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We conducted a systematic review investigating the efficacy and tolerability of adrenocorticotropic hormone (ACTH) and corticosteroids in children with epilepsies other than infantile epileptic spasm syndrome (IESS) that are resistant to anti-seizure medication (ASM). We included retrospective and prospective studies reporting on more than five patients and with clear case definitions and descriptions of treatment and outcome measures. We searched multiple databases and registries, and we assessed the risk of bias in the selected studies using a questionnaire based on published templates. Results were summarized with meta-analyses that pooled logit-transformed proportions or rates. Subgroup analyses and univariable and multivariable meta-regressions were performed to examine the influence of covariates. We included 38 studies (2 controlled and 5 uncontrolled prospective; 31 retrospective) involving 1152 patients. Meta-analysis of aggregate data for the primary outcomes of seizure response and reduction of electroencephalography (EEG) spikes at the end of treatment yielded pooled proportions (PPs) of 0.60 (95% confidence interval [CI] 0.52–0.67) and 0.56 (95% CI 0.43–0.68). The relapse rate was high (PP 0.33, 95% CI 0.27–0.40). Group analyses and meta-regression showed a small benefit of ACTH and no difference between all other corticosteroids, a slightly better effect in electric status epilepticus in slow sleep (ESES) and a weaker effect in patients with cognitive impairment and “symptomatic” etiology. Obesity and Cushing's syndrome were the most common adverse effects, occurring more frequently in trials addressing continuous ACTH (PP 0.73, 95% CI 0.48–0.89) or corticosteroids (PP 0.72, 95% CI 0.54–0.85) than intermittent intravenous or oral corticosteroid administration (PP 0.05, 95% CI 0.02–0.10). The validity of these results is limited by the high risk of bias in most included studies and large heterogeneity among study results. This report was registered under International Prospective Register of Systematic Reviews (PROSPERO) number CRD42022313846. We received no financial support.
Key points
* Systematic review resulting in low to moderately solid evidence on the efficacy and tolerability of adrenocorticotropic hormone (ACTH) and corticosteroid treatment in children with epilepsy other than infantile spasms.
* Meta-analysis based on aggregate data from 2 controlled prospective, 5 uncontrolled prospective, and 31 retrospective studies.
* Pooled data showing a seizure response in 60% and electroencephalography (EEG) response in 56% of patients, with no major differences between drugs. However, 30%–40% of patients relapse after the cessation of treatment.
* The most frequent adverse effects are obesity and Cushing's syndrome, occurring in 70% of patients under continuous treatment for some weeks, but in less than 10% undergoing pulsed, intermittent regimens.
* More prospective, randomized-controlled studies are needed to improve the level of evidence and define the optimal doses and treatment duration.
Background: Because Endomyocardial Biopsy has low sensitivity of about 20%, it can be performed near to myocardium that presented as Late Gadolinium Enhancement (LGE) in cardiovascular magnetic resonance (CMR). However the important issue of comparing topography of CMR and histological findings has not yet been investigated. Thus the current study was performed using an animal model of myocarditis. Results: In 10 male Lewis rats Experimental Autoimmune myocarditis was induced, 10 rats served as control. On day 21 animals were examined by CMR to compare topographic distribution of LGE to histological inflammation. Sensitivity, specificity, positive and negative predictive values for LGE in diagnosing myocarditis were determined for each segment of myocardium. Latter diagnostic values varied widely depending on topographic distribution of LGE and inflammation as well as on the used CMR sequence. Sensitivity of LGE was up to 76% (left lateral myocardium) and positive predictive values were up to 85% (left lateral myocardium), whereas sensitivity and positive predictive value dropped to 0 - 33% (left inferior myocardium). Conclusions: Topographic distribution of LGE and histological inflammation seem to influence sensitivity, specifity, positive and negative predictive values. Nevertheless, positive predictive value for LGE of up to 85% indicates that Endomyocardial Biopsy should be performed "MR-guided". LGE seems to have greater sensitivity than Endomyocardial Biopsy for the diagnosis of myocarditis.
Background: High-intensity focused ultrasound (HIFU) allows to inflict intracorporal thermal lesions without penetrating the skin or damaging the surrounding tissue. This analysis intends to assess the magnitude of HIFU-induced ablations within benign thyroid nodules using scintigraphic imaging with 99mTc.
Methods: Ten cold, hot, or indifferent nodules were treated using multiple pulses of HIFU to induce temperatures of around 85°C within the ablation zone. Pre- and posttreatment, uptake values of 99mTc pertechnetate or 99mTc-MIBI were recorded. The pre-post reduction of nodular uptake was evaluated to assess ablation magnitude.
Results: Relative nodular uptake in relation to total thyroidal uptake decreased after one session of HIFU in all cases. Median 99mTc-MIBI uptake reduction was 35.5% (ranging from 11% to 57%; p < 0.1), while 99mTc-pertechnetate scintigraphy showed a median uptake reduction of 27% (range 10% to 44%; p < 0.1). No major complications were observed.
Conclusions: HIFU appears to be safe and is an easy to perform means of thermal ablation. This study shows that HIFU treatment in thyroidal nodules can be evaluated by scintigraphic means shortly after the intervention. Due to small sample size, the exact magnitude of HIFU ablation efficiency in thyroidal nodules remains a value to beassessed in a larger study.
Previous studies document a relationship between gambling activity at the aggregate level and investments in securities with lottery-like features. We combine data on individual gambling consumption with portfolio holdings and trading records to examine whether gambling and trading act as substitutes or complements. We find that gamblers are more likely than the average investor to hold lottery stocks, but significantly less likely than active traders who do not gamble. Our results suggest that gambling behavior across domains is less relevant compared to other portfolio characteristics that predict investing in high-risk and high-skew securities, and that gambling on and off the stock market act as substitutes to satisfy the same need, e.g., sensation seeking.
The ongoing pandemic caused by the Betacoronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) demonstrates the urgent need of coordinated and rapid research towards inhibitors of the COVID-19 lung disease. The covid19-nmr consortium seeks to support drug development by providing publicly accessible NMR data on the viral RNA elements and proteins. The SARS-CoV-2 genome encodes for approximately 30 proteins, among them are the 16 so-called non-structural proteins (Nsps) of the replication/transcription complex. The 217-kDa large Nsp3 spans one polypeptide chain, but comprises multiple independent, yet functionally related domains including the viral papain-like protease. The Nsp3e sub-moiety contains a putative nucleic acid-binding domain (NAB) with so far unknown function and consensus target sequences, which are conceived to be both viral and host RNAs and DNAs, as well as protein-protein interactions. Its NMR-suitable size renders it an attractive object to study, both for understanding the SARS-CoV-2 architecture and drugability besides the classical virus’ proteases. We here report the near-complete NMR backbone chemical shifts of the putative Nsp3e NAB that reveal the secondary structure and compactness of the domain, and provide a basis for NMR-based investigations towards understanding and interfering with RNA- and small-molecule-binding by Nsp3e.
The current outbreak of the highly infectious COVID-19 respiratory disease is caused by the novel coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). To fight the pandemic, the search for promising viral drug targets has become a cross-border common goal of the international biomedical research community. Within the international Covid19-NMR consortium, scientists support drug development against SARS-CoV-2 by providing publicly available NMR data on viral proteins and RNAs. The coronavirus nucleocapsid protein (N protein) is an RNA-binding protein involved in viral transcription and replication. Its primary function is the packaging of the viral RNA genome. The highly conserved architecture of the coronavirus N protein consists of an N-terminal RNA-binding domain (NTD), followed by an intrinsically disordered Serine/Arginine (SR)-rich linker and a C-terminal dimerization domain (CTD). Besides its involvement in oligomerization, the CTD of the N protein (N-CTD) is also able to bind to nucleic acids by itself, independent of the NTD. Here, we report the near-complete NMR backbone chemical shift assignments of the SARS-CoV-2 N-CTD to provide the basis for downstream applications, in particular site-resolved drug binding studies.
The family of scaffold attachment factor B (SAFB) proteins comprises three members and was first identified as binders of the nuclear matrix/scaffold. Over the past two decades, SAFBs were shown to act in DNA repair, mRNA/(l)ncRNA processing, and as part of protein complexes with chromatin-modifying enzymes. SAFB proteins are approximately-100-kDa-sized dual nucleic acid-binding proteins with dedicated domains in an otherwise largely unstructured context, but whether and how they discriminate DNA- and RNA-binding has remained enigmatic. We here provide the SAFB2 DNA- and RNA-binding SAP and RRM domains in their functional boundaries and use solution NMR spectroscopy to ascribe DNA- and RNA-binding functions. We give insight into their target nucleic acid preferences and map the interfaces with respective nucleic acids on sparse data-derived SAP and RRM domain structures. Further, we provide evidence that the SAP domain exhibits intra-domain dynamics and a potential tendency to dimerise, which may expand its specifically targeted DNA sequence range. Our data provide a first molecular basis of and a starting point towards deciphering DNA- and RNA-binding functions of SAFB2 on the molecular level and serve a basis for understanding its localization to specific regions of chromatin and its involvement in the processing of specific RNA species.
Background: Infection is a main cause of morbidity and mortality after heart surgery, with multi-resistant pathogens increasingly representing a challenge. Daptomycin provides bactericidal activity against gram-positive organisms that are resistant to standard treatment including vancomycin.
Methods: A cohort of cardiac surgical patients, treated with daptomycin for major infection at two tertiary care centers, were retrospectively studied with a particular focus on the type of infection, causative pathogens and co-infections, daptomycin dosage, adverse events and outcome in order to provide evidence for the efficiency and safety of daptomycin in a distinct high-risk patient population.
Results: Sixty-five patients (87.7 % males, 60.4 ± 13.5 years) who had undergone aortic surgery (20.0 %), ventricular assist device (VAD) implantation (21.5 %), combined procedures (21.5 %), coronary artery bypass grafting (12.3 %), isolated valve surgery (15.4 %) and heart transplantation (7.7 %) were diagnosed with catheter-related infection (26.1 %), valve endocarditis (18.8 %), sternal wound (13.0 %), VAD-associated (11.6 %), cardiac implantable electrophysiological device (CIED)-associated (4.1 %), respiratory tract (4.3 %), bloodstream (4.3 %) and other infection (4.3 %). In 13.0 %, no focus of infection was identified though symptoms of severe infection were present. The most frequent pathogens were Staphylococcus epidermidis (30.4 %), Staphylococcus aureus (23.1 %) and Enterococcus species (10.1 %). Daptomycin doses ranging from 3 mg/kg every 48 h to 10 mg/kg every 24 h were administered for 15.4 ± 11.8 days. 87.0 % of the cases were classified as success, 7.2 % as treatment failure and 5.8 as non-evaluable. Adverse events were limited to one case of mild and one case of moderate neutropenia with recovery upon termination of treatment.
Conclusion: Daptomycin proved safe and effective in major infection in high-risk cardiac surgical patients.
Left ventricular non-compaction cardiomyopathy and left ventricular assist device: a word of caution
(2016)
BACKGROUND: In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge.
CASE PRESENTATION: We report a patient with LVNC who required urgent heart transplantation for inflow cannula obstruction nine months after receiving a LVAD. LVAD parameters, echocardiography and examination of the explanted heart suggested changes of left ventricular configuration brought about by LVAD support as the most likely cause of inflow cannula obstruction.
CONCLUSIONS: We conclude that changes experienced by non-compacted myocardium during LVAD support may give rise to inflow cannula obstruction and flow reduction. Presence of LVNC mandates tight surveillance for changes in LV configuration and LVAD flow characteristics and may justify urgent transplantation listing status.
Device-related infections in recipients of left ventricular assist devices (LVAD) have been recognized as a major source of morbidity and mortality. They require a high level of diagnostic effort as part of the overall burden resulting from infectious complications in LVAD recipients. We present a multi-allergic patient who was treated for persistent sterile intrathoracic abscess formation and pericardial empyema following minimally invasive LVAD implantation including use of a sheet of e-polytetrafluoroethylene (ePTFE) membrane to restore pericardial integrity. Sterile abscess formation and pericardial empyema recurred after surgical removal until the ePTFE membrane was removed, suggesting that in disposed patients, ePTFE may be related to sterile abscess formation or sterile empyema.
Mast cells are long-lived tissue-resident leukocytes, located most abundantly in the skin and mucosal surfaces. They belong to the first line of defence of the body, protecting against invading pathogens, toxins and allergens. Their secretory granules are densely packed with a plethora of mediators, which can be released immediately upon activation of the cell. Next to their role in IgE-mediated allergic diseases and in promoting inflammation, potential anti-inflammatory functions have been assigned to mast cells, depending on the biological setting. The aim of this thesis was to contribute to a better understanding of the role of mast cells during the resolution of a local inflammation. Therefore, in a first of step a suitable model of a local inflammation had to be identified. Since comparison of the two Toll-like receptor (TLR)-agonists zymosan and lipopolysaccharide (LPS), which are most commonly used to locally induce inflammation, revealed a systemic response after LPS-injection and a local inflammation after zymosan-injection, the TLR2 agonist zymosan was chosen for the subsequent experiments. Multi epitope ligand cartography (MELC) combined with statistical neighbourhood analysis showed that mast cells are located in an anti-inflammatory microenvironment next to M2 macrophages during resolution of inflammation, while neutrophils and M1 macrophages are located in the zymosan-filled core of the inflammation. Furthermore, infiltrating neutrophils during peak inflammation and an increasing population of macrophages phagocytosing neutrophils during resolution of inflammation could be observed. MELC as well as flow cytometry analysis of mast cell-deficient mice revealed a decreased phagocytosing activity of macrophages in the absence of mast cells. As an untargeted approach to identify mast cell-derived mediators induced by zymosan, mRNA sequencing of bone marrow-derived mast cells (BMMCs) was performed. Gene ontology term analysis of the sequencing data revealed the induction of the type I interferon (IFN) pathway as the dominant response. Contradicting previous studies, I could validate the production of IFN-β by mast cells in response to zymosan and LPS in vitro. Furthermore IFN-β expression by mast cells was also detected in vivo. In accordance with previous studies regarding other cell types the release of IFN-β by mast cells depends on endosomal signaling. The potential of IFN-β to enhance the phagocytosing activity of macrophages has been demonstrated recently. Besides IFN-β, various other mediators with reported enhancing effects on macrophage phagocytosis were also induced by zymosan in BMMCs, including Interleukin (IL)-1β, IL-4, IL-13, and Prostaglandin (PG) E2. Thus, either one of these mediators alone or a combination of them could promote macrophage phagocytosis.
In conclusion, I herein present mast cells as a novel source for IFN-β induced by non-viral TLR ligands and demonstrate their enhancing effect on macrophage phagocytosis, thereby contributing to the resolution of inflammation.
Bacterial and fungal toll-like receptor activation elicits type I IFN responses in mast cells
(2021)
Next to their role in IgE-mediated allergic diseases and in promoting inflammation, mast cells also have antiinflammatory functions. They release pro- as well as antiinflammatory mediators, depending on the biological setting. Here we aimed to better understand the role of mast cells during the resolution phase of a local inflammation induced with the Toll-like receptor (TLR)-2 agonist zymosan. Multiple sequential immunohistology combined with a statistical neighborhood analysis showed that mast cells are located in a predominantly antiinflammatory microenvironment during resolution of inflammation and that mast cell-deficiency causes decreased efferocytosis in the resolution phase. Accordingly, FACS analysis showed decreased phagocytosis of zymosan and neutrophils by macrophages in mast cell-deficient mice. mRNA sequencing using zymosan-induced bone marrow-derived mast cells (BMMC) revealed a strong type I interferon (IFN) response, which is known to enhance phagocytosis by macrophages. Both, zymosan and lipopolysaccharides (LPS) induced IFN-β synthesis in BMMCs in similar amounts as in bone marrow derived macrophages. IFN-β was expressed by mast cells in paws from naïve mice and during zymosan-induced inflammation. As described for macrophages the release of type I IFNs from mast cells depended on TLR internalization and endosome acidification. In conclusion, mast cells are able to produce several mediators including IFN-β, which are alone or in combination with each other able to regulate the phagocytotic activity of macrophages during resolution of inflammation.
Die neoklassische Arbitragetheorie setzt voraus, daß alle Marktteilnehmer identische Erwartungen bezüglich der künftigen zustandsabhängigen Auszahlungen von risikobehafteten Wertpapieren bilden. Die Unsicherheit besteht dann im Eintritt des Zustandes selber, jedoch nicht in dessen Ausprägung.
In diesem Artikel wird untersucht, wie eine zusätzliche Unsicherheit in Form des Unwissens über die genaue Ausprägung eines Umweltzustandes modelliert werden kann. Dazu werden die klassischen Finanzwirtschaftstheorien mit der Fuzzy Set Theorie (Theorie unscharfer Mengen) verbunden.
Ziel ist es, sowohl eine einperiodige als auch eine mehrperiodige Arbitragebewertung so zu modifizieren, daß vage Erwartungen der Marktteilnehmer unterstellt werden können.
Bipolar disorder (BD) is a heritable mental illness with complex etiology. While the largest published genome-wide association study identified 64 BD risk loci, the causal SNPs and genes within these loci remain unknown. We applied a suite of statistical and functional fine-mapping methods to these loci, and prioritized 22 likely causal SNPs for BD. We mapped these SNPs to genes, and investigated their likely functional consequences by integrating variant annotations, brain cell-type epigenomic annotations, brain quantitative trait loci, and results from rare variant exome sequencing in BD. Convergent lines of evidence supported the roles of SCN2A, TRANK1, DCLK3, INSYN2B, SYNE1, THSD7A, CACNA1B, TUBBP5, PLCB3, PRDX5, KCNK4, AP001453.3, TRPT1, FKBP2, DNAJC4, RASGRP1, FURIN, FES, YWHAE, DPH1, GSDMB, MED24, THRA, EEF1A2, and KCNQ2 in BD. These represent promising candidates for functional experiments to understand biological mechanisms and therapeutic potential. Additionally, we demonstrated that fine-mapping effect sizes can improve performance and transferability of BD polygenic risk scores across ancestrally diverse populations, and present a high-throughput fine-mapping pipeline (https://github.com/mkoromina/SAFFARI).
Am 27. Dezember 2015 verabschiedete der Ständige Ausschuss des Nationalen Volkskongresses das erste Antiterrorgesetz in der Geschichte der Volksrepublik China (VRC). Damit wurde eine über 25 Jahre erarbeitete umfangreiche Antiterrorstrategie zu Papier gebracht und mit ihr endlich eine verbindliche rechtliche Definition von „Terrorismus.“ Bereits gängige Praktiken wie öffentliche Medienzensur oder die Verpflichtung von Telekommunikationsunternehmen und Internetprovidern zur Bereitstellung von Inhaltsdaten wurden formalisiert und verschärft, sowie auch die Mobilisierung zivilgesellschaftlicher Organisationen auf eine rechtliche Grundlage gestellt. Allerdings stellt das Gesetz nur den finalen, formalen Schritt einer fünfundzwanzigjährigen Entwicklung dar. Tatsächlich kämpft Beijing seit Anfang der 1990er Jahre in der Provinz Xinjiang mit einer Mischung aus separatistisch und islamistisch motivierter politischer Gewalt, an deren Spitze seit spätestens 2008 das East Turkestan Independence Movement (ETIM) steht. ETIM weist ideell und organisatorisch eine Nähe zu Al Qaeda auf, und arbeitet transnational mit der Islamischen Bewegung Usbekistans, Tehrik-i-Taliban (Pakistan) und der al-Nusra Front (Syrien) zusammen...
This dissertation explores the breadth and variation of authoritarian counter-terrorism strategies and their legitimacy-related origins to challenge prevailing assumptions in Terrorism Studies. Research and analysis are conducted in the form of a Structured Focused Comparison of domestic counter-terrorism strategies in two electoral autocracies. The first case is Russia’s domestic engagement against a mix of ethno-separatist and Islamist terrorism emanating from its North Caucasus republics between 1999 and 2018. The second case is China’s engagement vis-à-vis a similar type of terrorism in its Xinjiang Uyghur Autonomous Region between 1990 and 2018.
The comparison shows that, contrary to prevailing assumptions, the two strategies differ immensely from one another while containing significant if not predominant non-coercive elements. It further shows that the two strategies are closely related to the two states’ sources and resources of legitimacy, both in their original motivation to tackle the terrorist threat and in the design of counter-terrorism strategies. Drawing on David Beetham’s theory of The Legitimation of Power and on the Comparative Politics, Terrorism Studies and Civil War literatures, the dissertation explores the influence of five sources and (re)sources of legitimacy on the two counter-terrorism strategies: responsiveness, performance legitimacy, ideology, discursive power and co-optation. While governmental discursive power is discarded as a source of variation, findings are significant with respect to the influence of ideology and performance legitimacy. Reliance on ideology or related patterns for legitimation raise vulnerability to terrorism and constrain or facilitate the adoption of communicative and preventive measures that accommodate the grievances of potentially defective or even violently terrorist groups. Performance legitimacy is a key motivator in counter-terrorism and an influence on certain types of counter-terrorism policies. Responsiveness and co-optation are identified as potential sources of variation, based on idiosyncratic concurrence with policy choices.
Der vorliegende Beitrag beschreibt den theoretischen Hintergrund und das Design des Projekts GLUE (Gemeinsame Lern-Umgebungen Entwickeln). Die Konzeption der Gemeinsamen Lern-Umgebungen zielt im Sinne der Prinzipien des ‚Universal Design of Learning‘ (Hall, Meyer & Rose, 2012) darauf ab, den inklusiven Mathematikunterricht von einem gemeinsamen Lerngegenstand aus zu denken, der einerseits Zugänglichkeit für alle Lernenden schafft und andererseits Unterstützungsmaßnahmen auf unterschiedlichen Niveaustufen zulässt.
Das Projekt geht der Frage nach, wie sich die Kompetenzentwicklung von berufserfahrenen Lehrkräften der allgemeinen Schule und für sonderpädagogische Förderung durch Fortbildungsangebote zum inklusiven Mathematikunterricht wirksam unterstützen lässt. Hierzu wurde ein Blended-Learning-Angebot zur Entwicklung gemeinsamer Lernumgebungen für alle Kinder einer Lerngruppe erarbeitet, die sich auch von mehreren Lehrkräften gemeinsam entwickeln lassen.
In diesem Beitrag werden der theoretische Hintergrund, die Konzeption und die methodische Anlage des Projekts vorgestellt. Kapitel 1 befasst sich mit Differenzieren und Fördern im Mathematikunterricht der Primarstufe, Kapitel 2 diskutiert zentrale Befunde zur Wirksamkeit von Lehrerfortbildungsmaßnahmen sowie zu Blended-Learning-Angeboten. Im dritten Kapitel werden auf dieser Grundlage die Ziele des Projekts (Kap. 3.1), die Inhalte und die Struktur des Fortbildungsangebots (Kap., 3.2), die Forschungsfragen (Kap. 3.3) und das Design der Interventionsstudie dargestellt (Kap. 3.4). Die Wirksamkeit wird in einem ausbalancierten Prä-Post-Follow-Up-Test-Design im Vergleich zu unbegleiteten Online-Angeboten evaluiert, die Ergebnisse sollen in einer Folgepublikation kommuniziert werden.
Physical exercise has been shown to alter sensory functions, such as sensory detection or perceived pain. However, most contributing studies rely on the assessment of single thresholds, and a systematic testing of the sensory system is missing. This randomised, controlled cross-over study aims to determine the sensory phenotype of healthy young participants and to assess if sub-maximal endurance exercise can impact it. We investigated the effects of a single bout of sub-maximal running exercise (30 min at 80% heart rate reserve) compared to a resting control in 20 healthy participants. The sensory profile was assessed applying quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain. QST comprises a broad spectrum of thermal and mechanical detection and pain thresholds. It was applied to the forehead of study participants prior and immediately after the intervention. Time between cross-over sessions was one week. Sub-maximal endurance exercise did not significantly alter thermal or mechanical sensory function (time × group analysis) in terms of detection and pain thresholds. The sensory phenotypes did not indicate any clinically meaningful deviation of sensory function. The alteration of sensory thresholds needs to be carefully interpreted, and only systematic testing allows an improved understanding of mechanism. In this context, sub-maximal endurance exercise is not followed by a change of thermal and mechanical sensory function at the forehead in healthy volunteers.
Does it pay to invest in art? A selection-corrected returns perspective : [draft october 15, 2013]
(2013)
This paper shows the importance of correcting for sample selection when investing in illiquid assets with endogenous trading. Using a large sample of 20,538 paintings that were sold repeatedly at auction between 1972 and 2010, we find that paintings with higher price appreciation are more likely to trade. This strongly biases estimates of returns. The selection-corrected average annual index return is 6.5 percent, down from 10 percent for traditional uncorrected repeat sales regressions, and Sharpe Ratios drop from 0.24 to 0.04. From a pure financial perspective, passive index investing in paintings is not a viable investment strategy once selection bias is accounted for. Our results have important implications for other illiquid asset classes that trade endogenously.
Structured RNA regions are important gene control elements in prokaryotes and eukaryotes. Here, we show that the mRNA of a cyanobacterial heat shock gene contains a built-in thermosensor critical for photosynthetic activity under stress conditions. The exceptionally short 5´-untranslated region is comprised of a single hairpin with an internal asymmetric loop. It inhibits translation of the Synechocystis hsp17 transcript at normal growth conditions, permits translation initiation under stress conditions and shuts down Hsp17 production in the recovery phase. Point mutations that stabilized or destabilized the RNA structure deregulated reporter gene expression in vivo and ribosome binding in vitro. Introduction of such point mutations into the Synechocystis genome produced severe phenotypic defects. Reversible formation of the open and closed structure was beneficial for viability, integrity of the photosystem and oxygen evolution. Continuous production of Hsp17 was detrimental when the stress declined indicating that shutting-off heat shock protein production is an important, previously unrecognized function of RNA thermometers. We discovered a simple biosensor that strictly adjusts the cellular level of a molecular chaperone to the physiological need.
Background: The increasing number of cases and hospital admissions due to COVID-19 created an urgent need for rapid, reliable testing procedures for SARS-CoV-2 in Emergency Departments (ED) in order to effectively manage hospital resources, allocate beds and prevent nosocomial spread of infection. The ID NOW™ COVID-19 assay is a simple, user-friendly, rapid molecular test run on an instrument with a small footprint enabling point-of-care diagnostics.
Methods: In the first wave, outsourced RT-PCR testing regularly required 36-48 hours before results were available. This prospective study was conducted in the second wave (October 2020-April 2021) and evaluated the impact the implementation of the ID NOW™ COVID-19 test in the ED had on clinical care processes and patient pathways. 710 patients were recruited upon arrival at the ED which included those presenting clinical symptoms, asymptomatic individuals or persons fulfilling epidemiological criteria. The first anterior nasal swab was taken by trained nurses in the ambulance or a separate consultation room. The ID NOW™ COVID-19 test was performed in the ED in strict compliance with the manufacturer’s instructions and positive or suspected cases were additionally tested with RT_PCR (cobas SARS-COV-2 RT-PCR, Roche) following collection of a second nasopharyngeal NP specimen.
Results: Swabs directly tested with the ID NOW™ COVID-19 test showed a diagnostic concordance of 98 % (sensitivity 99.59 %, specificity 94.55 %, PPV 97.6 %, NPV 99.05 %) compared to RT-PCR as reference. The 488 patients that tested positive with the ID NOW™ COVID-19 had a Ct range in RT-PCR results between 7.94 to 37.42 (in 23.2 % > 30). Two false negative results (0.28%) were recorded from patients with Ct values > 30. 14 (1.69%) discordant results were reviewed case-by-case and usually associated with either very early or very advanced stages of infection. Furthermore, patients initially negative with the ID NOW™ COVID-19 test and admitted to the hospital were tested again on days 5 and 12: no patient became positive.
Discussion: The ID NOW™ COVID-19 test for detection of SARS-CoV-2 demonstrated excellent diagnostic agreement with RT-PCR under the above-mentioned patients pathways implemented during the second wave. The main advantage of the system was the provision of reliable results within a few minutes. This not only allowed immediate initiative of appropriate therapy and care for COVID-19 (patient benefit) but provided essential information on isolation and thus available beds. This drastically helped the overall finances of the department and additionally allowed more patients to be admitted including those requiring immediate attention; this was not possible during the first wave since beds were blocked waiting for diagnostic confirmation. Our findings also show that when interpreting the results, the clinical condition and epidemiological history of the patient must be taken into account, as with any test procedure. Overall, the ID NOW™ COVID-19 test for SARS-CoV-2 provided a rapid and reliable alternative to laboratory-based RT-PCR in the real clinical setting which became an acceptable part of the daily routine within the ED and demonstrated that early patient management can mitigate the impact of the pandemic on the hospital.
Background: Endothelin-1 signalling plays an important role in pathogenesis of pulmonary hypertension. Although different endothelin-A receptor antagonists are developed, a novel therapeutic option to cure the disease is still needed. This study aims to investigate the therapeutic efficacy of the selective endothelin-A receptor antagonist TBC3711 in monocrotaline-induced pulmonary hypertension in rats.
Methods: Monocrotaline-injected male Sprague-Dawley rats were randomized and treated orally from day 21 to 35 either with TBC3711 (Dose: 30 mg/kg body weight/day) or placebo. Echocardiographic measurements of different hemodynamic and right-heart hypertrophy parameters were performed. After day 35, rats were sacrificed for invasive hemodynamic and right-heart hypertrophy measurements. Additionally, histologic assessment of pulmonary vascular and right-heart remodelling was performed.
Results: The novel endothelin-A receptor antagonist TBC3711 significantly attenuated monocrotaline-induced pulmonary hypertension, as evident from improved hemodynamics and right-heart hypertrophy in comparison with placebo group. In addition, muscularization and medial wall thickness of distal pulmonary vessels were ameliorated. The histologic evaluation of the right ventricle showed a significant reduction in fibrosis and cardiomyocyte size, suggesting an improvement in right-heart remodelling.
Conclusion: The results of this study suggest that the selective endothelin-A receptor antagonist TBC3711 demonstrates therapeutic benefit in rats with established pulmonary hypertension, thus representing a useful therapeutic approach for treatment of pulmonary hypertension.
The optimal follow-up care for relapse detection in acute myeloid leukemia (AML) patients in first remission after consolidation therapy with intensive chemotherapy is not established. In this retrospective study, we evaluate the diagnostic value of an intensive relapse surveillance strategy by regular bone marrow aspirations (BMA) in these patients. We identified 86 patients with newly diagnosed non-promyelocytic AML who had reached complete remission (CR) after intensive induction and consolidation chemotherapy between 2007 and 2019. Annual relapse rates were 40%, 17%, and 2% in years 1–3, respectively. Patients in CR were surveilled by BMA scheduled every 3 months for 2 years, followed by BMA every 6 months. This surveillance regimen detected 29 of 55 relapses (53%), 11 of which were molecular relapses (20%). The remaining 26 of 55 relapses (47%) were diagnosed by non-surveillance BMA prompted by specific suspicion of relapse. Most patients showed concurrent morphological abnormalities in peripheral blood (PB) at time of relapse. Seven percent of all morphological relapses occurred without simultaneous PB abnormalities and would have been delayed without surveillance BMA. Intensified monthly PB assessment paired with BMA every 3 months during the first 2 years may be a highly sensitive relapse surveillance strategy.
Objectives and Methods: Intracranial hemorrhage (ICH) in acute myeloid leukemia (AML) patients is a major concern due to the increased risk of mortality. Few studies have examined ICH specifically in newly diagnosed AML patients receiving intensive induction chemotherapy (IC) and prophylactic platelet transfusions during thrombocytopenia <10/nL. This retrospective cohort study included 423 newly diagnosed AML patients without acute promyelocytic leukemia who underwent IC between 2007 and 2019. We assessed risk factors, clinical features, and outcomes of ICH.
Results: 17 of 423 patients (4%) suffered ICH during hospital stay, and 4 patients (24%) died directly because of ICH despite routine prophylactic platelet transfusions. Patients with ICH had a negatively impacted overall survival (median OS, 20.1 vs. 104.8 months) and were more likely not to continue with curative treatment. Main risk factors were female gender, severe thrombocytopenia, and decreased fibrinogen. Patients with subsequent ICH also had laboratory signs of liver dysfunction.
Conclusions: Intracranial hemorrhage remains a potentially deadly complication with notable incidence despite prophylactic platelet substitution, suggesting that additional prophylactic interventions may be required to further reduce the frequency of ICH in high-risk patients. Unrecognized genetic factors may simultaneously predispose to AML and platelet dysfunction with ICH.
Background: We have analyzed the outcome of patients with localized extraskeletal Ewing sarcoma (EES) treated in three consecutive Cooperative Weichteilsarkomstudiengruppe (CWS) soft tissue sarcoma (STS) studies: CWS-91, CWS-96, and CWS-2002P.
Methods: Patients were treated in CWS-91 with four- (vincristine, dactinomycin, doxorubicin, and ifosfamide [VAIA] or cyclophosphamide [VACA II]) or five-drug (+etoposide [EVAIA]) cycles, in CWS-96 they were randomly assigned to receive VAIA or CEVAIE (+carboplatin and etoposide), and in CWS-2002P with VAIA III plus optional maintenance therapy (MT) with cyclophosphamide and vinblastine. Local therapy consisted of resection and/or radiotherapy (RT).
Results: Two hundred forty-three patients fulfilled the eligibility criteria. The 5-year event-free survival (EFS) and overall survival (OS) were 63% (95% confidence interval [CI] 57–69) and 73% (95% CI 67–79), respectively. The 5-year EFS by study was 64% (95% CI 54–74) in CWS-91, 57% (95% CI 48–66) in CWS-96, and 79% (95% CI 67–91) in CWS-2002P (n.s.). The 5-year OS was 72% (95% CI 62–82) in CWS-91, 70% (95% CI 61–79) in CWS-96, and 86% (95% CI 76–96) in CWS-2002P (n.s.). In CWS-96, 5-year EFS and OS in the VAIA arm versus the CEVAIE were 65% (95% CI 52–81) versus 55% (95% CI 39–76) log-rank p = .13, and 85% (95% CI 75–96) versus 61% (95% CI 45–82), log-rank p = .09.
Conclusion: Our analysis provides interesting information on the treatment and specificities of EES, which can be useful for a better understanding of this rare entity and should be considered in the development of future clinical trials for Ewing sarcoma defined as FET–ETS fusion positive tumors.
We document the structure of firm-bank relationships across the eleven largest euro area countries and present new stylised facts using novel data from the recent credit registry of the Eurosystem - AnaCredit. We look at the number of banking relationships, reliance on the main bank, credit instruments, loan maturity and interest rates. The granularity of the data allows us to account for cross country differences in firm characteristics. Firms in Southern European countries borrow from a larger number of banks and obtain a lower share of credit from the main bank compared to those in Northern European countries. They also tend to borrow more on short term, more expensive instruments and to obtain loans with shorter maturity. This is consistent with the hypothesis that Southern European countries rely less on relationship banking and obtain credit less conducive to firm growth, in line with the smaller average size of Southern European firms. Instead, no clear pattern emerges in terms of interest rates, consistent with the idea that banks appropriate part of the surplus generated by relationship lending through higher rates.
This dissertation presents the development of a new radio frequency quadrupole (RFQ) structure of the 4-rod type with an operating frequency of 108 MHz for the acceleration of heavy ions with mass-to-charge ratios of up to 8.5 at high duty cycles up to CW operation ("continuous wave") at the High Charge Injector (HLI) of the GSI Helmholtz Centre for Heavy Ion Research in Darmstadt.
The need to develop a completely new RFQ for the HLI arises from the fact that with the previously designed and built 4-rod RFQ structure, which was commissioned at the HLI in 2010 as part of the planned HLI upgrade program, the desired operating modes in both pulsed and CW operation could not be achieved even after several years of operating experience and considerable efforts to eliminate or at least mitigate the severe operational instabilities. Mechanical vibrations of the electrodes, which result in strong modulated power reflection, as well as the high thermal sensitivity proved to be particularly problematic.
In addition to the RF design of the new RFQ by simulations performed with the CST Microwave Studio software, the focus of the investigations fell on the mechanical analysis of vibrations on the electrode rods caused by RF operation, for which the ANSYS Workbench software was used. Due to the high thermal load of the RFQ structure of more than 30 kW/m in CW operation, an accurate analysis of the thermal effects on electrode deformation as well as resulting frequency detuning of the resonator is also required, which was investigated by simulations within the capabilities of CST Mphysics Studio.
Based on the results of the design studies carried out by simulations and the thereby achieved design optimizations, a 4-rod RFQ prototype with 6 stems was finally manufactured, on which most of the properties expected from the simulations could be validated by measurements of the RF characteristics as well as of the vibration behavior.
Finally, based on the results of the pre-tests and considering a newly developed beam dynamics concept, a completely revised RF design for a new full-length HLI-RFQ was derived from the prototype design.
The RFQ direct injection project (RFQ-DIP) for the neutrino physics experiment IsoDAR aims at an efficient injection of a high-current H²⁺ beam into the dedicated 60 MeV driver cyclotron. Therefore, it is intended to use a compact 32.8 MHz RFQ structure of the split-coaxial type as a pre-buncher. To determine the thermal elongation of the 1.4 m long electrode rods as well as the thermal frequency detuning of the RF structure at a maximum nominal power load of 3.6 kW, an extensive thermal and structural mechanical analysis using COMSOL Multiphysics was conducted. The water heating along the cooling channels as well as the properties of heat transfer from the copper structure to the cooling water were taken into account, which required CFD simulations of the cooling water flow in the turbulent regime. Here we present the methods and results of the sophisticated thermal and structural mechanical simulations using COMSOL and provide a comparison to more simplistic simulations conducted with CST Studio Suite.
Rezension zu: Social preferences: an introduction to behavioural economics and experimental research, by Michalis Drouvelis, Newcastle upon Tyne: Agenda Publishing, 2021, 205 pages, £22.99, ISBN 978-1-78821-417-9 (paperback).
This paper explores consequences of consumer education on prices and welfare in retail financial markets when some consumers are naive about shrouded add-on prices and firms try to exploit it. Allowing for different information and pricing strategies we show that education is unlikely to push firms to disclose prices towards all consumers, which would be socially efficient. Instead, price discrimination emerges as a new equilibrium. Further, due to a feedback on prices, education that is good for consumers who become sophisticated may be bad for consumers who stay naive and even for the group of all consumers as a whole
We provide evidence on the extent to which survey items in the Preference Survey Module and the resulting Global Preference Survey measuring social preferences − trust, altruism, positive and negative reciprocity − predict behavior in corresponding experimental games outside the original participant sample of Falk et al. (2022). Our results, which are based on a replication study with university students in Tehran, Iran, are mixed. While quantitative items considering hypothetical versions of the experimental games correlate significantly and economically meaningfully with individual behavior, none of the qualitative items show significant correlations. The only exception is altruism where results correspond more closely to the original findings.
How to write (international) legal histories that would be true to their protagonists while simultaneously relevant to present audiences? Most of us would also want to write "critically" – that is to say, at least by aiming to avoid Eurocentrism, hagiography and commitment to an altogether old-fashioned view of international law as an instrument of progress. Hence we write today our histories "in context". But this cannot be all. Framing the relevant "context" is only possible by drawing upon more or less conscious jurisprudential and political preferences. Should attention be focused on academic debates, military power, class structures or assumptions about the longue durée? Such choices determine for us what we think of as relevant "contexts", and engage us as participants in large conversations about law and power that are not only about what once "was" but also what there will be in the future.
In The Gentle Civilizer of Nations, I suggested that international law began in the 1860’s as part of liberal entrenchment in Europe as the clouds of nationalism, racism and socialism were rising in the political horizon. It began as a project of practicalmen, attorneys and lawyers active in politics and parliament, and not out of philosophical contemplation or system-construction. University professors were involved, but these were professors of something that was seen more as a craft than a science. What they aimed at was to "civilize" the behaviour of their nations, but also the colonies, and to do this by coordinating liberal legislative reform in Europe, by supporting formal empire in the colonies, and by doing all this as part of a set of cosmopolitan legal projects they grouped into their "international law" (Droit international, diritto internazionale, Völkerrecht). ...
Political theology’s recent rise to academic prominence has, no doubt, been inspired by the sense of a certain staleness of standard (read: Anglo-American) analytical political and legal theory. Especially postcolonial and postmodern philosophy has resuscitated debates about the reality of secularization in Europe, pointing out that much of our shared political metaphysic is indeed that – a metaphysic – with close historical links to debates in theology. That should be no surprise. For almost half a millennium theology stood as the primus inter pares among the three "higher faculties" at European universities. The best minds at work in Europe explained the social and political changes to European audiences within a fully God-centric intellectual universe. Awareness of that fact, as Wim Decock points out in this massive and brilliant work, not only assists us in understanding the development of our political and legal vocabularies. It also enables us to grasp the contingency of our present debates, the way opposite standpoints on political and legal obligation refer back to assumptions about human nature, the roles of individual and society and the nature of "law" that are hard to detach from religious speculation. ...
The article presents a brief overview of research and publication in the history of international law in Europe today. The upsurge of interest in historical studies is traced back to a sense of present transformation, with historical studies seeking to explore both aspects of continuity and change in the international legal system. The article outlines three tasks for the discipline in the future: to begin work for international law’s Ideengeschichte, to focus on the relationship between the West and its "Other", and to undertake studies in the historical sociology of international law.
This paper discusses the implications of transnational media production and diasporic networks for the cultural politics of migrant minorities. How are fields of cultural politics transformed if Hirschmann’s famous options ‘exit’ and ‘voice’ are no longer constituting mutually exclusive responses to dissent within a nation-state, but modes of action that can combine and build upon each other in the context of migration and diasporic media activism? Two case studies are discussed in more detail, relating to Alevi amateur television production in Germany and to a Kurdish satellite television station that reaches out to a diaspora across Europe and the Middle East. Keywords: migrant media, transnationalism, Alevis, Kurds, Turkey, Germany
Migranten werden in politischen Debatten oft als festgefügte Gemeinschaft betrachtet, die in ihrer eigenen nach außen abgeschotteten Welt leben – in einer Parallelgesellschaft. Doch ist das wirklich so? Wie gestalten insbesondere junge Leute mit Migrationshintergrund ihre sozialen Bindungen, wenn sie sich in der urbanen Clubszene europäischer Großstädte bewegen? Das Team um die Soziologin und Kulturanthropologin Kira Kosnick untersucht die Dynamiken dieser Prozesse.
This working paper is based on a lecture given at the Summer School “Multiple Inequalities in the Age of Transnationalization”, June 23-27 2014 at Goethe University Frankfurt. In it, I explore the linkages between sexuality and migration and aim to show that instead of deeming them a narrow subfield of migration studies, thinking through these linkages has much wider implications for different fields, including post- and decolonial queer studies, the study of race and sexuality, the study of citizenship and state projects of inclusion/exclusion, and for work that attempts to ce-center the predominant knowledge production focused on the Global North.
Die mikroskopische Anatomie sowie die pathologische Anatomie bilden einen wichtigen Baustein der Ausbildung von Medizin- und Zahnmedizinstudenten. Da die zeitlichen und personellen Kapazitäten in den Instituten für Pathologie bzw. Anatomie keine vierundzwanzigstündige Betreuung erlauben, bestand der Wunsch, ein zeit- und ortsunabhängiges webbasiertes und interaktives multimediales Lernprogramm zu entwickeln. Es sollte den Studierenden beim Erlernen der Histologie und Histopathologie helfen und die Präsenzveranstaltungen am Mikroskop und Vorlesungen Ergänzen. Das Lernprogramm wurde mit zahlreichen hochauflösenden Bildern aller histologischen Präparate, die Bestandteil der Histologie- und Histopathologiekurse sind, in verschiedenen Vergrößerungen ausgestattet und in die Kurse des Frankfurter Curriculum für Medizin- und Zahnmedizin integriert. Darüber hinaus wurden alle histologischen Webseiten mit den entsprechenden histopathologischen Seiten verlinkt und umgekehrt. Ein Autorensystem zur Aktualisierung, Korrektur und Erweiterung der Programme wurde entwickelt. Mit der Hilfe der Evaluation durch die Studierenden wurde das System im Verlauf stark verbessert. Die hohe Zahl der Zugriffe auf die Website über das Internet (500.000 – 800.000 im Monat) weist auf die hohe Akzeptanz und Beliebtheit des Programms hin. Im wesentlichen zeigt die vorliegende Arbeit, dass internet-basierte Multimedia-Projekte von Studierenden verwendet werden und ihnen helfen, komplexe Sachverhalte der Histologie und Histopathologie zu erlernen. Die enge Verzahnung zwischen histologischen und histopathologischen Themen und Präparaten ermöglicht Studierenden der vorklinischen Fächer, über krankheitsbedingte Veränderungen zu erfahren, Studierende der klinischen Fächer hingegen können das histologische Basiswissen rekapitulieren. Das Autorensystem kann zur Entwicklung weiterer webbasierter Anwendungen, wie z. B. Virtuelle Mikroskopie oder Wissensprüfungsprogramme für die Histologie/Histopathologie, verwendet werden.
Background: There is absence of specific biomarkers and an incomplete understanding of the pathophysiology of exudative age-related macular degeneration (AMD).
Methods and findings: Eighty-eight vitreous samples (73 from patients with treatment naïve AMD and 15 control samples from patients with idiopathic floaters) were analyzed with capillary electrophoresis coupled to mass spectrometry in this retrospective case series to define potential candidate protein markers of AMD. Nineteen proteins were found to be upregulated in vitreous of AMD patients. Most of the proteins were plasma derived and involved in biological (ion) transport, acute phase inflammatory reaction, and blood coagulation. A number of proteins have not been previously associated to AMD including alpha-1-antitrypsin, fibrinogen alpha chain and prostaglandin H2-D isomerase. Alpha-1-antitrypsin was validated in vitreous of an independent set of AMD patients using Western blot analysis. Further systems biology analysis of the data indicated that the observed proteomic changes may reflect upregulation of immune response and complement activity.
Conclusions: Proteome analysis of vitreous samples from patients with AMD, which underwent an intravitreal combination therapy including a core vitrectomy, steroids and bevacizumab, revealed apparent AMD-specific proteomic changes. The identified AMD-associated proteins provide some insight into the pathophysiological changes associated with AMD.
Introduction. To evaluate clinical feasibility and reproducibility of cytometric bead assay (CBA) in nondiluted vitreous samples of patients with age-related macular degeneration (ARMD), diabetic macular edema (DME), and central retinal vein occlusion (CRVO). Methods. Twelve patients from a single clinics day qualified for intravitreal injections (ARMD n = 6, DME n = 3, CRVO n = 3) and underwent a combination treatment including a single-site 23 gauge core vitrectomy which yielded a volume of 0.6 mL undiluted vitreous per patient. Interleukin-6 (IL-6), vascular endothelial growth factor isoform A (VEGF-A), and monocyte chemo-attractant protein-1 (MCP-1) were assessed directly from 0.3 mL at the same day (fresh samples). To assess the reproducibility 0.3 ml were frozen for 60 days at -80°, on which the CBA was repeated (frozen samples). Results. In the fresh samples IL-6 was highest in CRVO (median IL-6 55.8 pg/mL) > DME (50.6) > ARMD (3.1). Highest VEGF was measured in CRVO (447.4) > DME (3.9) > ARMD (2.0). MCP-1 was highest in CRVO (595.7) > AMD (530.8) > DME (178). The CBA reproducibility after frozen storage was examined to be most accurate for MCP1 (P = 0.91) > VEGF (P = 0.68) > IL-6 (P = 0.49). Conclusions. CBA is an innovative, fast determining, and reliable technology to analyze proteins in fluids, like the undiluted vitreous, which is important to better understand ocular pathophysiology and pharmacology. There is no influence of intermittent storage at -80° for the reproducibility of the CBA.
Purpose: To correlate inflammatory and proangiogenic key cytokines from undiluted vitreous of treatment-naïve central retinal vein occlusion (CRVO) patients with SD-OCT parameters.
Methods: Thirty-five patients (age 71.1 years, 24 phakic, 30 nonischemic) underwent intravitreal combination therapy, including a single-site 23-gauge core vitrectomy. Twenty-eight samples from patients with idiopathic, non-uveitis floaterectomy served as controls. Interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF-A) levels were correlated with the visual acuity (logMar), category of CRVO (ischemic or nonischemic) and morphologic parameters, such as central macular thickness-CMT, thickness of neurosensory retina-TNeuro, extent of serous retinal detachment-SRT and disintegrity of the IS/OS and others.
Results: The mean IL-6 was 64.7pg/ml (SD ± 115.8), MCP-1 1015.7 ( ± 970.1), and VEGF-A 278.4 ( ± 512.8), which was significantly higher than the control IL-6 6.2 ± 3.4pg/ml (P=0.06), MCP-1 253.2 ± 73.5 (P<0.0000001) and VEGF-A 7.0 ± 4.9 (P<0.0006). All cytokines correlated highly with one another (correlation coefficient r=0.82 for IL-6 and MCP-1; r=0.68 for Il-6 and VEGF-A; r=0.64 for MCP-1 and VEGF-A). IL-6 correlated significantly with CMT, TRT, SRT, dIS/OS, and dELM. MCP-1 correlated significantly with SRT, dIS/OS, and dELM. VEGF-A correlated not with changes in SD-OCT, while it had a trend to be higher in the ischemic versus the nonischemic CRVO group (P=0.09).
Conclusions: The inflammatory cytokines were more often correlated with morphologic changes assessed by SD-OCT, whereas VEGF-A did not correlate with CRVO-associated changes in SD-OCT. VEGF inhibition alone may not be sufficient in decreasing the inflammatory response in CRVO therapy.
We relate time-varying aggregate ambiguity (V-VSTOXX) to individual investor trading. We use the trading records of more than 100,000 individual investors from a large German online brokerage from March 2010 to December 2015. We find that an increase in ambiguity is associated with increased investor activity. It also leads to a reduction in risk-taking which does not reverse over the following days. When ambiguity is high, the effect of sentiment looms larger. Survey evidence reveals that ambiguity averse investors are more prone to ambiguity shocks. Our results are robust to alternative survey-, newspaper- or market-based ambiguity measures.
Caspase-8 is an aspartate-specific cysteine protease, which is best known for its apoptotic functions. Caspase-8 is placed at central nodes of multiple signal pathways, regulating not only the cell cycle but also the invasive and metastatic cell behavior, the immune cell homeostasis and cytokine production, which are the two major components of the tumor microenvironment (TME). Ovarian cancer often has dysregulated caspase-8 expression, leading to imbalance between its apoptotic and non-apoptotic functions within the tumor and the surrounding milieu. The downregulation of caspase-8 in ovarian cancer seems to be linked to high aggressiveness with chronic inflammation, immunoediting, and immune resistance. Caspase-8 plays therefore an essential role not only in the primary tumor cells but also in the TME by regulating the immune response, B and T lymphocyte activation, and macrophage differentiation and polarization. The switch between M1 and M2 macrophages is possibly associated with changes in the caspase-8 expression. In this review, we are discussing the non-apoptotic functions of caspase-8, highlighting this protein as a modulator of the immune response and the cytokine composition in the TME. Considering the low survival rate among ovarian cancer patients, it is urgently necessary to develop new therapeutic strategies to optimize the response to the standard treatment. The TME is highly heterogenous and provides a variety of opportunities for new drug targets. Given the variety of roles of caspase-8 in the TME, we should focus on this protein in the development of new therapeutic strategies against the TME of ovarian cancer.
Objective: Most patients suffering with rheumatic diseases who undergo surgical treatment are receiving immune-modulating therapy. To determine whether these medications affect their outcomes a national registry was established in Germany by the German Society of Surgery (DGORh). Data from the first 1000 patients were used in a pilot study to identify relevant corisk factors and to determine whether such a registry is suitable for developing accurate and relevant recommendations.
Design and participants: Data were collected from patients undergoing surgical treatments with their written consent. A second consent form was used, if complications occurred. During this pilot study, in order to obtain a quicker overview, risk factors were considered only in patients with complications. Only descriptive statistical analysis was employed in this pilot study due to limited number of observed complications and inhomogeneous data regarding the surgery and the medications the patients received. Analytical statistics will be performed to confirm the results in a future outcome study.
Results: Complications occurred in 26 patients and were distributed equally among the different types of surgeries. Twenty one of these patients were receiving immune-modulating therapy at the time, while five were not. Infections were observed in 2.3% of patients receiving and in 5.1% not receiving immunosuppression.
Conclusions: Due to the low number of cases, inhomogeneity in the diseases and the treatments received by the patients in this pilot study, it is not possible to develop standardised best-practice recommendations to optimise their care. Based on this observation we conclude that in order to be suitable to develop accurate and relevant recommendations a national registry must include the most important and relevant variables that impact the care and outcomes of these patients.
Production of J/ψ mesons in heavy ion collisions is considered within the statistical coalescence model. The model is in agreement with the experimental data of the NA50 Collaboration for Pb+Pb collisions at 158 AGeV in a wide centrality range, including the so-called “anomalous” suppression domain. The model description of the J/ψ data requires, however, strong enhancement of the open charm production in central Pb+Pb collisions. This model prediction may be checked in the future SPS runs.
Sphingosine kinases (SK) catalyze the phosphorylation of proapoptotic sphingosine to the prosurvival factor sphingosine 1-phosphate (S1P), thereby promoting oncogenic processes. Breast (MDA-MB-231), lung (NCI-H358), and colon (HCT 116) carcinoma cells were transduced with shRNA to downregulate SK-1 expression or treated with a pharmacologic SK-1 inhibitor. The effects of SK-1 targeting were investigated by measuring the level of intracellular sphingosine, the activity of protein kinase C (PKC) and cell cycle regulators, and the mitotic index. Functional assays included measurement of cell proliferation, colony formation, apoptosis, and cell cycle analysis. Downregulation of SK-1 or its pharmacologic inhibition increased intracellular sphingosine and decreased PKC activity as shown by reduced phosphorylation of PKC substrates. In MDA-MB-231 cells this effect was most pronounced and reduced cell proliferation and colony formation, which could be mimicked using exogenous sphingosine or the PKC inhibitor RO 31-8220. SK-1 downregulation in MDA-MB-231 cells increased the number of cells with 4N and 8N DNA content, and similar effects were observed upon treatment with sphingosine or inhibitors of SK-1 or PKC. Examination of cell cycle regulators unveiled decreased cdc2 activity and expression of Chk1, which may compromise spindle checkpoint function and cytokinesis. Indeed, SK-1 kd cells entered mitosis but failed to divide, and in the presence of taxol also failed to sustain mitotic arrest, resulting in further increased endoreduplication and apoptosis. Our findings delineate an intriguing link between SK-1, PKC and components of the cell cycle machinery, which underlines the significance of SK-1 as a target for cancer therapy.
Numbers and space are two semantic primitives that interact with each other. Both recruit brain regions along the dorsal pathway, notably parietal cortex. This makes parietal cortex a candidate for the origin of numerical–spatial interaction. The underlying cognitive architecture of the interaction is still under scrutiny. Two classes of explanations can be distinguished. The early interaction approach assumes that numerical and spatial information are integrated into a single representation at a semantic level. A second approach postulates independent semantic representations. Only at the stage of response selection and preparation these two streams interact. In this study we used a numerical landmark task to identify the locus of the interaction between numbers and space. While lying in an MR scanner participants decided on the smaller of two numerical intervals in a visually presented number triplet. The spatial position of the middle number was varied; hence spatial intervals were congruent or incongruent with the numerical intervals. Responses in incongruent trials were slower and less accurate than in congruent trials. By combining across-vertex correlations (micro pattern) with a cluster analysis (macro pattern) we identified large-scale networks that were devoted to number processing, eye movements, and sensory–motor functions. Using support vector classification in different regions of interest along the intraparietal sulcus, the frontal eye fields, and supplementary motor area we were able to distinguish between congruent and incongruent trials in each of the networks. We suggest that the identified networks participate in the integration of numerical and spatial information and that the exclusive assumption of either an early or a late interaction between numerical and spatial information does not do justice to the complex interaction between both dimensions.
The aim of this study is a better understanding of radiation processes in regional climate models (RCMs) in order to quantify their impact and to reduce possible errors. A first important task in finding an answer to this question was to examine the accuracy of the components of the radiation budget in regional climate simulations. To this end, the simulated radiation budgets of two regional climate simulations for Europe were compared with a satellite-based reference. In the simulations with the RCM COSMO-CLM there were some serious under- and overestimations of short- and long-wave net radiation in Europe. However, taking into account the differences in the reference datasets, the results of the COSMO-CLM were quite satisfactory.
Using statistical methods, the influence of potential sources of uncertainties was estimated. Uncertainties in the cloud cover and surface albedo had a significant impact on uncertainties in short-wave net radiation, the explained variance of uncertainties in cloud cover was two to three times higher than that of uncertainties in surface albedo. Uncertainties in the cloud cover resulted in significant errors in the net long-wave radiation. However, the influence of uncertainties in soil temperature on errors in the long-wave radiation budget was low or even negligible. These results were confirmed in a comparison with simulations of the REMO and ALADIN regional climate models. It is reasonable to expect that a better parameterization of relatively simple parameters such as cloud cover and surface albedo is a means of significantly improving the simulation of radiation budget components in the COSMO-CLM.
An important question for the application of RCMs is to examine whether the results of radiation uncertainties and their impact factors are comparable if the model is applied in a region that is not the one for which it was originally created. Comparisons of the simulated radiation budgets of different RCMs for West Africa showed that problems in the simulation of short- and long-wave radiation fluxes were a widespread problem. Most of the tested models showed some considerable under- or overestimation of the short- and long-wave radiation fluxes.
Similar to Europe uncertainties in cloud cover were also in the simulations for Africa a significant factor affecting uncertainties in the simulated radiation fluxes. However, for the African simulations uncertainties in the parameterization of surface albedo were much more important than in Europe. On average, overland uncertainties in the cloud cover and surface albedo were of similar importance. Uncertainties in soil temperature simulations were of higher importance in Africa, and reached overland similar values of the mean explained variance (R2 ≈ 0.2) such as uncertainties in the cloud cover. This indicates a geographical dependence of the model error. This study confirmed the assumption that an improved parameterization of relatively simple parameters such as the surface albedo in RCMs leads to a significant improvement in the modeled radiation budget, particularly in Africa.
The influence of errors in the simulated radiation budget components on the simulation of climate processes, such as the West-African monsoon (WAM), was investigated in a next step. The evaluation of ERA-Interim and ECHAM5 driven COSMO-CLM simulations for Africa showed that the main features of the WAM were well reproduced by the model, but there were only slight improvements compared to the driving data. The index of convective activity in the model simulations was much too high and precipitation was underestimated in large parts of tropical Africa. The partly considerable differences between the ERA-Interim and ECHAM5 driven simulations demonstrated the sensitivity of the RCM to the boundary conditions and in particular to the sea surface temperature. An excessive northwards shift of the monsoon in the model was influenced by the land-sea temperature gradient and the strength of the Saharan heat low. Consequently, a part of the error was due to the driving data and the model itself produced another part.
By modifying the parameterization of the bare soil albedo the errors in the radiation budget and 2 m temperature in the Sahara region were significantly reduced. Similarly, the overesti-mation of precipitation and convection has been reduced in the Sahel. The effect of this modifi-cation on the examined WAM area was low. This confirmed that especially in desert regions, errors in the surface albedo were a driving factor for errors in the radiation budget. However, there are other important factors not yet sufficiently understood that have a strong influence on the quality of the simulation of the WAM.
The analysis of the actual state, the quantification of error sources and the highlighting of connections made it possible to find means to reduce uncertainties in the simulated radiation in RCMs and to have a better understanding of radiation processes. However, the magnitude of the errors found, the number of possible influencing factors, and the complexity of interactions, indicate that there is still a need for further research in this area.
In this study, two different methods were applied to derive daily and monthly sunshine duration based on high-resolution satellite products provided by the European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT) Satellite Application Facility on Climate Monitoring using data from Meteosat Second Generation (MSG) SEVIRI (Spinning Enhanced Visible and Infrared Imager). The satellite products were either hourly cloud type or hourly surface incoming direct radiation. The satellite sunshine duration estimates were not found to be significantly different using the native 15-minute temporal resolution of SEVIRI. The satellite-based sunshine duration products give additional spatial information over the European continent compared with equivalent in situ-based products. An evaluation of the satellite sunshine duration by product intercomparison and against station measurements was carried out to determine their accuracy. The satellite data were found to be within ±1 h/day compared to high-quality Baseline Surface Radiation Network or surface synoptic observations (SYNOP) station measurements. The satellite-based products differ more over the oceans than over land, mainly because of the treatment of fractional clouds in the cloud type-based sunshine duration product. This paper presents the methods used to derive the satellite sunshine duration products and the performance of the different retrievals. The main benefits and disadvantages compared to station-based products are also discussed.
Heterodyne array receivers are employed in radio astronomy to reduce the observing time needed for mapping extended sources. One of the main factors limiting the amount of pixels in terahertz receivers is the difficulty of generating a sufficient amount of local oscillator power. Another challenge is efficient diplexing and coupling of local oscillator and signal power to the detectors. These problems are attacked in this dissertation by proposing the application of two vacuum electronic terahertz amplifier types for the amplification of the LO-signal and by introducing a new method for finding the defects in a quasioptical diplexer.
A traveling wave tube (TWT) design based on a square helix slow wave structure (SWS) at 825 GHz is introduced. It exhibits a simulated small-signal gain of 18.3 dB and a 3-dB bandwidth of 69 GHz. In order to generate LO-power at even higher frequencies, the operation of an 850-GHz square helix TWT as a frequency doubler has been studied. A simulated conversion efficiency of 7% to 1700 GHz, comparable with the state-of-art solid-state doublers, has been achieved for an input power of 25 mW.
The other amplifier type discussed in this work is a 1-THz cascade backward wave amplifier based on a double corrugated waveguide SWS. Specifically, three input/output coupler types between a rectangular waveguide and the SWS are presented. The structures have been realized with microfabrication, and the results of loss measurements at 1 THz will be shown.
Diplexing of the LO- and signal beams is often performed with a Martin-Puplett interferometer. Misalignment and deformation of the quasioptical components causes the polarization state of the output signal to be incorrect, which leads to coupling losses. A ray-tracing program has been developed for studying the influence of such defects. The measurement results of the diplexer of a multi-pixel terahertz receiver operated at the APEX telescope have been analyzed with the program, and the results are presented. The program allows the quasioptical configuration of the diplexer to be corrected in order to obtain higher receiver sensitivity.