Refine
Year of publication
Document Type
- Article (15)
- Doctoral Thesis (2)
- Preprint (2)
Has Fulltext
- yes (19)
Is part of the Bibliography
- no (19)
Keywords
- Human behaviour (3)
- acute myeloid leukemia (2)
- Attention (1)
- BCOR (1)
- BCORL1 (1)
- Bindungsproblem (1)
- CVID (1)
- Clinical Trials and Observations (1)
- Cognitive neuroscience (1)
- Decision (1)
Institute
- Medizin (14)
- Biochemie und Chemie (2)
- Biochemie, Chemie und Pharmazie (2)
- Psychologie (2)
- MPI für empirische Ästhetik (1)
Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs.
Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel.
Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy.
Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
Mutations of the isocitrate dehydrogenase-1 (IDH1) and IDH2 genes are among the most frequent alterations in acute myeloid leukemia (AML) and can be found in ∼20% of patients at diagnosis. Among 4930 patients (median age, 56 years; interquartile range, 45-66) with newly diagnosed, intensively treated AML, we identified IDH1 mutations in 423 (8.6%) and IDH2 mutations in 575 (11.7%). Overall, there were no differences in response rates or survival for patients with mutations in IDH1 or IDH2 compared with patients without mutated IDH1/2. However, distinct clinical and comutational phenotypes of the most common subtypes of IDH1/2 mutations could be associated with differences in outcome. IDH1-R132C was associated with increased age, lower white blood cell (WBC) count, less frequent comutation of NPM1 and FLT3 internal tandem mutation (ITD) as well as with lower rate of complete remission and a trend toward reduced overall survival (OS) compared with other IDH1 mutation variants and wild-type (WT) IDH1/2. In our analysis, IDH2-R172K was associated with significantly lower WBC count, more karyotype abnormalities, and less frequent comutations of NPM1 and/or FLT3-ITD. Among patients within the European LeukemiaNet 2017 intermediate- and adverse-risk groups, relapse-free survival and OS were significantly better for those with IDH2-R172K compared with WT IDH, providing evidence that AML with IDH2-R172K could be a distinct entity with a specific comutation pattern and favorable outcome. In summary, the presented data from a large cohort of patients with IDH1/2 mutated AML indicate novel and clinically relevant findings for the most common IDH mutation subtypes.
Simple Summary: Acute myeloid leukemia (AML) is a genetically heterogeneous disease. Clinical phenotypes of frequent mutations and their impact on patient outcome are well established. However, the role of rare mutations often remains elusive. We retrospectively analyzed 1529 newly diagnosed and intensively treated AML patients for mutations of BCOR and BCORL1. We report a distinct co-mutational pattern that suggests a role in disease progression rather than initiation, especially affecting mechanisms of DNA-methylation. Further, we found loss-of-function mutations of BCOR to be independent markers of poor outcomes in multivariable analysis. Therefore, loss-of-function mutations of BCOR need to be considered for AML management, as they may influence risk stratification and subsequent treatment allocation.
Abstract: Acute myeloid leukemia (AML) is characterized by recurrent genetic events. The BCL6 corepressor (BCOR) and its homolog, the BCL6 corepressor-like 1 (BCORL1), have been reported to be rare but recurrent mutations in AML. Previously, smaller studies have reported conflicting results regarding impacts on outcomes. Here, we retrospectively analyzed a large cohort of 1529 patients with newly diagnosed and intensively treated AML. BCOR and BCORL1 mutations were found in 71 (4.6%) and 53 patients (3.5%), respectively. Frequently co-mutated genes were DNTM3A, TET2 and RUNX1. Mutated BCORL1 and loss-of-function mutations of BCOR were significantly more common in the ELN2017 intermediate-risk group. Patients harboring loss-of-function mutations of BCOR had a significantly reduced median event-free survival (HR = 1.464 (95%-Confidence Interval (CI): 1.005–2.134), p = 0.047), relapse-free survival (HR = 1.904 (95%-CI: 1.163–3.117), p = 0.01), and trend for reduced overall survival (HR = 1.495 (95%-CI: 0.990–2.258), p = 0.056) in multivariable analysis. Our study establishes a novel role for loss-of-function mutations of BCOR regarding risk stratification in AML, which may influence treatment allocation.
Background: The aim of this study was to develop a child-specific classification system for long bone fractures and to examine its reliability and validity on the basis of a prospective multicentre study. Methods: Using the sequentially developed classification system, three samples of between 30 and 185 paediatric limb fractures from a pool of 2308 fractures documented in two multicenter studies were analysed in a blinded fashion by eight orthopaedic surgeons, on a total of 5 occasions. Intra- and interobserver reliability and accuracy were calculated. Results: The reliability improved with successive simplification of the classification. The final version resulted in an overall interobserver agreement of kappa=0.71 with no significant difference between experienced and less experienced raters. Conclusions: In conclusion, the evaluation of the newly proposed classification system resulted in a reliable and routinely applicable system, for which training in its proper use may further improve the reliability. It can be recommended as a useful tool for clinical practice and offers the option for developing treatment recommendations and outcome predictions in the future.
A novel thiazol‐based ratiometric dye for the detection of local pH values is synthesized, and its properties are characterized by a combination of optical spectroscopy, solid‐state NMR and DNP (dynamic nuclear polarization)‐enhanced solid‐state NMR. This novel dye covers a completely different sensitivity range with its acidic pKa value of 3.5 compared to other established dyes for ratiometric pH detection, such as SNARF. The dye is grafted to the surfaces of mesoporous silica materials, which enables, for the first time, direct in situ measurements of the local pH values in silica mesopores by a simple UV‐vis spectroscopy method. The obtained results, which are in good agreement with previous indirect techniques, indicate a background electrolyte‐dependent pKa shift of at least one pH unit under nanoconfined conditions compared to the pKa of the dye in bulk solution.
Aim: To assess outcomes in patients with advanced adenocarcinoma non-small-cell lung cancer who received nintedanib plus docetaxel after progression on prior chemotherapy followed by immune checkpoint inhibitor (ICI) therapy. Patients & methods: VARGADO is a prospective, noninterventional study. We describe initial data from a cohort of 22 patients who received nintedanib plus docetaxel after chemotherapy and ICI therapy. Results: Median progression-free survival with nintedanib plus docetaxel was 5.5 months (95% CI: 1.9–8.7 months). The objective response rate was 7/12 (58%) and the disease control rate was 10/12 (83%). Data for overall survival rate 12 months after the start of treatment (primary end point) are not yet mature and are not reported. Of 22 patients, 73% experienced drug-related adverse events; adverse events led to treatment discontinuation in 32% of patients. Conclusion: These data highlight the potential clinical benefit of nintedanib plus docetaxel in patients who failed prior ICI therapy.
Trial registration number: NCT02392455
Previous magnetoencephalography (MEG) studies have revealed gamma-band activity at sensors over parietal and fronto-temporal cortex during the delay phase of auditory spatial and non-spatial match-to-sample tasks, respectively. While this activity was interpreted as reflecting the memory maintenance of sound features, we noted that task-related activation differences might have been present already prior to the onset of the sample stimulus. The present study focused on the interval between a visual cue indicating which sound feature was to be memorized (lateralization or pitch) and sample sound presentation to test for task-related activation differences preceding stimulus encoding. MEG spectral activity was analyzed with cluster randomization tests (N = 15). Whereas there were no differences in frequencies below 40 Hz, gamma-band spectral amplitude (about 50–65 and 90–100 Hz) was higher for the lateralization than the pitch task. This activity was localized at right posterior and central sensors and present for several hundred ms after task cue offset. Activity at 50–65 Hz was also increased throughout the delay phase for the lateralization compared with the pitch task. Apparently cortical networks related to auditory spatial processing were activated after participants had been informed about the task.
Photoacids attract increasing scientific attention, as they are valuable tools to spatiotemporally control proton-release reactions and pH values of solutions. We present the first time-resolved spectroscopic study of the excited state and proton-release dynamics of prominent merocyanine representatives. Femtosecond transient absorption measurements of a pyridine merocyanine with two distinct protonation sites revealed dissimilar proton-release mechanisms: one site acts as a photoacid generator as its pKa value is modulated in the ground state after photoisomerization, while the other functions as an excited state photoacid which releases its proton within 1.1 ps. With a pKa drop of 8.7 units to −5.5 upon excitation, the latter phenolic site is regarded a super-photoacid. The 6-nitro derivative exhibits only a phenolic site with similar, yet slightly less photoacidic characteristics and both compounds transfer their proton to methanol and ethanol. In contrast, for the related 6,8-dinitro compound an intramolecular proton transfer to the ortho-nitro group is suggested that is involved in a rapid relaxation into the ground state.
In dieser Arbeit wird sowohl das Potenzial von molekularen Photoschaltern als lichtempfindliche Komponenten für photopharmakologische Anwendungen als auch das von künstlichen RNA-Aptameren als regulatorische Schalteinheiten für die Entwicklung von funktionellen Riboschaltern untersucht. Verschiedene wesentliche Aspekte beider Anwendungs-felder wurden eingehend einzeln untersucht und die beiden Schaltsysteme schließlich durch das Design eines synthetischen RNA-Aptamers kombiniert, dessen Ligandbindung durch licht-induzierte Isomerisierung seines Photoschalterliganden reguliert werden kann.
Molekulare Photoschalter wie Azobenzole und Spiropyrane haben sich als vielversprechende photochemische Werkzeuge erwiesen, um lichtgesteuert reversible und biochemisch nutzbare Effekte erzeugen. Spiropyrane bergen aufgrund der drastischen Veränderungen ihrer molekularen Eigenschaften infolge der Photoisomerisierung zum Merocyanin (MC) ein enormes Anwendungs-potenzial. Von den hier untersuchten wasserlöslichen Pyridin- (Py-) und Nitro-BIPS-Derivaten zeigt insbesondere die Py-BIPS-Verbindung 2 ein außerordentlich vielseitiges Verhalten. Im Vergleich zu anderen Vertretern dieser Photoschalterklasse wird ein deutlich höherer MC-Anteil von etwa 50% thermisch innerhalb von wenigen Minuten akkumuliert. Durch lichtinduzierten Ringschluss zum reinen Spiropyran (SP) und thermische Wiederherstellung des Gleichgewichts, kann diese hohe Schaltamplitude über mehrere Zyklen ohne signifikante Zersetzung beibehalten werden. Der Einsatz von schädlichem UV-Licht kann somit vermieden werden, was zusätzlich sehr vorteilhaft für einen möglichen Einsatz in einem biochemischen Kontext ist.
Verbindung 2 weist zudem mehrere Protonierungsstellen auf, die ihr in Abhängigkeit des pH-Wertes faszinierende photosaure Eigenschaften verleihen. Das einfach protonierte HMC Isomer ermöglicht eine lichtstimulierte reversible Kontrolle des pH-Wertes in einem Bereich von etwa 4,5 bis 7,5, mit möglichen pH-Sprüngen von bis zu 1,5 Einheiten. Durch transiente Absorptionsstudien wurde ein Mechanismus für die Protonenfreisetzung nachgewiesen, der lediglich auf der Veränderung des pKs-Wertes der N-protischen Position infolge des lichtinduzierten Ringschlusses beruht. Im Gegensatz dazu wird das phenolische Proton des doppelt protonierten HMCH Isomers innerhalb von 1-2 Pikosekunden nach Anregung aus dem angeregten Zustand an das Lösemittel übertragen. Durch eingehende Ultrakurzzeitmessungen der Freisetzung des phenolischen Protons, konnten die protonierten Spezies der Py- und Nitro-Merocyanine als Superphotosäuren etabliert werden. Sie können somit als ultraschnelle Auslöser für protonenvermittelte Prozesse eingesetzt werden, die zu den fundamentalsten Reaktionen in der Natur gehören.
Was potenzielle pharmakologische Zielsysteme betrifft, so dürfte RNA eine große Zukunft bevorstehen, da sie einfach zu synthetisieren ist und Zugang zu verschiedenen Ebenen zellulärer Regulationsmechanismen bietet. Insbesondere RNA-Aptamere, die in der Lage sind, niedermolekulare Liganden mit außergewöhnlich hoher Affinität und Spezifität zu binden, sind für die Entwicklung von künstlichen Riboschaltern hoch interessant. Während künstliche Aptamere für beliebige Liganden durch einen in vitro Selektionsprozess generiert werden können, ist nicht zur Gänze geklärt warum nur wenige von ihnen als aktive in vivo Riboschalter funktionieren. Die vorliegenden Ergebnisse zeigen die Bedeutung der konformationellen Aptamerdynamik während der Ligandenbindung für das Regulationspotential. Die Mg2+-abhängigen Bindungsstudien des hochfunktionellen Tetrazyklin (TC) -Aptamers zeigen, dass zweiwertige Kationen nicht nur für die korrekte Vorfaltung des Aptamers wichtig sind, sondern auch an der Ligandenbindung und RNA-Strukturanpassung selbst beteiligt sein können. Nach der Assoziation von TC an die Bindungstasche pflanzt sich eine Konformationsanpassung zur entfernten Dreifachhelixregion fort, wo Mg2+ zusätzlich für die Ausbildung endgültig gebundenen Zustandes benötigt wird.
Neben dem Einfluss von Mg2+, zeigen zeitaufgelöste Ligandenbindungsstudien von drei Ciprofloxacin (CFX) -Aptameren eine klare Korrelation zwischen der Kinetik des Struktur-anpassungsschrittes der RNA an den Liganden und dem beobachteten Regulationspotenzial in parallel durchgeführten in vivo Assays. Es wird geschlussfolgert, dass eine beschleunigte und irreversible RNA-Anpassung auf eine Konformationsänderung hindeutet, die ausgeprägt genug ist, um eine Aktivität als Riboschalter zu ermöglichen. Diese Erkenntnisse werden durch die berichteten Ligandenbindungskinetiken von anderen künstlichen Aptameren und auch von natürlichen Riboschaltern bestätigt und sollten weitreichende Implikationen für die Optimierung von Selektionsprotokollen für funktionelle Aptamere haben.
Schließlich wird ein lichtempfindliches RNA-Aptamer vorgestellt, dessen Ligand auf dem Antibiotikum Chloramphenicol (Cm) basiert, welches synthetisch mit einem Azobenzolfragment versehen wurde (azoCm). Durch systematische Optimierung von in vitro Selektionsprotokollen und die erfolgreiche Implementierung eines Belichtungsschrittes zur Isomerisierung des Liganden konnten Aptamere erhalten werden, die spezifisch an die trans-Form von azoCm binden. Bindungsaffinitätsstudien bestätigen diese Selektivität und durch Zirkulardichroismusstudien konnte zudem eine lichtinduzierte reversible Dissoziation des von cis-azoCm gezeigt werden. Damit wird hier eine erfolgreiche Entwicklungsstrategie für lichtabhängige RNA-Aptamer – Ligandsysteme dargelegt, welche wiederum fundamental neuartige Ansätze für die Erschließung lichtstimulierter biologischer Regulationswege zugänglich machen.
Spatial attention allows us to make more accurate decisions about events in our environment. Decision confidence is thought to be intimately linked to the decision making process as confidence ratings are tightly coupled to decision accuracy. While both spatial attention and decision confidence have been subjected to extensive research, surprisingly little is known about the interaction between these two processes. Since attention increases performance it might be expected that confidence would also increase. However, two studies investigating the effects of endogenous attention on decision confidence found contradictory results. Here we investigated the effects of two distinct forms of spatial attention on decision confidence; endogenous attention and exogenous attention. We used an orientation-matching task, comparing the two attention conditions (endogenous and exogenous) to a control condition without directed attention. Participants performed better under both attention conditions than in the control condition. Higher confidence ratings than the control condition were found under endogenous attention but not under exogenous attention. This finding suggests that while attention can increase confidence ratings, it must be voluntarily deployed for this increase to take place. We discuss possible implications of this relative overconfidence found only during endogenous attention with respect to the theoretical background of decision confidence.
Context information supports serial dependence of multiple visual objects across memory episodes
(2020)
Serial dependence is thought to promote perceptual stability by compensating for small changes of an object’s appearance across memory episodes. So far, it has been studied in situations that comprised only a single object. The question of how we selectively create temporal stability of several objects remains unsolved. In a memory task, objects can be differentiated by their to-be-memorized feature (content) as well as accompanying discriminative features (context). We test whether congruent context features, in addition to content similarity, support serial dependence. In four experiments, we observe a stronger serial dependence between objects that share the same context features across trials. Apparently, the binding of content and context features is not erased but rather carried over to the subsequent memory episode. As this reflects temporal dependencies in natural settings, our findings reveal a mechanism that integrates corresponding content and context features to support stable representations of individualized objects over time.
Objective: Many cancer patients complain about cognitive dysfunction. While cognitive deficits have been attributed to the side effects of chemotherapy, there is evidence for impairment at disease onset, prior to cancer-directed therapy. Further debated issues concern the relationship between self-reported complaints and objective test performance and the role of psychological distress.
Method: We assessed performance on neuropsychological tests of attention and memory and obtained estimates of subjective distress and quality of life in 27 breast cancer patients and 20 healthy controls. Testing in patients took place shortly after the initial diagnosis, but prior to subsequent therapy.
Results: While patients showed elevated distress, cognitive performance differed on a few subtests only. Patients showed slower processing speed and poorer verbal memory than controls. Objective and self-reported cognitive function were unrelated, and psychological distress correlated more strongly with subjective complaints than with neuropsychological test performance.
Conclusion: This study provides further evidence of limited cognitive deficits in cancer patients prior to the onset of adjuvant therapy. Self-reported cognitive deficits seem more closely related to psychological distress than to objective test performance.
Objective: Research on visual working memory has shown that individual stimulus features are processed in both specialized sensory regions and higher cortical areas. Much less evidence exists for auditory working memory. Here, a main distinction has been proposed between the processing of spatial and non-spatial sound features. Our aim was to examine feature-specific activation patterns in auditory working memory.
Methods: We collected fMRI data while 28 healthy adults performed an auditory delayed match-to-sample task. Stimuli were abstract sounds characterized by both spatial and non-spatial information, i.e., interaural time delay and central frequency, respectively. In separate recording blocks, subjects had to memorize either the spatial or non-spatial feature, which had to be compared with a probe sound presented after a short delay. We performed both univariate and multivariate comparisons between spatial and non-spatial task blocks.
Results: Processing of spatial sound features elicited a higher activity in a small cluster in the superior parietal lobe than did sound pattern processing, whereas there was no significant activation difference for the opposite contrast. The multivariate analysis was applied using a whole-brain searchlight approach to identify feature-selective processing. The task-relevant auditory feature could be decoded from multiple brain regions including the auditory cortex, posterior temporal cortex, middle occipital gyrus, and extended parietal and frontal regions.
Conclusion: In summary, the lack of large univariate activation differences between spatial and non-spatial processing could be attributable to the identical stimulation in both tasks. In contrast, the whole-brain multivariate analysis identified feature-specific activation patterns in widespread cortical regions. This suggests that areas beyond the auditory dorsal and ventral streams contribute to working memory processing of auditory stimulus features.
Solid state NMR is a emerging method for the study of membrane proteins, which has received much interest in recent years. Limiting the study of many pharmacologically relevant targets, are the often long measuring times, required to obtain especially higher dimensional solid state NMR spectra of good quality. To address this problem, multiple methods where developed in this work, which can be categorized into two groups. The first set of methods aims at the quality of certain spectra, by implementing a spectral filter, which increases the fidelity of the measured data. The second set of methods, addresses the problem of long measuring times directly, by increasing the sensitivity per unit time, as could be shown, for example, on homo- and heteronuclear singlequantum-singlequantum correlation experiments. The gains in measuring time for the latter group of methods are typically in the order of 2-3, but some experiments allow multiple methods to be employed simultaneously, which can lead to a decrease in measuring time of a factor of up to 8. It is important to mention, that none of the methods introduced in this work require any equipment in addition to the conventional setup present in most sold state NMR laboratories and no changes or addition to the samples under study are required. Therefore the gains reported in this work come at no extra cost and require only minimal implementation effort on the side of the user.
Die Vermittlung der Zusammenhänge zwischen psychologischen Funktionen und körperlichen Veränderungen sowie deren Relevanz für die Entstehung und Aufrechterhaltung von Krankheiten stellt ein zentrales Ziel der Ausbildung in Medizinischer Psychologie dar. Zur Veranschaulichung dieser Zusammenhänge führten wir ein Psychophysiologie-Praktikum im ersten vorklinischen Semester ein. Die Studierenden führten in Vierergruppen mit Hilfe ausführlicher schriftlicher Instruktionen jeweils ca. 30 Minuten andauernde praktische Übungen durch, die die folgenden Themen behandelten: (1) Stress (abhängige Variable: Herzrate), (2) "Lügendetektor" (abhängige Variable: Hautleitwertsreaktionen), (3) Biofeedback (abhängige Variable: Hauttemperatur) und (4) Elektroenzephalogramm (abhängige Variable: Amplituden der vier klassischen Frequenzbänder). Die praktischen Übungen wurden durch theoretische Gruppenarbeiten und einen Termin zur Zusammenfassung der Ergebnisse der Übungen ergänzt. Die studentische Evaluation des Praktikums war durchweg positiv. So wurde das Praktikum als Bereicherung des Kurses angesehen, und der selbstbeurteilte Kenntnisstand auf dem Gebiet der Psychophysiologie zeigte eine signifikante Verbesserung. Diese Ergebnisse sowie unsere Eindrücke während des Praktikums bekräftigten unseren Entschluss, ein Psychophysiologie-Praktikum als Teil des Kurses der Medizinischen Psychologie und Medizinischen Soziologie fest zu etablieren.
Die Wahrnehmung von Objekten gelingt uns jeden Tag unzählige Male – zumeist rasend schnell und problemlos. Obwohl fast immer mehrere unserer Sinne gleichzeitig bei ihrer Wahrnehmung angesprochen werden, erscheinen uns diese Objekte dennoch als ganzheitlich und geschlossen. Für die neuronale Verarbeitung eines bellenden Hundes zum Beispiel empfängt die Großhirnrinde zumindest Eingangsdaten des Seh- und des Hörsystems. Sie werden auf getrennten Pfaden und in spezialisierten Arealen mit aufsteigender Komplexität analysiert. Dieses Funktionsprinzip der parallel verteilten Verarbeitung stellt die Wissenschaftler aber auch vor das so genannte »Bindungsproblem«: Wo und wie werden die Details wieder zu einem Ganzen – zu einer neuronalen Repräsentation – zusammengefügt? Am Institut für medizinische Psychologie der Universitätsklinik Frankfurt untersuchen Neurokognitionsforscher die crossmodale Objekterkennung mit einer Kombination modernster Verfahren der Hirnforschung und kommen dabei den Ver - arbeitungspfaden in der Großhirnrinde auf die Spur.
Background: The combination of intermediate-dose cytarabine plus mitoxantrone (IMA) can induce high complete remission rates with acceptable toxicity in elderly patients with acute myeloid leukemia (AML). We present the final results of a randomized-controlled trial comparing IMA with the standard 7 + 3 induction regimen consisting of continuous infusion cytarabine plus daunorubicin (DA).
Patients and methods: Patients with newly diagnosed AML >60 years were randomized to receive either intermediate-dose cytarabine (1000 mg/m2 twice daily on days 1, 3, 5, 7) plus mitoxantrone (10 mg/m2 days 1–3) (IMA) or standard induction therapy with cytarabine (100 mg/m2 continuously days 1–7) plus daunorubicin (45 mg/m2 days 3–5) (DA). Patients in complete remission after DA received intermediate-dose cytarabine plus amsacrine as consolidation treatment, whereas patients after IMA were consolidated with standard-dose cytarabine plus mitoxantrone.
Results: Between February 2005 and October 2009, 485 patients were randomized; 241 for treatment arm DA and 244 for IMA; 76% of patients were >65 years. The complete response rate after DA was 39% [95% confidence interval (95% CI): 33–45] versus 55% (95% CI: 49–61) after IMA (odds ratio 1.89, P = 0.001). The 6-week early-death rate was 14% in both arms. Relapse-free survival curves were superimposable in the first year, but separated afterwards, resulting in 3-year relapse-free survival rates of 29% versus 14% in the DA versus IMA arms, respectively (P = 0.042). The median overall survival was 10 months in both arms (P = 0.513).
Conclusion: The dose escalation of cytarabine in induction therapy lead to improved remission rates in the elderly AML patients. This did not translate into a survival advantage, most likely due to differences in consolidation treatment. Thus, effective consolidation strategies need to be further explored. In combination with an effective consolidation strategy, the use of intermediate-dose cytarabine in induction may improve curative treatment for elderly AML patients.
Attention selects relevant information regardless of whether it is physically present or internally stored in working memory. Perceptual research has shown that attentional selection of external information is better conceived as rhythmic prioritization than as stable allocation. Here we tested this principle using information processing of internal representations held in working memory. Participants memorized four spatial positions that formed the endpoints of two objects. One of the positions was cued for a delayed match-non-match test. When uncued positions were probed, participants responded faster to uncued positions located on the same object as the cued position than to those located on the other object, revealing object-based attention in working memory. Manipulating the interval between cue and probe at a high temporal resolution revealed that reaction times oscillated at a theta rhythm of 6 Hz. Moreover, oscillations showed an anti-phase relationship between memorized but uncued positions on the same versus other object as the cued position, suggesting that attentional prioritization fluctuated rhythmically in an object-based manner. Our results demonstrate the highly rhythmic nature of attentional selection in working memory. Moreover, the striking similarity between rhythmic attentional selection of mental representations and perceptual information suggests that attentional oscillations are a general mechanism of information processing in human cognition. These findings have important implications for current, attention-based models of working memory.
Context information supports serial dependence of multiple visual objects across memory episodes
(2019)
Visual perception operates in an object-based manner, by integrating associated features via attention. Working memory allows a flexible access to a limited number of currently relevant objects, even when they are occluded or physically no longer present. Recently, it has been shown that we compensate for small changes of an object’s feature over memory episodes, which can support its perceptual stability. This phenomenon was termed ‘serial dependence’ and has mostly been studied in situations that comprised only a single relevant object. However, since we are typically confronted with situations where several objects have to be perceived and held in working memory, the central question of how we selectively create temporal stability of several objects has remained unsolved. As different objects can be distinguished by their accompanying context features, like their color or temporal position, we tested whether serial dependence is supported by the congruence of context features across memory episodes. Specifically, we asked participants to remember the motion directions of two sequentially presented colored dot fields per trial. At the end of a trial one motion direction was cued for continuous report either by its color (Experiment 1) or serial position (Experiment 2). We observed serial dependence, i.e., an attractive bias of currently toward previously memorized objects, between current and past motion directions that was clearly enhanced when items had the same color or serial position across trials. This bias was particularly pronounced for the context feature that was used for cueing and for the target of the previous trial. Together, these findings demonstrate that coding of current object representations depends on previous representations, especially when they share similar content and context features. Apparently the binding of content and context features is not completely erased after a memory episode, but it is carried over to subsequent episodes. As this reflects temporal dependencies in natural settings, the present findings reveal a mechanism that integrates corresponding bundles of content and context features to support stable representations of individualized objects over time.