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The survivin suppressant YM155 is a drug candidate for neuroblastoma. Here, we tested YM155 in 101 neuroblastoma cell lines (19 parental cell lines, 82 drug-adapted sublines). 77 cell lines displayed YM155 IC50s in the range of clinical YM155 concentrations. ABCB1 was an important determinant of YM155 resistance. The activity of the ABCB1 inhibitor zosuquidar ranged from being similar to that of the structurally different ABCB1 inhibitor verapamil to being 65-fold higher. ABCB1 sequence variations may be responsible for this, suggesting that the design of variant-specific ABCB1 inhibitors may be possible. Further, we showed that ABCC1 confers YM155 resistance. Previously, p53 depletion had resulted in decreased YM155 sensitivity. However, TP53-mutant cells were not generally less sensitive to YM155 than TP53 wild-type cells in this study. Finally, YM155 cross-resistance profiles differed between cells adapted to drugs as similar as cisplatin and carboplatin. In conclusion, the large cell line panel was necessary to reveal an unanticipated complexity of the YM155 response in neuroblastoma cell lines with acquired drug resistance. Novel findings include that ABCC1 mediates YM155 resistance and that YM155 cross-resistance profiles differ between cell lines adapted to drugs as similar as cisplatin and carboplatin.
The survivin suppressant YM155 is a drug candidate for neuroblastoma. Here, we tested YM155 in 101 neuroblastoma cell lines (19 parental cell lines, 82 drug-adapted sublines). Seventy seven (77) cell lines displayed YM155 IC50s in the range of clinical YM155 concentrations. ABCB1 was an important determinant of YM155 resistance. The activity of the ABCB1 inhibitor zosuquidar ranged from being similar to that of the structurally different ABCB1 inhibitor verapamil to being 65-fold higher. ABCB1 sequence variations may be responsible for this, suggesting that the design of variant-specific ABCB1 inhibitors may be possible. Further, we showed that ABCC1 confers YM155 resistance. Previously, p53 depletion had resulted in decreased YM155 sensitivity. However, TP53-mutant cells were not generally less sensitive to YM155 than TP53 wild-type cells in this study. Finally, YM155 cross-resistance profiles differed between cells adapted to drugs as similar as cisplatin and carboplatin. In conclusion, the large cell line panel was necessary to reveal an unanticipated complexity of the YM155 response in neuroblastoma cell lines with acquired drug resistance. Novel findings include that ABCC1 mediates YM155 resistance and that YM155 cross-resistance profiles differ between cell lines adapted to drugs as similar as cisplatin and carboplatin.
Survivin is a drug target and the survivin suppressant YM155 a drug candidate for high-risk neuroblastoma. Findings from one YM155-adapted subline of the neuroblastoma cell line UKF-NB-3 had suggested that increased ABCB1 (mediates YM155 efflux) levels, decreased SLC35F2 (mediates YM155 uptake) levels, decreased survivin levels, and TP53 mutations indicate YM155 resistance. Here, the investigation of ten additional YM155-adapted UKF-NB-3 sublines only confirmed the roles of ABCB1 and SLC35F2. However, cellular ABCB1 and SLC35F2 levels did not indicate YM155 sensitivity in YM155-naïve cells, as indicated by drug response data derived from the Cancer Therapeutics Response Portal (CTRP) and the Genomics of Drug Sensitivity in Cancer (GDSC) databases. Moreover, the resistant sublines were characterised by a remarkable heterogeneity. Only seven sublines developed on-target resistance as indicated by resistance to RNAi-mediated survivin depletion. The sublines also varied in their response to other anti-cancer drugs. In conclusion, cancer cell populations of limited intrinsic heterogeneity can develop various resistance phenotypes in response to treatment. Therefore, individualised therapies will require monitoring of cancer cell evolution in response to treatment. Moreover, biomarkers can indicate resistance formation in the acquired resistance setting, even when they are not predictive in the intrinsic resistance setting.
Survivin is a drug target and its suppressant YM155 a drug candidate mainly investigated for high-risk neuroblastoma. Findings from one YM155-adapted subline of the neuroblastoma cell line UKF-NB-3 had suggested that increased ABCB1 (mediates YM155 efflux) levels, decreased SLC35F2 (mediates YM155 uptake) levels, decreased survivin levels, and TP53 mutations indicate YM155 resistance. Here, the investigation of 10 additional YM155-adapted UKF-NB-3 sublines only confirmed the roles of ABCB1 and SLC35F2. However, cellular ABCB1 and SLC35F2 levels did not indicate YM155 sensitivity in YM155-naïve cells, as indicated by drug response data derived from the Cancer Therapeutics Response Portal (CTRP) and the Genomics of Drug Sensitivity in Cancer (GDSC) databases. Moreover, the resistant sublines were characterized by a remarkable heterogeneity. Only seven sublines developed on-target resistance as indicated by resistance to RNAi-mediated survivin depletion. The sublines also varied in their response to other anti-cancer drugs. In conclusion, cancer cell populations of limited intrinsic heterogeneity can develop various resistance phenotypes in response to treatment. Therefore, individualized therapies will require monitoring of cancer cell evolution in response to treatment. Moreover, biomarkers can indicate resistance formation in the acquired resistance setting, even when they are not predictive in the intrinsic resistance setting.
The study of neutron-induced reactions on actinides is of considerable importance for the design of advanced nuclear systems and alternative fuel cycles. Specifically, 230Th is produced from the α-decay of 234U as a byproduct of the 232Th/233U fuel cycle, thus the accurate knowledge of its fission cross section is strongly required. However, few experimental datasets exist in literature with large deviations among them, covering the energy range between 0.2 to 25 MeV. In addition, the study of the 230Th(n,f) cross-section is of great interest in the research on the fission process related to the structure of the fission barriers. Previous measurements have revealed a large resonance at En=715 keV and additional fine structures, but with high discrepancies among the cross-section values of these measurements. This contribution presents preliminary results of the 230Th(n,f) cross-section measurements at the CERN n_TOF facility. The high purity targets of the natural, but very rare isotope 230Th, were produced at JRC-Geel in Belgium. The measurements were performed at both experimental areas (EAR-1 and EAR-2) of the n_TOF facility, covering a very broad energy range from thermal up to at least 100 MeV. The experimental setup was based on Micromegas detectors with the 235U(n,f) and 238U(n,f) reaction cross-sections used as reference.
Background: Point of care devices for performing targeted coagulation substitution in patients who are bleeding have become increasingly important in recent years. New on the market is the Quantra. It is a device that uses sonorheometry, a sonic estimation of elasticity via resonance, which is a novel ultrasound-based technology that measures viscoelastic properties of whole blood. Several studies have already shown the comparability of the Quantra with devices already established on the market, such as the rotational thromboelastometry (ROTEM) device.
Objective: In contrast to existing studies, this study is the first prospective interventional study using this new system in a cardiac surgical patient cohort. We will investigate the noninferiority between an already existing coagulation algorithm based on the ROTEM/Multiplate system and a new algorithm based on the Quantra system for the treatment of coagulopathic cardiac surgical patients.
Methods: The study is divided into two phases. In an initial observation phase, whole blood samples of 20 patients obtained at three defined time points (prior to surgery, after completion of cardiopulmonary bypass, and on arrival in the intensive care unit) will be analyzed using both the ROTEM/Multiplate and Quantra systems. The obtained threshold values will be used to develop a novel algorithm for hemotherapy. In a second intervention phase, the new algorithm will be tested for noninferiority against an algorithm used routinely for years in our department.
Results: The main objective of the examination is the cumulative loss of blood within 24 hours after surgery. Statistical calculations based on the literature and in-house data suggest that the new algorithm is not inferior if the difference in cumulative blood loss is <150 mL/24 hours.
Conclusions: Because of the comparability of the Quantra sonorheometry system with the ROTEM measurement methods, the existing hemotherapy treatment algorithm can be adapted to the Quantra device with proof of noninferiority.
Trial Registration: ClinicalTrials.gov NCT03902275; https://clinicaltrials.gov/ct2/show/NCT03902275
International Registered Report Identifier (IRRID): DERR1-10.2196/17206
Perioperative management for patients with von Willebrand disease: Defining the optimal approach
(2020)
von Willebrand disease (VWD) is the most common inherited bleeding disorder characterised by a quantitative or qualitative deficiency in von Willebrand factor (VWF). During invasive surgical procedures, patients with VWD require additional treatment to maintain haemostasis; however, due to the complexity of VWD, there is a lack of consensus on the optimal management. In the perioperative period, patients are usually treated with VWF and factor FVIII (FVIII)‐containing concentrates to provide an immediate haemostatic response to prevent excessive bleeding during both elective and emergency surgery. With the introduction of recombinant VWF (rVWF), there is a need for guidance on the use of the various VWF products in the perioperative period for all types of patients and surgeries. This review provides an overview of the current evidence for the surgical management of patients with VWD and, summarises the optimal treatment approach during the perioperative period, and highlights key unanswered questions and the research needed to address the evidence gaps.
Introduction: Prophylaxis with factor VIII (FVIII) concentrates in children with haemophilia A (HA) is current standard of care. The benefit of prophylactic treatment for adult HA patients is not commonly accepted.
Aim: To investigate the benefit of prophylaxis over on‐demand treatment in adult and elderly patients with severe or non‐severe HA in a real‐life setting.
Methods: Data from 163 patients comprising 1202 patient‐years were evaluated for 7.5 (±5.3) years. The effects on the annual bleeding rate (ABR, including spontaneous and traumatic bleeds) of treatment with a plasma‐derived FVIII concentrate, the patient's age and disease severity were investigated. The effect of changing the treatment from on demand to continuous prophylaxis on the patients’ ABRs was further analysed.
Results: Prophylaxis had the greatest effect on the ABRs of patients of any age with severe or non‐severe HA. The difference in ABR of all patients treated on demand (median 31.4; interquartile range (IQR) 27.6; N = 83) compared with those treated prophylactically (median 1.3; IQR 3.6; N = 122) was statistically significant (P < .05), even for patients with non‐severe HA (median 8.4; IQR 15.5; N = 11) vs median 1.5; IQR 4.2 (N = 17), P < .05). Patients, aged up to 88 years, switching from on demand to continuous prophylaxis showed the lowest median ABR (1.1; N = 51) after their regimen change.
Conclusion: Any (even low‐frequency) prophylaxis results in lower ABR than on‐demand treatment. Patients switching to prophylaxis benefitted the most, irrespective of age or HA severity. Prophylactic treatment—even tertiary—is the regimen of choice for patients of any age, including elderly patients, with severe or non‐severe HA.
The novel coronavirus infection (COVID-19) is caused by the new coronavirus SARS-CoV-2 and is characterized by an exaggerated inflammatory response that can lead to severe manifestations such as adult respiratory syndrome, sepsis, coagulopathy, and death in a proportion of patients. Among other factors and direct viral effects, the increase in the vasoconstrictor angiotensin II, the decrease in the vasodilator angiotensin, and the sepsis-induced release of cytokines can trigger a coagulopathy in COVID-19. A coagulopathy has been reported in up to 50% of patients with severe COVID-19 manifestations. An increase in d-dimer is the most significant change in coagulation parameters in severe COVID-19 patients, and progressively increasing values can be used as a prognostic parameter indicating a worse outcome. Limited data suggest a high incidence of deep vein thrombosis and pulmonary embolism in up to 40% of patients, despite the use of a standard dose of low-molecular-weight heparin (LMWH) in most cases. In addition, pulmonary microvascular thrombosis has been reported and may play a role in progressive lung failure. Prophylactic LMWH has been recommended by the International Society on Thrombosis and Haemostasis (ISTH) and the American Society of Hematology (ASH), but the best effective dosage is uncertain. Adapted to the individual risk of thrombosis and the d-dimer value, higher doses can be considered, especially since bleeding events in COVID-19 are rare. Besides the anticoagulant effect of LMWH, nonanticoagulant properties such as the reduction in interleukin 6 release have been shown to improve the complex picture of coagulopathy in patients with COVID-19.
Objective: To assess the influence of biphasic calcium phosphate materials with different surface topographies on bone formation and osseointegration of titanium implants in standardized alveolar ridge defects.
Materials and methods: Standardized alveolar ridge defects (6 × 6 mm) were created in the mandible of 8 minipigs and filled with three biphasic calcium phosphate materials (BCP1–3, 90% tricalcium phosphate/10% hydroxyapatite) with different surface properties (micro- and macroporosities) as well as a bovine-derived natural bone mineral (NBM) as a control. At 12 weeks, implants were placed into the augmented defects. After further 8 weeks of healing, dissected blocks were processed for histological analysis (e.g., mineralized (MT), residual bone graft material (BS), bone-to-implant contact (BIC)).
Results: All four biomaterials showed well-integrated graft particles and new bone formation within the defect area. MT values were comparable in all groups. BS values were highest in the NBM group (21.25 ± 13.52%) and markedly reduced in the different BCP groups, reaching statistical significance at BCP1-treated sites (9.2 ± 3.28%). All test and control groups investigated revealed comparable and statistically not significant different BIC values, ranging from 73.38 ± 20.5% (BCP2) to 84.11 ± 7.84% (BCP1), respectively.
Conclusion* All bone graft materials facilitated new bone formation and osseointegration after 12 + 8 weeks of healing.
Metasomatic evolution of coesite-bearing diamondiferous eclogite from the Udachnaya Kimberlite
(2020)
A coesite-bearing diamondiferous eclogite from the Udachnaya kimberlite (Daldyn field, Siberian craton) has been studied to trace its complex evolution recorded in rock-forming and minor mineral constituents. The eclogite sample is composed of rock-forming omphacite (60 vol%), garnet (35 vol%) and quartz/coesite (5 vol%) and contains intergranular euhedral zoned olivine crystals, up to 200 µm long, coexisting with phlogopite, orthopyroxene, clinopyroxene (secondary), K-feldspar, plagioclase, spinel, sodalite and djerfisherite. Garnet grains are zoned, with a relatively homogeneous core and a more magnesian overgrowth rim. The rim zones further differ from the core in having higher Zr/Y (6 times that in the cores), ascribed to interaction with, or precipitation from, a kimberlite-related melt. Judging by pressure-temperature estimates (~1200 °C; 6.2 GPa), the xenolith originated at depths of ~180–200 km at the base of the continental lithosphere. The spatial coexistence of olivine, orthopyroxene and coesite/quartz with K-Na-Cl minerals in the xenolith indicates that eclogite reacted with a deep-seated kimberlite melt. However, Fe-rich olivine, orthopyroxene and low-pressure minerals (sodalite and djerfisherite) likely result from metasomatic reaction at shallower depths during transport of the eclogite by the erupting kimberlite melt. Our results demonstrate that a mixed eclogitic-peridotitic paragenesis, reported previously from inclusions in diamond, can form by interaction of eclogite and a kimberlite-related melt.
Bacteria constantly attempt to hold up ion gradients across their membranes to maintain their resting potential for routine cell function, while coping with sudden environmental changes. Under abrupt hyperosmotic conditions, as faced when invading a host, most bacteria restore their turgor pressure by taking up potassium ions to prevent death by plasmolysis. Here, the potassium transporter AB, or KtrAB for short, is a key player. KtrAB consists of the membrane-embedded KtrB dimer, which includes two pores organized in tandem, and a cytoplasmic, octameric KtrA ring, which regulates these two pores. The KtrB subunits alone were suggested to function as rather non-selective ion channels translocating potassium and sodium ions. The KtrA subunits confer transport velocity, K+ selectivity as well as Na+ and nucleotide dependency to the Ktr system. The nucleotide regulation by binding to KtrA is rather well characterized. In contrast, the regulatory role of Na+ remains elusive. Controversially discussed is how selective the ion translocation by KtrB is and how KtrA affects it. Although there are several functional and structural data available of KtrAB and its homolog TrkAH, the selectivity of the ion translocation was never thoroughly addressed. The functional characterization of whether KtrAB is a selective ion channel and how selectivity is achieved is in the focus of this thesis. Since selectivity is usually defined by the ion channels’ selectivity filter contained in the pore-forming domain, a particular attention was laid on the ion-translocating subunits KtrB.
KtrB belongs to the superfamily of K+ transporters (SKT). Each KtrB monomer consists of four covalently attached M1-P-M2 motifs, each motif is made of two transmembrane (TM or M) helices that are connected by a pore (P) helix. The four motifs, referred to as domains D1 to D4, are arranged in a pseudo-fourfold symmetry and together form the pore for potassium ion translocation. Each pore contains two structural features thought to be involved in ion selectivity and ion gating. These are the non-canonical selectivity filter and the intramembrane loop. The selectivity filter is localized at the extracellular side of the pore and mostly shaped by the backbone carbonyl groups of the loops connecting the P and M2 helices in each domain. In KtrB, each P-loop contains only one highly conserved glycine residue instead of the classical -TVGYG- signature sequence of a K+ channel. This simple constructed selectivity filter led to the hypothesis that KtrAB would only have low ion selectivity. The intramembrane loop is formed by broken helix D3M2 and is located directly under the selectivity filter. It consists mostly of polar residues and acts as a molecular gate restricting ion fluxes. The intramembrane loop has been shown to be regulated by nucleotide binding to KtrA. Additionally, it could directly or indirectly be affected by Na+ binding. Further, the loop might even be involved in ion selectivity because it presents a physical barrier inside the pore.
To address the ion selectivity of the Ktr system, first, the ion binding specificity of KtrB was investigated. Binding affinities of different cations to KtrB were determined using isothermal titration calorimetry (ITC). For this, KtrB from Vibrio alginolyticus was heterologously produced in and purified from Escherichia coli. 12 L of culture roughly yielded 4 to 8 mg of the functional KtrB dimer in detergent solution. ITC measurements were performed in two different buffers, one choline-Cl-based and one LiCl-based buffer. No differences in the affinity between Na+ (KD = 1.8 mM), K+ (KD = 2.9 mM), Rb+ (KD = 1.9 mM) or Cs+ (KD = 1.6 mM) were detected in the choline-Cl-based buffer; only Li+ did not bind. In contrast, ITC measurements in LiCl-based buffer revealed a significant preference for K+ (KD = 91 µM) over Rb+ (KD = 2.4 mM), Cs+ (KD = 1.7 mM) and particularly Na+ (for which no binding was observed). Similarly, the presence of low millimolar NaCl concentrations in the choline-Cl-based buffer led to a decreased KD value of 260 µM. Hence, small cations, which usually are present in the natural environment, seem to modulate the selectivity filter for a better binding of K+ ions providing K+ selectivity. In fact, the low binding affinities of the other ions could indicate that they do not even bind to the selectivity filter but to the cavity. However, ITC competition experiments showed that all four ions compete for the same or overlapping binding sites, with Rb+ and Cs+ even blocking K+ binding at concentrations 10-fold above their binding affinities. Importantly, at physiological NaCl concentrations of 200 mM, the apparent binding affinity for K+ to KtrB was still 3.5 mM. This suggested that Na+ can also bind to KtrB’s selectivity filter but with a comparably low binding affinity providing an unexpectedly high preference for K+ ions.
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The concept of solidarity has been receiving growing attention from scholars in a wide range of disciplines. While this trend coincides with widespread unsuccessful attempts to achieve solidarity in the real world, the failure of solidarity as such remains a relatively unexplored topic. In the case of the so-called European Union (EU) refugee crisis, the fact that EU member states failed to fulfil their commitment to solidarity is now regarded as established wisdom. But as we try to come to terms with failing solidarity in the EU we are faced with a number of important questions: are all instances of failing solidarity equally morally reprehensible? Are some motivations for resorting to unsolidaristic measures more valid than others? What claims have an effective countervailing force against the commitment to act in solidarity?
Generic tasks for algorithms
(2020)
Due to its links to computer science (CS), teaching computational thinking (CT) often involves the handling of algorithms in activities, such as their implementation or analysis. Although there already exists a wide variety of different tasks for various learning environments in the area of computer science, there is less material available for CT. In this article, we propose so-called Generic Tasks for algorithms inspired by common programming tasks from CS education. Generic Tasks can be seen as a family of tasks with a common underlying structure, format, and aim, and can serve as best-practice examples. They thus bring many advantages, such as facilitating the process of creating new content and supporting asynchronous teaching formats. The Generic Tasks that we propose were evaluated by 14 experts in the field of Science, Technology, Engineering, and Mathematics (STEM) education. Apart from a general estimation in regard to the meaningfulness of the proposed tasks, the experts also rated which and how strongly six core CT skills are addressed by the tasks. We conclude that, even though the experts consider the tasks to be meaningful, not all CT-related skills can be specifically addressed. It is thus important to define additional tasks for CT that are detached from algorithms and programming.
After a recent spate of terrorist attacks in European and American cities, liberal democracies are reintroducing emergency securitarian measures (ESMs) that curtail rights and/or expand police powers. Political theorists who study ESMs are familiar with how such measures become instruments of discrimination and abuse, but the fundamental conflict ESMs pose for not just civil liberty but also democratic equality still remains insufficiently explored. Such phenomena are usually explained as a function of public panic or fear-mongering in times of crisis, but I show that the tension between security and equality is in fact much deeper and more general. It follows a different logic than the more familiar tension between security and liberty, and it concerns not just the rule of law in protecting liberty but also the role of law in integrating new or previously subjected groups into a democratic community. As liberal-democratic societies become increasingly diverse and multicultural in the present era of mass immigration and global interconnectedness, this tension between security and equality is likely to become more pronounced.
This essay explores the problem of legitimation crises in deliberative systems. For some time now, theorists of deliberative democracy have started to embrace a “systemic approach.” But if deliberative democracy is to be understood in the context of a system of multiple moving parts, then we must confront the possibility that that system’s dynamics may admit of breakdowns, contradictions, and tendencies toward crisis. Yet such crisis potentials remain largely unexplored in deliberative theory. The present article works toward rectifying this lacuna, using the 2016 Brexit and Trump votes as examples of a particular kind of “legitimation crisis” that results in a sequence of failures in the deliberative system. Drawing on recent work of Rainer Forst, I identify this particular kind of legitimation crisis as a “justification crisis.”
Background: Obesity and depression are both associated with changes in sleep/wake regulation, with potential implications for individualized treatment especially in comorbid individuals suffering from both. However, the associations between obesity, depression, and subjective, questionnaire-based and objective, EEG-based measurements of sleepiness used to assess disturbed sleep/wake regulation in clinical practice are not well known.
Objectives: The study investigates associations between sleep/wake regulation measures based on self-reported subjective questionnaires and EEG-derived measurements of sleep/wake regulation patterns with depression and obesity and how/whether depression and/or obesity affect associations between such self-reported subjective questionnaires and EEG-derived measurements.
Methods: Healthy controls (HC, NHC = 66), normal-weighted depressed (DEP, NDEP = 16), non-depressed obese (OB, NOB = 68), and obese depressed patients (OBDEP, NOBDEP = 43) were included from the OBDEP (Obesity and Depression, University Leipzig, Germany) study. All subjects completed standardized questionnaires related to daytime sleepiness (ESS), sleep quality and sleep duration once as well as questionnaires related to situational sleepiness (KSS, SSS, VAS) before and after a 20 min resting state EEG in eyes-closed condition. EEG-based measurements of objective sleepiness were extracted by the VIGALL algorithm. Associations of subjective sleepiness with objective sleepiness and moderating effects of obesity, depression, and additional confounders were investigated by correlation analyses and regression analyses.
Results: Depressed and non-depressed subgroups differed significantly in most subjective sleepiness measures, while obese and non-obese subgroups only differed significantly in few. Objective sleepiness measures did not differ significantly between the subgroups. Moderating effects of obesity and/or depression on the associations between subjective and objective measures of sleepiness were rarely significant, but associations between subjective and objective measures of sleepiness in the depressed subgroup were systematically weaker when patients comorbidly suffered from obesity than when they did not.
Conclusion: This study provides some evidence that both depression and obesity can affect the association between objective and subjective sleepiness. If confirmed, this insight may have implications for individualized diagnosis and treatment approaches in comorbid depression and obesity.
Learning to fly through informational turbulence: critical thinking and the case of the minimum wage
(2020)
The paper addresses online reasoning and information processing with respect to a much debated issue: the pros and cons of the minimum wage. Like with all controversial issues, one can easily remain in a self-reinforcing bubble, once one has taken sides, and immunize oneself against criticism. Paradoxically, the more information we have at our disposal, the easier this gets (Roetzel, 2019). The only (and possibly universal) antidote seems to be “critical thinking” (Ennis, 1987, 2011). However, critical thinking is a very broad concept, purported to include diverse kinds of information processing, and it is also thought to be content-specific. Therefore, we aim at addressing both understanding of content knowledge and reasoning processes. We pursue three goals with this paper: First, we conduct a conceptual analysis of the learning content and of reasoning patterns for and against the minimum wage. Second, we explicate an inferential framework that can be applied for processes of critical thinking. Third, teaching strategies are discussed to support reasoning processes and to promote critical thinking skills.