; Uesaka, T. ; Uvarov, L. ; Vajta, Z. ; Velho, Paulo ; Vikhrov, V. ; Volknandt, Meiko ; Volkov, Vasily ; Neumann-Cosel, Peter von ; Schmid, Mirko von ; Wagner, A. ; Wamers, Felix ; Weick, Helmut ; Wells, D. ; Westerberg, L. ; Wieland, Oliver ; Wiescher, Michael ; Wimmer, Christine ; Wimmer, K. ; Winfield, John S. ; Winkel, M. ; Woods, Philip John ; Wyss, R. ; Yakorev, Dmitry ; Yavor, M. ; Zamora Cardona, Juan Carlos ; Zartova, I. ; Zerguerras, T. ; Zgura, M. ; Zhdanov, A. ; Zhukov, Mikhail V. ; Zieblinski, M. ; Zilges, Andreas ; Zuber, Kai
The nucleosynthesis of elements beyond iron is dominated by neutron captures in the s and r processes. However, 32 stable, proton-rich isotopes cannot be formed during those processes, because they are shielded from the s-process flow and r-process β-decay chains. These nuclei are attributed to the p and rp process.
For all those processes, current research in nuclear astrophysics addresses the need for more precise reaction data involving radioactive isotopes. Depending on the particular reaction, direct or inverse kinematics, forward or time-reversed direction are investigated to determine or at least to constrain the desired reaction cross sections.
The Facility for Antiproton and Ion Research (FAIR) will offer unique, unprecedented opportunities to investigate many of the important reactions. The high yield of radioactive isotopes, even far away from the valley of stability, allows the investigation of isotopes involved in processes as exotic as the r or rp processes.
A floristic description is presented of the study sites of the Research Training Group “The role of biodi-versity for biogeochemical cycles and biotic interactions in temperate deciduous forests”. To investi-gate different aspects of plant biodiversity in Hainich National Park (Thuringia), deciduous forest stands with low, medium and high canopy tree species diversity were compared. The results of species richness and forest communities show that the research sites are characterised by a typical central European forest flora. Greater vascular plant species richness occurs with higher diversity of tree species. Six of altogether twelve research sites are assigned to the beech forest alliance (Galioodorati-Fagion), the second half belongs to the oak-hornbeam forest alliance (Carpinionbetuli). Suballiances within the Galioodorati-Fagion in the study area include the Galio-Fagetum and the Hordelymo-Fagetum. All Carpinionbetuli relevées are assigned to the suballiance Stellario-Carpinetum.
Schmidt-Horlohé, Kay ; Wilde, Philipp ; Becker, Lars ; Reimertz, Christoph ; Bonk, Andreas ; Hoffmann, Reinhard
Meeting Abstract : Deutscher Kongress für Orthopädie und Unfallchirurgie ; 73. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie ; 95. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie ; 50. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie ; 21. - 24.10.2009, Berlin Fragestellung: Ziel war die Evaluierung der funktionellen und radiologischen Ergebnisse nach osteosynthestischer Versorgung von Olecranonfrakturen mit einer zur Hakenplatte modifizierten Drittelrohrplatte. Methodik: In einem Zeitraum von 12 Monaten wurden 29 Patienten mit Olecranonfrakturen prospektiv erfasst und eine Osteosynthese mit einer zur Hakenplatte modifizierten Kleinfragment-Drittelrohrplatte durchgeführt. Eine additive Verschraubung von zusätzlichen Fragmenten erfolgte bei 6 Patienten (20%). Das mittlere Patientenalter zum Unfallzeitpunkt betrug 50 Jahre (Min 29/ Max 83). Unter Verwendung der Frakturklassifikation nach Schatzker stellte sich in 8 Fällen (28%) eine Querfraktur vom Typ A, in 6 Fällen (20%) eine Querfraktur mit Impaktion vom Typ B und in 15 Fällen (52%) eine Mehrfragmentfraktur vom Typ D dar. Bei 4 Patienten (14%) lag eine offene Fraktursituation vor. Nach im Mittel 7,2 Monaten (Min 6/ Max 8) wurde das funktionelle Outcome anhand des Mayo Elbow Performence Scores (MEPS), der visuellen Analogskala (VAS) und des Disabilities of the Arm, Shoulder and Hand Scores (DASH) bewertet sowie die radiologischen Befunde erhoben. Ergebnisse und Schlussfolgerungen: Das Ziel einer primär übungsstabilen Osteosynthese konnte bei allen Patienten erreicht werden. Unter Verwendung des MEPS wurden annähernd ausschließlich sehr gute (12 Fälle/41%) und gute (16 Fälle/55%) Ergebnisse erzielt. Lediglich bei einem Patienten ergab sich ein nur befriedigendes Ergebnis. Der mittlere Punktwert für den MEPS betrug 91,4 (Min 65/Max 100). In der VAS konnte ein Mittelwert von 8,2 Punkten (Min 7/Max 10) erzielt werden (0=keine Zufriedenheit, 10=volle Zufriedenheit). Der mittlere DASH-Wert betrug 16,2 Punkte (Min 0/Max 39). Der mittlere Bewegungsumfang betrug für Extension/Flexion bei einem durchschnittlichen Streckdefizit von 8° (Min 0°/Max 25°) und einer Beugung von 135° (Min 105°/Max 155°) 125° (Min 90°/Max 155°). Die Unterarmumwendbewegungen waren mit 175° (Min 165°/Max 180°) kaum eingeschränkt. Bei keinem Patienten gab es postoperative Komplikationen. Eine zur Hakenplatte modifizierte Drittelrohrplatte stellt im Gegensatz zu präformierten, winkelstabilen Implantaten eine kostengünstige Alternative zur Osteosynthese bei Olecranonfrakturen dar. Auch bei komplexen mehrfragmentären Frakturtypen und osteoporotischer Knochenqualität konnte so im nachuntersuchten Kollektiv eine sichere Frakturretention erzielt werden. Hinsichtlich des funktionellen Ergebnisses profitieren die Patienten von einer dadurch unmittelbar postoperativ möglichen, physiotherapeutischen Nachbehandlung. Das für die Hakenplatte benötigte Osteosynthesematerial (Kleinfragment-Drittelrohrplatte) ist nahezu überall verfügbar und lässt sich in kurzer Zeit der individuellen Anatomie und Frakturmorphologie anpassen. Eine Drahtmigration, wie bei der weit verbreiteten Zuggurtungsosteosynthese häufig beobachtet, ist ausgeschlossen.
Scheel, Alexander Konrad ; Matteson, Eric L. ; Dasgupta, Bhaskar ; Bruyn, George A. W. ; Ohrndorf, Sarah ; Werner, Carola ; Schmidt, Wolfgang Andreas
Objective. A study supported by the EULAR and the ACR being conducted to establish classification criteria for polymyalgia rheumatica (PMR) will include ultrasound examination of the shoulders and hips. Ultrasound (US) depicts glenohumeral joint effusion, biceps tenosynovitis, subdeltoid bursitis, hip joint synovitis, and trochanteric bursitis in PMR. These findings may aid in distinguishing PMR from other diseases. The purpose of this study was to assess standards and US interreader agreement of participants in the PMR classification criteria study. Methods. Sixteen physicians in four groups examined shoulders and hips of 4 patients and 4 healthy adults with ultrasound. Overall agreement and interobserver agreement were calculated. Results. The overall agreement (OA) between groups was 87%. The OA for healthy shoulders was 88.8%, for healthy hips 100%, for shoulders with pathology 85.2%, and 74.3% for hips with pathology, respectively. Conclusion. There was a high degree of agreement found for the examination of healthy shoulders and pathologic hips. Agreement was moderate for pathologic shoulders and perfect for healthy hips. US of shoulder and hips performed by different examiners is a reliable and feasible tool for assessment of PMR related disease pathology and can be incorporated into a classification criteria study.
Schmidt, Martina V. ; Paulus, Patrick ; Kuhn, Anne-Marie ; Meilladec-Jullig, Virginie ; Zacharowski, Kai ; Brüne, Bernhard ; Knethen, Andreas von
Introduction: Immune paralysis with massive T-cell apoptosis is a central pathogenic event during sepsis and correlates with septic patient mortality. Previous observations implied a crucial role of peroxisome proliferator-activated receptor gamma (PPARγ) during T-cell apoptosis.
Methods: To elucidate mechanisms of PPARγ-induced T-cell depletion, we used an endotoxin model as well as the caecal ligation and puncture sepsis model to imitate septic conditions in wild-type versus conditional PPARγ knockout (KO) mice.
Results: PPARγ KO mice showed a marked survival advantage compared with control mice. Their T cells were substantially protected against sepsis-induced death and showed a significantly higher expression of the pro-survival factor IL-2. Since PPARγ is described to repress nuclear factor of activated T cells (NFAT) transactivation and concomitant IL-2 expression, we propose inhibition of NFAT as the underlying mechanism allowing T-cell apoptosis. Corroborating our hypothesis, we observed up-regulation of the pro-apoptotic protein BIM and downregulation of the anti-apoptotic protein Bcl-2 in control mice, which are downstream effector proteins of IL-2 receptor signaling. Application of a neutralizing anti-IL-2 antibody reversed the pro-survival effect of PPARγ-deficient T cells and confirmed IL-2-dependent apoptosis during sepsis.
Conclusion: Apparently antagonizing PPARγ in T cells might improve their survival during sepsis, which concomitantly enhances defence mechanisms and possibly provokes an increased survival of septic patients.
Pawlowski, Nikolaus ; Khaminets, Aliaksandr ; Hunn, Julia ; Papic, Natasa ; Schmidt, Andreas ; Uthaiah, Revathy Chottekalapanda ; Lange, Rita ; Vopper, Gabriela ; Martens, Sascha ; Wolf, Eva ; Howard, Jonathan C.
Background: The interferon-inducible immunity-related GTPases (IRG proteins/p47 GTPases) are a distinctive family of GTPases that function as powerful cell-autonomous resistance factors. The IRG protein, Irga6 (IIGP1), participates in the disruption of the vacuolar membrane surrounding the intracellular parasite, Toxoplasma gondii, through which it communicates with its cellular hosts. Some aspects of the protein's behaviour have suggested a dynamin-like molecular mode of action, in that the energy released by GTP hydrolysis is transduced into mechanical work that results in deformation and ultimately rupture of the vacuolar membrane. Results: Irga6 forms GTP-dependent oligomers in vitro and thereby activates hydrolysis of the GTP substrate. In this study we define the catalytic G-domain interface by mutagenesis and present a structural model, of how GTP hydrolysis is activated in Irga6 complexes, based on the substrate-twinning reaction mechanism of the signal recognition particle (SRP) and its receptor (SRalpha). In conformity with this model, we show that the bound nucleotide is part of the catalytic interface and that the 3'hydroxyl of the GTP ribose bound to each subunit is essential for trans-activation of hydrolysis of the GTP bound to the other subunit. We show that both positive and negative regulatory interactions between IRG proteins occur via the catalytic interface. Furthermore, mutations that disrupt the catalytic interface also prevent Irga6 from accumulating on the parasitophorous vacuole membrane of T. gondii, showing that GTP-dependent Irga6 activation is an essential component of the resistance mechanism. Conclusions: The catalytic interface of Irga6 defined in the present experiments can probably be used as a paradigm for the nucleotide-dependent interactions of all members of the large family of IRG GTPases, both activating and regulatory. Understanding the activation mechanism of Irga6 will help to explain the mechanism by which IRG proteins exercise their resistance function. We find no support from sequence or G-domain structure for the idea that IRG proteins and the SRP GTPases have a common phylogenetic origin. It therefore seems probable, if surprising, that the substrate-assisted catalytic mechanism has been independently evolved in the two protein families.
Fadini, Gian Paolo ; Maruyama, Shoichi ; Ozaki, Takenori ; Taguchi, Akihiko ; Meigs, James ; Dimmeler, Stefanie ; Zeiher, Andreas M. ; De Kreutzenberg, Saula ; Avogaro, Angelo ; Nickenig, Georg ; Schmidt-Lucke, Caroline ; Werner, Nikos
Background: Circulating progenitor cells (CPC) contribute to the homeostasis of the vessel wall, and a reduced CPC count predicts cardiovascular morbidity and mortality. We tested the hypothesis that CPC count improves cardiovascular risk stratification and that this is modulated by low-grade inflammation. Methodology/Principal Findings: We pooled data from 4 longitudinal studies, including a total of 1,057 patients having CPC determined and major adverse cardiovascular events (MACE) collected. We recorded cardiovascular risk factors and high-sensitive C-reactive protein (hsCRP) level. Risk estimates were derived from Cox proportional hazard analyses. CPC count and/or hsCRP level were added to a reference model including age, sex, cardiovascular risk factors, prevalent CVD, chronic renal failure (CRF) and medications. The sample was composed of high-risk individuals, as 76.3% had prevalent CVD and 31.6% had CRF. There were 331 (31.3%) incident MACE during an average 1.7±1.1 year follow-up time. CPC count was independently associated with incident MACE even after correction for hsCRP. According to C-statistics, models including CPC yielded a non-significant improvement in accuracy of MACE prediction. However, the integrated discrimination improvement index (IDI) showed better performance of models including CPC compared to the reference model and models including hsCRP in identifying MACE. CPC count also yielded significant net reclassification improvements (NRI) for CV death, non-fatal AMI and other CV events. The effect of CPC was independent of hsCRP, but there was a significant more-than-additive interaction between low CPC count and raised hsCRP level in predicting incident MACE. Conclusions/Significance: In high risk individuals, a reduced CPC count helps identifying more patients at higher risk of MACE over the short term, especially in combination with a raised hsCRP level.
Since the beginning of the 1990s, it has been widely expected that the implementation of the European Single Market would lead to a rapid convergence of Europe’s financial systems. In the present paper we will show that at least in the period prior to the introduction of the common currency this expected convergence did not materialise. Our empirical studies on the significance of various institutions within the financial sectors, on the financing patterns of firms in various countries and on the predominant mechanisms of corporate governance, which are summarised and placed in a broader context in this paper, point to few, if any, signs of a convergence at a fundamental or structural level between the German, British and French financial systems. The German financial system continues to appear to be bank-dominated, while the British system still appears to be capital market-dominated. During the period covered by the research, i.e. 1980 – 1998, the French system underwent the most far-reaching changes, and today it is difficult to classify. In our opinion, these findings can be attributed to the effects of strong path dependencies, which are in turn an outgrowth of relationships of complementarity between the individual system components. Projecting what we have observed into the future, the results of our research indicate that one of two alternative paths of development is most likely to materialise: either the differences between the national financial systems will persist, or – possibly as a result of systemic crises – one financial system type will become the dominant model internationally. And if this second path emerges, the Anglo-American, capital market-dominated system could turn out to be the “winner”, because it is better able to withstand and weather crises, but not necessarily because it is more efficient.
Wenn man untersuchen möchte, ob sich die Finanzsysteme verschiedener Länder im Verlauf der letzten Jahre aneinander angeglichen haben oder demnächst angleichen werden, braucht man ein Konzept zur Beschreibung von Finanzsystemen, durch das wesentliche Strukturen, deren Unterschiede und Veränderungen erkennbar werden, ohne dabei in "Systemgeschwafel" (D. Schneider) abzugleiten. Wir haben dafür das Konzept der Komplementarität als nützlich identifiziert. Der Beitrag stellt dieses Konzept vor und soll und seine Eignung belegen. Letztlich geht es dabei auch um die Frage, ob reale Finanzsysteme konsistente Systeme mit komplementären Elementen darstellen. Nach der Vorstellung der formalen Konzepte der Komplementarität und der Konsistenz wird "das Finanzsystem" auf seine Komple mentarität untersucht. Dazu wird ein Finanzsystem aus der Sicht von Unternehmen des nichtfinanziellen Sektors als ein System gekennzeichnet, das aus drei Teilsystemen besteht. Das erste Teilsystem ist das Finanzierungssystem einschließlich Finanzsektor und Mustern der Unternehmensfinanzierung, das zweite das Corporate Governance-System und das dritte das Unternehmens-Strategie-System. Für alle drei Teilsysteme wird – allgemein und mit Bezug auf die Finanzsysteme Deutschlands, Japans und der USA - gezeigt, inwieweit die Elemente der betreffenden Teilsysteme untereinander komplementär sind, und geprüft, ob sie in ihren Ausprägungen auch konsistent sind, d.h. wirklich "zueinander passen". Untersucht wird auch die Komplementarität und Konsistenz zwischen den Teilsystemen selbst. Der Beitrag endet mit Überlegungen über die Anwendung des Komplementaritätskonzepts. Dass ein Finanzsystem die Eigenschaft der Komplementarität aufweist, hat nicht nur weitreichende Implikationen für die Methodik der Analyse von Finanzsystemen, sondern auch für die Vorhersehbarkeit der Entwicklung von Finanzsystemen und damit für die Wahrscheinlichkeit einer Konvergenz von Finanzsystemen, für deren Effizienzeigenschaften und für die Möglichkeiten, Finanzsysteme durch gestaltende Eingriffe zu verbessern.
A widely recognized paper by Colin Mayer (1988) has led to a profound revision of academic thinking about financing patterns of corporations in different countries. Using flow-of-funds data instead of balance sheet data, Mayer and others who followed his lead found that internal financing is the dominant mode of financing in all countries, that therefore financial patterns do not differ very much between countries and that those differences which still seem to exist are not at all consistent with the common conviction that financial systems can be classified as being either bank-based or capital market-based. This leads to a puzzle insofar as it calls into question the empirical foundation of the widely held belief that there is a correspondence between the financing patterns of corporations on the one side, and the structure of the financial sector and the prevailing corporate governance system in a given country on the other side. The present paper addresses this puzzle on a methodological and an empirical basis. It starts by demonstrating that the surprising empirical results found by Mayer et al. are due to a hidden assumption underlying their methodology. It then derives an alternative method of measuring financing patterns, which also uses flow-of-funds data, but avoids the questionable assumption. This measurement concept is then applied to patterns of corporate financing in Germany, Japan and the United States. The empirical results are very much in line with the commonly held belief prior to Mayer’s influential contribution and indicate that the financial systems of the three countries do indeed differ from one another in a substantial way.
The paper presents an empirical analysis of the alledged transformation of the financial systems in the three major European economies, France, Germany and the UK. Based on a unified data set developed on the basis of national accounts statistics, and employing a new and consistent method of measurement, the following questions are addressed: Is there a common pattern of structural change; do banks lose importance in the process of change; and are the three financial systems becoming more similar? We find that there is neither a general trend towards disintermediation, nor towards a transformation from bank-based to capital market-based financial systems, nor for a loss of importance of banks. Only in the case of France strong signs of transformation as well as signs of a general decline in the role of banks could be found. Thus the three financial systems also do not seem to become more similar. However, there is also a common pattern of change: the intermediation chains are lengthening in all three countries. Nonbank financial intermediaries are taking over a more important role as mobilizers of capital from the non-financial sectors. In combination with the trend towards securitization of bank liabilites, this change increases the funding costs of banks and may put banks under pressure. In the case of France, this change is so pronounced that it might even threaten the stability of the financial system.
In this short note on my talk I want to point out the mathematical difficulties that arise in the study of the relation of Wightman and Euclidean quantum field theory, i.e., the relation between the hierarchies of Wightman and Schwinger functions. The two extreme cases where the reconstructed Wightman functions are either tempered distributions - the well-known Osterwalder-Schrader reconstruction - or modified Fourier hyperfunctions are discussed in some detail. Finally, some perpectives towards a classification of Euclidean reconstruction theorems are outlined and preliminary steps in that direction are presented.
We present a method for the construction of a Krein space completion for spaces of test functions, equipped with an indefinite inner product induced by a kernel which is more singular than a distribution of finite order. This generalizes a regularization method for infrared singularities in quantum field theory, introduced by G. Morchio and F. Strocchi, to the case of singularites of infinite order. We give conditions for the possibility of this procedure in terms of local differential operators and the Gelfand-Shilov test function spaces, as well as an abstract sufficient condition. As a model case we construct a maximally positive definite state space for the Heisenberg algebra in the presence of an infinite infrared singularity. See the corresponding paper: Schmidt, Andreas U.: "Mathematical Problems of Gauge Quantum Field Theory: A Survey of the Schwinger Model" and the presentation "Infinite Infrared Regularization in Krein Spaces"
This extended write-up of a talk gives an introductory survey of mathematical problems of the quantization of gauge systems. Using the Schwinger model as an exactly tractable but nontrivial example which exhibits general features of gauge quantum field theory, I cover the following subjects: The axiomatics of quantum field theory, formulation of quantum field theory in terms of Wightman functions, reconstruction of the state space, the local formulation of gauge theories, indefiniteness of the Wightman functions in general and in the special case of the Schwinger model, the state space of the Schwinger model, special features of the model. New results are contained in the Mathematical Appendix, where I consider in an abstract setting the Pontrjagin space structure of a special class of indefinite inner product spaces - the so called quasi-positive ones. This is motivated by the indefinite inner product space structure appearing in the above context and generalizes results of Morchio and Strocchi [J. Math. Phys. 31 (1990) 1467], and Dubin and Tarski [J. Math. Phys. 7 (1966) 574]. See the corresponding paper: Schmidt, Andreas U.: "Infinite Infrared Regularization and a State Space for the Heisenberg Algebra" and the presentation "Infinite Infrared Regularization in Krein Spaces".
Presentation at the AMS Southeastern Sectional Meeting 14-16 March 2003, and the Workshop Asymptotic Analysis, Stability, and Generalized Functions', 17-19 March 2003, Louisiana State University, Baton Rouge, Louisiana. See the corresponding papers "Mathematical Problems of Gauge Quantum Field Theory: A Survey of the Schwinger Model" and "Infinite Infrared Regularization and a State Space for the Heisenberg Algebra".
Wir führen eine neue Unterklasse der Fourier Hyperfunktionen mit polynomialen Wachstumsbedingungen ein mit dem Ziel, asymptotische Entwicklungen von Hyperfunktionen studieren zu wollen, wie sie für gewisse Distributionenklassen bekannt sind. Wir entwickeln zuerst die Theorie analytischer Funktionale auf Räumen integrabler Funktionen bezüglich Maßen mit Wachstum O(|Re z|^gamma), wobei gamma in R ist, im Unendlichen. Ein an das berühmte Phragmén-Lindelöf-Prinzip erinnerndes, einfaches analytisches Resultat bildet die Basis der Dualitätstheorie dieser Räume zu Funktionen mit festgelegtem Wachstumstyp. Wir studieren diese Dualität analytischer Funktionale mit Wachstumsbedingungen und unbeschränkten Trägern gründlich in einer Dimension unter Verwendung des von den Fourier Hyperfunktionen her bekannten exponentiell abfallenden Cauchy-Hilbert-Kerns. Daraus ergeben sich Analoga zu den Theoremen von Runge und Mittag-Leffler, die die Grundlage für die Garbentheorie der Hyperfunktionen mit polynomialen Wachstumsbedingungen sind, die wir sodann entwickeln. Die für uns wichtigsten neuen Klassen von Fourier Hyperfunktionen sind die von unendlichem Typ, das heißt solche, die wie eine beliebige Potenz wachsen beziehungsweise schneller als jede Potenz abfallen. In n Dimensionen benutzen wir die Fouriertransformation und Dualität um das Verhältnis dieser temperierten beziehungsweise asymptotischen Hyperfunktionen zu bekannten Distributionenräumen zu studieren. Wir leiten Theoreme vom Paley-Wiener-Typ her, die es uns erlauben, unsere Hyperfunktionen in ein Schema zu ordnen, das Wachstumsordnung und Singularität gegenüberstellt. Wir zeigen, daß dieses Schema eine sinvolle Erweiterung des von Gelfand und Shilow zur Charakterisierung von Testfunktionenräumen eingeführten Schemas der Räume S(alpha,beta) um verallgemeinerte Funktionen ist. Schließlich zeigen wir die Nuklearität der temperierten und asymptotischen Hyperfunktionen. Wir zeigen, daß die asymptotischen Hyperfunktionen genau die Klasse bilden, die Moment-asymptotische Entwicklungen erlauben, wie sie von Estrada et al. für Distributionen betrachtet wurden. Estradas Theorie ist damit ein Spezialfall der unsrigen. Für Hyperfunktionen lassen sich aber dank des Konzeptes der standard definierenden Funktionen die Moment-asymptotischen Entwicklungen als klassische asymptotische Entwicklungen von analytischen Funktionen verstehen. Wir zeigen die einfache Beziehung zwischen der Moment-asymptotischen Entwicklung und der Taylorentwicklung der Fouriertransformierten und benutzen dann ein Resultat von Estrada, um die Vollständigkeit unseres Moment-asymptotischen Schemas abzuleiten. Wir geben genaue Bedingungen für die Moment-Folgen von Hyperfunktionen mit kompaktem Träger an, die kürzlich von Kim et al. gefunden wurden. Die asymptotischen Entwicklungen übertragen wir auf den höherdimensionalen Fall, indem wir die von Kaneko und Takiguchi eingeführte Radontransformation für Hyperfunktionen verwenden. Die wohlbekannte Beziehung zwischen Radon- und Fouriertransformation zeigt wiederum das enge Verhältnis von asymptotischer Entwicklung zur Taylorentwicklung der Fouriertransformierten. Wir benutzen Kims Resultate, um die Moment-Folgen von Hyperfunktionen zu charakterisieren, die von Kugeln mit endlichem Radius getragen werden. Schließlich verwenden wir das Träger-Theorem der Radontransformation, um ein Resultat über das Singularitätenspektrum aus Bedingungen an die Radontransformierte abzuleiten.
Presentation at the Università di Pisa, Pisa, Itlay 3 July 2002, the conference on Irreversible Quantum Dynamics', the Abdus Salam ICTP, Trieste, Italy, 29 July - 2 August 2002, and the University of Natal, Pietermaritzburg, South Africa, 14 May 2003. Version of 24 April 2003: examples added; 16 December 2002: revised; 12 Sptember 2002. See the corresponding papers "Zeno Dynamics of von Neumann Algebras", "Zeno Dynamics in Quantum Statistical Mechanics" and "Mathematics of the Quantum Zeno Effect"
The dynamical quantum Zeno effect is studied in the context of von Neumann algebras. It is shown that the Zeno dynamics coincides with the modular dynamics of a localized subalgebra. This relates the modular operator of that subalgebra to the modular operator of the original algebra by a variant of the Kato-Lie-Trotter product formula.
We present an overview of the mathematics underlying the quantum Zeno effect. Classical, functional analytic results are put into perspective and compared with more recent ones. This yields some new insights into mathematical preconditions entailing the Zeno paradox, in particular a simplified proof of Misra's and Sudarshan's theorem. We empahsise the complex-analytic structures associated to the issue of existence of the Zeno dynamics. On grounds of the assembled material, we reason about possible future mathematical developments pertaining to the Zeno paradox and its counterpart, the anti-Zeno paradox, both of which seem to be close to complete characterisations. PACS-Klassifikation: 03.65.Xp, 03.65Db, 05.30.-d, 02.30.T . See the corresponding presentation: Schmidt, Andreas U.: "Zeno Dynamics of von Neumann Algebras" and "Zeno Dynamics in Quantum Statistical Mechanics"
We study the quantum Zeno effect in quantum statistical mechanics within the operator algebraic framework. We formulate a condition for the appearance of the effect in W*-dynamical systems, in terms of the short-time behaviour of the dynamics. Examples of quantum spin systems show that this condition can be effectively applied to quantum statistical mechanical models. Furthermore, we derive an explicit form of the Zeno generator, and use it to construct Gibbs equilibrium states for the Zeno dynamics. As a concrete example, we consider the X-Y model, for which we show that a frequent measurement at a microscopic level, e.g. a single lattice site, can produce a macroscopic effect in changing the global equilibrium. PACS - Klassifikation: 03.65.Xp, 05.30.-d, 02.30. See the corresponding papers: Schmidt, Andreas U.: "Zeno Dynamics of von Neumann Algebras" and "Mathematics of the Quantum Zeno Effect" and the talk "Zeno Dynamics in Quantum Statistical Mechanics" - http://publikationen.ub.uni-frankfurt.de/volltexte/2005/1167/
We reconsider estimates for the heat kernel on weighted graphs recently found by Metzger and Stollmann. In the case that the weights satisfy a positive lower bound as well as a finite upper bound, we obtain a specialized lower estimate and a proper generalization of a previous upper estimate. Reviews: Math. Rev. 1979406, Zbl. Math. 0934.46042
This paper starts out by pointing out the challenges and weaknesses which the German banking systems faces according to the prevailing views among national and international observers. These challenges include a generalproblem of profitability and, possibly as its main reason, the strong role of public banks. These concerns raise the questions whether the facts support this assessment of a general profitability problem and whether there are reasons to expect a fundamental or structural transformation of the German banking system. The paper contains four sections. The first one presents the evidence concerning the profitability problem in a comparative, international perspective. The second section presents information about the so-called three-pillar system of German banking. What might be surprising in this context is that the group of pub lic banks is not only the largest segment of the German banking system, but that the primary savings banks also are its financially most successful part. The German banking system is highly fragmented. This fact suggests to discuss past, present and possible future consolidations in the banking system in the third section. The authors provide evidence to the effect that within- group consolidation has been going on at a rapid pace in the public and the cooperative banking groups in recent years and that this development has not yet come to an end, while within-group consolidation among the large private banks, consolidation across group boundaries at a national level and cross-border or international consolidation has so far only happened at a limited scale, and do not appear to gain momentum in the near future. In the last section, the authors develop their explanation for the fact that large-scale and cross border consolidation has so far not materialized to any great extent. Drawing on the concept of complementarity, they argue that it would be difficult to expect these kinds of mergers and acquisitions happening within a financial system which is itself surprisingly stable, or, as one cal also call it, resistant to change.
A widely recognized paper by Colin Mayer (1988) has led to a profound revision of academic thinking about financing patterns of corporations in different countries. Using flow-of-funds data instead of balance sheet data, Mayer and others who followed his lead found that internal financing is the dominant mode of financing in all countries, that financing patterns do not differ very much between countries and that those differences which still seem to exist are not at all consistent with the common conviction that financial systems can be classified as being either bank-based or capital market-based. This leads to a puzzle insofar as it calls into question the empirical foundation of the widely held belief that there is a correspondence between the financing patterns of corporations on the one side, and the structure of the financial sector and the prevailing corporate governance system in a given country on the other side. The present paper addresses this puzzle on a methodological and an empirical basis. It starts by comparing and analyzing various ways of measuring financial structure and financing patterns and by demonstrating that the surprising empirical results found by studies that relied on net flows are due to a hidden assumption. It then derives an alternative method of measuring financing patterns, which also uses flow-of-funds data, but avoids the questionable assumption. This measurement concept is then applied to patterns of corporate financing in Germany, Japan and the United States. The empirical results, which use an estimation technique for determining gross flows of funds in those cases in which empirical data are not available, are very much in line with the commonly held belief prior to Mayer’s influential contribution and indicate that the financial systems of the three countries do indeed differ from one another in a substantial way, and moreover in a way which is largely in line with the general view of the differences between the financial systems of the countries covered in the present paper.
The German corporate governance system has long been cited as the standard example of an insider-controlled and stakeholder-oriented system. We argue that despite important reforms and substantial changes of individual elements of the German corporate governance system the main characteristics of the traditional German system as a whole are still in place. However, in our opinion the changing role of the big universal banks in the governance undermines the stability of the corporate governance system in Germany. Therefore a breakdown of the traditional system leading to a control vacuum or a fundamental change to a capital market-based system could be in the offing.
Die durch jahrzehntelange Planwirtschaft geprägten Strukturen sind in Russland noch fest verwurzelt. Dementsprechend ist das Bankensystem auch zwölf Jahre nach dem Ende des kommunistischen Regimes unterentwickelt. Die markantesten Merkmale der Finanzwirtschaft sind die ungewöhnliche Größenstruktur der Banken; deren Schwierigkeiten, die rapide zunehmende Zahl kleinster, kleiner und mittlerer Unternehmen mit Finanzdienstleistungen zu versorgen sowie die geringe Rolle ausländischer Banken. Überdies sind die weiterhin bestehenden Systemrisiken nicht zu unterschätzen.
An Hand von 4415 Vegetationsaufnahmen, die von einem Ackerbrachen-Versuch auf Dauerflächen im Neuen Botanischen Garten der Universität Göttingen aus dem Zeitraum 1969-2006 vorliegen, wird der Anteil an Neophyten untersucht. Der Neophytenanteil an der Gesamtflora des Sukzessionsversuchs (insgesamt 372 Taxa) liegt mit 8,6% in vergleichbarer Größenordnung wie in der Flora der Umgebung. In der ungestörten Ackerbrachen-Sukzession waren Neophyten mit 8-12% an der Artenzahl beteiligt. Der Anteil der Neophyten am Deckungsgrad der Krautschicht war im Grasland- und Strauchstadium (3.-20. Jahr nach dem Brachfallen) mit 50 bis zu 70% am höchsten und nahm mit der Entwicklung einer geschlossenen Gehölzschicht im Pionierwaldstadium signifikant ab. Wichtigste Neophyten in der ungestörten Ackerbrachen-Sukzession waren Conyza canadensis (Annuellen-Stadium), Epilobium ciliatum (Grasland-Stadium und vor allem Solidago canadensis (Grasland- bis Strauchstadium). Neophytische Gehölze spielen - im Gegensatz zu Nordamerika - in der Göttinger Ackerbrache bisher keine Rolle. Wurden die Ackerbrachen nur einmal jährlich gemäht so nahmen die Neophytenanteile am Deckungsgrad von weniger als 15% im ersten Jahrzehnt auf bis zu fast 90% im vierten Jahrzehnt zu. Bei zwei- bis achtmaliger Mahd lag der Anteil der Neophyten am Deckungsgrad nut bei etwa 1%, an der Artenzahl bei etwa 5%. Auf den mehrmals jährlich gemähten Flächen ließ sich keine Erhöhung des Neophytenanteils durch Düngung nachweisen, lediglich auf den einmal gemähten war dieser im Vergleich zu den ungedüngten Flächen höher. Obwohl Bodenstörungen häufig als eine wichtige Voraussetzung für die Etablierung von Neophyten angesehen werden, fiel der Anteil der Neophyten auf den regelmäßig gepflügten Flächen niedriger aus als bei einmaligem Mähen oder Mulchen. Entscheidend für die Unterschiede in den Neophytenanteilen war vor allem die Reaktion von Solidago canadensis auf die verschiedenen Versuchs(Störungs-)varianten (Mahd, Mulchen, Pflügen, Düngung). Am Beispiel Solidago canadensis zeigte sich auch sehr deutlich, dass der Erfolg eines Neophyten in einer Pflanzengemeinschaft sehr stark von seiner Identität abhängt, d.h. nicht der floristische Status, sondern die morphologischen, physiologischen und genetischen Eigenschaften entscheiden darüber, ob sich eine Art in einer Sukzession invasiv verhält oder nicht.
In der Literaturstudie werden Vegetationsaufnahmen aus 15 Eichen-Hainbuchen-Waldgebieten zwischen dem kontinental geprägten Mitteldeutschland und dem ozeanischen Nordwestdeutschland ausgewertet. Dabei können gegenläufige Abundanzen von Winterlinde (Tilia cordata Mill.) und Rotbuche (Fagus sylvaticus L.) entlang dieses Klimagradienten festgestellt werden. Mit zunehmender Ozeanität nimmt die Stetigkeit der Winterlinde ab, demgegenüber gewinnt die im Gegensatz zur Winterlinde in allen betrachteten Eichen-Hainbuchen-Wäldern vorkommende Buche an Stetigkeit. Die Winterlinde kommt dabei in subatlantischen Klimaräumen, die subkontinental beeinflusst sind, mit sehr unterschiedlichen Abundanzen vor. Dies kann durch den Übergangscharakter des Klimas der entsprechenden Wuchsbezirke erklärt werden, in denen sowohl Winterlinde als auch Buche vom Klima her gut gedeihen können, so dass dann eher edaphische und anthropogene Einflüsse über die Baumartenzusammensetzung entscheiden. Im atlantisch geprägten nordwestdeutschen Flachland und in der Westfälischen Bucht kommt die Winterlinde höchstwahrscheinlich nicht natürlich vor, allerdings verwischen in diesem Bereich zahlreiche gepflanzte Winterlinden das natürliche Verbreitungsbild.
Die Literaturstudie wird um eine Fallstudie im thüringischen Hainich ergänzt. Diese ermöglicht zusätzliche Erkenntnisse zur Abhängigkeit der Winterlinde von edaphischen und anthropologischen Faktoren. Im subkontinental beeinflussten Hainich sind Bestände des Stellario-Carpinentum durch eine stärker ausgeprägte Vertikalstruktur der Baumschicht gekennzeichnet als Bestände des Hordelymo- und Galio-Fagetum. Dies weist auf eine frühere Plenter- und vor allem Mittelwaldnutzung hin, wobei letztere die Linde fördert und die Buche zurückdrängt. Einen weitaus größeren Einfluss auf die Vegetationsdifferenzierung und damit auf die Baumartenzusammensetzung im Hainich hat aber vermutlich der Tongehalt des Bodens. Erhöhte Tongehalte resultieren in einer größeren Wechselfeuchte insbesondere der tieferen Bodenhorizonte, worauf die Buche im Gegensatz zur Winterlinde empfindlich reagiert. Obwohl im östlichen Hainich die Eichen-Hainbuchen-Wälder pflanzensoziologisch wenig scharf von den artenreichen Buchenwäldern getrennt sind, ist es doch sehr wahrscheinlich, dass dieses Gebiet bereits einen natürlichen Übergangsbereich zu echten Eichen-Hainbuchen-Wäldern der zonalen Vegetation dartstellt. Im Hainich wirkt sich ein zunehmender Winterlindenanteil günstig auf die Nährstoffversorgung des Oberbodens aus, auch wenn hierbei die Abnahme des Buchenanteils möglicherweise entscheidender ist.
Im Oberharz wurden 1985/86 100 künstlich angelegte, kleinflächige, zwischen 3 und 12 Jahre alte Stillgewässer hydrochemisch, floristisch und vegetationskundlich untersucht. Die Teiche konnten anhand der Nährstoffverhälthisse in eine ärmere (dystrophe und oligotrophe) und eine reichere (oligotroph-mesotrophe) Gruppe aufgeteilt werden, wobei bei letzterer der Hydrogenkarbonatgehalt noch eine weitere Untergliederung erlaubte. Diese Unterschiede in der Nährstoffversorgung spiegelten sich auch in der Flora und Vegetation wider. Die Besiedlung mit Pflanzen wurde außerdem noch durch die Vegetation vor der Anlage der Teiche sowie durch die Erreichbarkeit für Wasser- und Sumpfpflanzen bestimmt. Die Kleingewässer stellen in der durch Fichtenforsten geprägten Landschaft des Oberharzes eine wesentliche Bereicherung dar. Sie sind auch aus der Sicht des Naturschutzes zu begrüßen, da es sich überwiegend um naturnahe, nährstoffarme Lebensgemeinschaften handelt, die in Mitteleuropa stark gefährdet sind. Für die Neuanlage und Unterhaltung der Teiche werden abschließend Vorschläge gemacht.
Rudolf, Martin ; Czajka, Christina ; Börstler, Jessica ; Melaun, Christian ; Jöst, Hanna ; Thien, Heidrun von ; Badusche, Marlis ; Becker, Norbert ; Schmidt-Chanasit, Jonas ; Krüger, Andreas ; Tannich, Egbert ; Becker, Stefanie
Mosquitoes and other arthropods may transmit medically important pathogens, in particular viruses such as West Nile virus. The presence of suitable hosts and competent vectors for those zoonotic viruses is essential for an enzootic transmission, which is a prerequisite for epidemics. To establish reliable risk projections, it is an urgent need for an exact identification of mosquito species, which is especially challenging in the case of sibling species, such as Culex. pipiens pipiens biotypes pipiens and molestus. To facilitate detection of different Culex pipiens forms and their hybrids we established a multiplex real-time PCR. Culex pipiens samples were obtained by egg raft collection and rearing until imago stage or adult sampling using CO2 baited traps and gravid traps. In total, we tested more than 16,500 samples collected all over Germany in the years 2011 and 2012. The predominant species in Germany are Culex pipiens pipiens biotype pipiens and Culex. torrentium, but we also detected Culex pipiens pipiens biotype molestus and hybrids of the two pipiens biotypes at sites where both species occur sympatrically. This report of a potentially important bridge vector for West Nile virus might have major impact in the risk projections for West Nile virus in Germany.
Riecke, Kerstin ; Müller, Volkmar ; Weide, Rudolf ; Schmidt, Marcus ; Park-Simon, Tjoung-Won ; Möbus, Volker ; Mundhenke, Christoph ; Polasik, Arkadius ; Lübbe, Kristina ; Hesse, Tobias ; Laakmann, Elena ; Thill, Marc ; Fasching, Peter Andreas ; Denkert, Carsten ; Fehm, Tanja ; Nekljudova, Valentina ; Rey, Julia ; Loibl, Sibylle ; Witzel, Isabell
Simple Summary: The incidence of brain metastases from breast cancer is increasing and the treatment is still a major challenge. Several scores have been developed in order to estimate the prognosis of patients with brain metastases by objective criteria. Here, we validated all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer patients with brain metastases in the Brain Metastases in the German Breast Cancer (BMBC) registry. Although all three available GPA-scores were associated with OS, they all show limitations mainly in predicting short-term (below 3 months) survival but also in long-term (above 12 months) survival. We discuss the test performances of all scores in our work and provide evidence how physicians should use them as a tool to select patients for different treatment options.
Abstract: Several scores have been developed in order to estimate the prognosis of patients with brain metastases (BM) by objective criteria. The aim of this analysis was to validate all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer (BC) patients with BM in the Brain Metastases in the German Breast Cancer (BMBC) registry. The median age at diagnosis of BM was 57 years. All in all, 22.3% of patients (n = 197) had triple-negative, 33.4% (n = 295) luminal A like, 25.1% (n = 221) luminal B/HER2-enriched like and 19.2% (n = 169) HER2 positive like BC. Age ≥60 years, evidence of extracranial metastases (ECM), higher number of BM, triple-negative subtype and low Karnofsky-Performance-Status (KPS) were all associated with worse overall survival (OS) in univariate analysis (p < 0.001 each). All three GPA-scores were associated with OS. The breast-GPA showed the highest probability of classifying patients with survival above 12 months in the best prognostic group (specificity 68.7% compared with 48.1% for the updated breast-GPA and 21.8% for the original GPA). Sensitivities for predicting 3 months survival were very low for all scores. In this analysis, all GPA-scores showed only moderate diagnostic accuracy in predicting the OS of BC patients with BM.
Characteristics and clinical outcome of breast cancer patients with asymptomatic brain metastases
(2020)
Laakmann, Elena ; Witzel, Isabell ; Neunhöffer, Tanja ; Weide, Rudolf ; Schmidt, Marcus ; Park-Simon, Tjoung-Won ; Möbus, Volker ; Mundhenke, Christoph ; Polasik, Arkadius ; Lübbe, Kristina ; Hesse, Tobias ; Riecke, Kerstin ; Thill, Marc ; Fasching, Peter Andreas ; Denkert, Carsten ; Fehm, Tanja ; Nekljudova, Valentina ; Rey, Julia ; Loibl, Sibylle ; Müller, Volkmar
Simple Summary: The prognosis for patients with breast cancer that has spread to the brain is poor, and survival for these women hasn’t improved over the last few decades. We do not currently test for asymptomatic brain metastases in breast cancer patients, although this does happen in some other types of cancer. In this study we wanted to find out more about breast cancer that has spread to the brain and in particular to see whether there might be any advantage to spotting brain metastases before the development of neurological symptoms. Overall, our results suggest that women could be better off if their brain metastases are diagnosed before they begin to cause symptoms. We now need to carry out a clinical trial to see what happens if we screen high-risk breast cancer patients for brain metastases. This will verify whether doing so could increase survival, symptom control or quality of life.
Abstract: Background: Brain metastases (BM) have become a major challenge in patients with metastatic breast cancer. Methods: The aim of this analysis was to characterize patients with asymptomatic BM (n = 580) in the overall cohort of 2589 patients with BM from our Brain Metastases in Breast Cancer Network Germany (BMBC) registry. Results: Compared to symptomatic patients, asymptomatic patients were slightly younger at diagnosis (median age: 55.5 vs. 57.0 years, p = 0.01), had a better performance status at diagnosis (Karnofsky index 80–100%: 68.4% vs. 57%, p < 0.001), a lower number of BM (>1 BM: 56% vs. 70%, p = 0.027), and a slightly smaller diameter of BM (median: 1.5 vs. 2.2 cm, p < 0.001). Asymptomatic patients were more likely to have extracranial metastases (86.7% vs. 81.5%, p = 0.003) but were less likely to have leptomeningeal metastasis (6.3% vs. 10.9%, p < 0.001). Asymptomatic patients underwent less intensive BM therapy but had a longer median overall survival (statistically significant for a cohort of HER2-positive patients) compared to symptomatic patients (10.4 vs. 6.9 months, p < 0.001). Conclusions: These analyses show a trend that asymptomatic patients have less severe metastatic brain disease and despite less intensive local BM therapy still have a better outcome (statistically significant for a cohort of HER2-positive patients) than patients who present with symptomatic BM, although a lead time bias of the earlier diagnosis cannot be ruled out. Our analysis is of clinical relevance in the context of potential trials examining the benefit of early detection and treatment of BM.
Kowark, Ana ; Adam, Christian ; Ahrens, Jörg ; Bajbouj, Malek ; Bollheimer, Cornelius ; Borowski, Matthias ; Dodel, Richard ; Dolch, Michael ; Hachenberg, Thomas ; Henzler, Dietrich ; Hildebrand, Frank ; Hilgers, Ralf-Dieter ; Hoeft, Andreas ; Isfort, Susanne ; Kienbaum, Peter ; Knobe, Mathias ; Knüfermann, Pascal ; Kranke, Peter ; Laufenberg-Feldmann, Rita ; Nau, Carla ; Neuman, Mark D. ; Olotu, Cynthia ; Rex, Christopher ; Rossaint, Rolf ; Sanders, Robert D. ; Schmidt, Rene ; Schneider, Frank ; Siebert, Hartmut ; Skorning, Max ; Spies, Claudia ; Vicent, Oliver ; Wappler, Frank ; Wirtz, Dieter Christian ; Wittmann, Maria ; Zacharowski, Kai ; Zarbock, Alexander ; Coburn, Mark
Introduction: Hip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse.
Methods and analysis: The iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design. In total, 1032 patients with hip fracture (>65 years) will be randomised in an intended 1:1 allocation ratio to receive spinal anaesthesia (n=516) or general anaesthesia (n=516). Outcome assessment will occur in a blinded manner after hospital discharge and inhospital. The primary endpoint will be assessed by telephone interview and comprises the time to the first occurring event of the binary composite outcome of all-cause mortality or new-onset serious cardiac and pulmonary complications within 30 postoperative days. In-hospital secondary endpoints, assessed via in-person interviews and medical record review, include mortality, perioperative adverse events, delirium, satisfaction, walking independently, length of hospital stay and discharge destination. Telephone interviews will be performed for long-term endpoints (all-cause mortality, independence in walking, chronic pain, ability to return home cognitive function and overall health and disability) at postoperative day 30±3, 180±45 and 365±60.
Ethics and dissemination: iHOPE has been approved by the leading Ethics Committee of the Medical Faculty of the RWTH Aachen University on 14 March 2018 (EK 022/18). Approval from all other involved local Ethical Committees was subsequently requested and obtained. Study started in April 2018 with a total recruitment period of 24 months. iHOPE will be disseminated via presentations at national and international scientific meetings or conferences and publication in peer-reviewed international scientific journals.
Trial registration number: DRKS00013644; Pre-results
Dreis, Caroline ; Ottenlinger, Florian ; Putyrski, Mateusz ; Ernst, Andreas ; Huhn, Meik ; Schmidt, Katrin G. ; Pfeilschifter, Josef ; Radeke, Heinfried H.
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.
Mousset, Sabine ; Buchheidt, Dieter ; Heinz, Werner ; Ruhnke, Markus ; Cornely, Oliver Andreas ; Egerer, Gerlinde ; Krüger, William ; Link, Hartmut ; Neumann, Silke ; Ostermann, Helmut ; Panse, Jens ; Penack, Olaf ; Rieger, Christina ; Schmidt-Hieber, Martin ; Silling, Gerda ; Südhoff, Thomas ; Ullmann, Andrew J. ; Wolf, Hans-Heinrich ; Maschmeyer, Georg ; Böhme, Angelika
The Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) here presents its updated recommendations for the treatment of documented fungal infections. Invasive fungal infections are a main cause of morbidity and mortality in cancer patients undergoing intensive chemotherapy regimens. In recent years, new antifungal agents have been licensed, and agents already approved have been studied in new indications. The choice of the most appropriate antifungal treatment depends on the fungal species suspected or identified, the patient’s risk factors (e.g., length and depth of neutropenia), and the expected side effects. This guideline reviews the clinical studies that served as a basis for the following recommendations. All recommendations including the levels of evidence are summarized in tables to give the reader rapid access to the information.
Bieber, Miriam ; Görgülü, Esra ; Schmidt, Daniela ; Zabel, Kirsten ; Etyemez, Semra ; Friedrichs, Benedikt ; Prvulovic, David ; Reif, Andreas ; Oertel-Knöchel, Viola
The major depressive disorder is one of the most common mental illnesses worldwide. Current treatment standards recommend a combined therapy with medication and psychotherapy. As an additive component and to further improvements in treatment, physical activity such as yoga may be integrated into conventional treatment. This study investigates the impact of a 3-month body-oriented yoga in patients with major depressive disorder (MDD). In total, n = 83 patients were included. An intervention group received a vigorous Ashtanga-Yoga three times a week. The waiting-list control group obtained a treatment as usual (TAU). As a primary outcome depression scores (Beck Depression Inventory-II (BDI-II), Montgomery Asberg Depression Rating Scale (MADRS)) were tested at three time points. Secondary outcome was the positive and negative affect [Positive and Negative Affect Scale (PANAS)] and remission rates. To analyze the data, multilevel models and effect sizes were conducted. The results showed an improvement in BDI-II scores for both groups over time [γ = − 3.46, t(165) = − 7.99, p < 0.001] but not between groups [γ = 0.98, t(164) = 1.12, p = 0.263]. An interaction effect (time x group) occurred for MADRS [γ = 2.10, t(164) = 2.10, p < 0.038]. Positive affects improved over time for both groups [γ = 1.65, t(165) = 4.03, p < 0.001]. Negative affects decreased for all over time [γ = − 1.00, t(165) = − 2.51, p = 0.013]. There were no significant group differences in PANAS. Post hoc tests revealed a greater symptom reduction within the first 6 weeks for all measurements. The effect sizes for depression scores showed a positive trend. Remission rates indicated a significant improvement in the yoga group (BDI-II: 46.81%, MADRS: 17.02%) compared to the control group (BDI: 33.33%, MADRS: 8.33%). The findings suggest that there is a trendsetting additive effect of Ashtanga-Yoga after 3 months on psychopathology and mood with a greater improvement at the beginning of the intervention. Further research in this field can help to achieve more differentiated results.
Quantification of circulating endothelial progenitor cells using the modified ISHAGE protocol
(2010)
Schmidt-Lucke, Caroline ; Fichtlscherer, Stephan ; Aicher, Alexandra ; Tschöpe, Carsten ; Schultheiß, Heinz-Peter ; Zeiher, Andreas M. ; Dimmeler, Stefanie
Aims: Circulating endothelial progenitor cells (EPC), involved in endothelial regeneration, neovascularisation, and determination of prognosis in cardiovascular disease can be characterised with functional assays or using immunofluorescence and flow cytometry. Combinations of markers, including CD34+KDR+ or CD133+KDR+, are used. This approach, however may not consider all characteristics of EPC. The lack of a standardised protocol with regards to reagents and gating strategies may account for the widespread inter-laboratory variations in quantification of EPC. We, therefore developed a novel protocol adapted from the standardised so-called ISHAGE protocol for enumeration of haematopoietic stem cells to enable comparison of clinical and laboratory data. Methods and Results: In 25 control subjects, 65 patients with coronary artery disease (CAD; 40 stable CAD, 25 acute coronary syndrome/acute myocardial infarction (ACS)), EPC were quantified using the following approach: Whole blood was incubated with CD45, KDR, and CD34. The ISHAGE sequential strategy was used, and finally, CD45dimCD34+ cells were quantified for KDR. A minimum of 100 CD34+ events were collected. For comparison, CD45+CD34+ and CD45-CD34+ were analysed simultaneously. The number of CD45dimCD34+KDR+ cells only were significantly higher in healthy controls compared to patients with CAD or ACS (p = 0.005 each, p<0.001 for trend). An inverse correlation of CD45dimCD34+KDR+ with disease activity (r = -0.475, p<0.001) was confirmed. Only CD45dimCD34+KDR+ correlated inversely with the number of diseased coronaries (r = -0.344; p<0.005). In a second study, a 4-week de-novo treatment of atorvastatin in stable CAD evoked an increase only of CD45dimCD34+KDR+ EPC (p<0.05). CD45+CD34+KDR+ and CD45-CD34+KDR+ were indifferent between the three groups. Conclusion: Our newly established protocol adopted from the standardised ISHAGE protocol achieved higher accuracy in EPC enumeration confirming previous findings with respect to the correlation of EPC with disease activity and the increase of EPC during statin therapy. The data of this study show the CD45dim fraction to harbour EPC.
Early maternal care may counteract familial liability for psychopathology in the reward circuitry
(2018)
Holz, Nathalie E. ; Boecker-Schlier, Regina ; Jennen-Steinmetz, Christine ; Hohm, Erika ; Buchmann, Arlette ; Blomeyer, Dorothea ; Baumeister, Sarah ; Plichta, Michael M. ; Esser, Günter ; Schmidt, Martin ; Meyer-Lindenberg, Andreas ; Banaschewski, Tobias ; Brandeis, Daniel ; Laucht, Manfred
Reward processing is altered in various psychopathologies and has been shown to be susceptible to genetic and environmental influences. Here, we examined whether maternal care may buffer familial risk for psychiatric disorders in terms of reward processing. Functional magnetic resonance imaging during a monetary incentive delay task was acquired in participants of an epidemiological cohort study followed since birth (N = 172, 25 years). Early maternal stimulation was assessed during a standardized nursing/playing setting at the age of 3 months. Parental psychiatric disorders (familial risk) during childhood and the participants’ previous psychopathology were assessed by diagnostic interview. With high familial risk, higher maternal stimulation was related to increasing activation in the caudate head, the supplementary motor area, the cingulum and the middle frontal gyrus during reward anticipation, with the opposite pattern found in individuals with no familial risk. In contrast, higher maternal stimulation was associated with decreasing caudate head activity during reward delivery and reduced levels of attention deficit hyperactivity disorder (ADHD) in the high-risk group. Decreased caudate head activity during reward anticipation and increased activity during delivery were linked to ADHD. These findings provide evidence of a long-term association of early maternal stimulation on both adult neurobiological systems of reward underlying externalizing behavior and ADHD during development.
Kümmel, Andreas ; Alfen, Astrid ; Schmidt, Lars Henning ; Sebastian, Martin ; Wiewrodt, Rainer ; Schulze, Arik Bernard ; Buhl, Roland ; Radsak, Markus
Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1) can be found in the sera of patients with infectious, autoimmune and malignant diseases. The primary objective of this study was to investigate the prognostic significance of sTREM-1 in lung cancer patients. We analyzed the sera of 164 patients with lung cancer of all histologies and all stages at the time of diagnosis. We employed an ELISA using the anti-TREM-1 clone 6B1.1G12 mAb and recombinant human TREM-1. Patient data was collected retrospectively by chart review. In ROC-analysis, a sTREM-1 serum level of 163.1 pg/ml showed the highest Youden-Index. At this cut-off value sTREM-1 was a marker of short survival in patients with NSCLC (median survival 8.5 vs. 13.3 months, p = 0.04). A Cox regression model showed stage (p < 0.001) and sTREM-1 (p = 0.011) to indicate short survival. There were no differences in sTREM-1 serum values among patients with or without infection, pleural effusion or COPD. sTREM-1 was not associated with metastasis at the time of diagnosis and was not a predictor of subsequent metastasis. In SCLC patients sTREM-1 levels were lower than in NSCLC patients (p = 0.001) and did not predict survival. sTREM-1 did not correlate with CRP or the number of neutrophils. In non-small cell lung cancer patients, sTREM-1 in serum has prognostic significance.
Schnitzbauer, Andreas ; Zuelke, Carl ; Graeb, Christian ; Rochon, Justine ; Bilbao, Itxarone ; Burra, Patrizia ; de Jong, Koert P. ; Duvoux, Christophe ; Kneteman, Norman M. ; Adam, Rene ; Bechstein, Wolf Otto ; Becker, Thomas ; Beckebaum, Susanne ; Chazouilleres, Olivier ; Cillo, Umberto ; Colledan, Michele ; Fandrich, Fred ; Gugenheim, Jean ; Hauss, Johann P. ; Heise, Michael ; Hidalgo, Ernest ; Jamieson, Neville ; Königsrainer, Alfred ; Lamby, Philipp E. ; Lerut, Jan P. ; Makisalo, Heikki ; Margreiter, Raimund ; Mazzaferro, Vincenzo ; Mutzbauer, Ingrid ; Otto, Gerd ; Pageaux, Georges-Philippe ; Pinna, Antonio D. ; Pirenne, Jacques ; Rizell, Magnus ; Rossi, Giorgio ; Rostaing, Lionel ; Roy, Andre ; Turrion, Victor Sanchez ; Schmidt, Jan ; Troisi, Roberto I. ; Hoek, Bart van ; Valente, Umberto ; Wolf, Philippe ; Wolters, Heiner ; Mirza, Darius F. ; Scholz, Tim ; Steininger, Rudolf ; Soderdahl, Gunnar ; Strasser, Simone I. ; Jauch, Karl-Walter ; Neuhaus, Peter ; Schlitt, Hans J. ; Geissler, Edward K.
Background: The potential anti-cancer effects of mammalian target of rapamycin (mTOR) inhibitors are being intensively studied. To date, however, few randomised clinical trials (RCT) have been performed to demonstrate anti-neoplastic effects in the pure oncology setting, and at present, no oncology endpoint-directed RCT has been reported in the high-malignancy risk population of immunosuppressed transplant recipients. Interestingly, since mTOR inhibitors have both immunosuppressive and anti-cancer effects, they have the potential to simultaneously protect against immunologic graft loss and tumour development. Therefore, we designed a prospective RCT to determine if the mTOR inhibitor sirolimus can improve hepatocellular carcinoma (HCC)-free patient survival in liver transplant (LT) recipients with a pre-transplant diagnosis of HCC. Methods: The study is an open-labelled, randomised, RCT comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing LT for HCC. Patients with a histologically confirmed HCC diagnosis are randomised into 2 groups within 4-6 weeks after LT; one arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol and the second arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol for the first 4-6 weeks, at which time sirolimus is initiated. A 3-year recruitment phase is planned with a 5-year follow-up, testing HCC-free survival as the primary endpoint. Our hypothesis is that sirolimus use in the second arm of the study will improve HCC-free survival. The study is a non-commercial investigator-initiated trial (IIT) sponsored by the University Hospital Regensburg and is endorsed by the European Liver and Intestine Transplant Association; 13 countries within Europe, Canada and Australia are participating. Discussion: If our hypothesis is correct that mTOR inhibition can reduce HCC tumour growth while simultaneously providing immunosuppression to protect the liver allograft from rejection, patients should experience less post-transplant problems with HCC recurrence, and therefore could expect a longer and better quality of life. A positive outcome will likely change the standard of posttransplant immunosuppressive care for LT patients with HCC. (trial registered at www.clinicaltrials.gov: NCT00355862) (EudraCT Number: 2005-005362-36)
Engel, Andreas ; Bönisch, Harald ; Brunner, Dominik ; Fischer, Herbert ; Franke, Harald ; Günther, Gebhard ; Gurk, Christian Thomas ; Hegglin, Michaela I. ; Hoor, Peter ; Königstedt, Rainer ; Krebsbach, Michael ; Maser, Rolf ; Parchatka, Uwe ; Peter, Thomas ; Schell, Dieter ; Schiller, Cornelius ; Schmidt, Ulrich ; Spelten, Nicole ; Szabo, T. ; Weers, Uwe ; Wernli, Heini ; Wetter, Thomas ; Wirth, Volkmar
During SPURT (Spurenstofftransport in der Tropopausenregion, trace gas transport in the tropopause region) we performed measurements of a wide range of trace gases with different lifetimes and sink/source characteristics in the northern hemispheric upper troposphere (UT) and lowermost stratosphere (LMS). A large number of in-situ instruments were deployed on board a Learjet 35A, flying at altitudes up to 13.7 km, at times reaching to nearly 380 K potential temperature. Eight measurement campaigns (consisting of a total of 36 flights), distributed over all seasons and typically covering latitudes between 35° N and 75° N in the European longitude sector (10° W–20° E), were performed. Here we present an overview of the project, describing the instrumentation, the encountered meteorological situations during the campaigns and the data set available from SPURT. Measurements were obtained for N2O, CH4, CO, CO2, CFC12, H2, SF6, NO, NOy, O3 and H2O. We illustrate the strength of this new data set by showing mean distributions of the mixing ratios of selected trace gases, using a potential temperature – equivalent latitude coordinate system. The observations reveal that the LMS is most stratospheric in character during spring, with the highest mixing ratios of O3 and NOy and the lowest mixing ratios of N2O and SF6. The lowest mixing ratios of NOy and O3 are observed during autumn, together with the highest mixing ratios of N2O and SF6 indicating a strong tropospheric influence. For H2O, however, the maximum concentrations in the LMS are found during summer, suggesting unique (temperature- and convection-controlled) conditions for this molecule during transport across the tropopause. The SPURT data set is presently the most accurate and complete data set for many trace species in the LMS, and its main value is the simultaneous measurement of a suite of trace gases having different lifetimes and physical-chemical histories. It is thus very well suited for studies of atmospheric transport, for model validation, and for investigations of seasonal changes in the UT/LMS, as demonstrated in accompanying and elsewhere published studies.
On the observation of mesospheric air inside the arctic stratospheric polar vortex in early 2003
(2005)
Engel, Andreas ; Möbius, Tanja ; Haase, Hans-Peter ; Bönisch, Harald ; Wetter, Thomas ; Schmidt, Ulrich ; Levin, Ingeborg ; Reddmann, Thomas ; Oelhaf, Hermann ; Wetzel, Gerald ; Grunow, Katja ; Huret, Nathalie ; Pirre, Michel
During several balloon flights inside the Arctic polar vortex in early 2003, unusual trace gas distributions were observed, which indicate a strong influence of mesospheric air in the stratosphere. The tuneable diode laser (TDL) instrument SPIRALE (Spectroscopie InFrarouge par Absorption de Lasers Embarqués) measured unusually high CO values (up to 600 ppb) on 27 January at about 30 km altitude. The cryosampler BONBON sampled air masses with very high molecular Hydrogen, extremely low SF6 and enhanced CO values on 6 March at about 25 km altitude. Finally, the MIPAS (Michelson Interferometer for Passive Atmospheric Sounding) Fourier Transform Infra-Red (FTIR) spectrometer showed NOy values which are significantly higher than NOy* (the NOy derived from a correlation between N2O and NOy under undisturbed conditions), on 21 and 22 March in a layer centred at 22 km altitude. Thus, the mesospheric air seems to have been present in a layer descending from about 30 km in late January to 25 km altitude in early March and about 22 km altitude on 20 March. We present corroborating evidence from a model study using the KASIMA (KArlsruhe Simulation model of the Middle Atmosphere) model that also shows a layer of mesospheric air, which descended into the stratosphere in November and early December 2002, before the minor warming which occurred in late December 2002 lead to a descent of upper stratospheric air, cutting of a layer in which mesospheric air is present. This layer then descended inside the vortex over the course of the winter. The same feature is found in trajectory calculations, based on a large number of trajectories started in the vicinity of the observations on 6 March. Based on the difference between the mean age derived from SF6 (which has an irreversible mesospheric loss) and from CO2 (whose mesospheric loss is much smaller and reversible) we estimate that the fraction of mesospheric air in the layer observed on 6 March, must have been somewhere between 35% and 100%.