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Using 𝑒+𝑒−→Λ+𝑐¯Λ−𝑐 production from a 567 pb−1 data sample collected by BESIII at 4.6 GeV, a full angular analysis is carried out simultaneously on the four decay modes of Λ+𝑐→𝑝𝐾0𝑆, Λ𝜋+, Σ+𝜋0, and Σ0𝜋+. For the first time, the Λ+𝑐 transverse polarization is studied in unpolarized 𝑒+𝑒− collisions, where a nonzero effect is observed with a statistical significance of 2.1𝜎. The decay asymmetry parameters of the Λ+𝑐 weak hadronic decays into 𝑝𝐾0𝑆, Λ𝜋+, Σ+𝜋0 and Σ0𝜋+ are measured to be 0.18±0.43(stat)±0.14(syst), −0.80±0.11(stat)±0.02(syst), −0.57±0.10(stat)±0.07(syst), and −0.73±0.17(stat)±0.07(syst), respectively. In comparison with previous results, the measurements for the Λ𝜋+ and Σ+𝜋0 modes are consistent but with improved precision, while the parameters for the 𝑝𝐾0𝑆 and Σ0𝜋+ modes are measured for the first time.
Using a data sample of 4.481×108 𝜓(3686) events collected with the BESIII detector, we report the first observation of the four-lepton-decays 𝐽/𝜓→𝑒+𝑒−𝑒+𝑒− and 𝐽/𝜓→𝑒+𝑒−𝜇+𝜇− utilizing the process 𝜓(3686)→𝜋+𝜋−𝐽/𝜓. The branching fractions are determined to be [5.48±0.31(stat)±0.45(syst)]×10−5 and [3.53±0.22(stat)±0.13(syst)]×10−5, respectively. The results are consistent with theoretical predictions. No significant signal is observed for 𝐽/𝜓→𝜇+𝜇−𝜇+𝜇−, and an upper limit on the branching fraction is set at 1.6×10−6 at the 90% confidence level. A 𝐶𝑃 asymmetry observable is constructed for the first two channels, which is measured to be (−0.012±0.054±0.010) and (0.062±0.059±0.006), respectively. No evidence for 𝐶𝑃 violation is observed in this process.
Using 2.93 fb−1 of 𝑒+𝑒− annihilation data collected at a center-of-mass energy √𝑠=3.773 GeV with the BESIII detector operating at the BEPCII collider, we search for the semileptonic 𝐷0(+) decays into a 𝑏1(1235)−(0) axial-vector meson for the first time. No significant signal is observed for either charge combination. The upper limits on the product branching fractions are ℬ𝐷0→𝑏1(1235)−𝑒+𝜈𝑒·ℬ𝑏1(1235) −→ 𝜔𝜋−<1.12×10−4 and ℬ𝐷+→𝑏1(1235)0𝑒+𝜈𝑒·ℬ𝑏1(1235)0→𝜔𝜋0<1.75×10−4 at the 90% confidence level.
Using a sample of about 1010 𝐽/𝜓 events collected at a center-of-mass energy √𝑠=3.097 GeV with the BESIII detector, the electromagnetic Dalitz decays 𝐽/𝜓→𝑒+𝑒−𝜋+𝜋−𝜂′, with 𝜂′→𝛾𝜋+𝜋− and 𝜂′→𝜋+𝜋−𝜂, have been studied. The decay 𝐽/𝜓→𝑒+𝑒−𝑋(1835) is observed with a significance of 15𝜎, and also an 𝑒+𝑒− invariant-mass dependent transition form factor of 𝐽/𝜓→𝑒+𝑒−𝑋(1835) is presented for the first time. The intermediate states 𝑋(2120) and 𝑋(2370) are also observed in the 𝜋+𝜋−𝜂′ invariant-mass spectrum with significances of 5.3𝜎 and 7.3𝜎. The corresponding product branching fractions for 𝐽/𝜓→𝑒+𝑒−𝑋, 𝑋→𝜋+𝜋−𝜂′ [𝑋=𝑋(1835), 𝑋(2120), and 𝑋(2370)] are reported.
Erkenntnisse über das Wirt-Parasit-Verhältnis zwischen Hopfen Humulus lupulus L. und Hopfenblattlaus Phorodon humuli (Schrank) sind von entscheidender Bedeutung für die Selektion blattlausresistenter Sorten. Die Besiedelung des Wirts durch Blattläuse wird durch in den Pflanzen befindliche Substanzen erheblich beeinflusst (Nault & Styer 1972; Leath & al. 1974; Klingauf & al. 1978; Kendall & al. 1980; Singh 1980; Powell & al. 1999; Campo & al. 2003). Die in dieser Hinsicht wichtigsten Bestandteile des Hopfens sind die Bittersäuren, welche für den Parasit die Funktion von Signalstoffen haben können. In frischem Hopfen liegen sie überwiegend in Form der alpha-Bittersäuren (Humulon, co-Humulon, ad-Humulon) und der beta-Bittersäuren (Lupulon, co-Lupulon, ad-Lupulon) vor (Backleh 2001). Die Gehalte an Bitterstoffen im Pflanzengewebe des Hopfens schwanken stark im Lauf der Vegetationsperiode. Da ein Insekt sich an quantitative wie auch qualitative Unterschiede im Nährstoffangebot anzupassen vermag, sollten sich Änderungen im Wirtswahlverhalten bei der Nahrungsaufnahme von Blattläusen durch die saisonbedingten Stoffwechselschwankungen der Pflanzen ergeben. Um diese Veränderungen im Verhalten der Aphiden zu erfassen, war es notwendig, die Verhaltensbeobachtungen im Verlauf der Vegetationsperiode mehrfach zu wiederholen. Die Methode der Wahl zur Untersuchung quantitativer Unterschiede im Verhalten bei der Nahrungsaufnahme von Aphiden ist der Electrical Penetration Graph (EPG) (McLean & Kinsey 1964; Spiller 1988; Prado & Tjallingii 1994; Calatayud & al. 2001; 1978, 1988, 2006). In der vorliegenden Studie wurde diese Methode mit gleichzeitigen HPLC - Analysen der Bittersäurezusammensetzung des Gewebes relevanter Organe (Blätter und Zapfen) von Hopfen im Verlauf der Vegetationsperiode kombiniert.
Only a few Methyl-[11C]-l-methionine (MET) positron emission tomography (PET) studies have focused on children and young adults with brain neoplasm. Due to radiation exposure, long scan acquisition time, and the need for sedation in young children MET-PET studies should be restricted to this group of patients when a decision for further therapy is not possible from routine diagnostic procedures alone, e.g., structural imaging. We investigated the diagnostic accuracy of MET-PET for the differentiation between tumorous and non-tumorous lesions in this group of patients. Forty eight MET-PET scans from 39 patients aged from 2 to 21 years (mean 15 ± 5.0 years) were analyzed. The MET tumor-uptake relative to a corresponding control region was calculated. A receiver operating characteristic (ROC) was performed to determine the MET-uptake value that best distinguishes tumorous from non-tumorous brain lesions. A differentiation between tumorous (n = 39) and non-tumorous brain lesions (n = 9) was possible at a threshold of 1.48 of relative MET-uptake with a sensitivity of 83% and a specificity of 92%, respectively. A differentiation between high grade malignant lesions (mean MET-uptake = 2.00 ± 0.46) and low grade tumors (mean MET-uptake = 1.84 ± 0.31) was not possible. There was a significant difference in MET-uptake between the histologically homogeneous subgroups of astrocytoma WHO grade II and anaplastic astrocytoma WHO grade III (P = 0.02). MET-PET might be a useful tool to differentiate tumorous from non-tumorous lesions in children and young adults when a decision for further therapy is difficult or impossible from routine structural imaging procedures alone. Keywords Brain tumor - Children - PET - Methionine - Molecular imaging
Introduction: The Retro-IDEAL (ILUVIEN Implant for chronic DiabEtic MAcuLar edema) study is a retrospective study designed to assess real-world outcomes achieved with the ILUVIEN® (0.19 mg fluocinolone acetonide (FAc)) in patients with chronic diabetic macular edema (DME) in clinical practices in Germany.
Methods: This study was conducted across 16 sites in Germany and involved 81 eyes (63 patients) with persistent or recurrent DME and a prior suboptimal response to a first-line intravitreal therapy (primarily anti-VEGF intravitreal therapies).
Results: Patients were followed-up for 30.8 ± 11.3 months (mean ± standard deviation) and had a mean age of 68.0 ± 10.4 years. Best-recorded visual acuity (BRVA) improved by +5.5 letters at month 9 (P ⩽ 0.005, n=56; from a baseline of 49 letters) and this was maintained through to month 30 (P ⩽ 0.05, n = 42). There was a concurrent improvement in central macular thickness with a reduction from 502 µm at baseline to 338 µm at year 1 (P ⩽ 0.0001, n = 43). This effect was sustained to year 3 (i.e. 318 µm; P ⩽ 0.0001, n = 29). Mean intraocular pressure (IOP) remained constant between baseline and year 3 with a peak change of 1.9 mm Hg occurring at year 1. Elevated IOP was observed in a similar percentage of patients prior to (22.2% of cases) and following (27.2%) treatment with the FAc implant. In the majority of cases, these elevations were managed effectively with IOP medications.
Conclusions: Despite substantial amounts of prior intravitreal treatments – primarily with anti–vascular endothelial growth factor (VEGF) drugs – this real-world study showed that sustained structural and functional improvements can last for up to 3 years with a single FAc implant.
Im Unterschied zu den Berichten über die Tage der Artenvielfalt 2005 (vgl. GRAWE 2006), als keine einzelnen Arten im Bericht aufgelistet wurden, und den Berichten über die Jahre 2000 bis 2004 (vgl. GRAWE 2000, 2001, 2002, 2003, 2005) sowie 2007 (vgl. Artikel in diesem Heft, S. 60-69), als i. d. R. alle einzeln bestimmten Arten genannt wurden, möchten sich die Autoren an dieser Stelle auf die Ergebnislisten einer speziellen, intensiv durch Experten bearbeiteten Artengruppe, nämlich einen Teil der Insekten beschränken. Somit sind nur die Schmetterlinge, Bienen, Ameisen und Käfer aufgelistet. Insgesamt wurden neben den 74 nachfolgend aufgeführten Arten (alle von DUDLER, H., G. JOHANNSEN, G. BADTKE) über 200 Pflanzen- und über 50 weitere Tierarten gezählt.
Erstmals wird der Jahresbericht der Landschaftsstation eingegliedert in ein Gemeinschaftswerk der naturschutzfachlich aktiven Einrichtungen im Kreis Höxter und somit einer breiteren Öffentlichkeit als in den Jahren zuvor zur Verfügung gestellt. Ziel ist es, allen interessierten Bürgern einen Einblick in die Arbeiten "ihrer" Station zu geben und darüber hinaus Wissenswertes aus Natur und Landschaft zu vermitteln.
Eingedenk der Tatsache, dass aus Platzgründen neben der Hauptveranstaltung von über 400 lokalen Aktionen nur sieben mit einem Kurzartikel und weitere zwölf mit einer Erwähnung (mit Bild) in dem 32 Seiten umfassenden Magazin gewürdigt werden können, sind wir Organisatoren und Veranstalter diesmal doch ein bisschen stolz auf diesen Tag der Artenvielfalt. Dabei waren viele, auch kindgerechte und weniger „wissenschaftliche“ Programmpunkte zu erleben: ComNatura bot am zentralen Standort „Bootshaus“ umweltpädagogische Kinderbetreuung. Die Studenten im Fluss organisierten eine vorbildliche Arten-Rallye für Kinder im Vor- und Grundschulalter im Bereich des Taubenborns, während der ADFC Gruppen von Radfahrern durch die gesamte Ausdehnung des Untersuchungsgebiets führte, sowie einen viel beachteten Info-Stand am Radweg am rechten Ufer der Weser vor dem Bootshaus besetzte.
Die Grundlage der meisten in diesem Jahresbericht dargestellten Aktivitäten (Gliederungspunkte 2.-7., ohne 4.2) bildet ein mit den zuständigen Fachbehörden abgestimmter Arbeits- und Maßnahmenplan, in dem die Aufgaben der Landschaftsstation für das Jahr 2008 festgelegt wurden und dessen gebietsbezogene Erledigung den Fachbehörden in Form von umfangreichen „Fachdatenblättern“ übermittelt wurde. Der hier vorliegende Bericht ist daher nicht nur für die Aufsichtsbehörden gedacht. Allen anderen interessierten Leserinnen und Lesern soll er einen knappen Einblick in die Arbeit der Landschaftsstation des Jahres 2008 geben. Der Schwerpunkt der wissenschaftlichen Arbeiten lag 2008 im Monitoring verschiedener „Natura 2000“(Fauna-Flora-Habitat – FFH)-Arten, so des Kammmolchs im FFH-Gebiet „Steinheimer Holz“ (2.1), des Laubfroschs im FFH-Gebiet „Nieheimer Tongrube“ (2.2) oder der Schlingnatter im FFH-Gebiet „Kalkmagerrasen bei Willebadessen“ (2.3), sowie in der Optimierung der Betreuung der Gebiete und der Landnutzer (3.). Da das Jahr 2008 aber für alle Mitarbeiter auch durch die angelaufenen, v. a. wissenschaftlichen und touristisch orientierten Projekte des sog. „projektfinanzierten“ Stationsbereichs geprägt war, wollen wir am Ende dieses Jahresberichtes kurz aus diesen Vorhaben referieren (vgl. 8.). Auf ein Angebot unserer Öffentlichkeitsarbeit möchten wir an dieser Stelle besonders hinweisen: Als beliebt bei Volkshochschul-Kunden, Vereinen und Bürgern erwiesen sich unsere Vorträge und Powerpoint-Präsentationen über einzelne Gebiete, Lebensräume, Arten und Projekte im Kreis Höxter. Gerne können Sie uns betreffs einer solchen Veranstaltung ansprechen, die z. B. bei Ihnen, vor-Ort oder im dafür bestens geeigneten Steinernen Haus in Borgentreich stattfinden könnte - hier sowohl mit Führung und Besuch der Ausstellung als auch mit Ihrem Vereinsabend oder Ihrer Jahreshauptversammlung kombinierbar.
Jahresbericht 2006
(2007)
Die Jahre 2005 und 2006 gehörten in Bezug auf den Fortbestand der Biologischen Stationen in NRW sicher zu den turbulentesten Jahren. Über den zur Verfügung stehenden Etat der Landschaftsstation bestand im laufenden Jahr erst gegen Ende Juni 2006 Klarheit. Die im 3. Änderungsbescheid festgelegten Mittelkürzungen in Höhe von 15,2 % gegenüber dem Vorjahr (rund 35 % seit 2004) bedeuteten für den Verein, dass die vertraglich zugesicherten halben Stellen der Festangestellten allein über die Institutionelle Förderung nicht mehr gewährleistet werden konnten und somit weitere Strategien zum Fortbestand des Geschäftsbetriebes entwickelt werden müssen. Konträr zu den Mittelkürzungen ist das Ergebnis der „Kundenbefragung“ zu bewerten, die das Ministerium für Umwelt und Naturschutz, Landwirtschaft und Verbraucherschutz (MUNLV) zur Beurteilung der Biologischen Stationen in Auftrag gegeben hatte. Nachdem jeweils 175 Fragebögen/Station an Kunden und Partner der Biologischen Stationen verschickt wurden, konnte nicht nur ein ungewöhnlich hoher Rücklauf der umfangreichen Fragebögen, sondern auch eine äußerst positive Gesamtbeurteilung der Biologischen Stationen – die Landschaftsstation im Kreis Höxter ist hier in der Statistik im oberen Drittel angesiedelt – verzeichnet werden. Der Verein Landschaftsstation im Kreis Höxter möchte sich ganz herzlich bei allen bedanken, die sich an der Fragebogenaktion des MUNLV beteiligt haben. Aktuell sind die Wogen geglättet, der Fortbestand der Biologischen Stationen ist durch Minister Eckhard Uhlenberg zumindest bis zum Ende der laufenden Legislaturperiode zugesichert worden.
Background: Does the dogma of nephron sparing surgery (NSS) still stand for large renal masses? Available studies dealing with that issue are considerably biased often mixing imperative with elective indications for NSS and also including less malignant variants or even benign renal tumors. Here, we analyzed the oncological long-term outcomes of patients undergoing elective NSS or radical tumor nephrectomy (RN) for non-endophytic, large (≥7cm) clear cell renal carcinoma (ccRCC).
Methods: Prospectively acquired, clinical databases from two academic high-volume centers were screened for patients from 1980 to 2010. The query was strictly limited to patients with elective indications. Surgical complications were retrospectively assessed and classified using the Clavien-Dindo-classification system (CDS). Overall survival (OS) and cancer specific survival (CSS) were analyzed using the Kaplan-Meier-method and the log-rank test.
Results: Out of in total 8664 patients in the databases, 123 patients were identified (elective NSS (n = 18) or elective RN (n = 105)) for ≥7cm ccRCC. The median follow-up over all was 102 months (range 3–367 months). Compared to the RN group, the NSS group had a significantly longer median OS (p = 0.014) and median CSS (p = 0.04).
Conclusions: In large renal masses, NSS can be performed safely with acceptable complication rates. In terms of long-term OS and CSS, NSS was at least not inferior to RN. Our findings suggest that NSS should also be performed in patients presenting with renal tumors ≥7cm whenever technically feasible. Limitations include its retrospective nature and the limited availability of data concerning long-term development of renal function in the two groups.
Seit 2005 nutzt die Landschaftsstation die Schriftenreihe, um den interessierten Leserinnen und Lesern einen Einblick in die Arbeit unserer Einrichtung zu gewähren. Aufgrund der späten Drucklegung dieses Heftes ist es möglich, den Bericht für die Jahre 2009 und 2010 zusammenzufassen. Dies haben wir getan, denn so können wir Sie zeitnah über unsere Arbeiten auf dem Laufenden halten.
Das Vorkommen von Kalk-Halbtrockenrasen oder Kalkmagerrasen ist im Wesentlichen auf diejenigen Regionen beschränkt, die basenreiche Ausgangsgesteine aufweisen. Es handelt sich hierbei vorrangig um die aus Sedimentgesteinen des Muschelkalks bzw. des Juras und der Kreide aufgebauten Kalkgebirge, die sich in Mitteleuropa v. a. in der Frankenalb, der Schwäbischen Alb, an den Muschelkalkhängen von Kocher, Jagst, Tauber und Main mit Nebenflüssen, in der thüringischen und bayerischen Rhön, an den Hängen des Mittleren Saaletales in Thüringen und im Dreiländereck Ostwestfalen, Südniedersachsen und Nordhessen finden. In Nordrhein-Westfalen befinden sich die größten Vorkommen der Kalkmagerrasen in den Kreisen Euskirchen (Eifel) und Höxter sowie im Raum
Marsberg (Hochsauerlandkreis).
Die Grundlage der in diesem Jahresbericht dargestellten Aktivitäten bildet ein mit den zuständigen Fachbehörden abgestimmter Arbeits- und Maßnahmenplan, in dem die Aufgaben der Landschaftsstation für das Jahr 2007 festgelegt wurden. Die detaillierten Ergebnisse dieser Arbeiten wurden den Fachbehörden in Form von umfangreichen Fachdatenblättern übermittelt. Der hier vorliegende Bericht ist für die Aufsichtsbehörden gedacht. Allen anderen interessierten Leserinnen und Lesern soll er einen knappen Einblick in die Arbeit der Landschaftsstation 2007 geben. Der Schwerpunkt der wissenschaftlichen Arbeit im Jahr 2007 lag im Monitoring der betreuten Natura 2000 (FFH-)- und Naturschutz-Gebiete (NSG) „Hannoversche Klippen“ bei Würgassen, „Desenberg“" bei Daseburg, „Kalkmagerrasen bei Ottbergen (und Bruchhausen)“, „Kiebitzteich“ bei Reelsen, „Satzer Moor“ bei Herste, „Wandelnsberg“ zwischen Beverungen und Drenke, sowie „Bleikuhlen und Wäschebachtal“ im äußersten Südwesten des Kreises bei Blankenrode. Das Team der Landschaftsstation im Kreis Höxter bittet um Verständnis, dass sich die hauptamtlichen Mitarbeiter aufgrund der oben skizzierten Entwicklung auf ihre Kernaufgaben konzentrieren müssen und somit weitere Aufgaben wie die Außendarstellung, Exkursionen und sonstige Serviceleistungen nicht immer im gewünschten Maße wahrgenommen werden können.
Species' geographical distributions are tracking latitudinal and elevational surface temperature gradients under global climate change. To evaluate the opportunities to track these gradients across space, we provide a first baseline assessment of the steepness of these gradients for the world's terrestrial birds. Within the breeding ranges of 9,014 bird species, we characterized the spatial gradients in temperature along latitude and elevation for all and a subset of bird species, respectively. We summarized these temperature gradients globally for threatened and non-threatened species and determined how their steepness varied based on species' geography (range size, shape, and orientation) and projected changes in temperature under climate change. Elevational temperature gradients were steepest for species in Africa, western North and South America, and central Asia and shallowest in Australasia, insular IndoMalaya, and the Neotropical lowlands. Latitudinal temperature gradients were steepest for extratropical species, especially in the Northern Hemisphere. Threatened species had shallower elevational gradients whereas latitudinal gradients differed little between threatened and non-threatened species. The strength of elevational gradients was positively correlated with projected changes in temperature. For latitudinal gradients, this relationship only held for extratropical species. The strength of latitudinal gradients was better predicted by species' geography, but primarily for extratropical species. Our findings suggest threatened species are associated with shallower elevational temperature gradients, whereas steep latitudinal gradients are most prevalent outside the tropics where fewer bird species occur year-round. Future modeling and mitigation efforts would benefit from the development of finer grain distributional data to ascertain how these gradients are structured within species' ranges, how and why these gradients vary among species, and the capacity of species to utilize these gradients under climate change.
Der Nationale Aktionsplan für Menschen mit Seltenen Erkrankungen (SE) enthält 52 konkrete Maßnahmen, u. a. in den Handlungsfeldern Versorgung, Forschung, Diagnose und Informationsmanagement. Mit dem Ziel, langfristig die Qualität und Interoperabilität von nationalen Registern zu erhöhen, sieht Maßnahmenvorschlag 28 die Etablierung einer Strategiegruppe „Register für Seltene Erkrankungen“ vor. Diese Strategiegruppe hat 2016 ihre Arbeit aufgenommen. Sie berichtet hier über Entwicklungen auf nationaler und internationaler Ebene, um Empfehlungen für nationale Initiativen daraus abzuleiten.
Zusätzlich werden die Konsentierung und Implementierung sowie mit der Zeit ggf. die Anpassung eines Minimaldatensatzes zur Verwendung in Registern für Seltene Erkrankungen erläutert. Zusätzlich werden die verwendeten Datenelemente bzw. -schemata in einem sog. Metadata Repository abgebildet. Dieses Positionspapier wurde durch die Strategiegruppe sowie weitere Autoren erarbeitet und innerhalb der Gruppe konsentiert. Es wird als Konzeptpapier zum Aufbau und Betrieb von Registern der Strategiegruppe „Register“ veröffentlicht.
Improving long-term patient and graft survival after liver transplantation (LT) remains a major challenge. Compared to the early phase after LT, long-term morbidity and mortality of the recipients not only depends on complications immediately related to the graft function, infections, or rejection, but also on medical factors such as de novo malignancies, metabolic disorders (e.g., new-onset diabetes, osteoporosis), psychiatric conditions (e.g., anxiety, depression), renal failure, and cardiovascular diseases. While a comprehensive post-transplant care at the LT center and the connected regional networks may improve outcome, there is currently no generally accepted standard to the post-transplant management of LT recipients in Germany. We therefore described the structure and standards of post-LT care by conducting a survey at 12 German LT centers including transplant hepatologists and surgeons. Aftercare structures and form of cost reimbursement considerably varied between LT centers across Germany. Further discussions and studies are required to define optimal structure and content of post-LT care systems, aiming at improving the long-term outcomes of LT recipients.
Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme. This is not only related to the underlying heart disease but also to specific issues, such as psychological adaptation to living with an implanted device and, in implantable cardioverter-defibrillator patients, the risk of arrhythmia, syncope, and sudden cardiac death. Therefore, these patients should receive special attention, as their needs may differ from other patients participating in CR. As evidence from studies of CR in patients with cardiac implantable electronic devices is sparse, detailed clinical practice guidelines are lacking. Here, we aim to provide practical recommendations for CR in cardiac implantable electronic devices recipients in order to increase CR implementation, efficacy, and safety in this subset of patients.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD is caused by chronic exposure to cigarette smoke and/or other environmental pollutants that are believed to induce reactive oxygen species (ROS) that gradually disrupt signalling pathways responsible for maintaining lung integrity. Here we identify the antioxidant protein sestrin-2 (SESN2) as a repressor of PDGFRβ signalling, and PDGFRβ signalling as an upstream regulator of alveolar maintenance programmes. In mice, the mutational inactivation of Sesn2 prevents the development of cigarette-smoke-induced pulmonary emphysema by upregulating PDGFRβ expression via a selective accumulation of intracellular superoxide anions (O2−). We also show that SESN2 is overexpressed and PDGFRβ downregulated in the emphysematous lungs of individuals with COPD and to a lesser extent in human lungs of habitual smokers without COPD, implicating a negative SESN2-PDGFRβ interrelationship in the pathogenesis of COPD. Taken together, our results imply that SESN2 could serve as both a biomarker and as a drug target in the clinical management of COPD.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD is caused by chronic exposure to cigarette smoke and/or other environmental pollutants that are believed to induce reactive oxygen species (ROS) that gradually disrupt signalling pathways responsible for maintaining lung integrity. Here we identify the antioxidant protein Sestrin 2 (Sesn2) as a repressor of PDGFRβ signalling and PDGFRβ signalling as an upstream regulator of alveolar maintenance programs. In mice, the mutational inactivation of Sesn2 prevents the development of cigarette-smoke induced pulmonary emphysema by upregulating PDGFRβ expression via a selective accumulation of intracellular superoxide anions (O2-). We also show that SESN2 is overexpressed and PDGFRβ downregulated in the emphysematous lungs of patients with COPD and to a lesser extent in human lungs of habitual smokers without COPD, implicating a negative SESN2/PDGFRβ interrelationship in the pathogenesis of COPD. Taken together, our results imply that SESN2 could serve as both a biomarker and as a drug target in the clinical management of COPD.
Background: Critical organ shortage results in the utilization of extended donor criteria (EDC) liver grafts. These marginal liver grafts are prone to increased ischemia reperfusion injury (IRI) which may contribute to deteriorated graft function and survival. Experimental data have shown that the calcineurin inhibitor tacrolimus exerts protective effects on hepatic IRI when applied intravenously or directly as a hepatic rinse. Therefore, the aim of the present study is to examine the effects of an ex vivo tacrolimus perfusion on IRI in transplantation of EDC liver grafts.
Methods/Design: The TOP-Study (tacrolimus organ perfusion) is a randomized multicenter trial comparing the ex vivo tacrolimus perfusion of marginal liver grafts with placebo. We hypothesize that a tacrolimus rinse reduces IRI, potentially improving organ survival following transplantation of EDC livers. The study includes livers with two or more EDC, according to Eurotransplant International Foundation’s definition of EDC livers. Prior to implantation, livers randomized to the treatment group are rinsed with tacrolimus at a concentration of 20 ng/ml in 1000 ml Custodiol solution and in the placebo group with Custodiol alone. The primary endpoint is the maximum serum alanine transamninase (ALT) level within the first 48 hours after surgery; however, the study design also includes a 1-year observation period following transplantation. The TOP-Study is an investigator-initiated trial sponsored by the University of Munich Hospital. Seven other German transplant centers are participating (Berlin, Frankfurt, Heidelberg, Mainz, Münster, Regensburg, Tübingen) and aim to include a total of 86 patients.
Discussion: Tacrolimus organ perfusion represents a promising strategy to reduce hepatic IRI following the transplantation of marginal liver grafts. This treatment may help to improve the function of EDC grafts and therefore safely expand the donor pool in light of critical organ shortage.
Trial register: EudraCT number: 2010-021333-31, ClinicalTrials.gov identifier: NCT01564095
Background & Aims: In ACLF patients, an adequate risk stratification is essential, especially for liver transplant allocation, since ACLF is associated with high short-term mortality. The CLIF-C ACLF score is the best prognostic model to predict outcome in ACLF patients. While lung failure is generally regarded as signum malum in ICU care, this study aims to evaluate and quantify the role of pulmonary impairment on outcome in ACLF patients.
Methods: In this retrospective study, 498 patients with liver cirrhosis and admission to IMC/ICU were included. ACLF was defined according to EASL-CLIF criteria. Pulmonary impairment was classified into three groups: unimpaired ventilation, need for mechanical ventilation and defined pulmonary failure. These factors were analysed in different cohorts, including a propensity score-matched ACLF cohort.
Results: Mechanical ventilation and pulmonary failure were identified as independent risk factors for increased short-term mortality. In matched ACLF patients, the presence of pulmonary failure showed the highest 28-day mortality (83.7%), whereas mortality rates in ACLF with mechanical ventilation (67.3%) and ACLF without pulmonary impairment (38.8%) were considerably lower (p < .001). Especially in patients with pulmonary impairment, the CLIF-C ACLF score showed poor predictive accuracy. Adjusting the CLIF-C ACLF score for the grade of pulmonary impairment improved the prediction significantly.
Conclusions: This study highlights that not only pulmonary failure but also mechanical ventilation is associated with worse prognosis in ACLF patients. The grade of pulmonary impairment should be considered in the risk assessment in ACLF patients. The new score may be useful in the selection of patients for liver transplantation.
Crista junctions (CJs) are tubular invaginations of the inner membrane of mitochondria that connect the inner boundary with the cristae membrane. These architectural elements are critical for mitochondrial function. The yeast inner membrane protein Fcj1, called mitofilin in mammals, was reported to be preferentially located at CJs and crucial for their formation. Here we investigate the functional roles of individual domains of Fcj1. The most conserved part of Fcj1, the C-terminal domain, is essential for Fcj1 function. In its absence, formation of CJ is strongly impaired and irregular, and stacked cristae are present. This domain interacts with full-length Fcj1, suggesting a role in oligomer formation. It also interacts with Tob55 of the translocase of outer membrane β-barrel proteins (TOB)/sorting and assembly machinery (SAM) complex, which is required for the insertion of β-barrel proteins into the outer membrane. The association of the TOB/SAM complex with contact sites depends on the presence of Fcj1. The biogenesis of β-barrel proteins is not significantly affected in the absence of Fcj1. However, down-regulation of the TOB/SAM complex leads to altered cristae morphology and a moderate reduction in the number of CJs. We propose that the C-terminal domain of Fcj1 is critical for the interaction of Fcj1 with the TOB/SAM complex and thereby for stabilizing CJs in close proximity to the outer membrane. These results assign novel functions to both the C-terminal domain of Fcj1 and the TOB/SAM complex.
Objectives: Investigate the effectiveness of a complex intervention aimed at improving the appropriateness of medication in older patients with multimorbidity in general practice.
Design: Pragmatic, cluster randomised controlled trial with general practice as unit of randomisation.
Setting: 72 general practices in Hesse, Germany.
Participants: 505 randomly sampled, cognitively intact patients (≥60 years, ≥3 chronic conditions under pharmacological treatment, ≥5 long-term drug prescriptions with systemic effects); 465 patients and 71 practices completed the study.
Interventions: Intervention group (IG): The healthcare assistant conducted a checklist-based interview with patients on medication-related problems and reconciled their medications. Assisted by a computerised decision support system, the general practitioner optimised medication, discussed it with patients and adjusted it accordingly. The control group (CG) continued with usual care.
Outcome measures: The primary outcome was a modified Medication Appropriateness Index (MAI, excluding item 10 on cost-effectiveness), assessed in blinded medication reviews and calculated as the difference between baseline and after 6 months; secondary outcomes after 6 and 9 months’ follow-up: quality of life, functioning, medication adherence, and so on.
Results: At baseline, a high proportion of patients had appropriate to mildly inappropriate prescriptions (MAI 0–5 points: n=350 patients). Randomisation revealed balanced groups (IG: 36 practices/252 patients; CG: 36/253). Intervention had no significant effect on primary outcome: mean MAI sum scores decreased by 0.3 points in IG and 0.8 points in CG, resulting in a non-significant adjusted mean difference of 0.7 (95% CI −0.2 to 1.6) points in favour of CG. Secondary outcomes showed non-significant changes (quality of life slightly improved in IG but continued to decline in CG) or remained stable (functioning, medication adherence).
Conclusions: The intervention had no significant effects. Many patients already received appropriate prescriptions and enjoyed good quality of life and functional status. We can therefore conclude that in our study, there was not enough scope for improvement.
Trial registration number: ISRCTN99526053. NCT01171339; Results.
Crista junctions (CJs) are important for mitochondrial organization and function, but the molecular basis of their formation and architecture is obscure. We have identified and characterized a mitochondrial membrane protein in yeast, Fcj1 (formation of CJ protein 1), which is specifically enriched in CJs. Cells lacking Fcj1 lack CJs, exhibit concentric stacks of inner membrane in the mitochondrial matrix, and show increased levels of F1FO–ATP synthase (F1FO) supercomplexes. Overexpression of Fcj1 leads to increased CJ formation, branching of cristae, enlargement of CJ diameter, and reduced levels of F1FO supercomplexes. Impairment of F1FO oligomer formation by deletion of its subunits e/g (Su e/g) causes CJ diameter enlargement and reduction of cristae tip numbers and promotes cristae branching. Fcj1 and Su e/g genetically interact. We propose a model in which the antagonism between Fcj1 and Su e/g locally modulates the F1FO oligomeric state, thereby controlling membrane curvature of cristae to generate CJs and cristae tips.
Background: Although being considered as a rarely observed HIV-1 protease mutation in clinical isolates, the L76V-prevalence increased 1998-2008 in some European countries most likely due to the approval of Lopinavir, Amprenavir and Darunavir which can select L76V. Beside an enhancement of resistance, L76V is also discussed to confer hypersusceptibility to the drugs Atazanavir and Saquinavir which might enable new treatment strategies by trying to take advantage of particular mutations. Results: Based on a cohort of 47 L76V-positive patients, we examined if there might exist a clinical advantage for L76V-positive patients concerning long-term success of PI-containing regimens in patients with limited therapy options. Genotypic- and phenotypic HIV-resistance tests from 47 mostly multi-resistant, L76V-positive patients throughout Germany were accomplished retrospectively 1999-2009. Five genotype-based drug-susceptibility predictions received from online interpretation-tools for Atazanavir, Saquinavir, Amprenavir and Lopinavir, were compared to phenotype-based predictions that were determined by using a recombinant virus assay along with a Virtual Phenotype™(Virco). The clinical outcome of the L76V-adapted follow-up therapy was determined by monitoring viral load for 96 weeks. Conclusions: In this analysis, the mostly used interpretation systems overestimated the L76V-mutation concerning Atazanavir- and SQV resistance. In fact, a clear benefit in drug susceptibility for these drugs was observed in phenotype analysis after establishment of L76V. More importantly, long-term therapy success was significantly higher in patients receiving Atazanavir and/or Saquinavir plus one L76V-selecting drug compared to patients without L76V-selecting agents (p = 0.002). In case of L76V-occurrence ATV and/or SQV may represent encouraging options for patients in deep salvage situations.
Background: Alzheimer's disease is a common debilitating dementia with known heritability, for which 20 late onset susceptibility loci have been identified, but more remain to be discovered. This study sought to identify new susceptibility genes, using an alternative gene-wide analytical approach which tests for patterns of association within genes, in the powerful genome-wide association dataset of the International Genomics of Alzheimer's Project Consortium, comprising over 7 m genotypes from 25,580 Alzheimer's cases and 48,466 controls.
Principal findings: In addition to earlier reported genes, we detected genome-wide significant loci on chromosomes 8 (TP53INP1, p = 1.4×10−6) and 14 (IGHV1-67 p = 7.9×10−8) which indexed novel susceptibility loci.
Significance: The additional genes identified in this study, have an array of functions previously implicated in Alzheimer's disease, including aspects of energy metabolism, protein degradation and the immune system and add further weight to these pathways as potential therapeutic targets in Alzheimer's disease.
This paper reports on Monte Carlo simulation results for future measurements of the moduli of time-like proton electromagnetic form factors, |GE | and |GM|, using the ¯pp → μ+μ− reaction at PANDA (FAIR). The electromagnetic form factors are fundamental quantities parameterizing the electric and magnetic structure of hadrons. This work estimates the statistical and total accuracy with which the form factors can be measured at PANDA, using an analysis of simulated data within the PandaRoot software framework. The most crucial background channel is ¯pp → π+π−,due to the very similar behavior of muons and pions in the detector. The suppression factors are evaluated for this and all other relevant background channels at different values of antiproton beam momentum. The signal/background separation is based on a multivariate analysis, using the Boosted Decision Trees method. An expected background subtraction is included in this study, based on realistic angular distribuations of the background contribution. Systematic uncertainties are considered and the relative total uncertainties of the form factor measurements are presented.
Challenges of FAIR phase 0
(2018)
After two-year's shutdown, the GSI accelerators plus the latest addition of storage ring CRYRING, will be back into operation in 2018 as the FAIR phase 0 with the goal to fulfill the needs of scientific community and the FAIR accelerators and detector development. Even though GSI has been well known for its operation of a variety of ion beams ranging from proton up to uranium for multi research areas such as nuclear physics, astrophysics, biophysics, material science, the upcoming beam time faces a number of challenges in re-commissioning its existing circular accelerators with brand new control system and upgrade of beam instrumentations, as well as in rising failures of dated components and systems. The cycling synchrotron SIS18 has been undergoing a set of upgrade measures for fulfilling future FAIR operation, among which many measures will also be commissioned during the upcoming beam time. This paper presents the highlights of the challenges such as re-establishing the high intensity heavy ion operation as well as parallel operation mode for serving multi users. The status of preparation including commissioning results will also be reported.
Background and objectives: Our study aimed at examining the long-time inflammatory effects of rheumatoid arthritis (RA) as chronic immune-mediated disease on pain sensation and neuropathy development compared to healthy subjects (HS).
Methods: We used the quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain and Electroencephalography (EEG)–based contact heat evoked potentials (CHEPs) before and after topical capsaicin application. We recruited 16 RA patients in remission or low disease activity state (mean age: 59.38 years [± 10.18]) and 16 healthy subjects (mean age: 56.69 years [± 8.92]).
Results: The application of capsaicin cream on the thigh provoked a stronger effect in HS for both mechanical and heat pain thresholds (MPT and HPT, resp.), according to the area under the receiver operation characteristic (AUROC) (HS: HPT: 0.8965, MPT: 0.7402; RA: HPT: 0.7012, MPT: 0.6113). We observed contrary effects regarding changes in CHEPs (HS: g*max = − 0.65; RA patients: g*max = 0.72).
Conclusion: As the overall effect of topical capsaicin application was higher in HS for QST, we suggest the existence of a sensitization of TRPV1 channels in RA patients caused by long-time chronical inflammation, despite a lack of clinical signs of inflammation due to adequate treatment. The effect in CHEPs probably uncovers neuropathic symptoms. The effect of topical capsaicin on HPTs and CHEPs can act as a marker for the extent of sensitization and the development of neuropathic symptoms. Further studies are needed to prove if our proposed method can act as a marker for the success of anti-inflammatory treatment.