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This article has two aims: it discusses the use and function of a very specific contract clause in Hellenistic time and explores the possibilities and limits to use databases and their automated searches and visualisations as heuristic tools. It is argued, that praxis … kata to diagramma is mainly a regional variety of an executionclause and not connected to the Greek type lawcourts as supposed by Mitteis and Wolff. Graph-databases can help to see different possible decisive features at the same time and show, which connections are more intensive than others, but automated analysis is slowed down and blurred by the lack of categorizing specific to the questions of legal history
NMR spectroscopy is a potent method for the structural and biophysical characterization of RNAs. The application of NMR spectroscopy is restricted in RNA size and most often requires isotope‐labeled or even selectively labeled RNAs. Additionally, new NMR pulse sequences, such as the heteronuclear‐detected NMR experiments, are introduced. We herein provide detailed protocols for the preparation of isotope‐labeled RNA for NMR spectroscopy via in vitro transcription. This protocol covers all steps, from the preparation of DNA template to the transcription of milligram RNA quantities. Moreover, we present a protocol for a chemo‐enzymatic approach to introduce a single modified nucleotide at any position of any RNA. Regarding NMR methodology, we share protocols for the implementation of a suite of heteronuclear‐detected NMR experiments including 13C‐detected experiments for ribose assignment and amino groups, the CN‐spin filter heteronuclear single quantum coherence (HSQC) for imino groups and the 15N‐detected band‐selective excitation short transient transverse‐relaxation‐optimized spectroscopy (BEST‐TROSY) experiment.
Basic Protocol 1: Preparation of isotope‐labeled RNA samples with in vitro transcription using T7 RNAP, DEAE chromatography, and RP‐HPLC purification
Alternate Protocol 1: Purification of isotope‐labeled RNA from in vitro transcription with preparative PAGE
Alternate Protocol 2: Purification of isotope‐labeled RNA samples from in vitro transcription via centrifugal concentration
Support Protocol 1: Preparation of DNA template from plasmid
Support Protocol 2: Preparation of PCR DNA as template
Support Protocol 3: Preparation of T7 RNA Polymerase (T7 RNAP)
Support Protocol 4: Preparation of yeast inorganic pyrophosphatase (YIPP)
Basic Protocol 2: Preparation of site‐specific labeled RNAs using a chemo‐enzymatic synthesis
Support Protocol 5: Synthesis of modified nucleoside 3′,5′‐bisphosphates
Support Protocol 6: Preparation of T4 RNA Ligase 2
Support Protocol 7: Setup of NMR spectrometer for heteronuclear‐detected NMR experiments
Support Protocol 8: IPAP and DIPAP for homonuclear decoupling
Basic Protocol 3: 13C‐detected 3D (H)CC‐TOCSY, (H)CPC, and (H)CPC‐CCH‐TOCSY experiments for ribose assignment
Basic Protocol 4: 13C‐detected 2D CN‐spin filter HSQC experiment
Basic Protocol 5: 13C‐detected C(N)H‐HDQC experiment for the detection of amino groups
Support Protocol 9: 13C‐detected CN‐HSQC experiment for amino groups
Basic Protocol 6: 13C‐detected “amino”‐NOESY experiment
Basic Protocol 7: 15N‐detected BEST‐TROSY experiment
Reduced Cl− conductance causes inhibited muscle relaxation after forceful voluntary contraction due to muscle membrane hyperexcitability. This represents the pathomechanism of myotonia congenita. Due to the prevailing data suggesting that an increased potassium level is a main contributor, we studied the effect of a modulator of a big conductance Ca2+- and voltage-activated K+ channels (BK) modulator on contraction and relaxation of slow- and high-twitch muscle specimen before and after the pharmacological induction of myotonia. Human and murine muscle specimens (wild-type and BK−/−) were exposed to anthracene-9-carboxylic acid (9-AC) to inhibit CLC-1 chloride channels and to induce myotonia in-vitro. Functional effects of BK-channel activation and blockade were investigated by exposing slow-twitch (soleus) and fast-twitch (extensor digitorum longus) murine muscle specimens or human musculus vastus lateralis to an activator (NS1608) and a blocker (Paxilline), respectively. Muscle-twitch force and relaxation times (T90/10) were monitored. Compared to wild type, fast-twitch muscle specimen of BK−/− mice resulted in a significantly decreased T90/10 in presence of 9-AC. Paxilline significantly shortened T90/10 of murine slow- and fast-twitch muscles as well as human vastus lateralis muscle. Moreover, twitch force was significantly reduced after application of Paxilline in myotonic muscle. NS1608 had opposite effects to Paxilline and aggravated the onset of myotonic activity by prolongation of T90/10. The currently used standard therapy for myotonia is, in some individuals, not very effective. This in vitro study demonstrated that a BK channel blocker lowers myotonic stiffness and thus highlights its potential therapeutic option in myotonia congenital (MC).
Background: Cognitive dysfunctions represent a core feature of schizophrenia and a predictor for clinical outcomes. One possible mechanism for cognitive impairments could involve an impairment in the experience-dependent modifications of cortical networks.
Methods: To address this issue, we employed magnetoencephalography (MEG) during a visual priming paradigm in a sample of chronic patients with schizophrenia (n = 14), and in a group of healthy controls (n = 14). We obtained MEG-recordings during the presentation of visual stimuli that were presented three times either consecutively or with intervening stimuli. MEG-data were analyzed for event-related fields as well as spectral power in the 1–200 Hz range to examine repetition suppression and repetition enhancement. We defined regions of interest in occipital and thalamic regions and obtained virtual-channel data.
Results: Behavioral priming did not differ between groups. However, patients with schizophrenia showed prominently reduced oscillatory response to novel stimuli in the gamma-frequency band as well as significantly reduced repetition suppression of gamma-band activity and reduced repetition enhancement of beta-band power in occipital cortex to both consecutive repetitions as well as repetitions with intervening stimuli. Moreover, schizophrenia patients were characterized by a significant deficit in suppression of the C1m component in occipital cortex and thalamus as well as of the late positive component (LPC) in occipital cortex.
Conclusions: These data provide novel evidence for impaired repetition suppression in cortical and subcortical circuits in schizophrenia. Although behavioral priming was preserved, patients with schizophrenia showed deficits in repetition suppression as well as repetition enhancement in thalamic and occipital regions, suggesting that experience-dependent modification of neural circuits is impaired in the disorder.
Chronic viral hepatitis is associated with substantial morbidity and mortality worldwide. The aim of our study was to assess the ability of point shear‐wave elastography (pSWE) using acoustic radiation force impulse imaging for the prediction of the following liver‐related events (LREs): new diagnosis of HCC, liver transplantation, or liver‐related death (hepatic decompensation was not included as an LRE). pSWE was performed at study inclusion and compared with liver histology, transient elastography (TE), and serologic biomarkers (aspartate aminotransferase to platelet ratio index, Fibrosis‐4, FibroTest). The performance of pSWE and TE to predict LREs was assessed by calculating the area under the receiver operating characteristic curve and a Cox proportional‐hazards regression model. A total of 254 patients with a median follow‐up of 78 months were included in the study. LRE occurred in 28 patients (11%) during follow‐up. In both patients with hepatitis B virus and hepatitis C virus (HCV), pSWE showed significant correlations with noninvasive tests and TE, and median pSWE and TE values were significantly different between patients with LREs and patients without LREs (both P < 0.0001). In patients with HCV, the area under the receiver operating characteristic curve for pSWE and TE to predict LREs were comparable: 0.859 (95% confidence interval [CI], 0.747‐0.969) and 0.852 (95% CI, 0.737‐0.967) (P = 0.93). In Cox regression analysis, pSWE independently predicted LREs in all patients with HCV (hazard ratio, 17.9; 95% CI, 5.21‐61‐17; P < 0.0001) and those who later received direct‐acting antiviral therapy (hazard ratio, 17.11; 95% CI, 3.88‐75.55; P = 0.0002). Conclusion: Our study shows good comparability between pSWE and TE. pSWE is a promising tool for the prediction of LREs in patients with viral hepatitis, particularly those with chronic HCV. Further studies are needed to confirm our data and assess their prognostic value in other liver diseases.
Au Tchad, à cause de ses retombées financières une attention particulière est prêtée aux arbres à karité (Vitella- ria paradoxa C.F.Gaertn.). Cependant, cette culture est menacée par les plantes vasculaires parasites de la famille des Lo- ranthaceae. La présente étude a été effectuée dans 3 sites dans la région du Mandoul pour évaluer l’ampleur des attaques de Loranthaceae (gui africain) sur des arbres en fonction des classes de circonférence du tronc à 1,5 cm du sol. Elle a consisté à dénombrer sur une de surface, les arbres à karité infestés et les touffes de parasites rencontrées sur ces arbres, afin de dé- terminer leur taux et leur intensité d’infestation. Les résultats obtenus montrent que Tapinanthus dodoneifolus (DC) Danser a été trouvée comme la seule espèce de Loranthaceae qui parasite les arbres karité étudiés dans la zone d’étude. Le taux moyen d’infestation estimé à 73% augmente avec l’âge des arbres karité. La moyenne d’intensité de l’infestation/arbre (2,75 touffes à Békôh, 2,27 à Yomi and 2,04 à Bébopen) montre que Tapinanthus dodoneifolus constitue une réelle menace pour les peu- plements de karité dans la zone d’étude. Il reste à rechercher le seuil d’infestation qui provoque une réduction significative de la fructification. Pour l’instant, bien que pénible à cause de la hauteur des arbres adultes, la lutte mécanique contre les Ta- pinanthus par la coupe systématique des branches infestées est urgente dans les parcs à karité dans cette zone d’étude.
Déterminants de l’utilisation de Acacia auriculiformis comme bois d’œuvre en Afrique de l’Ouest
(2020)
Acacia auriculiformis, un bois énergie, suscite de plus en plus des intérêts de bois d’œuvre au niveau des industriels de bois au Bénin. L’appréciation des performances de l’espèce dans les usines et en plantation est déterminante pour la vul- garisation de l’espèce comme alternative pour mitiger la déforestation en lien avec la demande en bois d’œuvre. L’objectif principal de ce travail est donc d’évaluer les conditions entourant l’adoption de Acacia auriculiformis comme espèce de bois d’œuvre au Bénin, Afrique de l’Ouest. Au total, 154 usines de bois et 25 plantations ont été enquêtées dans les zones abritant les plantations à A. auriculiformis. A. auriculiformis est l’espèce la plus fréquente dans les usines de bois (81%) suivie de Afzelia africana (55%), Tectona grandis (47%) et Khaya senegalensis (47%). Les superficies des plantations à A. auriculi- formis ont augmenté entre 1999 et 2019. Les connaissances sur l’utilisation de ce bois sont variables dans la zone d’étude. Le bois de A. auriculiformis est apprécié comme bois d’œuvre parce qu’il présente une couleur esthétique, un séchage rapide, une facilité de mise en œuvre, une imprégnabilité élevée, une densité moyenne à élevée et un bel aspect après mise en œuvre. Cependant, son bois fournit beaucoup de sciure, a beaucoup de nœuds et présente une déformabilité moyenne. Sa disponibili- té et son accessibilité sont les principaux facteurs justifiant la préférence de l’espèce par les industriels de bois d’œuvre. Cette forme d’utilisation de l’espèce est également remarquée au Togo, en Côte d’Ivoire. L’espèce présente une bonne perspective d’utilisation comme bois d’œuvre.
Ipomoea beninensis Akoègn., Lisowski & Sinsin (Convolvulaceae) is the only endemic plant known for Benin. To date, no data exist on its usages, distribution, abundance, and threats. An improved understanding of indigenous know- ledge and of local practices can provide insight into how the species could be sustainably conserved. We interviewed 114 local residents for collecting ethnobotanical and ethnoecological data in six sites known to host the species. Data were pro- cessed by calculation of descriptive statistics and variance and multivariate analyses. A total of twelve uses were reported. Among them, treatment of varicella (19%), malaria (18%) and fodder (17%) were the most recurrent. These mainly involve use of the species rootstock. Almost all respondents mentioned decline of the species in natural habitats. None of them was aware about the endemic status of the species. Consequently, negative practices toward the protection of I. beninensis were prevalent among local residents. Several conservation measures are proposed to ensure the longterm survival of I. beninensis.
Table of contents:
Hospice Gbèwonmèdéa Dassou, Rodrigue Idohou, Aristide Cossi Adomou,
Jéronime Marie-Ange Sènami Ouachinou, Hounnankpon Yédomonhan : Indigenous knowledge and local practices concerning the endemic plant Ipomoea beninensis Akoègn., Lisowski & Sinsin (Convolvulaceae): an initial assessment for its conservation in Benin
Jesugnon Fifamè Murielle Féty Tonouéwa, Eméline Sèssi Pélagie Assèdé, Samadori Sorotori Honoré Biaou : The use determinants of Acacia auriculiformis wood as timber in West Africa
Idriss Tourgou Kanika, Christophe Djekota, Elvire Hortense Biye : Characterization of Tapinanthus dodonaeifolius (Loranthaceae) infestation of shea butter tress in Chad
Neural oscillations are at the core of important computations in the mammalian brain. Interactions between oscillatory activities in different frequency bands, such as delta (1–4 Hz), theta (4–8 Hz) or gamma (>30 Hz), are a powerful mechanism for binding fundamentally distinct spatiotemporal scales of neural processing. Phase-amplitude coupling (PAC) is one such plausible and well-described interaction, but much is yet to be uncovered regarding how PAC dynamics contribute to sensory representations. In particular, although PAC appears to have a major role in audition, the characteristics of coupling profiles in sensory and integration (i.e. frontal) cortical areas remain obscure. Here, we address this question by studying PAC dynamics in the frontal-auditory field (FAF; an auditory area in the bat frontal cortex) and the auditory cortex (AC) of the bat Carollia perspicillata. By means of simultaneous electrophysiological recordings in frontal and auditory cortices examining local-field potentials (LFPs), we show that the amplitude of gamma-band activity couples with the phase of low-frequency LFPs in both structures. Our results demonstrate that the coupling in FAF occurs most prominently in delta/high-gamma frequencies (1-4/75-100 Hz), whereas in the AC the coupling is strongest in the delta-theta/low-gamma (2-8/25-55 Hz) range. We argue that distinct PAC profiles may represent different mechanisms for neuronal processing in frontal and auditory cortices, and might complement oscillatory interactions for sensory processing in the frontal-auditory cortex network.
Background: Recently, RBFOX1, a gene encoding an RNA binding protein, has consistently been associated with aggressive and antisocial behavior. Several loci in the gene have been nominally associated with aggression in genome-wide association studies, the risk alleles being more frequent in the general population. We have hence examined the association of four RBFOX1 single nucleotide polymorphisms, previously found related to aggressive traits, with aggressiveness, personality, and alcohol use disorder in birth cohort representative samples.
Methods: We used both birth cohorts of the Estonian Children Personality Behavior and Health Study (ECPBHS; original n = 1,238). Aggressiveness was assessed using the Buss–Perry Aggression Questionnaire and the Lifetime History of Aggressiveness structured interview at age 25 (younger cohort) or 33 (older cohort). Big Five personality at age 25 was measured with self-reports and the lifetime occurrence of alcohol use disorder assessed with the MINI interview. RBFOX1 polymorphisms rs809682, rs8062784, rs12921846, and rs6500744 were genotyped in all participants. Given the restricted size of the sample, correction for multiple comparisons was not applied.
Results: Aggressiveness was not significantly associated with the RBFOX1 genotype. RBFOX1 rs8062784 was associated with neuroticism and rs809682 with extraversion. Two out of four analyzed RBFOX1 variants, rs8062784 and rs12921846, were associated with the occurrence of alcohol use disorder.
Conclusions: In the birth cohort representative sample of the ECPBHS, no association of RBFOX1 with aggressiveness was found, but RBFOX1 variants affected basic personality traits and the prevalence of alcohol use disorder. Future studies on RBFOX1 should consider the moderating role of personality and alcohol use patterns in aggressiveness.
Objective: The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language.
Methods: Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. To assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery.
Results: The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006).
Significance: To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery.
APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management
(2020)
Background: Peanut allergy (PA) is associated with marked quality‐of‐life (QoL) impairment. However, data are lacking on the experience and impact of living with PA from the perspectives of persons with PA (PwPA) and their caregivers. Allergy to Peanuts imPacting Emotions And Life study 1 (APPEAL‐1) was a pan‐European survey investigating these perspectives. This first of two articles reports clinical characteristics of PwPA and PA management practices.
Methods: APPEAL‐1 was a quantitative, online survey conducted in eight European countries, developed by eight representatives of patient advocacy groups and five healthcare professionals and researchers. Eligible participants included adults with PA and parents/caregivers of PwPA who responded by self‐report and provided proxy‐report for the PwPA under their care. Data were summarized using nonweighted descriptive statistics.
Results: Of 1846 completed/analysed questionnaires, 528 were from adults with PA (self‐report); 437 by proxy for children with PA (34 aged 0‐3 years, 287 aged 4‐12 years, 116 aged 13‐17 years) and 881 from parents/caregivers (self‐report). Of PwPA (N = 965), 95% reported diagnosis by healthcare professionals, mostly by clinical history and peanut‐specific allergy testing. Rates of allergic rhinitis, asthma and other food allergies in PwPA were 50%, 42% and 79%, respectively. Only 31% of PwPA received HCP advice/support following their worst allergic reaction, and 28% had not been prescribed an adrenaline auto‐injector. Results were similar by country but varied by age group.
Conclusions: The APPEAL‐1 findings contribute to greater understanding of PA impact on PwPA, caregivers and family members and the need for improved PA management across Europe.
Objectives: To assess the short‐term clinical outcomes of lateral augmentation of deficient extraction sockets and two‐stage implant placement using autogenous tooth roots (TR).
Material and methods: A total of n = 13 patients (13 implants) were available for the analysis. At the time of tooth extraction, each subject had received lateral augmentation using the respective non‐retainable but non‐infected tooth root where the thickness of the buccal bone was <0.5 mm or where a buccal dehiscence‐type defect was present. Titanium implants were placed after a submerged healing period of 6 months and loaded after 20 ± 2 weeks (V8). Clinical parameters (e.g., bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR, clinical attachment level—CAL) were recorded at V8 and after 26 ± 4 weeks (V9) of implant loading.
Results: At V9, all patients investigated revealed non‐significant changes in mean BOP (−19.23 ± 35.32%), PD (0.24 ± 0.49 mm), MR (0.0 ± 0.0 mm) and CAL (0.24 ± 0.49 mm) values, respectively. There was no significant correlation between the initial gain in ridge width and changes in BOP and PD values.
Conclusions: The surgical procedure was associated with stable peri‐implant tissues on the short‐term.
High-risk rhabdomyosarcoma (RMS) occurring in childhood to young adulthood is associated with a poor prognosis; especially children above the age of 10 with advanced stage alveolar RMS still succumb to the disease within a median of 2 years. The advent of chimeric antigen receptor (CAR)-engineered T cells marked significant progress in the treatment of refractory B cell malignancies, but experience for solid tumors has proven challenging. We speculate that this is at least in part due to the poor quality of the patient's own T cells and therefore propose using CAR-modified cytokine-induced killer (CIK) cells as effector cells. CIK cells are a heterogeneous population of polyclonal T cells that acquire phenotypic and cytotoxic properties of natural killer (NK) cells through the cultivation process, becoming so-called T-NK cells. CIK cells can be genetically modified to express CARs. They are minimally alloreactive and can therefore be acquired from haploidentical first-degree relatives. Here, we explored the potential of ERBB2-CAR-modified random-donor CIK cells as a treatment for RMS in xenotolerant mice bearing disseminated high-risk RMS tumors. In otherwise untreated mice, RMS tumors engrafted 13–35 days after intravenous tumor cell injection, as shown by in vivo bioluminescence imaging, immunohistochemistry, and polymerase chain reaction for human gDNA, and mice died shortly thereafter (median/range: 62/56–66 days, n = 5). Wild-type (WT) CIK cells given at an early stage delayed and eliminated RMS engraftment in 4 of 6 (67%) mice, while ERBB2-CAR CIK cells inhibited initial tumor load in 8 of 8 (100%) mice. WT CIK cells were detectable but not as active as CAR CIK cells at distant tumor sites. CIK cell therapies during advanced RMS delayed but did not inhibit tumor progression compared to untreated controls. ERBB2-CAR CIK cell therapy also supported innate immunity as evidenced by selective accumulation of NK and T-NK cell subpopulations in disseminated RMS tumors, which was not observed for WT CIK cells. Our data underscore the power of heterogenous immune cell populations (T, NK, and T-NK cells) to control solid tumors, which can be further enhanced with CARs, suggesting ERBB2-CAR CIK cells as a potential treatment for high-risk RMS.
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a subtype of Hodgkin lymphoma with a preserved B‐cell phenotype and follicular T helper (TFH) cells rosetting around the tumor cells, the lymphocyte‐predominant (LP) cells. As we recently described reactivity of the B‐cell receptors of LP cells of some NLPHL cases with Moraxella spp. proteins, we hypothesized that LP cells could present peptides to rosetting T cells in a major histocompatibility complex class II (MHCII)‐bound manner. Rosetting PD1+ T cells were present in the majority of NLPHL cases, both in typical (17/20) and variant patterns (16/19). In most cases, T‐cell rosettes were CD69+ (typical NLPHL, 17/20; NLPHL variant, 14/19). Furthermore, both MHCII alpha and beta chains were expressed in the LP cells in 23/39 NLPHL. Proximity ligation assay and confocal laser imaging demonstrated interaction of the MHCII beta chain expressed by the LP cells and the T‐cell receptor alpha chain expressed by rosetting T cells. We thus conclude that rosetting T cells in NLPHL express markers that are encountered after antigenic exposure, that MHCII is expressed by the LP cells, and that LP cells interact with rosetting T cells in an immunological synapse in a subset of cases. As they likely receive growth stimulatory signals in this way, blockade of this interaction, for example, by PD1‐directed checkpoint inhibitors, could be a treatment option in a subset of cases in the future.
Objective: To evaluate the benefit of resective surgical periodontal therapy (root amputation or resection, root separation, tunnelling) in periodontitis patients exhibiting class II and III furcation involvement (FI) compared with non‐surgical treatment (SRP) or open flap debridement (OFD).
Material: Outcomes were tooth survival (primary), vertical probing attachment gain, and reduction in probing pocket depth (secondary) evidenced by randomized clinical trials, prospective and retrospective cohort studies and case series with ≥ 12 months of follow‐up. Search was performed on 3 electronic databases from January 1998 to December 2018.
Results: From a total of 683 articles, 66 studies were identified for full‐text analysis and 7 studies finally included. Six hundred sixty‐seven patients contributed 2,021 teeth with class II or III FI. Data were very heterogeneous regarding follow‐up and distribution of FI. A total of 1,515 teeth survived 4 to 30.8 years after therapy. Survival ranged from 38%–94.4% (root amputation or resection, root separation), 62%–67% (tunnelling), 63%–85% (OFD) and 68%–80% (SRP). Overall, treatment provided better results for class II FI than class III.
Conclusion: Within their limits, the data indicate that in class II and III FI, SRP and OFD may result in similar survival rates as root amputation/resection, root separation or tunnelling.
The tetraaryl μ‐hydridodiborane(4) anion [2H]− possesses nucleophilic B−B and B−H bonds. Treatment of K[2H] with the electrophilic 9‐H‐9‐borafluorene (HBFlu) furnishes the B3 cluster K[3], with a triangular boron core linked through two BHB two‐electron, three‐center bonds and one electron‐precise B−B bond, reminiscent of the prominent [B3H8]− anion. Upon heating or prolonged stirring at room temperature, K[3] rearranges to a slightly more stable isomer K[3 a]. The reaction of M[2H] (M+=Li+, K+) with MeI or Me3SiCl leads to equimolar amounts of 9‐R‐9‐borafluorene and HBFlu (R=Me or Me3Si). Thus, [2H]− behaves as a masked [:BFlu]− nucleophile. The HBFlu by‐product was used in situ to establish a tandem substitution‐hydroboration reaction: a 1:1 mixture of M[2H] and allyl bromide gave the 1,3‐propylene‐linked ditopic 9‐borafluorene 5 as sole product. M[2H] also participates in unprecedented [4+1] cycloadditions with dienes to furnish dialkyl diaryl spiroborates, M[R2BFlu].
Subvalent boron compounds contain boron atoms with oxidation numbers lower than +III. Over the last decades, the development of isolable derivatives has relied heavily on the use of specially designed ligands capable of stabilizing the electron‐rich boron centers electronically or through steric protection. Herein, we are exclusively reviewing anionic organo(hydro)boranes largely devoid of stabilizing ligands or heteroatom substituents. The restriction to these subvalent species is intended to minimize the risk of ligand artifacts being included when carving out the characteristic properties of the respective boron centers, such as nucleophilic or carbenoid behavior. The scope of this review encompasses triorganoborane radical monoanions ([·BR3]–) along with closed‐shell dianions ([:BR3]2–), boryl anions ([:BR2]–), as well as B–B single‐bonded diborane(6) dianions ([R3B–BR3]2–) and diborane(5) monoanions ([R2B–BR3]–), and finally B=B double‐bonded diborane(4) dianions ([R2B=BR2]2–). We are showing how these species are related to each other and comment on their bonding situations from an experimentalist's perspective.
Understanding the conformational sampling of translation-arrested ribosome nascent chain complexes is key to understand co-translational folding. Up to now, coupling of cysteine oxidation, disulfide bond formation and structure formation in nascent chains has remained elusive. Here, we investigate the eye-lens protein γB-crystallin in the ribosomal exit tunnel. Using mass spectrometry, theoretical simulations, dynamic nuclear polarization-enhanced solid-state nuclear magnetic resonance and cryo-electron microscopy, we show that thiol groups of cysteine residues undergo S-glutathionylation and S-nitrosylation and form non-native disulfide bonds. Thus, covalent modification chemistry occurs already prior to nascent chain release as the ribosome exit tunnel provides sufficient space even for disulfide bond formation which can guide protein folding.
A model for the description of proton collisions from molecules composed of atoms such as hydrogen, carbon, nitrogen, oxygen and phosphorus (H, C, N, O, P) was recently extended to treat collisions with multiply charged ions with a focus on net ionization. Here we complement the work by focusing on net capture. The ion–atom collisions are computed using the two-center basis generator method. The atomic net capture cross sections are then used to assemble two models for ion–molecule collisions: An independent atom model (IAM) based on the Bragg additivity rule (labeled IAM-AR), and also the so-called pixel-counting method (IAM-PCM) which introduces dependence on the orientation of the molecule during impact. The IAM-PCM leads to significantly reduced capture cross sections relative to IAM-AR at low energies, since it takes into account the overlap of effective atomic cross sectional areas. We compare our results with available experimental and other theoretical data focusing on water vapor (H2O), methane (CH4) and uracil (C4H4N2O2). For the water molecule target we also provide results from a classical-trajectory Monte Carlo approach that includes dynamical screening effects on projectile and target. For small molecules dominated by a many-electron atom, such as carbon in methane or oxygen in water, we find a saturation phenomenon for higher projectile charges (q=3) and low energies, where the net capture cross section for the molecule is dominated by the net cross section for the many-electron atom, and the net capture cross section is not proportional to the total number of valence electrons.
An important measure in pain research is the intensity of nociceptive stimuli and their cortical representation. However, there is evidence of different cerebral representations of nociceptive stimuli, including the fact that cortical areas recruited during processing of intranasal nociceptive chemical stimuli included those outside the traditional trigeminal areas. Therefore, the aim of this study was to investigate the major cerebral representations of stimulus intensity associated with intranasal chemical trigeminal stimulation. Trigeminal stimulation was achieved with carbon dioxide presented to the nasal mucosa. Using a single‐blinded, randomized crossover design, 24 subjects received nociceptive stimuli with two different stimulation paradigms, depending on the just noticeable differences in the stimulus strengths applied. Stimulus‐related brain activations were recorded using functional magnetic resonance imaging with event‐related design. Brain activations increased significantly with increasing stimulus intensity, with the largest cluster at the right Rolandic operculum and a global maximum in a smaller cluster at the left lower frontal orbital lobe. Region of interest analyses additionally supported an activation pattern correlated with the stimulus intensity at the piriform cortex as an area of special interest with the trigeminal input. The results support the piriform cortex, in addition to the secondary somatosensory cortex, as a major area of interest for stimulus strength‐related brain activation in pain models using trigeminal stimuli. This makes both areas a primary objective to be observed in human experimental pain settings where trigeminal input is used to study effects of analgesics.
Background: Enhancers play a fundamental role in orchestrating cell state and development. Although several methods have been developed to identify enhancers, linking them to their target genes is still an open problem. Several theories have been proposed on the functional mechanisms of enhancers, which triggered the development of various methods to infer promoter–enhancer interactions (PEIs). The advancement of high-throughput techniques describing the three-dimensional organization of the chromatin, paved the way to pinpoint long-range PEIs. Here we investigated whether including PEIs in computational models for the prediction of gene expression improves performance and interpretability.
Results: We have extended our TEPIC framework to include DNA contacts deduced from chromatin conformation capture experiments and compared various methods to determine PEIs using predictive modelling of gene expression from chromatin accessibility data and predicted transcription factor (TF) motif data. We designed a novel machine learning approach that allows the prioritization of TFs binding to distal loop and promoter regions with respect to their importance for gene expression regulation. Our analysis revealed a set of core TFs that are part of enhancer–promoter loops involving YY1 in different cell lines.
Conclusion: We present a novel approach that can be used to prioritize TFs involved in distal and promoter-proximal regulatory events by integrating chromatin accessibility, conformation, and gene expression data. We show that the integration of chromatin conformation data can improve gene expression prediction and aids model interpretability.
The aging process is characterized by a chronic, low‐grade inflammatory state, termed “inflammaging.” It has been suggested that macrophage activation plays a key role in the induction and maintenance of this state. In the present study, we aimed to elucidate the mechanisms responsible for aging‐associated changes in the myeloid compartment of mice. The aging phenotype, characterized by elevated cytokine production, was associated with a dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis and diminished serum corticosteroid levels. In particular, the concentration of corticosterone, the major active glucocorticoid in rodents, was decreased. This could be explained by an impaired expression and activity of 11β‐hydroxysteroid dehydrogenase type 1 (11β‐HSD1), an enzyme that determines the extent of cellular glucocorticoid responses by reducing the corticosteroids cortisone/11‐dehydrocorticosterone to their active forms cortisol/corticosterone, in aged macrophages and peripheral leukocytes. These changes were accompanied by a downregulation of the glucocorticoid receptor target gene glucocorticoid‐induced leucine zipper (GILZ) in vitro and in vivo. Since GILZ plays a central role in macrophage activation, we hypothesized that the loss of GILZ contributed to the process of macroph‐aging. The phenotype of macrophages from aged mice was indeed mimicked in young GILZ knockout mice. In summary, the current study provides insight into the role of glucocorticoid metabolism and GILZ regulation during aging.
Acetogenic bacteria have gained much attraction in recent years as they can produce different biofuels and biochemicals from H2 plus CO2 or even CO alone, therefore opening a promising alternative route for the production of biofuels from renewable sources compared to existing sugar‐based routes. However, CO metabolism still raises questions concerning the biochemistry and bioenergetics in many acetogens. In this study, we focused on the two acetogenic bacteria Acetobacterium woodii and Thermoanaerobacter kivui which, so far, are the only identified acetogens harbouring a H2‐dependent CO2 reductase and furthermore belong to different classes of ‘Rnf’‐ and ‘Ech‐acetogens’. Both strains catalysed the conversion of CO into the bulk chemical acetate and formate. Formate production was stimulated by uncoupling the energy metabolism from the Wood–Ljungdahl pathway, and specific rates of 1.44 and 1.34 mmol g−1 h−1 for A. woodii ∆rnf and T. kivui wild type were reached. The demonstrated CO‐based formate production rates are, to the best of our knowledge, among the highest rates ever reported. Using mutants of ∆hdcr, ∆cooS, ∆hydBA, ∆rnf and ∆ech2 with deficiencies in key enzyme activities of the central metabolism enabled us to postulate two different CO utilization pathways in these two model organisms.
Precipitation extremes with devastating socioeconomic consequences within the South American Monsoon System (SAMS) are expected to become more frequent in the near future. The complexity in SAMS behavior, however, poses severe challenges for reliable future projections. Thus, robust paleomonsoon records are needed to constrain the high spatiotemporal variability in the response of SAMS rainfall to different climatic drivers. This study uses Ti/Ca ratios from X‐ray fluorescence scanning of a sediment core retrieved off eastern Brazilian to trace precipitation changes over the past 322 Kyr. The results indicate that despite the spatiotemporal complexity of the SAMS, insolation forcing is the primary pacemaker of variations in the monsoonal system. Additional modulation by atmospheric pCO2 suggests that SAMS intensity over eastern Brazil will be suppressed by rising CO2 emissions in the future. Lastly, our record reveals an unprecedented strong and persistent wet period during Marine Isotope Stage 6 driven by anomalously strong trade winds.
CO2 has been electrochemically reduced to the intermediate formate, which was subsequently used as sole substrate for the production of the polymer polyhydroxybutyrate (PHB) by the microorganism Cupriavidus necator. Faradaic efficiencies (FE) up to 54 % have been reached with Sn‐based gas‐diffusion electrodes in physiological electrolyte. The formate containing electrolyte can be used directly as drop‐in solution in the following biological polymer production by resting cells. 56 mg PHB L−1 and a ratio of 34 % PHB per cell dry weight were achieved. The calculated overall FE for the process was as high as 4 %. The direct use of the electrolyte as drop‐in media in the bioconversion enables simplified processes with a minimum of intermediate purification effort. Thus, an optimal coupling between electrochemical and biotechnological processes can be realized.
Investigating the inhibition of anti-apoptotic BCL-2 family proteins in pediatric cancer cells
(2020)
Cancer is amongst the leading causes of death in childhood. Rhabdomyosarcoma (RMS) is the most frequently occurring soft tissue sarcoma in children and adolescents. It presumably arises from mesenchymal progenitors of skeletal muscle cells and presents with different subtypes that differ both histologically and genetically. Osteosarcoma (OS) and Ewing sarcoma (ES) are the most frequently diagnosed pediatric bone tumors. Even though the prognosis of these cancer entities improved significantly during recent decades, the survival rates are currently stagnating. Especially, dismal prognosis of relapsed and metastasizing cases of these malignancies urgently call for novel treatment options. BCL-2 proteins are vital guardians that control intrinsic apoptosis. Furthermore, it was shown that BCL-2 proteins critically regulate apoptosis in pediatric solid tumors. BH3 mimetics are small molecules that bind and inhibit anti-apoptotic BCL-2 proteins. They have already been investigated as cancer therapeutics for several years and show first encouraging clinical results. Therefore, we hypothesized that targeting BCL-2, MCL-1 and BCL-XL might be a promising approach to treat RMS, OS and ES.
In this study, we aimed to comprehensively evaluate the potential of anti-apoptotic BCL-2 family proteins as therapeutic targets for pediatric solid tumors such as RMS, OS and ES.
Notably, RMS, OS and ES cells largely expressed the most relevant BCL-2 family protein members. However, cells were widely insensitive to single pharmacological inhibition of either BCL-XL, BCL-2 or MCL-1 by A-1331852, ABT-199 and S63845, respectively. This finding was independent of their BCL-2 family protein expression levels. Significantly, co-administration of A-1331852 and S63845 induced cell death in RMS, OS and ES cell lines in a highly synergistic manner. Transient silencing of MCL-1 and/or BCL-XL verified the co-dependency of RMS cells on these proteins for survival. Importantly, A-1331852/S63845 co-treatment was more efficient in causing cell death in RMS, OS and ES cells than either inhibitor combined with ABT-199. Efficacy of A-1331852/S63845 co-treatment could be additionally demonstrated in a primary sample of pediatric malignant epithelioid mesothelioma.
Mechanistically, concomitant A-1331852/S63845 treatment mediated rapid intrinsic apoptosis involving swift loss of the mitochondrial outer membrane potential as well as activation of caspases-3, -8 and -9. An observed caspase dependent loss of MCL-1 might further amplify the A-1331852/S63845 triggered pro-death signaling. Furthermore, we identified BAX and BAK as key mediators of apoptosis caused by dual inhibition of MCL-1 and BCL-XL. A-1331852/S63845 induced cell death was relying on BAX and/or BAK in a cell line dependent manner. Interestingly, treatment with A-1331852 and S63845 liberated BAK from its interaction with MCL-1 and BCL-XL. Moreover, BAX and BAK were activated and interacted with each other to form a pore in the outer mitochondrial membrane. Further, in RD cells BIM and NOXA partially contributed to A-1331852/S63845 mediated cell death. Consistently, in this cell line BIM and NOXA were disrupted from their binding to BCL-XL and MCL-1 by A-1331852 and S63845, respectively. However, BH3 only proteins were not involved in A-1331852/S63845 induced cell death in Kym-1 cells. Therefore, we concluded that BH3 only proteins played only a marginal and cell line dependent role in mediating cell death caused by MCL-1 and BCL-XL co-repression.
Notably, A-1331852/S63845 co-treatment spared non-malignant fibroblasts, myoblasts and peripheral blood mononuclear cells, which suggests a therapeutic window for its application in vivo. Besides, we could demonstrate that sequential BH3 mimetic treatment still significantly induced cell death, albeit to minor extents compared to its dual administration. Importantly, we successfully evaluated concomitant treatment with A-1331852 and S63845 in multicellular RMS spheroids and in an in vivo embryonic chicken model of RMS. These findings stress the high transcriptional relevance of A-1331852/S63845 as an emerging novel cancer regimen.
Collectively, the thesis at hand explored the great potential of co-treatment with A-1331852 and S63845 in pediatric solid tumors and unveiled the underlying molecular mechanisms of cell death in RMS. Together, the current investigations support further preclinical and clinical studies to evaluate the effect of dual MCL-1 and BCL-XL targeting in pediatric solid tumors.
Fiscal policies and household consumption during the COVID-19 pandemic: a review of early evidence
(2020)
We review early evidence on how household consumption behavior has evolved over the pandemic and how different groups of households have responded to fiscal stimulus programs. Due to the scarcity of evidence for Europe, our review focuses on evidence from the US. Notwithstanding the institutional and demographic differences, we highlight generalizable findings and challenges to the design of stimulus policies from the pandemic. In conclusion, we identify several open issues for dis cussion.
We study the effects of releases from the U.S. Strategic Petroleum Reserve (SPR) within the context of fully specified models of the global oil market that explicitly allow for storage demand as well as unanticipated changes in the SPR. We show that historically SPR policy interventions, defined as sequences of exogenous SPR shocks during selected periods, have helped stabilize the price of oil. Their effect on the price of oil, however, has been modest. For example, the cumulative effect of the SPR releases after the invasion of Kuwait in 1990 was a reduction of $2/barrel in the real price of oil after 7 months. Whereas emergency drawdowns tend to lower the real price of oil, we find that exchanges tend to raise the real price of oil in the long run. We also provide a detailed analysis of the benefits of the 2018 White House proposal to sell off half of the SPR within the next decade. We show that the expected fiscal benefits of this plan are somewhat higher than the revenue of $16.6 billion dollars projected by the White House.
There has been much interest in the relationship between the price of crude oil, the value of the U.S. dollar, and the U.S. interest rate since the 1980s. For example, the sustained surge in the real price of oil in the 2000s is often attributed to the declining real value of the U.S. dollar as well as low U.S. real interest rates, along with a surge in global real economic activity. Quantifying these effects one at a time is difficult not only because of the close relationship between the interest rate and the exchange rate, but also because demand and supply shocks in the oil market in turn may affect the real value of the dollar and real interest rates. We propose a novel identification strategy for disentangling the causal effects of traditional oil demand and oil supply shocks from the effects of exogenous variation in the U.S. real interest rate and in the real value of the U.S. dollar. Our approach exploits a combination of sign and zero restrictions and narrative restrictions motivated by economic theory and extraneous evidence. We empirically evaluate popular views about the role of exogenous real exchange rate shocks in driving the real price of oil, and we examine the extent to which shocks in the global oil market drive the U.S real exchange rate and U.S. real interest rates. Our evidence for the first time provides direct empirical support for theoretical models of the link between these variables.
The conventional wisdom that inflation expectations respond to the level of the price of oil (or the price of gasoline) is based on testing the null hypothesis of a zero slope coefficient in a static single-equation regression model fit to aggregate data. Given that the regressor in this model is not stationary, the null distribution of the t-test statistic is nonstandard, invalidating the use of the normal approximation. Once the critical values are adjusted, these regressions provide no support for the conventional wisdom. Using a new structural vector regression model, however, we demonstrate that gasoline price shocks may indeed drive one-year household inflation expectations. The model shows that there have been several such episodes since 1990. In particular, the rise in household inflation expectations between 2009 and 2013 is almost entirely explained by a large increase in gasoline prices. However, on average, gasoline price shocks account for only 39% of the variation in household inflation expectations since 1981.
In the wake of the global pandemic known as COVID-19, retirees, along with those hoping to retire someday, have been shocked into a new awareness of the need for better risk management tools to handle longevity and aging. This paper offers an assessment of the status quo prior to the spread of the coronavirus, evaluates how retirement systems are faring in the wake of the shock. Next we examine insurance and financial market products that may render retirement systems more resilient for the world’s aging population. Finally, potential roles for policymakers are evaluated.
Mehr Nachhaltigkeit im deutschen Leitindex DAX - Reformvorschläge im Lichte des Wirecard-Skandals
(2020)
Im Rahmen der Aufarbeitung des Wirecard-Skandals wird ebenfalls eine Änderung der Kriterien zur Aufnahme in den deutschen Leitindex DAX diskutiert. Die bislang von der Deutschen Börse vorgelegten Vorschläge zur Reformierung des DAX gehen in die richtige Richtung, sind aber nicht weitreichend genug. Es bedarf eines deutlichen Zeichens, dass sich künftig nur solche Unternehmen für den DAX qualifizieren können, die ein zumindest befriedigendes Maß an Nachhaltigkeit gemessen durch einen ESG (Environment, Social, Governance)-Risk-Score in ihrer Geschäftstätigkeit erreichen. Eine Simulation verdeutlicht, dass nach ESG-Kriterien seit langem kritisch betrachtete Unternehmen dem DAX nicht mehr angehören würden. Dies würde klare Anreize bei den Unternehmen setzen, Nachhaltigkeitsaspekte stärker als bisher in ihrer Strategie zu berücksichtigen. Letztlich kann eine Neugestaltung wichtiger Aktienindizes einen Beitrag dazu leisten, dass mehr Kapital in nachhaltig wirtschaftende Unternehmen und Sektoren fließt.
OTC discount
(2020)
We document a sizable OTC discount in the interdealer market for German sovereign bonds where exchange and over-the-counter trading coexist: the vastmajority of OTC prices are favorable with respect to exchange quotes. This is a challenge for theories of OTC markets centered around search frictions but consistent with models of hybrid markets based on information frictions. We show empiricallythat proxies for both frictions determine variation in the discount, which is largely passed on to customers. Dealers trade on the exchange for immediacy and via brokers for opacity and anonymity, highlighting the complementary roles played by the di↵erent protocols.
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.
Supranational rules, national discretion: increasing versus inflating regulatory bank capital?
(2020)
We study how higher capital requirements introduced at the supranational level affect the regulatory capital of banks across countries. Using the 2011 EBA capital exercise as a quasi-natural experiment, we find that treated banks exploit discretion in the calculation of regulatory capital to inflate their capital ratios without a commensurate increase in their book equity and without a reduction in bank risk. Regulatory capital inflation is more pronounced in countries where credit supply is expected to tighten, suggesting that national authorities forbear their domestic banks to meet supranational requirements, with a focus on short-term economic considerations.
The small photoreceptor Photoactive Yellow Protein (PYP) enters a reversible photocycle after excitation with blue light. The intermediate states are formed on timescales ranging from femtoseconds to seconds including chromophore isomerization and protonation as well as large structural rearrangements. To obtain local dynamic information the vibrational label thiocyanate (SCN) can be inserted site-specifically at any desired position in the protein by cysteine mutation and cyanylation. The label's CN stretch vibration is highly sensitive to polarity, hydrogen bonding interactions and electric fields and is spectrally well separated from the overlapping protein absorptions. During the course of this thesis it was impressively demonstrated that the successful incorporation of the SCN label at selected positions in PYP provides a powerful tool to study structure changes and dynamics during the photocycle and enhance the local information that are obtained by infrared (IR) spectroscopic methods. Hence the SCN-labeled protein mutants were studied under equilibrium (steady-state) and non-equilibrium conditions.
Examination of the SCN absorption by FTIR spectroscopy showed the influence of various local environments on the label for different locations in the dark state. The response of the label under illumination with blue light reveals information about structural changes in the signaling state. Additional information for both states were obtained by the vibrational lifetime of the CN vibration measured via ultrafast IR-pump-IR-probe experiments. This observable is particularly sensitive for solvent exposure of the label. Time-resolved IR spectroscopy proved to be an excellent method to follow the protein dynamics throughout most part of the photocycle on a hundreds of femtoseconds to milliseconds timescale. By close inspection of protein and chromophore dynamics in wildtype-PYP over nine decades in time, new insights into the changes leading to the proposed photocycle intermediates were obtained. The investigation of the SCN label allowed to follow the different transient structure changes with high local resolution. Depending on its position within the protein the response of the label provided additional information on the photocycle transitions.
The insights that are obtained by the different observables in the steady-state and by the reaction of the SCN label to formation of the different intermediate states during the photocycle contribute to an improved understanding of local, light-induced structure changes in the photoreceptor PYP. This comprehensive study demonstrated the potential provided by the application of SCN as IR label for investigation of protein dynamics.
Aim: Our aim was to analyse the diagnostic workup of hospitalised infants with symptoms of congenital cytomegalovirus (CMV) infections.
Methods: This retrospective study was carried out at the University Hospital Frankfurt, Germany, from 2008 to 2017 on infants aged 4 weeks to 12 months presenting with neurological symptoms consistent with congenital CMV infections.
Results: We studied 117 infants, and workup data for CMV infections were available for 84%. Of these, 54% were immunoglobulin G‐ and immunoglobulin M‐seronegative for CMV or immunoglobulin G‐seropositive with no viral shedding. Congenital CMV infection was excluded in these cases. In 16%, the CMV workup was incomplete, precluding a definitive diagnosis. Dried blood spots (DBS) were requested from 30%. CMV polymerase chain reaction was negative in 19 of these 29 infants, and CMV deoxyribonucleic acid detection confirmed congenital CMV infections in six patients. DBS had been destroyed in line with German law in four cases. Congenital CMV infections were diagnosed (5%) or excluded (62%) in 67% of patients and unanswered in the remaining 33%.
Conclusion: Diagnoses of congenital CMV infections were widely considered and found in 5%. CMV was not stringently investigated in all patients or remained elusive due to German law on destroying DBS.
Aims: Heart failure (HF) leads to repeat hospitalisations and reduces the duration and quality of life. Pulmonary artery pressure (PAP)‐guided HF management using the CardioMEMS™ HF system was shown to be safe and reduce HF hospitalisation (HFH) rates in New York Heart Association (NYHA) class III patients. However, these findings have not been replicated in health systems outside the United States. Therefore, the CardioMEMS European Monitoring Study for Heart Failure (MEMS‐HF) evaluated the safety, feasibility, and performance of this device in Germany, The Netherlands, and Ireland.
Methods and results: A total of 234 NYHA class III patients (68 ± 11 years, 22% female, ≥1 HFH in the preceding year) from 31 centres were implanted with a CardioMEMS sensor and underwent PAP‐guided HF management. One‐year rates of freedom from device‐ or system‐related complications and from sensor failure (co‐primary outcomes) were 98.3% [95% confidence interval (CI) 95.8–100.0] and 99.6% (95% CI 97.6–100.0), respectively. Survival rate was 86.2%. For the 12 months post‐ vs. pre‐implant, HFHs decreased by 62% (0.60 vs. 1.55 events/patient‐year; hazard ratio 0.38, 95% CI 0.31–0.48; P < 0.0001). After 12 months, mean PAP decreased by 5.1 ± 7.4 mmHg, Kansas City Cardiomyopathy Questionnaire (KCCQ) overall/clinical summary scores increased from 47.0 ± 24.0/51.2 ± 24.8 to 60.5 ± 24.3/62.4 ± 24.1 (P < 0.0001), and the 9‐item Patient Health Questionnaire sum score improved from 8.7 ± 5.9 to 6.3 ± 5.1 (P < 0.0001).
Conclusion: Haemodynamic‐guided HF management proved feasible and safe in the health systems of Germany, The Netherlands, and Ireland. Physician‐directed treatment modifications based on remotely obtained PAP values were associated with fewer HFH, sustainable PAP decreases, marked KCCQ improvements, and remission of depressive symptoms.
Background and Objectives: Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non‐inferiority or even superiority of restrictive transfusion guidelines over liberal transfusion guidelines in specific clinical situations outside of medical oncology. In this study, we analysed whether more restrictive RBC transfusion reduces blood use without affecting hard outcomes.
Materials and Methods: A total of 352 AML patients diagnosed between 2007 and 2018 and undergoing intensive induction chemotherapy were included in this retrospective analysis. In the less restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 8 g/dl (2007–2014). In the restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 7 g/dl (2016–2018). Liberal transfusion triggers were never endorsed.
Results: A total of 268 (76·1%) and 84 (23·9%) AML patients fell into the less restrictive and restrictive transfusion groups, respectively. The less restrictive transfusion group had 1 g/dl higher mean haemoglobin levels, received their first RBC transfusions earlier and needed 1·5 more units of RBC during the hospital stay of induction chemotherapy. Febrile episodes, C‐reactive protein levels, admission to the intensive care unit, length of hospital stay as well as response and survival rates did not differ between the two cohorts.
Conclusion: From our retrospective analysis, we conclude that a more restrictive transfusion trigger does not affect important outcomes of AML patients. The opportunity to test possible effects of the more severe anaemia in the restrictive transfusion group on quality of life was missed.
Overconsumption of carbohydrates and lipids are well known to cause nonalcoholic fatty liver disease (NAFLD), while the role of nutritional protein intake is less clear. In Western diet, meat and other animal products are the main protein source, with varying concentrations of specific amino acids. Whether the amount or composition of protein intake is associated with a higher risk for disease severity has not yet been examined. In this study, we investigated associations of dietary components with histological disease activity by analyzing detailed 14‐day food records in a cohort of 61 patients with biopsy‐proven NAFLD. Furthermore, we used 16S ribosomal RNA gene sequencing to detect associations with different abundances of the gut microbiota with dietary patterns. Patients with definite nonalcoholic steatohepatitis (NAFLD activity score of 5‐8 on liver biopsy) had a significantly higher daily relative intake of protein compared with patients with a NAFLD activity score of 0‐4 (18.0% vs. 15.8% of daily protein‐based calories, P = 0.018). After adjustment for several potentially confounding factors, a higher protein intake (≥17.3% of daily protein‐based calories) remained associated with definite nonalcoholic steatohepatitis, with an odds ratio of 5.09 (95% confidence interval 1.22‐21.25, P = 0.026). This association was driven primarily by serine, glycine, arginine, proline, phenylalanine, and methionine. A higher protein intake correlated with a lower Bacteroides abundance and an altered abundance of several other bacterial taxa. Conclusion: A high protein intake was independently associated with more active and severe histological disease activity in patients with NAFLD. Further studies are needed to investigate the potential harmful role of dietary amino acids on NAFLD, with special attention to meat as their major source.
Since type and duration of an appropriate adjuvant chemotherapy in early-stage ovarian cancer (OC) are still being debated, novel markers for a better stratification of these patients are of utmost importance for the design of an improved chemotherapeutical strategy. In contrast to numerous cancer studies on cellular proliferation based on the immunohistochemistry-driven evaluation of protein expression, we compared mRNA and protein expression of two independent markers of cellular proliferation, Ki-67 and Plk1, in a large cohort of 243 early-stage OC and their relationship with clinicopathological features and survival. Based on marker expression we demonstrate that early-stage OC patients (stages I/II, low-grade, serous) with high expression (Ki-67, Plk1) had a significantly shorter progression-free survival (PFS) and overall survival (OS) compared to patients with low expression (Ki-67, Plk1). Remarkably, based on mRNA expression this significant difference got lost in advanced stages (III/IV): At least for PFS, high levels of Ki-67 and Plk1 correlate with moderately better survival compared to patients with low expressing tumors. Our data suggest that in addition to Ki-67, Plk1 is a novel marker for the stratification of early-stage OC patients to maximize therapeutic efforts. Both, Ki-67 and Plk1, seem to be better suited in early-stages (I/II) as therapeutical targets compared to advanced-stages (III/IV) OC.
The respiratory chain of Escherichia coli contains two different types of terminal oxidase that are differentially regulated as a response to changing environmental conditions. These oxidoreductases catalyze the reduction of molecular oxygen to water and contribute to the proton motive force. The cytochrome bo3 oxidase (cyt bo3) acts as the primary terminal oxidase under atmospheric oxygen levels, whereas the bd‐type oxidase is most abundant under microaerobic conditions. In E. coli, both types of respiratory terminal oxidase (HCO and bd‐type) use ubiquinol‐8 as electron donor. Here, we assess the inhibitory potential of newly designed and synthesized 3‐alkylated Lawson derivatives through L‐proline‐catalyzed three‐component reductive alkylation (TCRA). The inhibitory effects of these Lawson derivatives on the terminal oxidases of E. coli (cyt bo3 and cyt bd‐I) were tested potentiometrically. Four compounds were able to reduce the oxidoreductase activity of cyt bo3 by more than 50 % without affecting the cyt bd‐I activity. Moreover, two inhibitors for both cyt bo3 and cyt bd‐I oxidase could be identified. Based on molecular‐docking simulations, we propose binding modes of the new Lawson inhibitors. The molecular fragment benzyl enhances the inhibitory potential and selectivity for cyt bo3, whereas heterocycles reduce this effect. This work extends the library of 3‐alkylated Lawson derivatives as selective inhibitors for respiratory oxidases and provides molecular probes for detailed investigations of the mechanisms of respiratory‐chain enzymes of E. coli.
Vicinally diiodinated polycyclic aromatic hydrocarbons (I2‐PAHs) are accessible from the corresponding diborylated B2‐PAHs through boron/iodine exchange. The B2‐PAHs have been prepared via twofold electrophilic borylation reactions templated by a vicinally disilylated benzene. Our protocol is applicable to fluorenes, acenes, annulated acenes, oligoaryls, and even [5]helicene. Using B2‐naphthalene as the example, we have shown that the reaction scope can, in principle, be expanded to include the synthesis of vicinally dibrominated and dihydroxylated PAHs. The usefulness of the building blocks provided by our method in the field of optoelectronic materials was demonstrated by the successful conversion of I2‐fluoranthene to the analogous doubly alkynylated fluoranthene emitter.
A plethora of data has highlighted the role of epigenetics in the development of cancer. Initiation and progression of different cancer types are associated with a variety of changes of epigenetic mechanisms, including aberrant DNA methylation, histone modifications, and miRNA expression. At the same time, advances in the available epigenetic tools allow to investigate and reverse these epigenetic changes and form the basis for the development of anticancer drugs in human oncology. Although human and canine cancer shares several common features, only recently that studies emerged investigating the epigenetic landscape in canine cancer and applying epigenetic modulators to canine cancer. This review focuses on the existing studies involving epigenetic changes in different types of canine cancer and the use of small-molecule inhibitors in canine cancer cells.
Rationale: Bronchiolitis obliterans syndrome (BOS) is a severe, chronic inflammation of the airways leading to an obstruction of the bronchioles. So far, there are only a few studies looking at the long‐term development of pulmonary impairment in children with BOS.
Objective: The objective of this study was to investigate the incidence and long‐term outcome of BOS in children who underwent allogeneic hematopoietic stem cell transplantation (HSCT).
Methods: Medical charts of 526 children undergoing HSCT in Frankfurt/Main, Germany between 2000 and 2017 were analyzed retrospectively and as a result, 14 patients with BOS were identified. A total of 271 lung functions (spirometry and body plethysmography), 26 lung clearance indices (LCI), and 46 chest high‐resolution computed tomography (HRCT) of these 14 patients with BOS were evaluated.
Results: Fourteen patients suffered from BOS after HSCT (2.7%), whereby three distinctive patterns of lung function impairment were observed: three out of 14 patients showed a progressive lung function decline; two died and one received a lung transplant. In five out of 14 patients with BOS persisted with a severe obstructive and secondarily restrictive pattern in lung function (forced vital capacity [FVC] < 60%, forced expiratory volume in 1 second [FEV1] < 50%, and FEV1/FVC < 0.7) and increased LCI (11.67‐20.9), six out of 14 patients recovered completely after moderate lung function impairment and signs of BOS on HRCT. Long‐term FVC in absolute numbers was increased indicating that the children still have lung growth.
Conclusion: Our results showed that the incidence of BOS in children is low. BOS was associated with high mortality and may lead to persistent obstructive lung disease; although, lung growth continued to exist.
Unresolved inflammation maintained by release of danger‐associated molecular patterns, particularly high‐mobility group box‐1 (HMGB1), is crucial for hepatocellular carcinoma (HCC) pathogenesis. To further characterize interactions between leucocytes and necrotic cancerous tissue, a cellular model of necroinflammation was studied in which murine Raw 264.7 macrophages or primary splenocytes were exposed to necrotic lysates (N‐lys) of murine hepatoma cells or primary hepatocytes. In comparison to those derived from primary hepatocytes, N‐lys from hepatoma cells were highly active—inducing in macrophages efficient expression of inflammatory cytokines like C‐X‐C motif ligand‐2 , tumor necrosis factor‐α, interleukin (IL)‐6 and IL‐23‐p19. This activity associated with higher levels of HMGB1 in hepatoma cells and was curbed by pharmacological blockage of the receptor for advanced glycation end product (RAGE)/HMGB1 axis or the mitogen‐activated protein kinases ERK1/2 pathway. Analysis of murine splenocytes furthermore demonstrated that N‐lys did not comprise of functionally relevant amounts of TLR4 agonists. Finally, N‐lys derived from hepatoma cells supported inflammatory splenic Th17 and Th1 polarization as detected by IL‐17, IL‐22 or interferon‐γ production. Altogether, a straightforward applicable model was established which allows for biochemical characterization of immunoregulation by HCC necrosis in cell culture. Data presented indicate a remarkably inflammatory capacity of necrotic hepatoma cells that, at least partly, depends on the RAGE/HMGB1 axis and may shape immunological properties of the HCC microenvironment.
Background and Aim: Several studies observed alterations in the gut microbiota in patients with non‐alcoholic fatty liver disease (NAFLD). However, analyzed patient populations and methods strongly differ among these studies. The aim of this study was to prove the reproducibility of published results and to provide a detailed overview of all findings in our NAFLD cohort using next generation sequencing methods.
Methods: The individual taxonomic microbiota composition of fecal samples from 90 NAFLD patients and 21 healthy controls was analyzed using 16S rRNA gene sequencing. Study participants were grouped according to their disease stage and compared regarding their gut microbiota composition. Studies were identified from PubMed listed publications, and the results were compared with the findings in our cohort.
Results: Results from 13 identified studies were compared with our data. A decreased abundance of the Bacteroidetes and Ruminococcaceae as well as an increased abundance of Lactobacillaceae and Veillonellaceae and Dorea were the most frequently reported changes among NAFLD patients in 4/13, 5/13, 4/13, 2/13, and 3/13 studies, respectively. Even though these alterations in the gut microbiota composition were also observed in our patient cohort, the majority of published differences could not be reproduced, neither in our own nor in other NAFLD cohort studies.
Conclusion: Despite repeatedly reproduced abundance patterns of specific bacteria, the heterogeneous study results did not reveal a consistent disease specific gut microbiota signature. Further prospective studies with homogenous patient cohorts and standardized methods are necessary to phenotype NAFLD by the gut microbiota.
Objective: Clostridial gas gangrene (GG) or clostridial myonecrosis is a very rare but life‐threatening necrotizing soft tissue infection (NSTI) caused by anaerobic, spore‐forming, and gas‐producing clostridium subspecies. It is the most rapidly spreading and lethal infection in humans, also affecting muscle tissue. The high mortality, of up to 100%, in clostridial GG is mediated by potent bacterial exotoxins. Necrotizing fasciitis (NF) is an important differential diagnosis, most often caused by group A streptococci, primarily not affecting musculature but the subcutaneous tissue and fascia. In the early stages of the infection, it is difficult to distinguish between GG and NF. Therefore, we compare both infection types, identify relevant differences in initial clinical presentation and later course, and present the results of our patients in a retrospective review.
Methods: Patients diagnosed with GG from 2008 to 2018 in our level one trauma center were identified. Their charts were reviewed retrospectively and data analyzed in terms of demographic information, microbiological and histological results, therapeutic course, outcome, and mortality rates. The laboratory risk indicator for NF (LRINEC) score was applied on the first blood work acquired. Results were compared to those of a second group diagnosed with NF.
Results: Five patients with GG and nine patients with NF were included in the present study. Patients with GG had a mortality rate of 80% compared to 0% in patients with NF. In eight patients with NF, affected limbs could be salvaged; one NF underwent amputation. LRINEC did not show significant differences between the groups; however, C‐reactive protein was significantly increased (P = 0.009) and hemoglobin (Hb) was significantly decreased (P = 0.02) in patients with GG. Interleukin‐6 and procalcitonin levels did not show significant difference. Patients with GG were older (70.2 vs 50 years). Of the isolated bacteria, 86% were sensitive to the initial calculated antibiotic treatment with ampicillin‐sulbactam or imipenem plus metronidazole plus clindamycin.
Conclusion: Both GG and NF need full‐scale surgical, antibiotic, and intensive care treatment, especially within the first days. Among patients with NSTI, those with clostridial GG have a significantly increased mortality risk due to early septic shock caused by clostridial toxins. In the initial stages, clinical differences are hardly detectable. Immediate surgical debridement is the key to successful therapy for NSTI and needs to be performed as early as possible. However, patients should be treated in a center with an experienced interdisciplinary intensive care team based on a predetermined treatment plan.
Objectives: To assess tolerability and efficacy of lacosamide in adults with cerebrovascular epilepsy etiology (CVEE).
Materials and methods: Exploratory post hoc analyses of a double‐blind, initial monotherapy trial of lacosamide vs carbamazepine‐controlled release (carbamazepine‐CR) (SP0993; NCT01243177); a double‐blind conversion to lacosamide monotherapy trial (SP0902; NCT00520741); and an observational study of adjunctive lacosamide added to one antiepileptic drug (SP0973 VITOBA; NCT01098162). Patients with CVEE were identified based on epilepsy etiology recorded at baseline.
Results: In the initial monotherapy trial, 61 patients had CVEE (lacosamide: 27; carbamazepine‐CR: 34). 20 (74.1%) patients on lacosamide (27 [79.4%] on carbamazepine‐CR) reported treatment‐emergent adverse events (TEAEs), most commonly (≥10%) headache, dizziness, and fatigue (carbamazepine‐CR: headache, dizziness). A numerically higher proportion of patients on lacosamide than carbamazepine‐CR completed 6 months (22 [81.5%]; 20 [58.8%]) and 12 months (18 [66.7%]; 17 [50.0%]) treatment without seizure at last evaluated dose. In the conversion to monotherapy trial, 26/30 (86.7%) patients with CVEE reported TEAEs, most commonly (≥4 patients) dizziness, convulsion, fatigue, headache, somnolence, and cognitive disorder. During lacosamide monotherapy, 17 (56.7%) patients were 50% responders and six (20.0%) were seizure‐free. In the observational study, 36/83 (43.4%) patients with CVEE reported TEAEs, most commonly (≥5%) fatigue and dizziness. Effectiveness was assessed for 75 patients. During the last 3 months, 60 (80%) were 50% responders and 42 (56.0%) were seizure‐free.
Conclusions: These exploratory post hoc analyses suggested lacosamide was generally well tolerated and effective in patients with CVEE, with data from the initial monotherapy trial suggesting numerically better efficacy than carbamazepine‐CR.
Objective: To explore and describe exposure to suicidality in healthcare providers (HCP) working with oncological patients. Special emphasis was put on five central aspects from the HCPs perspective: Exposure, Confidence, Expertise, Distress, and Education.
Methods: A 48‐item online questionnaire was developed and distributed to HCPs working with cancer patients. Three hundred fifty‐four answered questionnaires were analyzed.
Results: Overall 83.3% of HCPs reported to have encountered at least one suicidal patient in the last year. Feeling confident in talking about suicidality was reported by 72.1% of HCPs, with 71.2% of nurses reporting feeling insecure compared with only 5.1% of psychotherapists. Similarly, 22.3% of HCPs felt overwhelmed when confronted with a patient who substantiated his suicidality during consultation. A lack of personal knowledge concerning suicidality in general and in oncological patients in particular, was reported by 39.6% and 49.8%, respectively. In total, 88.1% of HCPs reported feeling distressed when confronted with suicidality, while 81.1% of participants wanted further education regarding suicidality in cancer patients despite that 73.2% had already received some sort of psycho‐oncology education.
Conclusions: Despite the well‐documented fact of elevated suicide rates in cancer patients, there remain deficits in knowledge, which induce feelings of insecurity and helplessness in HCPs. There is a demand for further education concerning the treatment of suicidal cancer patients. Therefore, special curricula addressing this topic should be devised. A general debate about suicidality in cancer patients could help raise awareness of this problem and generate means of prevention.
The endemic argan woodlands cover large parts of South Morocco and create a characteristic landscape with areas of sparsely vegetated and bare soil surfaces between single trees. This unique ecosystem has been under extensive agrosilvopastoral management for centuries and is now at risk of degradation caused by overgrazing and increasing scarcity and variability of rainfall.
To investigate susceptibility to wind erosion, we conducted an experimental–empirical study including wind tunnel tests and a drone‐generated digital elevation model and quantified wind‐erodible material on five different associated surface types by means of sediment catchers. The highest emission flux was measured on freshly ploughed surfaces (1875 g m–2 h–1), while older ploughed areas with a re‐established crust produced a much lower emission flux (795 g m–2 h–1). Extensive tillage may have been a sustainable practice for generations, but increasing drought and uncertainty of rainfall now lead to an acute risk of severe soil erosion and dust production. The typical crusted surfaces characterized by residual rock fragment accumulation and wash processes produced the second highest emission flux (1,354 g m–2 h–1). Material collected from tree‐shaded areas (933 g m–2 h–1) was revealed to be a considerable source of organic material, possibly affecting substrate conditions positively on a larger regional scale. The lowest flux was measured on rock fragment‐covered surfaces (301 g m–2 h–1).
The data show that open argan woodland may be a considerable source for wind erosion and dust production, depending on surface characteristics strongly related to management. An adapted management must include the conservation of argan trees to offer a promising approach to prevent severe wind erosion and dust production and mitigate possible impacts of land‐use change and climate change related shifts in wind and rainfall patterns.
Recently, photochromic derivatives of nucleobases have drawn attention for regulating oligonucleotide hybridization with light for photopharmacological applications. The nucleobase moiety provides attractive interaction for hybridization, whereas the photochromic moiety can alter the interaction upon irradiation due to conformational changes. Herein we report the synthesis of 2‐phenyldiazenyl‐substituted 2’‐deoxyadenosine (dAAzo) and 2’‐deoxyguanosine (dGAzo) and investigate their influence in a DNA context by UV/Vis absorption, fluorescence and CD spectroscopies. For comparison, the literature‐known azobenzene C‐nucleoside DNAzo was used as a reference system. It could be shown that photochromic purines improve overall hybridization affinity compared to azobenzene C‐nucleosides. In particular, 2’‐deoxyadenosine analogue dAAzo increases melting temperatures by 7.5 °C in the favored trans state with 86 % of the switching efficiency of the reference system.
Type 1 diabetes (T1D) is mainly precipitated by the destruction of insulin-producing β-cells in the pancreatic islets of Langerhans by autoaggressive T cells. The etiology of the disease is still not clear, but besides genetic predisposition the exposure to environmental triggers seems to play a major role. Virus infection of islets has been demonstrated in biopsies of T1D patients, but there is still no firm proof that such an infection indeed results in islet-specific autoimmunity. However, virus infection results in a local inflammation with expression of inflammatory factors, such as cytokines and chemokines that attract and activate immune cells, including potential autoreactive T cells. Many chemokines have been found to be elevated in the serum and expressed by islet cells of T1D patients. In mouse models, it has been demonstrated that β-cells express chemokines involved in the initial recruitment of immune cells to the islets. The bulk load of chemokines is however released by the infiltrating immune cells that also express multiple chemokine receptors. The result is a mutual attraction of antigen-presenting cells and effector immune cells in the local islet microenvironment. Although there is a considerable redundancy within the chemokine ligand-receptor network, a few chemokines, such as CXCL10, seem to play a key role in the T1D pathogenesis. Studies with neutralizing antibodies and investigations in chemokine-deficient mice demonstrated that interfering with certain chemokine ligand-receptor axes might also ameliorate human T1D. However, one important aspect of such a treatment is the time of administration. Blockade of the recruitment of immune cells to the site of autoimmune destruction might not be effective when the disease process is already ongoing. By that time, autoaggressive cells have already arrived in the islet microenvironment and a blockade of migration might even hold them in place leading to accelerated destruction. Thus, an anti-chemokine therapy makes most sense in situations where the cells have not yet migrated to the islets. Such situations include treatment of patients at risk already carrying islet-antigen autoantibodies but are not yet diabetic, islet transplantation recipients, and patients that have undergone a T cell reset as occurring after anti-CD3 antibody treatment.
Safety requirements and the need of low‐migration UV inks have received increasing attention in the packaging industry. Crucial for the development and design of low‐migration UV inkjet inks for migration‐sensitive applications is the polymerization degree. In this study, curing‐behavior of a black, high purity packaging ink (HPP‐ink) was monitored using ATR‐FTIR spectroscopy. UV irradiation of HPP‐ink led to changes in specific absorption bands of the FTIR spectra due to crosslinking reaction of double bonds. Changes in absorptions bands at 1,408 and 1,321 cm−1 permitted the determination of CC conversion of acrylic and vinyl double bond, independently of one another. In addition, a method was developed which allows the investigation of surface‐cure and deep‐cure behavior, separately.
Hofstadter-Hubbard physics
(2020)
The Hofstadter model, besides the Haldane and Kane-Mele models, is the most common tight-binding model which hosts topologically nontrivial states of matter. In its time-reversal-symmetric formulation the model can even describe topological insulators. Experimentally, the Hofstadter model was realized with ultracold quantum gases in optical lattices which is a wellcontrolled way to engineer quantum states of tight-binding Hamiltonians. Another established control parameter in ultracold quantum gases are twoparticle, on-site interactions, also known as Hubbard interactions. This work aims at introducing the reader to the concepts of topological states of matter, a collection of corresponding tight-binding models, and the methodology to treat interacting topological states with dynamical mean-field theory.We present recent results for inhomogeneous, interacting systems, spinimbalanced magnetic systems, propose experimental detection methods, and extensions to three-dimensional topological states.
Objective: Children with pre-school asthma suffer disproportionally more often from severe asthma exacerbations with emergency visits and hospital admissions compared to school children. Despite this high disease burden, there are only a few reports looking at this particular severe asthma cohort. Similarly, there is little real-life research on the distribution of asthma phenotypes and personalized treatment at discharge in this age group. Patients and Methods: Retrospective analysis of the electronic charts of all children aged 1–5 years with asthma hospitalizations (ICD J45) at the Frankfurt University between 2008 and 2017. An acute severe asthma exacerbation was defined as dyspnea, oxygen demand, and/or systemic steroid therapy. Age, gender, duration of hospitalization, asthma phenotype, treatment, and readmission rate were analyzed. Results: Of 572 patients, 205 met the definition of acute severe asthma. The phenotypic characterization showed 56.1% had allergic asthma, 15.2% eosinophilic asthma and 28.7% non-allergic asthma. Of these patients, 71.7% were discharged with inhaled corticosteroids (ICS) or ICS + long-acting-beta-agonists (LABA), 15.1% with leukotriene antagonists (LTRA) and 7.3% salbutamol on demand. The rate of emergency presentations (emergency department and readmission) within 12 months after discharge was high (n = 42; 20.5%). No phenotype tailored treatment was detectable. Neither the number of eosinophils (>300/μl) nor the treatment at discharge had an effect on emergency visits and readmission rate. Conclusion: Despite protective therapy with ICS, ICS + LABA, or LTRA, the readmission rate was high. Thus, current care and treatment strategies should be reevaluated continuously, in order to better control asthma in pre-school children and prevent hospitalization.
This study examined age‐related differences in the effectiveness of two generative learning strategies (GLSs). Twenty‐five children aged 9–11 and 25 university students aged 17–29 performed a facts learning task in which they had to generate either a prediction or an example before seeing the correct result. We found a significant Age × Learning Strategy interaction, with children remembering more facts after generating predictions rather than examples, whereas both strategies were similarly effective in adults. Pupillary data indicated that predictions stimulated surprise, whereas the effectiveness of example‐based learning correlated with children’s analogical reasoning abilities. These findings suggest that there are different cognitive prerequisites for different GLSs, which results in varying degrees of strategy effectiveness by age.
Photochemical internalization (PCI) is a technology to induce a localized, intracellular enhancement of therapeutics that are processed through endosomal pathways, including gemcitabine in malignant cells. In addition to a direct phototoxic and tumoricidal effect, PCI specifically disrupts endosomal membranes and, thereby, the compartmentalization of certain cytotoxic compounds to enhance a drug’s intended intracellular target reach within the tissue treated.
Non-resectable extrahepatic cholangiocarcinoma (eCCA) is a common primary tumor and gemcitabine/cisplatin chemotherapy is widely considered standard of care for it. PCI is well suited as an endoscopic intervention, and clinical observations in three subjects participating in a phase I/IIa dose escalation safety trial are described. The trial included patients with perihilar, non-resectable CCA suitable for standard-of-care chemotherapy. Per protocol, a single endoscopic PCI procedure with gemcitabine was conducted at the initiation of standard gemcitabine/cisplatin therapy. Sixteen patients enrolled in the initial dose escalation phase of the trial, which later was extended to explore the safety of a second PCI procedure during chemotherapy.
While limited to a case series, the various clinical observations described here serve to illustrate the effects of localized, perihilar tumor targeting in appropriate patients by any safe methodology, including PCI. As previously indicated by clinical data using other localized treatment modalities, adding a directed, tumor-targeting treatment to systemic therapy to ameliorate the progressively expanding extrahepatic tumor burden can have important effects on the overall outcome of systemic treatment in many patients who have incurable eCCA.
A novel, broad-acting peptide inhibitor of double-stranded DNA virus gene expression and replication
(2020)
Viral infections are a global disease burden with only a limited number of antiviral agents available. Due to newly emerging viral pathogens and increasing occurrence of drug resistance, there is a continuous need for additional therapeutic options, preferably with extended target range. In the present study, we describe a novel antiviral peptide with broad activity against several double-stranded DNA viruses. The 22-mer peptide TAT-I24 potently neutralized viruses such as herpes simplex viruses, adenovirus type 5, cytomegalovirus, vaccinia virus, and simian virus 40 in cell culture models, while being less active against RNA viruses. The peptide TAT-I24 therefore represents a novel and promising drug candidate for use against double-stranded DNA viruses.
Particulate autogenous tooth roots are used for alveolar bone augmentation surgery; however, dental plaque may provoke an inflammatory response that may counteract the desired graft consolidation process. Traditional mechanical cleaning of extracted teeth may be of support to lower a possible inflammatory response of the autograft. To test this assumption, extracted porcine teeth were left either uncleaned or underwent mechanical cleaning with a toothbrush and toothpaste before being fragmented and subjected to acid lysis, termed as unclean acid dentine lysate (ucADL) and clean acid dentine lysate (cADL), respectively. The inflammatory responses of murine macrophage RAW 264.7 cells being exposed to the respective acid dentine lysates were evaluated at the level of inflammatory gene expression and IL6 immunoassays. We report here that acid lysates obtained from uncleaned teeth provoked a robust increase in IL1β, IL6, and COX2 in RAW 264.7 cells. The mechanical removal of dental plaque significantly reduced the inflammatory response. Consistently, Limulus tests revealed that tooth cleaning lowers the presence of endotoxins in dentine lysates. To further prove the involvement of endotoxins, a toll-like receptor 4 (TLR4) inhibitor TAK242 was introduced. TAK242 abolished the inflammatory response provoked by acid lysates obtained from uncleaned teeth in RAW 264.7 cells. Moreover, nuclear translocation and phosphorylation of the TLR4 downstream NFκB-p65 were attenuated at the presence of cleaned versus uncleaned dentine lysates. Taken together, our data support the importance of dental plaque removal of teeth being extracted for alveolar bone augmentation surgery.
Volatility clustering and fat tails are prominently observed in financial markets. Here, we analyze the underlying mechanisms of three agent-based models explaining these stylized facts in terms of market instabilities and compare them on empirical grounds. To this end, we first develop a general framework for detecting tail events in stock markets. In particular, we introduce Hawkes processes to automatically identify and date onsets of market turmoils which result in increased volatility. Second, we introduce three different indicators to predict those onsets. Each of the three indicators is derived from and tailored to one of the models, namely quantifying information content, critical slowing down or market risk perception. Finally, we apply our indicators to simulated and real market data. We find that all indicators reliably predict market events on simulated data and clearly distinguish the different models. In contrast, a systematic comparison on the stocks of the Forbes 500 companies shows a markedly lower performance. Overall, predicting the onset of market turmoils appears difficult, yet, over very short time horizons high or rising volatility exhibits some predictive power.
A realistic simulation of the atmospheric boundary layer (ABL) depends on an accurate representation of the land–atmosphere coupling. Land surface temperature (LST) plays an important role in this context and the assimilation of LST can lead to improved estimates of the boundary layer and its processes. We assimilated synthetic satellite LST retrievals derived from a nature run as truth into a fully coupled, state‐of‐the‐art land–atmosphere numeric weather prediction model. As assimilation system a local ensemble transform Kalman filter was used and the control vector was augmented by the soil temperature and humidity. To evaluate the concept of the augmented control vector, two‐day case‐studies with different control vector settings were conducted for clear‐sky periods in March and August 2017. These experiments with hourly LST assimilation were validated against the nature run and overall, the RMSE of atmospheric and soil temperature of the first‐guess (and analysis) were reduced. The temperature estimate of the ABL was particularly improved during daytime as was the estimate of the soil temperature during the whole diurnal cycle. The best impact of LST assimilation on the soil and the ABL was achieved with the augmented control vector. Through the coupling between the soil and the atmosphere, the assimilation of LST can have a positive impact on the temperature forecast of the ABL even after 15 hr because of the memory of the soil. These encouraging results motivate further work towards the assimilation of real satellite LST retrievals.
The Ebola virus (EBOV) can cause severe infections in humans, leading to a fatal outcome in a high percentage of cases. Neutralizing antibodies against the EBOV surface glycoprotein (GP) can prevent infections, demonstrating a straightforward way for an efficient vaccination strategy. Meanwhile, many different anti‐EBOV antibodies have been identified, whereas the exact binding epitopes are often unknown. Here, the analysis of serum samples from an EBOV vaccine trial with the recombinant vesicular stomatitis virus‐Zaire ebolavirus (rVSV‐ZEBOV) and an Ebola virus disease survivor, using high‐density peptide arrays, is presented. In this proof‐of‐principle study, distinct IgG and IgM antibodies binding to different epitopes of EBOV GP is detected: By mapping the whole GP as overlapping peptide fragments, new epitopes and confirmed epitopes from the literature are found. Furthermore, the highly selective binding epitope of a neutralizing monoclonal anti‐EBOV GP antibody could be validated. This shows that peptide arrays can be a valuable tool to study the humoral immune response to vaccines in patients and to support Ebola vaccine development.
Hepatocellular carcinoma (HCC) is highly resistant to anticancer therapy and novel therapeutic strategies are needed. Chronotherapy may become a promising approach because it may improve the efficacy of antimitotic radiation and chemotherapy by considering timing of treatment. To date little is known about time‐of‐day dependent changes of proliferation and DNA damage in HCC. Using transgenic c‐myc/transforming growth factor (TGFα) mice as HCC animal model, we immunohistochemically demonstrated Ki67 as marker for proliferation and γ‐H2AX as marker for DNA damage in HCC and surrounding healthy liver (HL). Core clock genes (Per1, Per2, Cry1, Cry2, Bmal 1, Rev‐erbα and Clock) were examined by qPCR. Data were obtained from samples collected ex vivo at four different time points and from organotypic slice cultures (OSC). Significant differences were found between HCC and HL. In HCC, the number of Ki67 immunoreactive cells showed two peaks (ex vivo: ZT06 middle of day and ZT18 middle of night; OSC: CT04 and CT16). In ex vivo samples, the number of γ‐H2AX positive cells in HCC peaked at ZT18 (middle of the night), while in OSC their number remained high during subjective day and night. In both HCC and HL, clock gene expression showed a time‐of‐day dependent expression ex vivo but no changes in OSC. The expression of Per2 and Cry1 was significantly lower in HCC than in HL. Our data support the concept of chronotherapy of HCC. OSC may become useful to test novel cancer therapies.
Analogical reasoning by comparison is considered a special case of inductive reasoning, which is fundamental to the scientific method. By reasoning analogically, learners can abstract the underlying commonalities of several entities, thereby ignoring single objects’ superficial features. We tested whether different task environments designed to trigger analogical reasoning by comparison would support preschoolers’ induction of the concept of material kind to predict and explain objects’ floating or sinking as a central aspect of scientific reasoning. Specifically, in two experiments, we investigated whether the number of presented objects (one versus two standards), consisting of a specific material and the labeling of objects with the respective material name, would benefit preschoolers’ material-based inferences. For each item set used in both experiments, we asked the children (N = 59 in Experiment 1, N = 99 in Experiment 2) to predict an object’s floating or sinking by matching it to the standards and to verbally explain their selections. As expected, we found a significant effect for the number of standards in both experiments on the prediction task, suggesting that children successfully induced the relevance of material kind by comparison. However, labels did not increase the effect of the standards. In Experiment 2, we found that the children could transfer their conceptual knowledge on material kind but that transfer performance did not differ among the task environments. Our findings suggest that tasks inviting analogical reasoning by comparison with two standards are useful for promoting young children’s scientific reasoning.
Background: To volumetrically assess the bone microstructure following vertical alveolar ridge augmentation using differently conditioned autogenous tooth roots (TR) and second‐stage implant placement.
Materials and methods: The upper premolars were bilaterally extracted in n = 4 beagle dogs and randomly assigned to either autoclavation (TR‐A) or no additional treatment (TR‐C). Subsequently, TR were used as block grafts for vertical alveolar ridge augmentation in both lower quadrants. At 12 weeks, titanium implants were inserted and left to heal 3 weeks. Microcomputed tomography was used to quantify bone volume per tissue volume (BV/TV), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp) at vestibular (v) and oral (o) aspects along the implant and in the augmented upper half of the implant, respectively.
Results: Median BV/TV [TR‐C: 51.33% (v) and 70.42% (o) vs TR‐A: 44.05% (v) and 64.46% (o)], Tb.th [TR‐C: 0.22 mm (v) and 0.27 mm (o) vs TR‐A: 0.23 mm (v) and 0.29 mm (o)] and Tb.Sp [TR‐C: 0.26 mm (v) and 0.13 mm (o) vs TR‐A: 0.29 μm (v) and 0.15 mm (o)] values were comparable in both groups.
Conclusion: Both TR‐C and TR‐A grafts were associated with a comparable bone microstructure within the grafted area.
Sphingosine‐1‐phosphate lyase 1 (S1P lyase or SGPL1) is an essential sphingosine‐1‐phosphate‐degrading enzyme. Its manipulation favors onset and progression of colorectal cancer and others in vivo. Thus, SGPL1 is an important modulator of cancer initiation. However, in established cancer, the impact of retrospective SGPL1 modulation is elusive. Herein, we analyzed how SGPL1 siRNA affects malignancy of the human colorectal cancer cells DLD‐1 and found that in parallel to the reduction of SGPL1 expression levels, migration, invasion, and differentiation status changed. Diminished SGPL1 expression was accompanied with reduced cell migration and cell invasion in scratch assays and transwell assays, whereas metabolic activity and proliferation was not altered. Decreased migration was attended by increased cell–cell‐adhesion through upregulation of E‐cadherin and formation of cadherin‐actin complexes. Spreading cell islets showed lower vimentin abundance in border cells. Furthermore, SGPL1 siRNA treatment induced expression of epithelial cell differentiation markers, such as intestinal alkaline phosphatase and cytokeratin 20. Hence, interference with SGPL1 expression augmented a partial redifferentiation of colorectal cancer cells toward normal colon epithelial cells. Our investigation showed that SGPL1 siRNA influenced tumorigenic activity of established colorectal cancer cells. We therefore suggest SGPL1 as a target for lowering malignant potential of already existing cancer.
Hypersensitivity reactions to non‐steroidal anti‐inflammatory drugs (NSAIDs) – a retrospective study
(2020)
Background: The aim of this study was to verify the validity of clinical history and oral provocation challenges of patients with NSAID hypersensitivity and to identify safe alternatives. The COX‐2 inhibitor etoricoxib, in particular, was studied.
Patients and methods: In all, 104 patients with confirmed diagnoses of NSAID hypersensitivity treated at the Department of Dermatology, Frankfurt University Hospital, Germany between 2004 and 2012 were retrospectively studied.
Results: The medical history and hypersensitivity symptoms during oral provocation testing (OPT) largely coincided and were mostly mild to moderate. Acetylsalicylic acid (ASA) was the most frequent trigger both anamnestically (27.9 %) and during OPT (47.8 %). Etoricoxib caused the fewest reactions during OPT (4.2 %). Acetaminophen led to reactions in only 6.7 % of the cases studied although it was named more often in clinical histories (14 %).
Conclusions: OPT should be the aim whenever possible as most symptoms are mild to moderate. To distinguish between selective and cross‐hypersensitivity reactions, ASA should be part of the test protocol. Furthermore, the findings of this study indicate that etoricoxib and acetaminophen are safe treatment alternatives in case of NSAID hypersensitivity. However, these drugs should not be administered without prior OPT in an inpatient setting, as severe symptoms can occur.
Background: The present study aimed to assess the three‐dimensional changes following soft tissue augmentation using free gingival grafts (FGG) at implant sites over a 3‐month follow‐up period.
Methods: This study included 12 patients exhibiting deficient keratinized tissue (KT) width (i.e., <2 mm) at the vestibular aspect of 19 implants who underwent soft tissue augmentation using FGG at second stage surgery following implant placement. Twelve implants were considered for the statistical analysis (n = 12). The region of interest (ROI) was intraorally scanned before surgery (S0), immediately post‐surgery (S1), 30 (S2) and 90 (S3) days after augmentation. Digital scanned files were used for quantification of FGG surface area (SA) and converted to standard tessellation language (STL) format for superimposition and evaluation of thickness changes between the corresponding time points. FGG shrinkage (%) in terms of SA and thickness was calculated between the assessed time points.
Results: Mean FGG SA amounted to 91 (95% CI: 63 to 119), 76.2 (95% CI: 45 to 106), and 61.3 (95% CI: 41 to 81) mm2 at S1, S2, and S3, respectively. Mean FGG SA shrinkage rate was 16.3% (95% CI: 3 to 29) from S1 to S2 and 33% (95% CI: 19 to 46) from S1 to S3. Mean thickness gain from baseline (S0) to S1, S2, and S3 was 1.31 (95% CI: 1.2 to 1.4), 0.82 (95% CI: 0.5 to 1.12), and 0.37 (0.21 to 0.5) mm, respectively. FGG thickness shrinkage was of 38% (95% CI: 17.6 to 58) from S1 to S2 and 71.8% (95% CI: 60 to 84) from S1 to S3. Dimensional changes from S1 to S3 were statistically significant, P <0.017. Soft tissue healing was uneventful in all patients.
Conclusions: The present three‐dimensional assessment suggests that FGG undergo significant dimensional changes in SA and thickness over a 3‐month healing period.
Purpose: Surgery of KOOS IV vestibular schwannoma remains challenging regarding the balance of extent of tumor resection (EoR) and functional outcome. Our aim was to evaluate the outcome of surgical resection and define a cut-off value for safe resection with low risk for tumor regrowth of KOOS IV vestibular schwannoma.
Methods: All patients presenting at the authors’ institution between 2000 and 2019 with surgically treated KOOS IV vestibular schwannoma were included. Outcome measures included EoR, facial/hearing nerve function, surgical complications and progression of residual tumor during the median follow-up period of 28 months.
Results: In 58 patients, mean tumor volume was 17.1 ± 9.2 cm3, and mean EoR of 81.6 ± 16.8% could be achieved. Fifty-one patients were available for the follow-up analysis. Growth of residual tumor was observed in 11 patients (21.6%) followed by adjuvant treatment with stereotactic radiosurgery or repeat surgery in 15 patients (29.4%). Overall serviceable hearing preservation was achieved in 38 patients (74.5%) and good facial outcome at discharge was observed in 66.7% of patients, significantly increasing to 82.4% at follow-up. Independent predictors for residual tumor growth was EoR ≤ 87% (OR11.1) with a higher EoR being associated with a very low number of residual tumor progression amounting to 7.1% at follow-up (p=0.008).
Conclusions: Subtotal tumor resection is a good therapeutic concept in patients with KOOS IV vestibular schwannoma resulting in a high rate of good hearing and facial nerve function and a very low rate of subsequent tumor progression. The goal of surgery should be to achieve more than 87% of tumor resection to keep residual tumor progression low.
Respiratory chain signalling is essential for adaptive remodelling following cardiac ischaemia
(2020)
Cardiac ischaemia‐reperfusion (I/R) injury has been attributed to stress signals arising from an impaired mitochondrial electron transport chain (ETC), which include redox imbalance, metabolic stalling and excessive production of reactive oxygen species (ROS). The alternative oxidase (AOX) is a respiratory enzyme, absent in mammals, that accepts electrons from a reduced quinone pool to reduce oxygen to water, thereby restoring electron flux when impaired and, in the process, blunting ROS production. Hence, AOX represents a natural rescue mechanism from respiratory stress. This study aimed to determine how respiratory restoration through xenotopically expressed AOX affects the re‐perfused post‐ischaemic mouse heart. As expected, AOX supports ETC function and attenuates the ROS load in post‐anoxic heart mitochondria. However, post‐ischaemic cardiac remodelling over 3 and 9 weeks was not improved. AOX blunted transcript levels of factors known to be up‐regulated upon I/R such as the atrial natriuretic peptide (Anp) whilst expression of pro‐fibrotic and pro‐apoptotic transcripts were increased. Ex vivo analysis revealed contractile failure at nine but not 3 weeks after ischaemia whilst label‐free quantitative proteomics identified an increase in proteins promoting adverse extracellular matrix remodelling. Together, this indicates an essential role for ETC‐derived signals during cardiac adaptive remodelling and identified ROS as a possible effector.
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.
Aims: Preventing hospitalization by detecting early evidence of heart failure (HF) decompensation in an outpatient setting can improve patient's quality of life and reduce costs of care. The purpose of this study was to assess the value of cardiac acoustic biomarkers (CABs), a combination of cardiohaemic vibrations synchronized with ECG signals, and heart rate (HR) for detecting HF decompensation during first 3 months after hospital discharge for HF.
Methods and results: Patients with an ejection fraction ≤35% (HFrEF) and hospitalized for decompensated HF were enrolled in a prospective observational study. All subjects wore a wearable cardioverter‐defibrillator (ZOLL LifeVest®, Pittsburgh, PA, USA) that is capable of recording CABs and HR. The primary endpoint of the study was the first HF event, defined as HF readmission or HF emergency room visit. From June 2017 through August 2019, 671 patients with HFrEF were enrolled. Eighty‐one patients (12.1%) had a total of 112 HF events. The algorithm detected HF events with a median of 32 days (interquartile range = 11‐45) in advance of the first HF event. The algorithm had a sensitivity of 69%, specificity of 60%, positive predictive value of 19%, and a negative predictive value of 94%. Of note, the baseline (first 7 days post‐enrolment) algorithm using CABs and HR was superior to New York Heart Association classification in detecting patients more likely to have HF decompensation (sensitivity and specificity of 61% and 68% vs. 46% and 55%, respectively).
Conclusions: This prospective international registry showed that an algorithm incorporating CABs and HR data detected HF events 30 days in advance of the event in patients with HFrEF during first 3 months after hospital discharge. Therefore, integrating CAB technology into clinical practice may prevent HF rehospitalizations.
Large carnivores often impact human livelihoods and well‐being. Previous research has mostly focused on the negative impacts of large carnivores on human well‐being but has rarely considered the positive aspects of living with large carnivores. In particular, we know very little on people's direct experiences with large carnivores like personal encounters and on people's awareness and tolerance toward their exposure to large carnivores. Here, we focus on the wolf (Canis lupus), and report on a phone survey in Germany. We examined whether encounters with wolves were positive or negative experiences and quantified people's awareness and tolerance related to their exposure to wolves. We found that the majority of people reported positive experiences when encountering wolves, regardless of whether wolves were encountered in the wild within Germany, in the wild abroad, or in captivity. The frequency of encounters did not affect the probability to report positive, neutral, or negative experiences. Moreover, people in Germany expressed a high tolerance of living in close vicinity to wolves. These findings are novel and important because they highlight the positive aspects of living in proximity with large carnivores in human‐dominated landscapes.
Central cholinergic function and metabolic changes in streptozotocin‐induced rat brain injury
(2020)
As glucose hypometabolism in the brain is an early sign of Alzheimer´s dementia (AD), the diabetogenic drug streptozotocin (STZ) has been used to induce Alzheimer‐like pathology in rat brain by intracereboventricular injection (icv‐STZ). However, many details of the pathological mechanism of STZ in this AD model remain unclear. Here, we report metabolic and cholinergic effects of icv‐STZ using microdialysis in freely moving animals. We found that icv‐STZ at a dose of 3 mg/kg (2 × 1.5 mg/kg) causes overt toxicity reflected in body weight loss. Three weeks after STZ administration, histological examination revealed a high number of glial fibrillary acidic protein reactive cells in the hippocampus, accompanied by Fluoro‐Jade C‐positive cells in the CA1 region. Glucose and lactate levels in microdialysates were unchanged, but mitochondrial respiration measured ex vivo was reduced by 9%–15%. High‐affinity choline uptake, choline acetyltransferase, and acetylcholine esterase (AChE) activities in the hippocampus were reduced by 16%, 28%, and 30%, respectively. Importantly, extracellular acetylcholine (ACh) levels in the hippocampus were unchanged and responded to behavioral and pharmacological challenges. In comparison, extracellular ACh levels and cholinergic parameters in the striatum were unchanged or slightly increased. We conclude that the icv‐STZ model poorly reflects central cholinergic dysfunction, an important characteristic of dementia. The icv‐STZ model may be more aptly described as an animal model of hippocampal gliosis.
The digital and information age has fundamentally transformed the way in which students learn and the study material they have at their disposal, especially in higher education. Students need to possess a number of higher-order cognitive and metacognitive skills, including effective information processing and critical reasoning to be able to navigate the Internet and use online sources, even those found outside of academically curated domains and in the depths of the Internet, and to solve (domain-specific) problems. Linking qualitative and quantitative research and connecting the humanities to empirical educational science studies, this article investigates the role of narratives and their impact on university students’ information seeking and their critical online reasoning (COR). This study focuses on the link between students’ online navigation skills, information seeking behavior and critical reasoning with regard to the specific domains: economics and medicine. For the empirical analysis in this article, we draw on a study that assesses the COR skills of undergraduate students of economics and medicine at two German universities. To measure COR skills, we used five tasks from the computer-based assessment “Critical Online Reasoning Assessment” (CORA), which assesses students’ skills in critically evaluating online sources and reasoning using evidence on contentious issues. The conceptual framework of this study is based on an existing methodology – narrative economics and medicine – and discusses its instructional potential and how it can be used to develop a new tool of “wise interventions” to enhance students’ COR in higher education. Based on qualitative content analyses of the students’ written responses, i.e., short essays, three distinct patterns of information seeking behavior among students have been identified. These three patterns – “Unambiguous Fact-Checking,” “Perspective-Taking Without Fact-Checking,” and “Web Credibility-Evaluating” – differ substantially in their potential connection to underlying narratives of information used by students to solve the CORA tasks. This analysis suggests that training university students in narrative analysis can strongly contribute to enhancing their critical online reasoning.
Despite the great interest in glycoproteins, structural information reporting on conformation and dynamics of the sugar moieties are limited. We present a new biochemical method to express proteins with glycans that are selectively labeled with NMR‐active nuclei. We report on the incorporation of 13C‐labeled mannose in the C‐mannosylated UNC‐5 thrombospondin repeat. The conformational landscape of the C‐mannose sugar puckers attached to tryptophan residues of UNC‐5 is characterized by interconversion between the canonical 1C4 state and the B03 / 1S3 state. This flexibility may be essential for protein folding and stabilization. We foresee that this versatile tool to produce proteins with selectively labeled C‐mannose can be applied and adjusted to other systems and modifications and potentially paves a way to advance glycoprotein research by unravelling the dynamical and conformational properties of glycan structures and their interactions.
In der vorliegenden Untersuchung wurde das bovine, Hydroxylapatit-basierte, Knochenersatzmaterial Hypro-Oss® zunächst ex vivo überprüft, anschließend subkutan in den interskapulären Bereich von 12 weiblichen Wistar-Ratten (Testgruppe) eingebracht; bei 12 weiteren Tieren erfolgte eine Sham-Operation ohne Einbringung von Biomaterial (Kontrollgruppe). Anschließend wurde die Gewebereaktion über 30 Tage beobachtet und die Explantate jeweils nach Tag 3, 15 und 30 histologisch und histomorphometrisch untersucht.
Die histologische Analyse zeigte innerhalb des Beobachtungszeitraums von 30 Tagen eine störungsfreie Eingliederung der Hypro-Oss®-Granula in das umliegende Gewebe. Bereits 3 Tage nach Einbringung des Biomaterials waren mononukleäre Zellen erkennbar, die bis Tag 30 weiter zunahmen. Ab diesem Zeitpunkt zeigten sich auch TRAP-positive, CD-68-negative Multinukleäre Zellen, die das Ergebnis einer Fusion von Makrophagen sind und eine Fremdkörperreaktion indizierten. Nach 30 Tagen zeigten sich die Granula histologisch stabil integriert ohne Anzeichen einer immunologischen Abstoßungsreaktion.
Die CD-68-Expression der aufgefundenen Makrophagen und mehrkernigen Riesenzellen bildete ein Kriterium zur Unterscheidung der MNGCs von Osteoklasten, die ebenfalls mehrkernig sind, aber dieses Cluster of Differentiation nicht tragen. Dies charakterisiert die vorgefundenen MNGCs als Fremdkörper-Riesenzellen, da sie ebenso wie die pathologischen Riesenzellen vom Typ Langerhans CD-68 exprimieren.
Dieses Bild bestätigte sich für die Hypro-Oss®-Gruppe in der histomorphometrischen Betrachtung über eine kontinuierliche Zunahme von überwiegend CD-68-positiven Makrophagen bis zum Tag 30, während sie für die Kontrollgruppe über die gesamte Zeit rückläufig waren. Die Multinukleären Zellen erreichten dagegen bereits an Tag 15 ihren Höhepunkt, während in der Kontrollgruppe über den gesamten Beobachtungszeitraum erwartungsgemäß keine MNGCs gefunden wurden.
Der hoch signifikante Anstieg der MNGC-Zahl der Testgruppe bis Tag 15 korreliert positiv mit den Vaskularisationsdaten, was darauf hindeutet, dass die Multinukleären Zellen durch die Einbringung des Biomaterials induziert wurden und über die Sekretion des Signalmoleküls VEGF einen wesentlichen Faktor für die Blutgefäßbildung bilden.
Eine Auffälligkeit hat sich jedoch in Bezug auf das Alleinstellungsmerkmal von Hypro-Oss® gezeigt, welches bei der Aufreinigung nicht erhitzt wird. Diverse Studien haben einen Zusammenhang der Höhe der Sintertemperatur mit der Bildung von MNGCs nachgewiesen, wonach für Hypro-Oss® eine geringe Induzierung von MNGCs zu erwarten gewesen wäre als für vergleichbare, höher erhitzte bovine Knochenersatzmaterialien. Dagegen zeigten die Vaskularisationsdaten unserer Untersuchung für Hypro-Oss® im Vergleich zu 2 anderen bovinen Knochenersatzmaterialien (Bio-Oss® und BEGO OSS®) jedoch signifikant höhere Werte für die Blutgefäßbildung als dies aus der Korrelation von Sintertemperatur mit der Anzahl Multinukleärer Riesenzellen zu erwarten gewesen wäre.
Aufgrund der relativ kurzen Dauer der Beobachtung lassen sich keine belastbaren Ergebnisse in Bezug auf den zu erwartenden Materialabbau und die ossäre Integration von Hypro-Oss® feststellen, welche einer längerfristigen Analyse bedürften als es in dieser Untersuchung möglich war. Es gibt aber klinische Erfahrungsberichte23 hinsichtlich Handling, Heilungsverlauf und Materialintegration von Hypro-Oss® bei Sinusbodenelevation und Guided Bone Regeneration, die auch in der Langfristbetrachtung positive Ergebnisse zeigten. Offen bleibt, ob nicht eine physiologische Wundheilung nur mittels Makrophagen einer pathologischen Wundheilung unter Mitwirkung Multinukleärer Riesenzellen überlegen ist: zumindest robustere Knochenersatzmaterialien wie z.B. das hier untersuchte Hypro-Oss® scheinen dabei weniger sensibel auf Multinukleäre Riesenzellen zu reagieren.
Der Inhalt dieser Arbeit ist die Entwicklung und Evaluation einer mobilen Webanwendung für die Annotation von Texten. Dem Benutzer ist es durch diese Webanwendung, im folgenden auch MobileAnnotator genannt, möglich Wörter und Textausschnitte zu kategorisieren oder auch mit Wissensquellen, zum Beispiel Wikipedia, zu verknüpfen. Der MobileAnnotator ist dabei für mobile Endgeräte ausgelegt und insbesondere für Smartphones optimiert worden.
Für die Funktionalität verwendet der MobileAnnotator die Architektur des bereits existierenden und etablierten TextAnnotators. Dieser stellt bereits eine Vielzahl von Annotations Werkzeugen bereit, von denen zwei auf den MobileAnnotator übertragen wurden. Da der TextAnnotator vollständig für einen Desktopbetrieb ausgelegt wurde, ist es jedoch nicht möglich diese Werkzeuge ohne Anpassungen für ein mobiles Gerät umzubauen. Der MobileAnnotator beschränkt sich somit auf ein Mindestmaß an Funktionen dieser Werkzeuge um sie dem Benutzer in geeigneter Art und Weise verfügbar zu machen.
Für die Evaluation der Benutzerfreundlichkeit des MobileAnnotator und dessen Werkzeuge wurde anschließend eine Studie durchgeführt. Den Probanten war es innerhalb der Studie möglich Aussagen über die Bedienbarkeit des MobileAnnotators zu treffen und einen Vergleich zwischen dem Mobile- und TextAnnotator zu ziehen.
Acute lymphoblastic leukemia (ALL), a neoplastic disorder of blood cells of the lymphoid lineage, is the most frequent childhood cancer. In spite of increasing survival rates, the outcome for adults, infants or relapsed patients is still less favorable, highlighting the need for novel treatment options. Reactive oxygen species (ROS) are important signaling molecules that are involved in a variety of cellular pathways. As high ROS levels lead to oxidative stress and irreversible oxidation of cellular macromolecules, the production and elimination of ROS is tightly controlled. Therefore, cells express several antioxidant molecules and enzymes, including glutathione, catalase and the thioredoxin (Trx) system, to balance ROS levels. As cancer cells were found to have increased ROS levels that could contribute to tumor progression and metastasis, they rely strongly on these antioxidant systems to prevent oxidative damage, making cancer cells especially vulnerable to ROS-inducing treatments. ROS and oxidative stress have been shown to induce programmed cell death via different pathways, however the exact mechanisms that couples oxidative signaling and cell death is not completely understood.
As a disturbance of the cellular redox homeostasis was reported during leukemia development and progression, we wanted to determine the potential of Trx inhibitors for ALL therapy. Additionally, we aimed to further understand the role of ROS and subsequent protein oxidation in the induction and execution of programmed cell death.
First, we demonstrated that the Trx1 inhibitor PX-12 induced cell death in three ALL cell lines. Further analysis of the events leading to PX-12-induced cell death in FADD-deficient (FD) Jurkat cells revealed an increase in ROS levels and oxidation-mediated dimer formation of peroxiredoxin 3 (PRDX3). Interestingly cell death was inhibited by the thiol-containing antioxidant N-acetylcysteine (NAC), but not by non-thiol-containing ROS scavengers. PX-12 treatment further induced cleavage of caspase-9 and -3 and activation of the pro-apoptotic BCL-2 protein BAK, leading us to the conclusion that mitochondria-dependent apoptosis was induced. Interestingly, we could demonstrate an important role for the BH3-only protein NOXA in the mediation of PX-12-induced apoptosis as knock-down of NOXA prevented cell death induction and BAK activation. Our findings give novel insights into the mechanism of PX-12-induced cell death in ALL cell lines and underscores the potential of PX-12 for the treatment of ALL.
To further understand the processes leading to cell death upon inhibition of the Trx system, we analyzed global protein oxidation in Jurkat FD cells upon treatment with the Trx reductase inhibitor Auranofin. In line with previous results, Auranofin induced intrinsic apoptosis that was dependent on BAK and accompanied by increased ROS levels. Using a BIAM Switch Assay followed by mass spectrometry, we demonstrated that Auranofin treatment induced oxidation of over 200 proteins. We identified several proteins whose oxidation upon Auranofin treatment was expected, like Trx1, Trx2 and several peroxiredoxins. Additionally, we verified oxidation of APAF1-interacting protein (APIP) and protein arginine N-methyltransferase (PRMT1) that are both implicated in the regulation of apoptosis. With this analysis we were able to demonstrate that Auranofin treatment leads to changes in global protein oxidation. Whether oxidation of the determined proteins changes their functionality and contributes to apoptosis induction remains to be elucidated.
As we identified BAK as an important player in PX-12- and Auranofin-induced cell death in the previous parts of this study, we wanted to further understand its involvement in ROS-mediated cell death. First analyses in wild-type (WT) and BAK-/- murine embryonic fibroblasts (MEFs) revealed that BAK was essential for Auranofin-induced cell death and that this cell death was caspase-independent in MEFs. Interestingly, BAK oxidation was induced upon treatment with Auranofin, but not upon stimulation with the apoptosis-inducing compound Etoposide. Expression of mutated BAK, with either one or both oxidation-sensitive cysteines mutated to oxidation-insensitive serines, revealed that mutating already one cysteine protected cells from Auranofin , but not Etoposide-induced cell death. Of note, mutation of the BAK BH3 domain rescued MEFs from both, Auranofin- and Etoposide-mediated cell death. The presence of cysteine residues also altered BAK interactions as observed by a mass spectrometric analysis of Auranofin-treated MEFs expressing either WT or cysteine-less BAK. We identified interactions of WT BAK with proteins involved in mitochondrial fission and vesicle transport upon Auranofin treatment. Of note, interaction with proteins involved in apoptosis, like BAX or BCL-XL, was not changed between WT and cysteine-less BAK. Our results demonstrate a critical role for BAK oxidation in Auranofin-induced cell death. Furthermore, we identified novel oxidation-dependent BAK interaction partners.
To conclude, this study highlights the potential of ROS-inducing treatments for ALL therapy and provides novel insights into the redox regulation of programmed cell death.
Aufgrund der starken Heterogenität und Komplexität der akuten myeloischen Leukämie ist diese bis heute nicht zufriedenstellend zu behandeln. Die bestmögliche Therapie wird mittlerweile zunehmend auf die Erkrankung des Einzelnen angepasst. Vermehrt gewinnen Tyrosinkinase-Inhibitoren in der Therapie an Bedeutung. Diese Inhibitoren hemmen Proteine auf zellulärer Ebene.
Bei etwa 30% der AML-Patienten lassen sich Mutationen des FLT3-Gens nachweisen. Das Gen kodiert für die fms like tyrosine kinase 3, eine Rezeptor-Tyrosinkinase an der Zelloberfläche von unreifen Blutzellen des Knochenmarks. Durch Mutationen des FLT3 Gens erhalten diese Zellen einen Proliferationsvorteil gegenüber den physiologischen Blutzellen.
Am häufigsten kommt es zu in frame-Insertionen des FLT3-Gens, vor allem im Bereich der juxtamembranen Domäne: sogenannte interne Tandemduplikationen (ITD). Weiterhin kommen zu einem geringeren Teil Punktmutationen einzelner Codons, zum Beispiel im Bereich des activation loops oder im Bereich des gatekeepers vor. Durch das Auftreten der Punktmutationen, die entweder bereits zum Zeitpunkt der Diagnose vorliegen oder erst während einer Therapie mit einem Tyrosinkinase-Inhibitor entstehen können, verändert sich das Bindungsverhalten vieler solcher gegen FLT3 gerichteten Inhibitoren. Durch Letzteres kann ein mögliches Therapieversagen beispielsweise während der Behandlung mit AC220 (Quizartinib) erklärt werden (Smith et al.).
In der vorliegenden Dissertationsschrift sind Unterschiede der Signalwege zwischen FLT3-ITD und FLT3-ITD mit der zusätzlichen gatekeeper-Punktmutation F691L herausgearbeitet. Dafür wurden die beiden FLT3-Mutationen in den Vektor pMy-IRES-GFP eingebracht und retroviral in Ba/F3-Zellen transduziert. Nach Überprüfung der Expression von FLT3 ITD und dem Wachstumsverhalten unter Zugabe von AC220 (Quizartinib), wurden verschiedene Signalkaskaden von FLT3 mittels Western Blot untersucht. Hierbei zeigten sich sowohl Unterschiede für die Expression von phosphoryliertem ERK als auch von phosphoryliertem STAT5.
Durch verschieden starke Expressionen der FLT3130kDa- und FLT3160kDA-Varianten wurde eine unterschiedliche Lokalisation von FLT3-ITD in Zellen mit und ohne die Mutation F691L postuliert. Allerdings ließ sich diese experimentell mittels Immunfluoreszenz nicht belegen, da die Methode für die verwendeten Suspensionszellen nicht ausreichend geeignet war.
In den durchgeführten Versuchen zum Wachstumsverhalten der Zellen bei der Verwendung von Kinaseinhibitoren konnte bei der Verwendung des SYK-Inhibitors R406 eine dosisabhängige Proliferationshemmung der FLT3-ITD-mutierten Ba/F3- und 32D-Zellen beobachtet werden. Die Hemmung von FLT3 durch R406 wurde in der Literatur bereits beschrieben (Braselmann et al.).
Die abschließenden Experimente der Massenspektrometrie mit SILAC Markierung lassen mit der Detektion von mehreren hundert signifikant regulierten phosphorylierten Proteinen in den beiden FLT3-ITD-exprimierenden Populationen auf die Aktivierung unterschiedlicher Signalwege schließen. Durch das Vergleichen einzelner Teilexperimente ergaben sich Proteine, deren Phosphorylierung mehrfach in die gleiche Richtung reguliert war. Für Zellen, die zusätzlich zur ITD-Mutation die Mutation F691L besaßen, konnten insgesamt sieben hoch-regulierte, phosphorylierte Proteine ermittelt werden, bei denen ein zellulärer Effekt durch die Phosphorylierung der entsprechenden Aminosäurereste in der Literatur beschrieben ist.
Das im Western Blot nachgewiesene, in Zellen mit der Mutation F691L stärker phosphorylierte STAT5 ist aller Voraussicht nach Ursache der nachgewiesenen verstärkten Phosphorylierung von RPS6 im Experiment der globalen Phosphorylierung. Die PIM-Kinasen als Substrate einer STAT5-induzierten Transkription phosphorylieren RPS6 an Serin 235. Dies führt seinerseits zu einer verstärkten Translation von mRNA weiterer Gene. Die genauen Zusammenhänge der hier ermittelten Unterschiede müssen jedoch weiter untersucht werden.
In Zukunft könnte zudem die Untersuchung der beiden Proteine SHP 1 oder HSP90 weitere Aufschlüsse über die unterschiedlichen Signalwege geben. Für beide Proteine wurden Phosphorylierungen detektiert, die in den untersuchten Zellen mit FLT3-ITD bzw. der zusätzlichen Punktmutation F691L unterschiedlich reguliert sind.
Even one century after Santiago Ramón y Cajal’s groundbreaking contribu- tions to neuroscience, one of the most fundamental questions in the field is still largely open, namely understanding how the shape of a dendrite is adapted to its specific biological function. A systematic investigation of this problem is challenging both technically and conceptually because neurons have diverse genetic, molecular, morphological, connectional and functional properties.
In the light of the preceding, dendritic arborisation (da) neurons of the Drosophila melanogaster larva PNS have proven to be an excellent model system for the study of such growth and patterning processes. Structure and function in these cell classes are intimately intertwined, as class type-specific dendritic arbour differentiation processes are required to satisfy a given phys- iological need. Also, there is a remarkable genetic toolkit that enables one to selectively and reproducibly label, image and manipulate each one of these sensory neuron classes. In this thesis, I address the aforementioned open problem by linking single-cell patterning, information processing and wiring optimisation in sensory da neurons to behaviour in Drosophila larva.
In particular, I study Class I ventral peripherical dendritic arborisation (c1vpda) neurons. These are a class of proprioceptive neurons that relay information on the position of the larva’s body back to the CNS during crawling behaviour to assure proper locomotion. Their stereotypical comb- like shaped dendritic branches spread along the body-wall, and they get noticeably deformed during crawling behaviour. The bending of the den- dritic branches is hypothesised to be a possible mechanism to transduce the mechanosensory inputs arising from cuticle folding. Interestingly, c1vpda neurons do not necessarily satisfy optimal wiring constraints since they are required to pattern into a specific shape to fulfil their function. Therefore, I considered the da system to study how the specific functional requirements may be combined with optimal wiring constraints during development.
Although the molecular machinery of dendrite patterning in c1vpda neurons is well studied, the precise elaboration of the comb-like shaped dendrites of these cells remains elusive. Moreover, even though a lot of work has been put into the description and quantification of growth processes of the nervous system, there are still few solid and standardised models of arbour staging and patterning. Importantly, the defining parameters that determine the dendrite elaboration program that in turn is responsible for creating the final arbour morphology are still unknown. As a result, unraveling possible universal stages of dendrite elaboration shared between different model systems and cell types is challenging.
Thus, in order to understand the development of the fine regulation of branch outgrowth that leads to the observed terminal arbour morphology in the mature cell, I collected in vivo, long-term, non-invasive high temporal res- olution time-lapse recordings of dendritic trees during the differentiation process in the embryo and its maturation phase in the larva. For further analysis, I developed new algorithms that quantified the structural changes in dendrite morphology in the time-lapse videos. My approach provides a framework to analyse such developmental data, or any dataset comprising continuous morphological dynamical processes in an unbiased way. Using these newly developed methods, I examined the development of a sample of c1vpda cells and identified five stages of differentiation in these data: initial stem polarization, extension, pruning, stabilization, and isometric stretching during larval stages.
The beginning of the growth process is marked by the polarisation of the main stem. Subsequently, during the extension phase, branches emerge interstitially from the existing main stem. Later, higher-order branches sprout from pre-existing lateral branches, increasing arbour complexity. This is followed by a pruning stage where developmental intermediate dendritic branches are removed. This step leads to a spatial rearrangement of the dendritic tree. The end of the pruning step is followed by a stabilisation period where arbour morphology remains virtually unaltered in the embryo. After hatching, c1vpda dendrites experience an isometric scaling, with their branching complexity and pattern being invariant across all larval stages.
After dissecting the c1vpda dendrites spatiotemporal differentiation process, I established a link between dendritic shape and behaviour. I measured intra- cellular Ca++ activity in the dendrite branches of l1 larvae during forward locomotion, while simultaneously recording branch deformation using a dual genetic line. I reported that post-embryonic c1vpda dendrites Ca++ responses increased in freely crawling larvae. Furthermore, I showed strong correlations between Ca++ signal and deformation of the comb-like dendritic ranches during body-wall contractions.
Then, using a geometrical model, I provided evidence that the pruning stage could reorganise the dendrite morphology to maximise mechanosensory re- sponses during body wall contraction. I showed that the angle orientation of each side branch correlates with the bending curvature and thus with the me- chanical displacement of the cell membrane during locomotion. During the pruning phase, I observed a preferential reduction of less efficient branches with low bending curvature, influencing the mechanisms of dendritic sig- nal integration of c1vpda sensory neurons. I proceeded to quantify branch dynamics at single tip resolution during pruning, providing evidence that a simple random pruning mechanism is sufficient to remodel the tree structure compatible with the observed way.
I used these time-lapse data to constrain a new computational noisy growth model with random pruning based on optimal wiring principles. This model is able to generate highly realistic synthetic c1vpda morphologies. The model furthermore requires few parameters to generate highly accurate temporal development trajectories and morphologies at single-cell level. Utilising this data and model enabled me to investigate upon the hypothesis that a noisy dendrite growth and random pruning mechanism synergise to achieve den- dritic trees efficient in terms of both wiring and function. My findings show how single neurons can create functionally specialised dendrites while min- imising wiring costs, elucidating how general principles of self-organisation may be involved in the generation of these structures.
Hintergrund. Die Achtung der individuellen Autonomie ist eines von vier medizinethischen Prinzipien, das im Kontext von Medizin und Forschung insbesondere in Bezug auf die informierte Einwilligung einer Person thematisiert wird. Menschen mit Demenz können aufgrund innerer oder äußerer Faktoren in ihrer Einwilligungsfähigkeit beeinträchtigt sein, was zu einer Einschränkung ihres Rechts auf Selbstbestimmung führen kann. Im diesbezüglichen Spannungsfeld zwischen Fürsorge und Autonomie soll Entscheidungsassistenz zur Ermöglichung selbstbestimmter Entscheidungen beitragen.
Zielrichtung der Arbeit. Ziel der vorliegenden Dissertation ist die Definition, Implementierung und Evaluation von Entscheidungsassistenzmaßnahmen für Menschen mit Demenz, um deren Autonomie in Entscheidungsprozessen zu unterstützen. Drei Teilprojekte umfassen die Ermittlung des internationalen Forschungsstands zu Entscheidungsassistenz bei Demenz, die Definition und Pilotierung von Unterstützungstools in der Praxis und die Analyse des individuellen Erlebens der vereinfachten Aufklärungsgespräche durch Menschen mit Demenz.
Methode. Im ersten Teilprojekt wurde eine am PRISMA-Standard orientierte systematische Literaturrecherche in Medline und PsycINFO durchgeführt. Die extrahierten relevanten Informationen wurden inhaltlich systematisiert. Aufbauend auf diesen Ergebnissen wurden im zweiten Teilprojekt konkrete Unterstützungstools definiert und in reale Aufklärungsgespräche (Lumbalpunktion) implementiert. Die Tools wurden in der Pilotierung in der Praxis sowie in einem iterativen Diskussionsprozess mit Experten weiterentwickelt. Im dritten Teilprojekt wurde das individuelle Erleben der Teilnehmer der vereinfachten Aufklärungsgespräche mittels problemzentrierter Interviews untersucht und die Daten einer qualitativen Inhaltsanalyse unterzogen.
Ergebnisse. Die Datenbankrecherche ergab initial 2348 Treffer. Nach Screenings der Titel, Abstracts und Volltexte konnten 11 Artikel eingeschlossen werden. Vier der eingeschlossenen Studien sind Interventionsstudien, die übrigen sieben qualitative Interviewstudien. Die identifizierten Unterstützungsmaßnahmen wurden zunächst den beiden Kategorien Interventionen und Strategien und anschließend unter Zuhilfenahme des Konzepts des Contextual Consents fünf komplexitätssteigernden Dimensionen einer Entscheidungssituation zugeordnet (individuelle, soziale, medizinische, informationelle und Folgendimension). Darauf aufbauend wurden im zweiten Teilprojekt acht Entscheidungsassistenzmaßnahmen abgeleitet: (1) Gesprächsstruktur, (2) Elaborierte klare Sprache, (3) Ambiente / Raumgestaltung, (4) Stichwortlisten, (5) Prioritätenkarten, (6) Visualisierung, (7) Vereinfachte schriftliche Einverständniserklärung sowie (8) Personenzentrierte Haltung des Entscheidungsassistenten (1-7: Tools, 8: Grundeinstellung). Die Tools zielen überwiegend auf eine Komplexitätsreduktion in der informationellen Dimension unter Berücksichtigung der fähigkeitsbezogenen und der bedürfnisbezogenen individuellen Dimension ab. Durch Anpassungen der Informationsdarbietung oder der kommunikativen Interaktion im Gespräch dienen sie mehrheitlich der Förderung des (Informations-) Verständnisses. Die Analyse der qualitativen Daten im dritten Teilprojekt zeigt, dass die Erfahrung der vereinfachten Aufklärungsgespräche durch drei übergreifende Themen gekennzeichnet ist. Die Kategorie Formalität versus Informationsgewinn illustriert die individuelle Bedeutung des Aufklärungsgesprächs für die Teilnehmer und deren Bewertung des Prozesses der informierten Einwilligung. Die Kategorie Wahrnehmung der Unterstützung skizziert die Bewertungen der angewandten Unterstützungstools durch die Teilnehmer. Die Kategorie Der Wahrheit ins Auge sehen müssen stellt dar, dass die erlebte Situation des vereinfachten Aufklärungsgesprächs wesentlich durch die Verdachtsdiagnose Demenz bestimmt ist, die im Rahmen aller Aufklärungsgespräche besprochen wurde.
Fazit. Bislang gibt es wenig empirische Forschung zu Entscheidungsassistenz für Menschen mit Demenz und Unterstützungsmaßnahmen werden überwiegend unsystematisch entwickelt und angewendet. Die Wirksamkeit einzelner Unterstützungsmaßnahmen kann aufgrund fehlender Interventionsstudien selten beurteilt werden. Unterstützungsmaßnahmen zielen überwiegend auf eine Komplexitätsreduktion in der Informationsdarbietung und im kommunikativen Interaktionsprozess ab, wobei sie kognitive Beeinträchtigungen und Interaktions-/ Entscheidungsbedürfnisse von Menschen mit Demenz berücksichtigen. Die definierten Tools können als erste konkret handhabbare Werkzeuge verstanden werden, die das strukturierte Leisten von Entscheidungsassistenz für Menschen mit Demenz erleichtern sollen. Sie sind übertragbar auf verschiedene Entscheidungssituationen. Eine Bewertung der Wirksamkeit der definierten Tools sollte in weiteren Entscheidungssituationen und mit größeren Stichproben weiteruntersucht werden. Die Ergebnisse der Evaluation liefern jedoch erste Hinweise darauf, dass einige Teilnehmer sich von einzelnen Tools unterstützt gefühlt haben und die anvisierte Komplexitätsreduktion in der informationellen Dimension in einigen Fällen erfolgreich war. Eine wesentliche Komplexitätssteigerung in der untersuchten Entscheidungssituation entstand durch die negative Emotionen auslösende Vermittlung einer potentiellen Demenzdiagnose (Folgendimension). Dieses Ergebnis impliziert, dass die definierte „verständnisfördernde Toolbox“ um Unterstützungsmaßnahmen zur emotionalen Entlastung von Menschen mit Demenz erweitert werden muss, da davon ausgegangen werden kann, dass vielfältige Entscheidungssituationen für Menschen mit Demenz emotional hoch belastend sind.
Hintergrund
Obwohl Feedback ein wichtiges und gut untersuchtes Element der medizinischen Ausbildung darstellt, wird es trotz eines großen Bedarfs der Studierenden sowohl im Unterricht als auch in Prüfungssituationen nur selten angewendet. Die Frankfurter Medizinstudierenden beklagen besonders, dass sie zu ihren Objective Structured Clinical Examinations (OSCEs) als Abschlussprüfung im Fach Chirurgie bisher kein detailliertes Feedback erhalten. Auch die Prüfenden beklagen häufig, dass sie die Studierenden weder für herausragende Leistungen loben noch über auftretende Fehler informieren können.
Ziel dieser Arbeit ist deshalb die Erstellung und Implementierung eines strukturierten schriftlichen Feedbacks in eine bestehende OSCE-Prüfung im Fach Chirurgie, das an den Bedürfnissen sowohl der Studierenden als auch der Prüfenden orientiert ist.
Material und Methoden
Das Studiendesign war prospektiv. Im ersten Schritt wurde eine Befragung erfahrener OSCE-Prüfender durchgeführt, um zu erheben, welches Feedback sie gerne an Studierende weitergeben würden. Basierend hierauf wurde ein erster Feedbackbogen erstellt. Dieser umfasste neben vorformulierten Aussagen auch die Möglichkeit Freitextkommentare zu geben und wurde von den Prüfenden für jeden Studierenden in der Wechselzeit zwischen den OSCE-Stationen ausgefüllt. Die Feedbackbögen wurden anschließend eingescannt und per E- Mail an die Studierenden geschickt. Im Anschluss hieran erfolgte eine webbasierte Befragung der Studierenden und der OSCE-Prüfenden, sowie eine tiefergehende Befragung der Studierenden in Form von Fokusgruppen- Interviews.
Basierend auf den Ergebnissen der Umfragen und der Fokusgruppen wurden die Feedbackbögen nochmals grundlegend überarbeitet und im folgenden OSCE erneut angewendet. Die Zufriedenheit der Prüfenden und Studierenden wurde analog zur ersten Befragung erhoben.
Ergebnisse
Insgesamt nahmen 351 Studierende und 51 Prüfende in beiden OSCEs an der Studie teil. In der abschließenden Online-Evaluation gaben 87,5% der Studierenden und 91,6% der Prüfenden an, dass sie zustimmen oder eher zustimmen, dass das schriftliche Feedback in zukünftigen OSCE-Prüfungen weiterhin angewendet werden soll. Mehr als 50% der Studierenden gaben jedoch an, dass das Feedback noch nicht konkret genug sei.
Mehr als ein Viertel der Prüfenden gab an, dass das Ausfüllen der Feedbackbögen zeitlich herausfordernd sei. In allen Fokusgruppen wurde das schriftliche Feedback durch die Studierenden befürwortet.
Schlussfolgerung
Die Implementierung eines strukturierten schriftlichen Feedbacks in einen OSCE ist problemlos möglich. Das schriftliche Feedback wird sowohl von den Prüfenden als auch von den Studierenden als nützlich empfunden.
In heavy-ion collisions, the quark-gluon plasma is produced far from equilibrium. This regime is currently inaccessible by direct quantum chromodynamics (QCD) computations. In a holographic context, we propose a general method to characterize transport properties based on well-defined two-point functions. We calculate shear transport and entropy far from equilibrium, defining a time-dependent ratio of shear viscosity to entropy density, . Large deviations from its near-equilibrium value , up to a factor of 2.5, are found for realistic situations at the Large Hadron Collider. We predict the far-from-equilibrium time-dependence of to substantially affect the evolution of the QCD plasma and to impact the extraction of QCD properties from flow coefficients in heavy-ion collision data.
Pokémon Go is one of the most successful mobile games of all time. Millions played and still play this mobile augmented reality (AR) application, although severe privacy issues are pervasive in the app due to its use of several sensors such as location data and camera. In general, individuals regularly use online services and mobile apps although they might know that the use is associated with high privacy risks. This seemingly contradictory behavior of users is analyzed from a variety of different perspectives in the information systems domain. One of these perspectives evaluates privacy-related decision making processes based on concepts from behavioral economics. We follow this line of work by empirically testing one exemplary extraneous factor within the “enhanced APCO model” (antecedents–privacy concerns–outcome). Specific empirical tests on such biases are rare in the literature which is why we propose and empirically analyze the extraneous influence of a positivity bias. In our case, we hypothesize that the bias is induced by childhood brand nostalgia towards the Pokémon franchise. We analyze our proposition in the context of an online survey with 418 active players of the game. Our results indicate that childhood brand nostalgia influences the privacy calculus by exerting a large effect on the benefits within the trade-off and, therefore, causing a higher use frequency. Our work shows two important implications. First, the behavioral economics perspective on privacy provides additional insights relative to previous research. However, the effects of several other biases and heuristics have to be tested in future work. Second, relying on nostalgia represents an important, but also double-edged, instrument for practitioners to market new services and applications.