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Background: Zolpidem is a non-benzodiazepine hypnotic agent which has been shown to be effective in inducing and maintaining sleep in adults and is one of the most frequently prescribed hypnotics in the world. For drugs that are used to treat sleeping disorders, the time to reach the maximum concentration (Tmax) of the drug in plasma is important to achieving a fast onset of action and this must be maintained when switching from one product to another.
Objectives: The main objective of the present work was to create a PBPK/PD model for zolpidem and establish a clinically relevant “safe space” for dissolution of zolpidem from the commercial immediate release (IR) formulation. A second objective was to analyze literature pharmacokinetic data to verify the negative food effect ascribed to zolpidem and consider its ramifications in terms of the “safe space” for dissolution.
Methods: Using dissolution, pharmacokinetic and pharmacodynamic data, an integrated PBPK/PD model for immediate release zolpidem tablets was constructed in Simcyp®. This model was used to identify the clinically relevant dissolution specifications necessary to ensure efficacy.
Results: According to the simulations, as long as 85% of the drug is released in 45 minutes or less, the impact on the PK and PD profiles of zolpidem would be minimal. According to the FDA, the drug has to dissolve from the test and reference products at a similar rate and to an extent of 85% in not more than 30 minutes to pass bioequivalence via the BCS-biowaiver test. Thus, the BCS-biowaiver specifications are somewhat more stringent than the “safe space” based on the PBPK/PD model. Published data from fasted and fed state pharmacokinetic studies suggest but do not prove a negative food effect of zolpidem.
Conclusions: A PBPK/PD model indicates that current BCS biowaiver criteria are more restrictive for immediate release zolpidem tablets than they need to be. In view of the close relationship between PK and PD, it remains advisable to avoid taking zolpidem tablets with or immediately after a meal, as indicated by the Stilnox® labeling.
Im hymnologischen Bereich sind die Entstehung und jahrhundertelange Tradierung deutscher evangelischer Kirchenlieder von großer Bedeutung. Sie übten in zahlreichen Ländern großen Einfluss aus. Im 19. Jahrhundert beispielsweise wurden sie in das Englische übersetzt und in Ländern dieses Sprachraums gesungen. Bei der Missionierung Koreas wurden westliche – darunter auch einige deutsche – Kirchenlieder eingeführt. Es fällt aber auf, dass im Übertragungsprozess inhaltliche und sprachliche Unterschiede zwischen deutschen und koreanischen Fassungungen auftreten konnten. Auf dieses Geschehen hat die Verfasserin der vorliegenden Studie bei ihrer Tätigkeit als Kirchenmusikerin in Deutschland das Augenmerk gerichtet und es zum Ausgangspunkt ihrer Dissertation gewählt.
Ende des 19. Jahrhunderts wurde Korea von anderen Ländern gezwungen, sich zu öffnen. Daraufhin kamen viele Ausländer – unter ihnen auch christliche Missionare – ins Land, die je eine eigene Gesangbuchliteratur mitbrachten. Insbesondere die amerikanische Mission fasste Fuß. Das erste koreanische Gesangbuch Chanmiga wurde im Jahr 1892 veröffentlicht; ihm folgten weitere Ausgaben. In der ersten Hälfte des 20. Jahrhunderts waren amerikanische Missionare Mitherausgeber dieser Gesangbücher. Folgerichtig dominierte westliches Liedgut.
Die vorliegende Arbeit untersucht jene deutschen Kirchenlieder, die vor 1945 in das Koreanische Gesangbuch aufgenommen wurden. Sie fragt danach, auf welche Weise sie übernommen wurden und sich Änderungen bei ihrer Übermittlung vollzogen haben. Methodisch werden Quellen miteinander verglichen, die zum Zeitpunkt der Aufnahme relevant waren. Dank der älteren deutschen, englischen und amerikanischen Gesangbücher, die online und in deutschen Bibliotheken (Online-Archive) freigeschaltet sowie im Gesangbucharchiv Mainz vorhanden sind, ist diese umfangreiche Forschung möglich geworden.
Die Bedeutung des Singens ist für die koreanische Christenheit während der Annexion durch Japan (1910-1945) groß gewesen. Sie sang als Unabhängigkeitsbewegung Kirchenlieder, unter denen besonders Martin Luthers Choral Ein feste Burg ist unser Gott unverzichtbar wurde. Aussagen zeitgenössischer Christen belegen seine damalige Beliebtheit. Ein Grund dafür liegt darin, dass in ihm zahlreiche Analogien zur Situation der unterdrückten Koreaner erkennbar waren. Das Lied vermittelte ihnen Trost, Mut und einen festen Gottesglauben. Seine besondere Bedeutung erkannte auch das japanische Regime und verbot es während der gesamten Besatzungszeit.
Auch nach 1945 wurden deutsche Kirchenlieder in koreanische Gesangbücher aufgenommen. Ihre Anzahl sank jedoch gegen Ende des 20. Jahrhunderts; das aktuelle Gesangbuch, 21st Century Hymnal, von 2006 enthält nur noch 21. Es ist schließlich festzuhalten, dass Ein feste Burg nicht nur im Gottesdienst, sondern auch im Theater zu hören ist – paradigmatisch in der Oper Son Yang Won, eine Komposition des Kirchenmusikers Chae Hoon Park (*1922) aus dem Jahr 2011. Die Oper trägt den Namen des Märtyrers Yang Won Son (1902-1950) und thematisiert geschichtliche Ereignisse von nationaler Bedeutung: die Problematik der Anarchie, beginnend mit der Landesteilung durch die Sowjetunion und USA in zwei Besatzungszonen 1945 sowie die Yeosu-Sucheon-Rebellion von 1948, organisiert von wenigen kommunistischen Soldaten gegen die südkoreanische Regierung. Die vorliegende Studie untersucht, welche Bedeutung das Lied Ein feste Burg in der Oper einnimmt und wie Chae Hoon Park es bearbeitet hat.
Die Dissertation beschränkt ihre hymnologische Forschung nicht auf die Übernahme und Rezeption deutscher Kirchenlieder in Korea; sie blickt umgekehrt auch auf die Rezeption koreanischer Gesänge in Deutschland. Durch Begegnungen von deutschen mit koreanischen Christen entstanden bzw. entstehen neue Gesänge und Kompositionen und werden durch ökumenische Gottesdienste und Veranstaltungen verbreitet. Die ökumenische Bewegung bewirkte nach dem Zweiten Weltkrieg Änderungen im Liedrepertoire. Gesänge, nicht nur aus England, Europa und Nordamerika, sondern auch aus Afrika, Asien und Südamerika, wurden überall aufgenommen und gesungen. Die aktuellen deutschen und koreanischen Gesangbuchinhalte belegen dies.
Die Ausführungen der Studie halten fest, dass religiöse Bewegungen – Missions- und ökumenische Bewegung – bei der Übermittlung althergebrachter und der Entstehung neuer Lieder eine große Rolle spielten. Dies ist anhand der Entwicklung des Koreanischen Gesangbuchs erkennbar. Früher wurden westliche Kirchenlieder von amerikanischen Missionaren nach Korea transferiert; die einheimischen Christen vernachlässigten wiederum ihre eigene Kultur und Musik. Deshalb dominierte für geraume Zeit westlich geprägtes Liedgut. Die Koreanisierung der Kirchenlieder bzw. Gesangbücher wird nun seit einigen Jahrzehnten forciert. Die wachsende kirchenmusikalische Qualifikation koreanischer Musiker, das zunehmend selbstbewusst werdende einheimische Christentum und die ökumenische Öffnung der Kirchen leisten hier wertvolle Beiträge.
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.
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.
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.
Der Tumormarker Sialinsäure
(2020)
Die vorliegende Übersicht zum Tumormarker Sialinsäure wird im Rahmen der Serie „Tumormarker“ des Zentralblatts für Arbeitsmedizin, Arbeitsschutz und Ergonomie publiziert, die sich mit dem immer häufigeren Gebrauch der Bestimmung von spezifischen Markern bei sog. Manager-Vorsorgen und Check-up-Untersuchungen beschäftigt. Sialinsäure eignet sich grundsätzlich nicht für solche Vorsorgen, sondern ist ein Marker zur Therapie‑, Verlaufs- und Rezidivkontrolle von Mundhöhlenkarzinomen. Hier zeigt dieser eine hohe Sensitivität und Spezifität, wobei der Marker aber auf keinen Fall als Screeningparameter zur Frühdiagnostik eingesetzt werden soll.
Temperature elevations constitute a major threat to plant performance. In recent years, much was learned about the general molecular mode of heat stress reaction of plants. The current research focuses on the integration of the knowledge into more global networks, including the reactions of cellular compartments. For instance, chloroplast function is central for plant growth and survival, and the performance of chloroplasts is tightly linked to the general status of the cell and vice versa. We examined the changes in photosynthesis, chloroplast morphology and proteomic composition posed in Arabidopsis thaliana chloroplasts after a single or repetitive heat stress treatment over a period of two weeks. We observed that the acclimation is potent in the case of repetitive application of heat stress, while a single stress results in lasting alterations. Moreover, the physiological capacity and its adjustment are dependent on the efficiency of the protein translocation process as judged from the analysis of mutants of the two receptor units of the chloroplast translocon, TOC64, and TOC33. In response to repetitive heat stress, plants without TOC33 accumulate Hsp70 proteins and plants without TOC64 have a higher content of proteins involved in thylakoid structure determination when compared to wild-type plants.
The subfamily Bromelioideae is one of the most diverse groups among the neotropical Bromeliaceae. Previously, key innovations have been identified which account for the extraordinary radiation and species richness of this subfamily, especially in the so-called core Bromelioideae. However, in order to extend our understanding of the evolutionary mechanisms, the genomic mechanisms (e.g. polyploidy, dysploidy) that potentially underlie this accelerated speciation also need to be tested. Here, using PI and DAPI staining and flow cytometry we estimated genome size and GC content of 231 plants covering 30 genera and 165 species and combined it with published data. The evolutionary and ecological significance of all three genomic characters was tested within a previously generated dated phylogenetic framework using ancestral state reconstructions, comparative phylogenetic methods, and multiple regressions with climatic variables. The absolute genome size (2C) of Bromelioideae varied between 0.59 and 4.11 pg, and the GC content ranged between 36.73 and 41.43%. The monoploid genome sizes (Cx) differed significantly between core and early diverging lineages. The occurrence of dysploidy and polyploidy was, with few exceptions, limited to the phylogenetically isolated early diverging tank-less lineages. For Cx and GC content Ornstein–Uhlenbeck models outperformed the Brownian motion models suggesting adaptive potential linked to the temperature conditions. 2C-values revealed different rates of evolution in core and early diverging lineages also related to climatic conditions. Our results suggest that polyploidy is not associated with higher net diversification and fast radiation in core bromelioids. On the other hand, although coupled with higher extinction rates, dysploidy, polyploidy, and resulting genomic reorganizations might have played a role in the survival of the early diverging bromelioids in hot and arid environments.
Reprogramming of tomato leaf metabolome by the activity of heat stress transcription factor HsfB1
(2020)
Plants respond to high temperatures with global changes of the transcriptome, proteome, and metabolome. Heat stress transcription factors (Hsfs) are the core regulators of transcriptome responses as they control the reprogramming of expression of hundreds of genes. The thermotolerance-related function of Hsfs is mainly based on the regulation of many heat shock proteins (HSPs). Instead, the Hsf-dependent reprogramming of metabolic pathways and their contribution to thermotolerance are not well described. In tomato (Solanum lycopersicum), manipulation of HsfB1, either by suppression or overexpression (OE) leads to enhanced thermotolerance and coincides with distinct profile of metabolic routes based on a metabolome profiling of wild-type (WT) and HsfB1 transgenic plants. Leaves of HsfB1 knock-down plants show an accumulation of metabolites with a positive effect on thermotolerance such as the sugars sucrose and glucose and the polyamine putrescine. OE of HsfB1 leads to the accumulation of products of the phenylpropanoid and flavonoid pathways, including several caffeoyl quinic acid isomers. The latter is due to the enhanced transcription of genes coding key enzymes in both pathways, in some cases in both non-stressed and stressed plants. Our results show that beyond the control of the expression of Hsfs and HSPs, HsfB1 has a wider activity range by regulating important metabolic pathways providing an important link between stress response and physiological tomato development.
A growing body of experimental syntactic research has revealed substantial variation in the magnitude of island effects, not only across languages but also across different grammatical constructions. Adopting a well-established experimental design, the present study examines island effects in Spanish using a speeded acceptability judgment task. To quantify variation across grammatical constructions, we tested extraction from four different types of structure (subjects, complex noun phrases, adjuncts and interrogative clauses). The results of Bayesian mixed effects modelling showed that the size of island effects varied between constructions, such that there was clear evidence of subject, adjunct and interrogative island effects, but not of complex noun phrase island effects. We also failed to find evidence that island effects were modulated by participants’ working memory capacity as measured by an operation span task. To account for our results, we suggest that variability in island effects across constructions may be due to the interaction of syntactic, semantic-pragmatic and processing factors, which may affect island types differentially due to their idiosyncratic properties.
Making agriculture sustainable is a global challenge. In the European Union (EU), the Common Agricultural Policy (CAP) is failing with respect to biodiversity, climate, soil, land degradation as well as socio‐economic challenges.
The European Commission's proposal for a CAP post‐2020 provides a scope for enhanced sustainability. However, it also allows Member States to choose low‐ambition implementation pathways. It therefore remains essential to address citizens' demands for sustainable agriculture and rectify systemic weaknesses in the CAP, using the full breadth of available scientific evidence and knowledge.
Concerned about current attempts to dilute the environmental ambition of the future CAP, and the lack of concrete proposals for improving the CAP in the draft of the European Green Deal, we call on the European Parliament, Council and Commission to adopt 10 urgent action points for delivering sustainable food production, biodiversity conservation and climate mitigation.
Knowledge is available to help moving towards evidence‐based, sustainable European agriculture that can benefit people, nature and their joint futures.
The statements made in this article have the broad support of the scientific community, as expressed by above 3,600 signatories to the preprint version of this manuscript. The list can be found here (https://doi.org/10.5281/zenodo.3685632).
A free Plain Language Summary can be found within the Supporting Information of this article.
We study how the Eurosystem Collateral Framework for corporate bonds helps the European Central Bank (ECB) fulfill its policy mandate. Using the ECBs eligibility list, we identify the first inclusion date of both bonds and issuers. We find that due to the increased supply and demand for pledgeable collateral following eligibility, (i) securities lending market trading activity increases, (ii) eligible bonds have lower yields, and (iii) the liquidity of newly-issued bonds declines, whereas the liquidity of older bonds is una↵ected/improves. Corporate bond lending relaxes the constraint of limited collateral supply, thereby making the market more cohesive and complete. Following eligibility, bond-issuing firms reduce bank debt and expand corporate bond issuance, thus increasing overall debt size and extending maturity.
We study how the Eurosystem Collateral Framework for corporate bonds helps the European Central Bank (ECB) fulfill its policy mandate. Using the ECBs eligibility list, we identify the first inclusion date of both bonds and issuers. We find that due to the increased supply and demand for pledgeable collateral following eligibility, (i) securities lending market trading activity increases, (ii) eligible bonds have lower yields, and (iii) the liquidity of newly-issued bonds declines, whereas the liquidity of older bonds is unaffected/improves. Corporate bond lending relaxes the constraint of limited collateral supply, thereby making the market more cohesive and complete. Following eligibility, bond-issuing firms reduce bank debt and expand corporate bond issuance, thus increasing overall debt size and extending maturity.
Market fragmentation and technological advances increasing the speed of trading altered the functioning and stability of global equity limit order markets. Taking market resiliency as an indicator of market quality, we investigate how resilient are trading venues in a high-frequency environment with cross-venue fragmented order flow. Employing a Hawkes process methodology on high-frequency data for FTSE 100 stocks on LSE, a traditional exchange, and on Chi-X, an alternative venue, we find that when liquidity becomes scarce Chi-X is a less resilient venue than LSE with variations existing across stocks and time. In comparison with LSE, Chi-X has more, longer, and severer liquidity shocks. Whereas the vast majority of liquidity droughts on both venues disappear within less than one minute, the recovery is not lasting, as liquidity shocks spiral over the time dimension. Over half of the shocks on both venues are caused by spiralling. Liquidity shocks tend to spiral more on Chi-X than on LSE for large stocks suggesting that the liquidity supply on Chi-X is thinner than on LSE. Finally, a significant amount of liquidity shocks spill over cross-venue providing supporting evidence for the competition for order flow between LSE and Chi-X.
Die vorliegende Arbeit beschäftigt sich mit der außerhäuslichen Alltagsmobilität älterer Menschen, die eine zentrale Schlüsselfunktion in der Erhaltung von Lebensqualität und Gesundheit besonders im höheren Lebensalter einnimmt. Außerhäusliche Alltagsmobilität vollzieht sich stets in einem räumlichen Umweltausschnitt und kann aus ökogerontologischer Perspektive als Ergebnis eines gelungenen Person-Umwelt-Austauschs verstanden werden. Inwiefern psychologische Ressourcen im Sinne mobilitätsspezifischer Einstellungen zum Verständnis von zielgerichteter und habitualisierter Alltagsmobilität älterer Menschen beitragen können, ist Gegenstand der vorliegenden Arbeit. Altersspezifische, mobilitätsrelevante Einstellungen im außerhäuslichen Kontext werden sowohl in der sozialwissenschaftlichen Mobilitäts- und Alternsforschung als auch in der Praxis, etwa im Rahmen einer altersgerechten Stadtgestaltung, bislang noch zu wenig berücksichtigt. Die vorliegende Arbeit reagiert auf dieses Forschungsdesiderat, indem sie mobilitätsspezifische Einstellungen im höheren Lebensalter konzeptuell beschreibt, in den Kontext ökogerontologischer Theorien einbettet und ihre Bedeutung für den Erhalt eines aktiven und gelingenden Alterns untersucht. Im Rahmen der Dissertation wurde zunächst auf der Basis klassischer und neuer ökogerontologischer Modelle das Konstrukt der mobilitätsbezogenen Handlungsflexibilität und Routinen (MBFR) konzeptuell entwickelt. MBFR umfasst einerseits die individuelle Überzeugung, das eigene Mobilitätsverhalten an Herausforderungen außer Haus anpassen zu können (FLEX) und andererseits die Präferenz für mobilitätsbezogene Alltagsroutinen (ROU). Daraufhin wurde ein standardisiertes Messinstrument zur Erfassung des MBFR-Konzepts entwickelt, optimiert und hinsichtlich seiner psychometrischen Qualität untersucht. Die Formulierung der Testitems erfolgte in Anlehnung an bereits existierende Fragebögen zu verwandten Konstrukten. In der vorwiegend online durchgeführten Pilotstudie (Penger & Oswald, 2017) wurden die Items mittels explorativer Faktorenanalysen hinsichtlich ihrer dimensionalen Struktur untersucht. Die Stichprobe umfasste 265 Personen im Alter von 65 Jahren oder älter. Die Analysen des MBFR-Instruments ergaben nach Ausschluss von Items mit niedrigen und nicht eindeutigen Ladungen drei substanzielle Faktoren. Die Items der ersten Dimension bildeten die Überzeugung ab, flexibel mit personenbezogenen, altersassoziierten Herausforderungen (z. B. Schwierigkeiten im Gehen oder auf eine Gehhilfe angewiesen sein) umgehen zu können, um außerhäuslich mobil zu sein. Die Items der zweiten Dimension erfassten die Überzeugung, flexibel mit herausfordernden außerhäuslichen Umweltbedingungen (z. B. eine verlegte Haltestelle oder ein schlechter Zustand der Gehwege) umgehen zu können. Items, die auf den dritten Faktor luden, bildeten die Neigung zu Routinen im Mobilitätsalltag ab, z. B. bekannte Wege beizubehalten oder bei der Ausübung von außerhäuslichen Aktivitäten vertraute Orte aufzusuchen. Während die ersten beiden Faktoren mobilitätsbezogene Handlungsflexibilität (FLEX) messen, werden im dritten Faktor habitualisierte Verhaltensweisen (ROU) erfasst. Alle drei Faktoren wiesen eine akzeptable Reliabilität auf. Auf Basis von Rückmeldungen der Studienteilnehmer:innen wurde das MBFR-Instrument anschließend sprachlich angepasst und gekürzt. Der modifizierte Fragebogen wurde daraufhin in der empirischen Studie „MOBIL bleiben in Stuttgart“ (MBIS) eingesetzt. Dabei sollte die Frage beantwortet werden, ob das finale MBFR-Instrument die zugrundeliegenden Konstrukte valide und reliabel erfasst und die Testwerte somit ausreichende Gültigkeit hinsichtlich faktorieller, Konstrukt- und Kriteriumsvalidität bei älteren Menschen im urbanen Raum aufweisen (Penger & Conrad, eingereicht). Es wurden insgesamt 211 privatwohnende Stuttgarter:innen ab 65 Jahren in persönlichen Interviews und mithilfe eines 7-tägigen Wegetagebuchs zu verschiedenen Aspekten ihrer Mobilität im Wohnumfeld befragt. Statistische Analysen auf latenter Ebene erfolgten mittels Strukturgleichungsmodellen. Bivariate Zusammenhänge und Subgruppenanalysen wurden mittels Korrelations- und Regressionsanalysen berechnet. Die dreifaktorielle Struktur des MBFR-Fragebogens konnte im konfirmatorischen Modell empirisch bestätigt werden. Zudem fiel die interne Konsistenz aller drei Faktoren gut aus. Zusammenhänge zu konstruktverwandten Merkmalen – wie allgemeine und mobilitätsspezifische Einstellungen – deuten darauf hin, dass das MBFR-Instrument ausreichend konvergente Validität aufweist. Analysen auf latenter Ebene ergaben, dass Befragte durchschnittlich mehr außerhäusliche Wege zurückzulegten, wenn sie in stärkerem Maße überzeugt waren, flexibel auf mobilitätsbezogene Herausforderungen reagieren zu können (FLEX). Weiterhin ließen sich positive Zusammenhänge zwischen FLEX und der erlebten Selbstständigkeit sowie dem subjektiven Wohlbefinden aufzeigen. Die Befunde belegen somit hinreichende Übereinstimmungsvalidität der Testwerte. Differenzierte Analysen machten darüber hinaus deutlich, dass FLEX vor allem bei Befragten mit Mobilitätseinschränkungen bedeutsam zur Vorhersage des außerhäuslichen Mobilitätsverhaltens beitrug. ...
Netzwerkmodelle spielen in verschiedenen Wissenschaftsdisziplinen eine wichtige Rolle und dienen unter anderem der Beschreibung realistischer Graphen.
Sie werden häufig als Zufallsgraphen formuliert und stellen somit Wahrscheinlichkeitsverteilungen über Graphen dar.
Meist ist die Verteilung dabei parametrisiert und ergibt sich implizit, etwa über eine randomisierten Konstruktionsvorschrift.
Ein früher Vertreter ist das G(n,p) Modell, welches über allen ungerichteten Graphen mit n Knoten definiert ist und jede Kante unabhängig mit Wahrscheinlichkeit p erzeugt.
Ein aus G(n,p) gezogener Graph hat jedoch kaum strukturelle Ähnlichkeiten zu Graphen, die zumeist in Anwendungen beobachtet werden.
Daher sind populäre Modelle so gestaltet, dass sie mit hinreichend hoher Wahrscheinlichkeit gewünschte topologische Eigenschaften erzeugen.
Beispielsweise ist es ein gängiges Ziel die nur unscharf definierte Klasse der sogenannten komplexen Netzwerke nachzubilden, der etwa viele soziale Netze zugeordnet werden.
Unter anderem verfügen diese Graphen in der Regel über eine Gradverteilung mit schweren Rändern (heavy-tailed), einen kleinen Durchmesser, eine dominierende Zusammenhangskomponente, sowie über überdurchschnittlich dichte Teilbereiche, sogenannte Communities.
Die Einsatzmöglichkeiten von Netzwerkmodellen gehen dabei weit über das ursprüngliche Ziel, beobachtete Effekte zu erklären, hinaus.
Ein gängiger Anwendungsfall besteht darin, Daten systematisch zu produzieren.
Solche Daten ermöglichen oder unterstützen experimentelle Untersuchungen, etwa zur empirischen Verifikation theoretischer Vorhersagen oder zur allgemeinen Bewertung von Algorithmen und Datenstrukturen.
Hierbei ergeben sich insbesondere für große Probleminstanzen Vorteile gegenüber beobachteten Netzen.
So sind massive Eingaben, die auf echten Daten beruhen, oft nicht in ausreichender Menge verfügbar, nur aufwendig zu beschaffen und zu verwalten, unterliegen rechtlichen Beschränkungen, oder sind von unklarer Qualität.
In der vorliegenden Arbeit betrachten wir daher algorithmische Aspekte der Generierung massiver Zufallsgraphen.
Um Anwendern Reproduzierbarkeit mit vorhandenen Studien zu ermöglichen, fokussieren wir uns hierbei zumeist auf getreue Implementierungen etablierter Netzwerkmodelle,
etwa Preferential Attachment-Prozesse, LFR, simple Graphen mit vorgeschriebenen Gradsequenzen, oder Graphen mit hyperbolischer (o.Ä.) Einbettung.
Zu diesem Zweck entwickeln wir praktisch sowie analytisch effiziente Generatoren.
Unsere Algorithmen sind dabei jeweils auf ein geeignetes Maschinenmodell hin optimiert.
Hierzu entwerfen wir etwa klassische sequentielle Generatoren für Registermaschinen, Algorithmen für das External Memory Model, und parallele Ansätze für verteilte oder Shared Memory-Maschinen auf CPUs, GPUs, und anderen Rechenbeschleunigern.
When a visual stimulus is repeated, average neuronal responses typically decrease, yet they might maintain or even increase their impact through increased synchronization. Previous work has found that many repetitions of a grating lead to increasing gamma-band synchronization. Here we show in awake macaque area V1 that both, repetition-related reductions in firing rate and increases in gamma are specific to the repeated stimulus. These effects showed some persistence on the timescale of minutes. Further, gamma increases were specific to the presented stimulus location. Importantly, repetition effects on gamma and on firing rates generalized to natural images. These findings suggest that gamma-band synchronization subserves the adaptive processing of repeated stimulus encounters, both for generating efficient stimulus responses and possibly for memory formation.
Attention selects relevant information regardless of whether it is physically present or internally stored in working memory. Perceptual research has shown that attentional selection of external information is better conceived as rhythmic prioritization than as stable allocation. Here we tested this principle using information processing of internal representations held in working memory. Participants memorized four spatial positions that formed the endpoints of two objects. One of the positions was cued for a delayed match-non-match test. When uncued positions were probed, participants responded faster to uncued positions located on the same object as the cued position than to those located on the other object, revealing object-based attention in working memory. Manipulating the interval between cue and probe at a high temporal resolution revealed that reaction times oscillated at a theta rhythm of 6 Hz. Moreover, oscillations showed an anti-phase relationship between memorized but uncued positions on the same versus other object as the cued position, suggesting that attentional prioritization fluctuated rhythmically in an object-based manner. Our results demonstrate the highly rhythmic nature of attentional selection in working memory. Moreover, the striking similarity between rhythmic attentional selection of mental representations and perceptual information suggests that attentional oscillations are a general mechanism of information processing in human cognition. These findings have important implications for current, attention-based models of working memory.
Aim: To evaluate the level of agreement between the periodontal risk assessment (PRA) and the periodontal risk calculator (PRC).
Materials and methods: Periodontal risk was retrospectively assessed among 50 patients using PRA and PRC. Both methods were modified. PRA by assessing probing pocket depths and bleeding on probing at four (PRA4) and six (PRA6) sites per tooth, PRC by permanently marking or unmarking the dichotomously selectable factors “irregular recall,” “oral hygiene in need of improvement” and “completed scaling and root planing” for PRC. Agreement between PRA and PRCred (summarized risk categories) was determined using weighted kappa.
Results: Fifty patients enrolled in periodontal maintenance (48% female, age: 63.8 ± 11.2 years) participated. PRA4 and PRA6 matched in 32 (64%) patients (κ‐coefficient = 0.48, p < .001). There was 100% agreement between both PRC versions. There was minimal agreement of PRA6 and PRCred (66%, 28% one different category, 6% two different categories; κ‐coefficient = 0.34; p = .001). PRA4 and PRCred did not match (60% agreement, 34% one different category, 6% two different categories; κ‐coefficient = 0.23; p = .13). For the SPT diagnosis of severe periodontitis, PRA6 and PRCred agreed weakly (κ‐coefficient = 0.44; p = .004).
Conclusion: PRA and PRC showed a minimal agreement. Specific disease severity may result in improved agreement.
Background and Objective: Long-term tooth retention is the ultimate goal of periodontal therapy. Aim of this study was to evaluate tooth loss (TL) during 10 years of supportive periodontal therapy (SPT) in periodontal compromised patients and to identify factors influencing TL on patient level. Material and Methods: Patients were re-examined 120 ± 12 months after active periodontal therapy. TL and risk factors [smoking, initial diagnosis, SPT adherence, interleukin-1 polymorphism, cardiovascular diseases, age at baseline, bleeding on probing (BOP), change of practitioner, insurance status, number of SPT, marital and educational status] influencing TL on patient level were assessed. Results: One-hundred patients (52 female, mean age 65.6 ± 11 years) lost 121 of 2428 teeth (1.21 teeth/patient; 0.12 teeth/patient/y) during 10 years of SPT. Forty-two of these were lost for periodontal reasons (0.42 teeth/patient; 0.04 teeth/patient/y). Significantly more teeth were lost due to other reasons (P < .001). Smoking, baseline severity of periodontitis, non-adherent SPT, positive interleukin-1 polymorphism, marital and educational status, private insurance, older age at baseline and BOP, small number of SPT were identified as patient-related risk factors for TL (P < .05). Conclusion: During 120 ± 12 months of SPT, only a small number of teeth was lost in periodontally compromised patients showing the positive effect of a well-established periodontal treatment concept. The remaining risk for TL should be considered using risk-adopted SPT allocation.
Der Beitrag stellt zunächst dar, dass und warum dem geltenden UWG ein schlüssiger innerer Zusammenhang fehlt, und zwar sowohl im Hinblick auf den Prüfungsaufbau für Ansprüche als auch im Hinblick auf die im Gesetz zum Tragen kommenden materiellen Systematisierungskriterien. Sodann wird ein Vorschlag für einen alternativen Gesetzesaufbau unterbreitet, der am unverändert richtigen Gedanken festhält, wonach Wettbewerbsverhalten in seinen komplexen Auswirkungen auf sämtliche Marktteilnehmer ganzheitlich zu erfassen und zu regulieren ist, während die Orientierung an Gruppen von Marktteilnehmern zwangsläufig zu Abgrenzungsproblemen führt. Folglich bilden im unterbreiteten Vorschlag nicht die Schutzsubjekte des UWG, sondern der Unwertgehalt der geschäftlichen Handlung (Irreführung, Aggressivität, sonstige Wettbewerbsverfälschung) das primäre Systematisierungskriterium. Übergeordnetes Ziel des Vorschlags ist es, die methodengerechte Anwendung des geschriebenen Rechts zu erleichtern und auf diese Weise gesetzesferne Eigenrationalitäten der Praxis einzuhegen.
The long-standing battle between economic nationalism and globalism has again taken center stage in geopolitics. This article applies this dichotomy to the law and policy of international intellectual property (IP). Most commentators see IP as a prime example of globalization. The article challenges this view on several levels. In a nutshell, it claims that economic nationalist concerns about domestic industries and economic development lie at the heart of the global IP system. To support this argument, the article summarizes and categorizes IP policies adopted by selected European countries, the European Union, and the U.S. Section I presents three types of inbound IP policies that aim to foster local economic development and innovation. Section II adds three versions of outbound IP policies that, in contrast, target foreign countries and markets. Concluding section III traces a dialectic virtuous circle of economic nationalist motives leading to global legal structures and identifies the function and legal structure of IP as the reason for the resilience and even dominance of economic nationalist motives in international IP politics. IP concerns exclusive private rights that are territorially limited creatures of (supra-)national statutes. These legal structures make up the economic nationalist DNA of IP.
On the basis of the economic theory of network effects, this article provides a novel explanation of the so-called patent paradox, i.e. the question why the propensity to patent is so strong when the expected average value of most patents is low. It demonstrates that the patent system of a country resembles a telephone network or a social media platform. Patents are perceived as nodes in a virtual network that, as a whole, exhibits network effects. It is explained why patents are not independent of other patents but that they complement each other in several ways both within and beyond markets and fields of technology, and that patents thus create synchronization value over and above individual interests of patent holders in exclusivity. As a consequence, the more patents there are, the more valuable it is to also seek patents, and vice versa. Since patents thus display increasing returns to adoption, the willingness to pay for the next patent slopes upwards. This explains why, after a phase of early instability and a certain tipping point, many countries’ patent systems expanded quickly and eventually became a rigid standard (“lock-in”). The concluding section raises the question what regulatory measures are suitable to effectively address the ensuing anticommons effects.
Die rechtshistorische Forschung konzentriert sich auf die Herausbildung spezifisch juristischer Figuren wie das frühneuzeitliche Privileg oder das spätere „geistige Eigentum“. Die Geschichte des urheberrechtlichen Werkbegriffs – immerhin der Gegenstand der „Werkherrschaft“ des Urhebers – hat demgegenüber verhältnismäßig wenig Aufmerksamkeit erfahren. Dabei ist letztlich unstreitig, dass auch die Vorstellung eines von seinen Verkörperungen unabhängigen und daher abstrakt-immateriellen, eigentumsfähigen Werks keine gegebene Wirklichkeit darstellt, sondern erst seit dem Ende des 18. Jahrhunderts etabliert ist. Der Beitrag historisiert das Urheberrecht ausgehend von seiner – so die Hypothese – vorgestellten Wirklichkeit. Betrachtet werden drei Vorbedingungen, die das juristische Reden und Denken in Kategorien eines abstrakt-unkörperlichen, eigentumsfähigen Werks und damit zugleich das „geistige Eigentum“ an diesem Werk möglich gemacht haben: Reproduktionstechnologien, das Ideal des genialen Werks und die dezentral-anonyme Marktwirtschaft.
Das Netzwerkdurchsetzungsgesetz (NetzDG) ist einseitig auf die Löschung rechtswidriger Inhalte ausgerichtet. Vorzugswürdig erscheint demgegenüber ein ganzheitlicher Regulierungsansatz, der darauf abzielt, dass Anbieter großer Universalplattformen gleichermaßen rechtswidrige Inhalte löschen und rechtmäßige Kommunikation nicht willkürlich beeinträchtigen. Dazu wird hier ein konkreter Entwurf zur Änderung des NetzDG nebst Begründung vorgelegt.
Der Beitrag nimmt zu den Entscheidungen des BGH v. 21.2.2019 in Sachen HHole (for Mannheim) u.a., wonach die Vernichtung eines urheberrechtlich geschützten Werks eine „andere Beeinträchtigung“ im Sinne des § 14 UrhG darstellt, kritisch Stellung. Hinterfragt wird insbesondere, worauf sich Entstellungen oder Beeinträchtigungen gem. § 14 UrhG beziehen, was also unter einem „Werk“ gem. § 14 UrhG zu verstehen ist.
Durch die Digitalisierung ist die soziale Bedeutung des Urheberrechts stark gewachsen. Die vom Urheberrecht etablierte Exklusivitätskultur steht überdies in einem fundamentalen Konflikt mit der im Internet vorherrschenden Zugangskultur. Ein Beispiel hierfür ist der Streit um die jüngste Urheberrechtsrichtlinie der EU.
Through digitalization, the social importance of copyright law has grown considerably. Moreover, the culture of exclusivity established by copyright law conflicts fundamentally with the culture of access prevalent on the internet. An example for this is the dispute over the EU’s latest copyright directive. Does it ring in the end of the internet as we know it, or does it »only« see to fair remuneration for those working in the creative economy?
Der Beitrag erläutert aus rechtswissenschaftlicher Sicht, welche Begriffe, Perspektiven und Methoden zur Beantwortung folgender Frage geeignet sind: Wie lässt sich erklären, dass das gerade einmal ca. 200 Jahre alte Rechtsgebiet des „geistigen Eigentums“, dessen Legitimität stets heftig umstritten war, praktisch weltweite Anerkennung in nationalen, supranationalen und völkerrechtlichen Rechtsquellen finden konnte und die globalen Handels- und Kommunikationsströme auch tatsächlich wirksam reguliert? Oder anders gewendet: Wie kann ein schwacher Geltungsanspruch eine faktisch wirkmächtige Ordnung hervorbringen? Nach kritisch-diskurstheoretischen Ansätzen bildet der Streit um Rechtfertigungen den zentralen Treiber normativer Ordnungen. Der Aufsatz zeigt jedoch, dass im Hinblick auf das „geistige Eigentum“ normexterne Bedingungen wie technischer Fortschritt und der Wandel der allgemeinen Wirtschaftsordnung von entscheidender Bedeutung waren und der Frage nach den Gründen z.T. logisch vorausliegen. Schließlich wird gezeigt, dass sozialontologische Analysen besonders gut geeignet erscheinen, strukturelle Normativität/Macht zu adressieren, die unterhalb expliziter Rechtfertigungen bzw. im „Hintergrund“ angesiedelt ist, so wie Sprache generell die logische Voraussetzung für ein rechtfertigendes Rede-und-Antwort-Stehen bildet.
This article documents and classifies instances of transnational intellectual property (IP) enforcement and licensing on the Internet with a particular focus on the territorial reach of the respective regimes. Regarding IP enforcement, I show that the bulk of transnational or even global measures is adopted in the context of “voluntary” self-regulation by various intermediaries, namely domain name registrars, access and host providers, search engines, and advertising and payment services. Global IP licensing is, in contrast, less prevalent than one might expect. It is practically limited to freely accessible Open Content, whereas markets for fee-based services remain territorially fragmented. Overall, three layers of IP governance on the Internet can be distinguished. Based on global licenses, Open Content is freely accessible everywhere. Plain IP infringements are equally combatted on a worldwide scale. Territorial fragmentation persists, instead, in the market segment of fee-based services and in hard cases of conflicts of IP laws/rights. All three universal norms (global accessibility, global illegality, global fragmentation) are supported by a quite solid, “rough” global consensus.
This paper shows that judicial enforcement has substantial effects on firms’ decisions with regard to their employment policies. To establish causality, I exploit a reorganization of the court districts in Italy involving judicial district mergers as a shock to court productivity. I find that an improvement in enforcement, as measured by a reduction in average trial length, has a large, positive effect on firm employment. These effects are stronger in firms with high leverage, or that belong to industries more dependent on external finance and characterized by higher complementarity between labor and capital, consistent with a financing channel driving the results. Moreover, in presence of stronger enforcement, firms can raise more debt to dampen the impact of negative shocks and, in this way, reduce employment fluctuations.
Acinetobacter baumannii is an opportunistic pathogen, which has become a rising threat in healthcare facilities worldwide due to increasing antibiotic resistances and optimal adaptation to clinical environments and the human host. We reported in a former publication on the identification of three phopholipases of the phospholipase D (PLD) superfamily in A. baumannii ATCC 19606T acting in concerted manner as virulence factors in Galleria mellonella infection and lung epithelial cell invasion. This study focussed on the function of the three PLDs. A Δpld1-3 mutant was defect in biosynthesis of the phospholipids cardiolipin (CL) and monolysocardiolipin (MLCL), whereas the deletion of pld2 and pld3 abolished the production of MLCL. Complementation of the Δpld1-3 mutant with pld1 restored CL biosynthesis demonstrating that the PLD1 is implicated in CL biosynthesis. Complementation of the Δpld1-3 mutant with either pld2 or pld3 restored MLCL and CL production leading to the conclusion that PLD2 and PLD3 are implicated in CL and MLCL production. Mutant studies revealed that two catalytic motifs are essential for the PLD3-mediated biosynthesis of CL and MLCL. The Δpld1-3 mutant exhibited a decreased colistin and polymyxin B resistance indicating a role of CL in cationic antimicrobial peptides (CAMPs) resistance.
Der Plexus tympanicus ist ein komplex aufgebautes Nervengeflecht in der Mukosa des Mittelohrs. Aus anatomischen Studien ist bekannt, dass zuführende und wegführende Verbindungen unterschiedlichen Hirnnerven und sympathischen Bahnen angehören. Insbesondere werden parasympathische und sympathische Innervationssysteme beschrieben und damit stellt der Plexus tympanicus einen Plexus des vegetativen Nervensystems dar.
Bisher fehlen detaillierte Analysen über die Chemoarchitektur dieses Plexus. In der vorliegenden Studie soll das Vorhandensein unterschiedlicher Neurotransmitter und -peptide untersucht werden, um Vorstellungen über die Funktion dieses komplexen Geflechts zu entwickeln.
Es wurden immuncytochemische Färbungen an sechs Parallelserien von Kryostatschnitten durchgeführt. Dabei wurden Primärantikörper benutzt, die gegen Cholinacetyltransferase (ChAT), Dopamin-β-Hydroxylase (DBH), Substanz P (SP), Vasoaktives intestinales Peptid (VIP) und Neuropeptid Y (NPY) gerichtet waren. Dadurch konnten sympathische Nervenfasern durch den Nachweis von DBH als Leitenzym für die Noradrenalinsynthese analysiert werden; parasympathische Strukturen konnten durch Anti-ChAT-AK, das Leitenzym für die Acetylcholinsynthese, differenziert werden.
Alle genannten Neurotransmitter und -peptide konnten in den Mittelohrschnitten nachgewiesen werden. Dabei wurden sie in folgenden Lokalisationen gefunden: VIP wurde vor allem in perikapillären Boutons und Gefäßwänden im gesamten Ohrbereich sowie basal im Drüsenbereich des Meatus acusticus externus nachgewiesen. In der Mittelohrschleimhaut war VIP weit verbreitet und gerade im Bereich des Promotoriums waren einzelne Zellen intensiv angefärbt, die Zeichen sekretorischer Aktivität trugen. SP wurde vor allem in netzartigen um Gefäße gelagerten Fasern und in beaded Nervenfasern in der Mittelohrschleimhaut gefunden. Auch im Bereich der Drüsen, vor allem an Talgdrüsen des äußeren Gehörgangs, wurde SP nachgewiesen. NPY-IR zeigte sich in Geflechten um große Gefäße, an motorischen Endplatten der benachbarten Muskulatur, in der Mittelohrschleimhaut, in Nervenstämmen, Ganglien des Mittelohrbereichs und weniger dicht an Drüsen. ChAT-ir Strukturen sind direkt auf dem Knochen aufliegend in der Mittelohrschleimhaut, gefäßbegleitend an motorischen Endplatten und basal an Drüsenzellen vorhanden. ChAT-ir Nervenzellperikaryen wurden in großer Zahl in Ganglien gefunden, außerdem waren die Nerven allgemein leicht positiv. DBH-ir Strukturen wurden zwischen den Drüsen, in den Gefäßwänden der Arterien im Mittelohrbereich und in Nervenstämmen nachgewiesen. Einige DBH-ir Nervenzellperikaryen befanden sich in den Ganglien innerhalb des Mittelohrbereichs und der zuführenden Hirnnerven. Auch in der Mittelohrschleimhaut wurden Perikaryen, teilweise ganglienartig organisiert, gefunden. In verschiedenen Strukturen im Innenohrbereich konnten alle Neurotransmitter und -peptide in unterschiedlich starker Tingierung nachgewiesen werden.
Anhand des Verteilungsmuster lassen sich Kolokalisationen der Neuropeptide mit noradrenergen und cholinergen Neuronen vermuten, die bereits in anderen Studien für verschiedene Komponenten des vegetativen Nervensystems beschrieben wurden. Anhand der vorliegenden Analysen wurden Lokalisationsübereinstimmungen von ChAT und VIP, ChAT und SP und DBH und NPY gefunden.
Diese Studie soll als Grundlage für weitere Untersuchungen dienen. Insbesondere für das Verständnis von Funktionen und Pathologien des Nervengeflechts bedarf es weiterer Forschung. Die vorliegende Arbeit weist eindeutig nach, dass der Plexus tympanicus ein integratives System darstellt, das im Gegensatz zu früheren Vorstellungen einer reinen Durchgangsorganisation alle Voraussetzungen für ein Kontrollsystem erfüllt.
Die Dissertation befasst sich mit Daten zum frühinvasiven kolorektalen Karzinom aus der Westpfalz in einem Zeitraum von 6 Jahren (2010 – 2016). In diesem Zeitraum sind 11% (n=130) frühinvasive kolorektale Karzinome aufgetreten. Davon besitzen 11% (n=14) Lymphknotenmetastasen. Beim pT1 Kolonkarzinom (n=92) treten Lymphknotenmetastasen in 13% (n=12) und beim pT1 Rektumkarzinom (n=38) in 5% (n=2) auf. Zur Risikostratifizierung werden pT1 kolorektale Karzinome in Low-Risk (sm1, G1, G2) und High-Risk (sm3, G3, G4) Karzinome eingeteilt. 84% (n=109) der pT1 kolorektalen Karzinome sind gut (G1) und mäßig differenziert (G2) und 35% (n=46) besitzen eine Submucosaeindringtiefe von sm1. 15% der G1 und G2 (n=11 von 73) pT1 Kolonkarzinome und 6% der G1 und G2 (n=2 von 36) pT1 Rektumkarzinome sind nodal positiv. Ein positiver nodaler Status ist in 12% (n=4 von 33) bei pT1sm1 Kolonkarzinomen aufgetreten. Ähnliches gilt für pT1sm1 Rektumkarzinome mit 8% (n=1 von 13). Weder im sm3 Stadium noch beim G3 pT1 Rektumkarzinom ist ein no-dal positiver Status vorgekommen. Dies zeigt, dass die Einteilung in Low- und High-Risk Karzinome nach der S3–Leitlinie zu überdenken ist. Ein positiver Lymphknoten-status tritt auch bei Low-Risk Karzinomen auf und verschlechtert das onkologische Outcome signifikant. Die Überlebensraten verdeutlichen diese Erkenntnis. Frühinvasi-ve kolorektale Karzinome besitzen eine ähnliche 5 Jahres-Überlebensrate von 81% wie fortgeschrittene neoadjuvant behandelte ypT1 kolorektale Karzinome. Das Gleiche gilt für nodal negative pT1 Karzinome (83%) im Vergleich mit fortgeschrittenen nodal negativen ypT0 und ypT1 Karzinomen (81%). Auch nodal positive pT1 Karzinome und fortgeschrittene nodal positive ypT0 und ypT1 Karzinome haben ähnliche Überle-bensraten (66% versus 67%). Auch dieser Vergleich zeigt, dass frühinvasive kolorekta-le Karzinome unterschätzt werden. Zur Optimierung des onkologischen Outcomes ist eine systemische Therapie bei frühinvasiven kolorektalen Karzinomen - auch ohne Lymphknotenmetastasen - zur Verbesserung des Überlebens nach 5 Jahren zu erwägen. Diese Thematik bietet einen Ansatzpunkt für weitere Studien um eine konkrete Aussa-ge über die Signifikanz einer neo-oder adjuvanten Therapie bei frühinvasiven kolorek-talen Karzinomen zu ermöglichen. Ein angepasstes multimodales Therapiekonzept sowie eine adäquate Nachsorge erscheinen bei frühinvasiven kolorektalen Karzinomen unabdingbar.
Endocannabinoids are important lipid-signaling mediators. Both protective and deleterious effects of endocannabinoids in the cardiovascular system have been reported but the mechanistic basis for these contradicting observations is unclear. We set out to identify anti-inflammatory mechanisms of endocannabinoids in the murine aorta and in human vascular smooth muscle cells (hVSMC). In response to combined stimulation with cytokines, IL-1β and TNFα, the murine aorta released several endocannabinoids, with anandamide (AEA) levels being the most significantly increased. AEA pretreatment had profound effects on cytokine-induced gene expression in hVSMC and murine aorta. As revealed by RNA-Seq analysis, the induction of a subset of 21 inflammatory target genes, including the important cytokine CCL2 was blocked by AEA. This effect was not mediated through AEA-dependent interference of the AP-1 or NF-κB pathways but rather through an epigenetic mechanism. In the presence of AEA, ATAC-Seq analysis and chromatin-immunoprecipitations revealed that CCL2 induction was blocked due to increased levels of H3K27me3 and a decrease of H3K27ac leading to compacted chromatin structure in the CCL2 promoter. These effects were mediated by recruitment of HDAC4 and the nuclear corepressor NCoR1 to the CCL2 promoter. This study therefore establishes a novel anti-inflammatory mechanism for the endogenous endocannabinoid AEA in vascular smooth muscle cells. Furthermore, this work provides a link between endogenous endocannabinoid signaling and epigenetic regulation.
Background: The number of implantable cardioverter defibrillator (ICD) infections is increasing due to an increased number of ICD implants, higher-risk patients, and more frequent replacement procedures, which carry a higher risk of infection. Reducing the morbidity, mortality, and cost of ICD-related infections requires an understanding of the current rate of this complication and its predictors.
Methods: The Shock Implant Evaluation Trial (SIMPLE) trial randomized 2500 ICD recipients to defibrillation testing or not. Over an average of 3.1 years, patients were seen every 6 months and examined for evidence of ICD infection, which was defined as requiring device removal and/or intravenous antibiotics.
Results: Within 24 months, 21 patients (0.8%) developed infection. Fourteen patients (67%) with infection presented within 30 days, 20 patients by 12 months, and only 1 patient beyond 12 months. Univariate analysis demonstrated that patients with primary electrical disorders (3 patients, P = 0.009) and those with a secondary prevention indication (13 patients, P = 0.0009) were more likely to develop infection. Among the 2.2% of patients who developed an ICD wound hematoma, 10.4% developed an infection. Among the 8.3% of patients requiring an ICD reintervention, 1.9% developed an infection.
Conclusions: This cohort of ICD recipients at high-volume centres have a low risk of device-related infection. However; strategies to reduce wound hematoma and the need for ICD reintervention could further reduce the rate of infection.
The risk of increasing dengue (DEN) and chikungunya (CHIK) epidemics impacts 240 million people, health systems, and the economy in the Hindu Kush Himalayan (HKH) region. The aim of this systematic review is to monitor trends in the distribution and spread of DEN/CHIK over time and geographically for future reliable vector and disease control in the HKH region. We conducted a systematic review of the literature on the spatiotemporal distribution of DEN/CHIK in HKH published up to 23 January 2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. In total, we found 61 articles that focused on the spatial and temporal distribution of 72,715 DEN and 2334 CHIK cases in the HKH region from 1951 to 2020. DEN incidence occurs in seven HKH countries, i.e., India, Nepal, Bhutan, Pakistan, Bangladesh, Afghanistan, and Myanmar, and CHIK occurs in four HKH countries, i.e., India, Nepal, Bhutan, and Myanmar, out of eight HKH countries. DEN is highly seasonal and starts with the onset of the monsoon (July in India and June in Nepal) and with the onset of spring (May in Bhutan) and peaks in the postmonsoon season (September to November). This current trend of increasing numbers of both diseases in many countries of the HKH region requires coordination of response efforts to prevent and control the future expansion of those vector-borne diseases to nonendemic areas, across national borders.
Article 4 of Protocol No. 4 to the European Convention on Human Rights (ECHR) is short. Its title reads "Prohibition of collective expulsion of aliens", its text reads: "Collective expulsion of aliens is prohibited." It comes as a historical disappointment that the European Court of Human Rights (ECtHR) in its decision in the case N.D. and N.T. v. Spain from 13 February 2020 distorts this clear guarantee to exclude apparently "unlawful" migrants from its protection. The decision is a shock for the effective protection of rights in Europe and at its external borders. Consequently the Guardian titled that the Court is "under fire". Reading the majority opinion is at times a puzzling experience, to say the least.
Background: Re-treatment in patients with a chronic hepatitis C virus (HCV) infection and a previous failure to direct-acting antiviral (DAA) treatment remains a challenge. Therefore, we investigated the success rate of treatment and re-treatment regimens used at our center from October 2011 to March 2018.
Methods: A retrospective analysis of DAA-based HCV therapies of 1096 patients was conducted. Factors associated with a virological relapse were identified by univariable and multivariable logistic regression, treatment success of the re-treatment regimens was evaluated by an analysis of sustained virological response (SVR) rates in patients with a documented follow-up 12 weeks after the end of treatment.
Results: Of 1096 patients treated with DAA-based regimens, 91 patients (8%) were lost to follow-up, 892 of the remaining 1005 patients (89%) achieved an SVR12. Most patients (65/113, 58%) who experienced a virological relapse received an interferon-based DAA regimen. SVR rates were comparable in special cohorts like liver transplant recipients (53/61, 87%) and people with a human immunodeficiency virus (HIV) coinfection (41/45, 91%). On multivariable analysis, interferon-based DAA therapy was associated with treatment failure (odds ratio 0.111, 95%-confidence interval 0.054–0.218) among others. One hundred seventeen patients with multiple DAA treatment courses were identified, of which 97 patients (83%) experienced a single relapse, but further relapses after two (18/117, 15%) or even three (2/117, 2%) treatment courses were also observed. Eighty-two of 96 (85%) re-treatment attempts with all-oral DAA regimens were successful after an initial treatment failure.
Conclusion: Overall, DAA re-treatments were highly effective in this real-world cohort and only a minority of patients failed more than two treatment courses. Switching to–or addition of–a new drug class seem to be valid options for the re-treatment of patients especially after failure of an interferon-based regimen.
Background: The intraoperative blood loss is estimated daily in the operating room and is mainly done by visual techniques. Due to local standards, the surgical sponge colours can vary (e.g. white in US, green in Germany). The influence of sponge colour on accuracy of estimation has not been in the focus of research yet. Material and methods: A blood loss simulation study containing four “bleeding” scenarios each per sponge colour were created by using expired whole blood donation samples. The blood donations were applied to white and green surgical sponges after dilution with full electrolyte solution. Study participants had to estimate the absorbed blood loss in sponges in all scenarios. The difference to the reference blood loss was analysed. Multivariate linear regression analysis was performed to investigate other influence factors such as staff experience and sponge colour. Results: A total of 53 anaesthesists participated in the study. Visual estimation correlated moderately with reference blood loss in white (Spearman's rho: 0.521; p = 3.748*10−16) and green sponges (Spearman's rho: 0.452; p = 4.683*10−12). The median visually estimated blood loss was higher in white sponges (250ml IRQ 150–412.5ml) than in green sponges (150ml IQR 100-300ml), compared to reference blood loss (103ml IQR 86–162.8). For both colour types of sponges, major under- and overestimation was observed. The multivariate statistics demonstrates that fabric colours have a significant influence on estimation (p = 3.04*10−10), as well as clinician’s qualification level (p = 2.20*10−10, p = 1.54*10−08) and amount of RBL to be estimated (p < 2*10−16). Conclusion: The deviation of correct blood loss estimation was smaller with white surgical sponges compared to green sponges. In general, deviations were so severe for both types of sponges, that it appears to be advisable to refrain from visually estimating blood loss whenever possible and instead to use other techniques such as e.g. colorimetric estimation.
Purpose: Trauma is the leading cause of death in children. In adults, blood transfusion and fluid resuscitation protocols changed resulting in a decrease of morbidity and mortality over the past 2 decades. Here, transfusion and fluid resuscitation practices were analysed in severe injured children in Germany.
Methods: Severely injured children (maximum Abbreviated Injury Scale (AIS) ≥ 3) admitted to a certified trauma-centre (TraumaZentrum DGU®) between 2002 and 2017 and registered at the TraumaRegister DGU® were included and assessed regarding blood transfusion rates and fluid therapy.
Results: 5,118 children (aged 1–15 years) with a mean ISS 22 were analysed. Blood transfusion rates administered until ICU admission decreased from 18% (2002–2005) to 7% (2014–2017). Children who are transfused are increasingly seriously injured. ISS has increased for transfused children aged 1–15 years (2002–2005: mean 27.7–34.4 in 2014–2017). ISS in non-transfused children has decreased in children aged 1–15 years (2002–2005: mean 19.6 to mean 17.6 in 2014–2017). Mean prehospital fluid administration decreased from 980 to 549 ml without affecting hemodynamic instability.
Conclusion: Blood transfusion rates and amount of fluid resuscitation decreased in severe injured children over a 16-year period in Germany. Restrictive blood transfusion and fluid management has become common practice in severe injured children. A prehospital restrictive fluid management strategy in severely injured children is not associated with a worsened hemodynamic state, abnormal coagulation or base excess but leads to higher hemoglobin levels.
Introduction: In recent years, resource-saving handling of allogeneic blood products and a reduction of transfusion rates in adults has been observed. However, comparable published national data for transfusion practices in pediatric patients are currently not available. In this study, the transfusion rates for children and adolescents were analyzed based on data from the Federal Statistical Office of Germany during the past 2 decades. Methods: Data were queried via the database of the Federal Statistical Office (Destasis). The period covered was from 2005 to 2018, and those in the sample group were children and adolescents aged 0–17 years receiving inpatient care. Operation and procedure codes (OPS) for transfusions, procedures, or interventions with increased transfusion risk were queried and evaluated in detail. Results: In Germany, 0.9% of the children and adolescents treated in hospital received a transfusion in 2018. A reduction in transfusion rates from 1.02% (2005) to 0.9% (2018) was observed for the total collective of children and adolescents receiving inpatient care. Increases in transfusion rates were recorded for 1- to 4- (1.41–1.45%) and 5- to 10-year-olds (1.24–1.33%). Children under 1 year of age were most frequently transfused (in 2018, 40.2% of the children were cared for in hospital). Transfusion-associated procedures such as chemotherapy or machine ventilation and respiratory support for newborns and infants are on the rise. Conclusion: Transfusion rates are declining in children and adolescents, but the reasons for increases in transfusion rates in other groups are unclear. Prospective studies to evaluate transfusion rates and triggers in children are urgently needed.
The Brachybasidiaceae are a family of 22 known species of plant-parasitic microfungi belonging to Exobasidiales, Basidiomycota. Within this family, species of the largest genus Kordyana develop balls of basidia on top of stomatal openings. Basidial cells originate from fungal stroma filling substomatal chambers. Species of Kordyana typically infect species of Commelinaceae. During fieldwork in the neotropics, fungi morphologically similar to Kordyana spp. were found on Goeppertia spp. (syn. Calathea spp., Marantaceae), namely on G. panamensis in Panama and on G. propinqua in Bolivia. These specimens are proposed as representatives of a genus new to science, Marantokordyana, based on the distinct host family and molecular sequence data of ITS and LSU rDNA regions. The specimens on the two host species represent two species new to science, M. oberwinkleriana on G. panamensis and M. boliviana on G. propinqua. They differ by the size and shape of their basidia, molecular sequence data of ITS and LSU rDNA regions, and host plant species. In the past, the understanding of Brachybasidiaceae at order and family level was significantly improved by investigation realized by Franz Oberwinkler and his collaborators at the University of Tübingen, Germany. On species level, however, our knowledge is still very poor due to incomplete species descriptions of several existing names in literature, scarceness of specimens, as well as sequence data lacking for many taxa and for further barcode regions. Especially species of Kordyana and species of Dicellomyces are in need of revision.
The paper examines the application of the category of ‘populism’ to Athenian democracy. Unlike previous works on the subject, which have focused on the fifth century, it studies the fourth, where the tradition is much better, since we can refer to contemporary public speeches. It shows that, despite some parallels on the lexical level, 'populist’ strategies matching the criteria of modern political science cannot be identified in Athenian political communication and interprets this result in its historical context.
Nitro fatty acids (NFAs) are endogenously generated lipid mediators deriving from reactions of unsaturated electrophilic fatty acids with reactive nitrogen species. Furthermore, Mediterranean diets can be a source of NFA. These highly electrophilic fatty acids can undergo Michael addition reaction with cysteine residues, leading to post-translational modifications (PTM) of selected regulatory proteins. Such modifications are capable of changing target protein function during cell signaling or in biosynthetic pathways. NFA target proteins include the peroxisome proliferator-activated receptor γ (PPAR-γ), the pro-inflammatory and tumorigenic nuclear factor-κB (NF-κB) signaling pathway, the pro-inflammatory 5-lipoxygenases (5-LO) biosynthesis pathway as well as soluble epoxide hydrolase (sEH), which is essentially involved in the regulation of vascular tone. In several animal models of inflammation and cancer, the therapeutic efficacy of well-tolerated NFA has been demonstrated. This has already led to clinical phase II studies investigating possible therapeutic effects of NFA in subjects with pulmonary arterial hypertension. Albeit Michael acceptors feature a broad spectrum of bioactivity, they have for a rather long time been avoided as drug candidates owing to their presumed unselective reactivity and toxicity. However, targeted covalent modification of regulatory proteins by Michael acceptors became recognized as a promising approach to drug discovery with the recent FDA approvals of the cancer therapeutics, afatanib (2013), ibrutinib (2013), and osimertinib (2015). Furthermore, the Michael acceptor, neratinib, a dual inhibitor of the human epidermal growth factor receptor 2 and epidermal growth factor receptor, was recently approved by the FDA (2017) and by the EMA (2018) for the treatment of breast cancer. Finally, a number of further Michael acceptor drug candidates are currently under clinical investigation for pharmacotherapy of inflammation and cancer. In this review, we focus on the pharmacology of NFA and other Michael acceptor drugs, summarizing their potential as an emerging class of future antiphlogistics and adjuvant in tumor therapeutics.
The cumulant ratios up to fourth order of the Z distributions of the largest fragment in spectator fragmentation following 107,124Sn+Sn and 124La+Sn collisions at 600 MeV/nucleon have been investigated. They are found to exhibit the signatures of a second-order phase transition established with cubic bond percolation and previously observed in the ALADIN experimental data for fragmentation of 197Au projectiles at similar energies. The deduced pseudocritical points are found to be only weakly dependent on the A/Z ratio of the fragmenting spectator source. The same holds for the corresponding chemical freeze-out temperatures of close to 6 MeV.The experimental cumulant distributions are quantitatively reproduced with the Statistical Multifragmentation Model and parameters used to describe the experimental fragment multiplicities, isotope distributions and their correlations with impact-parameter related observables in these reactions. The characteristic coincidence of the zero transition of the skewness with the minimum of the kurtosis excess appears to be a generic property of statistical models and is found to coincide with the maximum of the heat capacity in the canonical thermodynamic fragmentation model.
Erratum for: Cyclic AMP induces transactivation of the receptors for epidermal growth factor and nerve growth factor, thereby modulating activation of MAP kinase, Akt, and neurite outgrowth in PC12 cells.Journal of biological chemistry, 2002 Nov 15;277(46):43623-30. doi: 10.1074/jbc.M203926200. Epub 2002 Sep 5.
Limb stump pain after amputation, due to sensitized neuromas, is a common condition that can cause a great deal of suffering in affected patients. Treatment is difficult, requiring a multidisciplinary approach that is often unsatisfactory. One treatment used to mitigate pain is electrical stimulation (EStim), administered using several different therapeutic approaches. The research described in this dissertation sought to characterize changes in peripheral nerve morphology, and neuroma formation, following limb amputation, with an eye toward developing better treatment strategies, that intervene before neuromas are fully formed. Another focus of this study was to evaluate the effect EStim has on changes in peripheral nerve morphology, and neuroma formation, following limb amputation.
Right forelimbs of 42 male Sprague Dawley rats were amputated. At 3, 7, 28, 60 and 90 days post amputation (DPA) 6 limb stumps, in each group, were harvested and changes in peripheral nerve morphology, and neuroma formation were measured. In addition, limb stumps of 6 EStim treated, 6 sham-treated (deactivated EStim devices), and 6 non-treated rats were harvested at 28 DPA.
Analysis revealed six distinct morphological characteristics of peripheral nerves during nerve regrowth and neuroma development; 1) normal nerve, 2) degenerating axons, 3) axonal sprouts, 4) unorganized bundles of axons in connective tissue, 5) unorganized axon growth into muscles, and 6) unorganized axon growth into fibrotic tissue (neuroma). At the early stages (3 & 7 DPA), normal nerves could be identified throughout the limb stump tissues and small areas of axonal sprouts were present near the distal tip of the stumps. Signs of degenerating axons were evident from 7 to 90 DPA. From day 28 on, variability of nerve characteristics, with signs of unorganized axon growth into muscle and fibrotic tissue, and neuroma formation, became visible in multiple areas of stump tissue. These pathological features became more evident at 60 and 90 DPA. EStim treated stumps revealed neuroma formation in 1 out of 6 animals, whereas in sham and controls, neuroma formation was seen in 4 out of 6 stumps respectively.
We were able to identify 6 separate histological stages of peripheral nerve regrowth and neuroma formation over 90 days following amputation. Axonal regrowth was observed as early as 3 DPA, and signs of unorganized axonal growth and neuroma formation were evident by 28 DPA. Our observations suggest that EStim-based treatment and/or other prevention strategies might be more effective if administered in the initial dynamic stages of neuroma development.
Background: Brodalumab is a fully human monoclonal immunoglobulin IgG2 antibody that binds to the human IL-17 receptor subunit A and by that inhibits the biologic action of IL-17A, IL-17F, IL-17C and IL-17E. Therapy with fumaric acid esters (FAE) is a well established and widely used first-line systemic treatment for subjects with moderate-to-severe plaque psoriasis. Objectives: To compare brodalumab to FAE in terms of clinical efficacy, patient-reported outcomes and safety in subjects with moderate-to-severe plaque psoriasis who were naïve to systemic treatment. Methods: Eligible subjects were randomized 1 : 1 to 210 mg brodalumab injections or oral FAE according to product label in this 24-week, open-label, assessor-blinded, multi-centre, head-to-head phase 4 trial. The primary endpoints were having PASI75 and having sPGA score of 0 or 1 (sPGA 0/1). Subjects with missing values for the primary endpoints were considered non-responders. Results: A total of 210 subjects were randomized. 91/105 subjects completed brodalumab treatment and 58/105 subjects completed FAE treatment. At Week 24, significantly more subjects in the brodalumab group compared to the FAE group had PASI75 (81.0% vs. 38.1%, P < 0.001) and sPGA 0/1 (64.8% vs. 20.0%, P < 0.001). In the brodalumab group, the median time to both PASI75 and to PASI90 was significantly shorter than in the FAE group (4.1 weeks vs. 16.4 weeks, and 7.4 weeks vs. 24.4 weeks, respectively, P < 0.0001 for both). The rate of adverse events was lower in subjects treated with brodalumab compared to subjects treated with FAE (616.4 vs. 1195.8 events per 100 exposure years). No new safety signals were detected for brodalumab. Conclusions: Brodalumab was associated with rapid and significant improvements in signs and symptoms of moderate-to-severe plaque psoriasis, with a superior efficacy profile to what was observed with FAE in systemic-naïve subjects over 24 weeks.
O presente trabalho, de natureza teórica, analisa fragmentos dos escritos de Theodor W. Adorno (1903-1969) e Jean-Paul Sartre (1905-1980) e destaca reflexões para a pesquisa sociológica no campo da Educação, considerando a inflexão que ambos propõem em “direção ao sujeito”. De modo mais específico, realizamos uma leitura de como cada autor refletiu sobre sua própria infância e educação, buscando articular a reflexão autobiográfica que cada um realiza, de diferentes formas, ao núcleo duro de suas concepções teóricas. Ao observarmos como cada autor, na condição de adulto, rememora de forma sistematizada (na filosofia ou na literatura) sua própria infância, refletindo, entre outros aspectos, sobre a condição social de suas famílias e da classe burguesa, a relação com os adultos e com os artefatos (culturais e tecnológicos) de sua época, incluindo a escolarização, podemos também perceber elementos de suas concepções teóricas sobre a subjetividade e de suas análises sobre as vicissitudes do sujeito no contemporâneo. Enquanto que, para Sartre, a infância emerge no âmbito de uma concepção restauradora da narrativa como mediadora da experiência, em um processo, sempre ainda aberto, de transformação da existência, para Adorno, a rememoração sobre sua infância se articula às temáticas da pátria (não como território, mas como humanidade) e da utopia e se coloca como possibilidade de releitura das singularidades das experiências infantis como forma de confrontação e atualização das promessas contidas no passado.
Fokus meiner Doktorarbeit ist die Anwendung und Entwicklung NMR-spektroskopischer Methoden zur Charakterisierung zeitabhängiger Strukturänderungen von Biomolekülen – von lokalen dynamischen Veränderungen bis zur vollständigen Rückfaltung von Proteinen – und fasst die Ergebnisse meiner drei wichtigsten PhD-Projekte zusammen.
In meinem ersten Projekt habe ich die Leistung eines Temperatursprung-Probenkopfs – mit dem Proben mit hoher Salzkonzentration schnell erwärmt werden können – mithilfe einer Hochfrequenzspule technisch optimiert. Die optimierten Radiofrequenz-Bestrahlungsparameter, Lösungsmittel-bedingungen und der reduzierte Arbeitszyklus führten zu einem Temperatursprung von 20 °C in 400 ms. Ich habe eine Cystein-freie Mutante von Barstar hergestellt, die nach Zugabe von Harnstoff bei 0 °C kalt denaturiert werden kann, während sie ihren gefalteten Zustand bei 30 °C hält. Dadurch wurde auch ermöglicht, dass der Rückfaltungsprozess hunderte Male ohne Abbau oder Aggregation wiederholt werden kann. Die Kombination von reversibler Rückfaltung und rascher Temperaturänderung des kalt denaturierten Barstars ermöglichte die Entwicklung eines neuen kinetischen Experiments, bei dem der Rückfaltungsprozess von Barstar mit einem zweidimensionalen Echtzeit-NMR in hoher Zeitauflösung untersucht wird. Die vollständige Rückgratresonanzzuweisung wurde sowohl für den gefalteten als auch für den kalt denaturierten Zustand von Barstar durchgeführt und ergab, dass in der denaturierten Form beide Prolin-Reste einen gemischten Konformationszustand aufweisen. Dabei befindet sich die Tyr47-Pro48-Amidbindung im ungefalteten Zustand hauptsächlich in trans-, während im gefalteten Zustand in der seltenen cis-Konformation. Das neue hochauflösende kinetische Experiment zeigte, dass die Rückfaltung von Barstar durch die trans-cis-Isomerisierung der Tyr47-Pro48-Amidbindung verlangsamt wird, was sowohl die Sekundärstruktur als auch die Bildung der Tertiärstruktur beeinflusst. Basierend auf diesen Ergebnissen konnte ich einen plausiblen Faltungsmechanismus für den langsamen Faltungsweg von kalt denaturiertem Barstar skizzieren. Durch Änderung der Zeitparameter des Heizungszyklus wurde erreicht, dass die Tyr47-Pro48-Amidbindung im ungefalteten Zustand in der cis-Konformation bleibt und daher der schnelle Faltungsweg dominant wird. Das Starten des Magnetisierungstransfers vor der Temperaturänderung ermöglichte die Aufzeichnung eines Spektrums, das den entfalteten Zustand mit dem gefalteten Zustand korreliert. Dieses Spektrum ermöglichte quantitative Analysen des schnellen Faltungsweges und lieferte sogar indirekte Hinweise auf einen Zwischenzustand. Diese Methode aus Kombination von schnellem Temperatursprung und Kaltdenaturierung zeigt ein hohes Potenzial, Proteinfaltung auf atomarer Ebene experimentell zu untersuchen und ein tieferes Verständnis verschiedener Faltungswege zu erlangen.
In meinem zweiten Projekt – das Teil einer interdisziplinären Forschung war – konzentrierte ich mich auf die NMR-spektroskopische Charakterisierung von Nukleinsäuren, die mit einer photolabilen Schutzgruppe modifiziert wurden. Zuerst wurde mithilfe homonuklearer Korrelationsexperimente eine vollständige Protonresonanzzuweisung erreicht. Danach wurde die relative Konfiguration der photolabilen Schutzgruppen bestimmt basierend auf einer dreidimensionalen Modellstruktur und spezifischer NOE-Korrelationen. Des Weiteren wurde ein Strukturmodell unter Verwendung von NOE-Einschränkungen berechnet. Dieses Strukturmodell zeigte eine eingeschränkte Rotation um die CN-Bindung zwischen dem Käfig und der Nukleobase. Das Modell zeigte auch, dass der Käfig in der Hauptrille positioniert ist und nicht in das Lösungsmittel herausklappt. Im Vergleich zu einem zuvor charakterisierten NPE-Käfig führte die erhöhte Größe zu einer weiteren Senkung des Schmelzpunkts, zeigte jedoch einen geringeren Schmelzpunktunterschied zwischen der S- und der R-Konfiguration des Käfigs, wobei die S-Konfiguration zu einer größeren Reduktion des Schmelzpunktes führt. Dieser Trend wurde weiter untersucht und durch ein Screening unterstützt. Durch selektive Wasserinversions-Rückgewinnungsexperimente konnte ich auch zeigen, dass der Käfig die lokale Stabilität nur bis zu einer Entfernung von zwei benachbarten Basenpaaren von der Modifikationsstelle verringert. Die NOE-Daten dienten auch als guter Bezugspunkt, um die Qualität molekulardynamischer Simulationen zu testen, mit denen zusätzliche Käfigdesigns untersucht wurden. Die Kombination aus Synthese, NMR-Spektroskopie und MD-Simulationen ermöglichte bis jetzt die detaillierteste Untersuchung des Effekts vom Einbau eines einzelnen Käfigs zur Destabilisierung der DNA-Sekundärstruktur. Dabei wurden Einschränkungen des möglichen Designs aufgedeckt, aber auch die Entwicklung einer neuen, effizienteren Struktur ermöglicht.
Mein drittes Projekt konzentrierte sich auf die Charakterisierung eines RNA-Modellsystems. NMR-spektroskopische Daten von kleinen RNA-Modellsystemen – wie NOE, skalare Kopplungen, kreuzkorrelierte Relaxationsraten und RDC – sind eine unschätzbare Referenz für MD-Simulationen, obwohl die Menge der verfügbaren Literaturdaten – bis jetzt – sehr begrenzt ist. ...
The C40A/C82A double mutant of barstar has been shown to undergo cold denaturation above the water freezing point. By rapidly applying radio-frequency power to lossy aqueous samples, refolding of barstar from its cold-denatured state can be followed by real-time NMR spectroscopy. Since temperature-induced unfolding and refolding is reversible for this double mutant, multiple cycling can be utilized to obtain 2D real-time NMR data. Barstar contains two proline residues that adopt a mix of cis and trans conformations in the low-temperature-unfolded state, which can potentially induce multiple folding pathways. The high time resolution real-time 2D-NMR measurements reported here show evidence for multiple folding pathways related to proline isomerization, and stable intermediates are populated. By application of advanced heating cycles and state-correlated spectroscopy, an alternative folding pathway circumventing the rate-limiting cis-trans isomerization could be observed. The kinetic data revealed intermediates on both, the slow and the fast folding pathway.
Deconfinement of Mott localized electrons into topological and spin–orbit-coupled Dirac fermions
(2020)
The interplay of electronic correlations, spin–orbit coupling and topology holds promise for the realization of exotic states of quantum matter. Models of strongly interacting electrons on honeycomb lattices have revealed rich phase diagrams featuring unconventional quantum states including chiral superconductivity and correlated quantum spin Hall insulators intertwining with complex magnetic order. Material realizations of these electronic states are, however, scarce or inexistent. In this work, we propose and show that stacking 1T-TaSe2 into bilayers can deconfine electrons from a deep Mott insulating state in the monolayer to a system of correlated Dirac fermions subject to sizable spin–orbit coupling in the bilayer. 1T-TaSe2 develops a Star-of-David charge density wave pattern in each layer. When the Star-of-David centers belonging to two adyacent layers are stacked in a honeycomb pattern, the system realizes a generalized Kane–Mele–Hubbard model in a regime where Dirac semimetallic states are subject to significant Mott–Hubbard interactions and spin–orbit coupling. At charge neutrality, the system is close to a quantum phase transition between a quantum spin Hall and an antiferromagnetic insulator. We identify a perpendicular electric field and the twisting angle as two knobs to control topology and spin–orbit coupling in the system. Their combination can drive it across hitherto unexplored grounds of correlated electron physics, including a quantum tricritical point and an exotic first-order topological phase transition.
Excavation of burrows is an extremely physically demanding activity producing a large amount of metabolic heat. Dissipation of its surplus is crucial to avoid the risk of overheating, but in subterranean mammals it is complicated due to the absence of notable body extremities and high humidity in their burrows. IR-thermography in a previous study on two species of African mole-rats revealed that body heat was dissipated mainly through the ventral body part, which is notably less furred. Here, we analyzed the dorsal and ventral skin morphology, to test if dermal characteristics could contribute to higher heat dissipation through the ventral body part. The thickness of the epidermis and dermis and the presence, extent and connectivity of fat tissue in the dermis were examined using routine histological methods, while vascular density was evaluated using fluorescent dye and confocal microscopy in the giant mole-rat Fukomys mechowii. As in other hitherto studied subterranean mammals, no subcutaneous adipose tissue was found. All examined skin characteristics were very similar for both dorsal and ventral regions: relative content of adipose tissue in the dermis (14.4 ± 3.7% dorsally and 11.0 ± 4.0% ventrally), connectivity of dermal fat (98.5 ± 2.8% and 95.5 ± 6.8%), vascular density (26.5 ± 3.3% and 22.7 ± 2.3%). Absence of large differences in measured characteristics between particular body regions indicates that the thermal windows are determined mainly by the pelage characteristics.
Three AKT serine/threonine kinase isoforms (AKT1/AKT2/AKT3) mediate proliferation, metabolism, differentiation and anti-apoptotic signals. AKT isoforms are activated down- stream of PI3-kinase and also by PI3-kinase independent mechanisms. Mutations in the lipid phosphatase PTEN and PI3-kinase that increase PIP3 levels increase AKT signaling in a large proportion of human cancers. AKT and other AGC kinases possess a regulatory mechanism that relies on a conserved hydrophobic motif (HM) C-terminal to the catalytic core. In AKT, the HM is contiguous to the serine 473 and two other newly discovered (serine 477 and tyrosine 479) regulatory phosphorylation sites. In AKT genes, this regulatory HM region is encoded in the final exon. We identified a splice variant of AKT2 (AKT2-13a), which contains an alternative final exon and lacks the HM regulatory site. We validated the presence of mRNA for this AKT2-13a splice variant in different tissues, and the presence of AKT2-13a protein in extracts from HEK293 cells. When overexpressed in HEK293 cells, AKT2-13a is phosphorylated at the activation loop and at the zipper/turn motif phosphoryla- tion sites but has reduced specific activity. Analysis of the human transcriptome correspond- ing to other AGC kinases revealed that all three AKT isoforms express alternative transcripts lacking the HM regulatory motif, which was not the case for SGK1-3, S6K1-2, and classical, novel and atypical PKC isoforms. The transcripts of splice variants of Akt1-3 excluding the HM regulatory region could lead to expression of deregulated forms of AKT.
Drought is understood as both a lack of water (i.e., a deficit as compared to some requirement) and an anomaly in the condition of one or more components of the hydrological cycle. Most drought indices, however, only consider the anomaly aspect, i.e., how unusual the condition is. In this paper, we present two drought hazard indices that reflect both the deficit and anomaly aspects. The soil moisture deficit anomaly index, SMDAI, is based on the drought severity index, DSI, but is computed in a more straightforward way that does not require the definition of a mapping function. We propose a new indicator of drought hazard for water supply from rivers, the streamflow deficit anomaly index, QDAI, which takes into account the surface water demand of humans and freshwater biota. Both indices are computed and analyzed at the global scale, with a spatial resolution of roughly 50 km, for the period 1981-2010, using monthly time series of variables computed by the global water resources and the model WaterGAP2.2d. We found that the SMDAI and QDAI values are broadly similar to values of purely anomaly-based indices. However, the deficit anomaly indices provide more differentiated, spatial and temporal patterns that help to distinguish the degree of the actual drought hazard to vegetation health or the water supply. QDAI can be made relevant for stakeholders with different perceptions about the importance of ecosystem protection, by adapting the approach for computing the amount of water that is required to remain in the river for the well being of the river ecosystem. Both deficit anomaly indices are well suited for inclusion in local or global drought risk studies.
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.
This thesis reports three experiments on structural choices during grammatical encoding in monolingual adult speakers of German. Conceptual accessibility, one of the most central notions in language production research, as well as the phenomena of structural and perceptual priming are investigated.
In the first two experiments, a manipulation in terms of inherent conceptual accessibility which has shown universal influences on language production - the factor animacy - is combined with a manipulation making the non-canonical passive structure itself more accessible via structural priming.
Results show that, in addition to a preference for animate entities preceding inanimate entities, speakers can be structurally primed. Structural priming of passive structures led to significantly more passive responses compared to (intransitive) baseline structures.
This holds for monologue settings (Experiment 1) as well as dialogue settings (Experiment 2).
The structural priming effect was stronger in the dialogue setting compared to the monologue setting.
The third experiment combines contexts manipulating the derived conceptual accessibility of one of two entities to be described with a visual cueing manipulation increasing the perceptual accessibility of one of the referents.
Whereas a comprehensive literature review as well as the experimental work conducted within this thesis suggest that animacy and topicalization may exert universal influences on structural choices during language production, perceptual accessibility does not seem to have this potential.
In line with previous cross-linguistic work, perceptual priming in form of an implicit visual cueing manipulation did not show significant effects on speakers' structural choices in German.
These findings contrast with findings obtained for English, suggesting that language-specific characteristics in terms of word order flexibility may influence effcts on grammatical encoding during language production.
Increasing the derived accessibility of one of two referents, however, once again showed significant influences on speakers' structural choices with the topicalization of a patient referent leading to an enhanced production of passive responses.
Purpose: The diagnosis of abusive head trauma (AHT) is complex and neuroimaging plays a crucial role. Our goal was to determine whether non-neuroradiologists with standard neuroradiology knowledge perform as well as neuroradiologists with experience in pediatric neuroimaging in interpreting MRI in cases of presumptive AHT (pAHT).
Methods: Twenty children were retrospectively evaluated. Patients had been diagnosed with pAHT (6 patients), non-abusive head trauma-NAHT (5 patients), metabolic diseases (3 patients), and benign enlargement of the subarachnoid spaces (BESS) (6 patients). The MRI was assessed blindly, i.e., no clinical history was given to the 3 non-neuroradiologists and 3 neuroradiologists from 2 different institutions.
Results: Blindly, neuroradiologists demonstrated higher levels of sensitivity and positive predictive value in the diagnosis of pAHT (89%) than non-neuroradiologists (50%). Neuroradiologists chose correctly pAHT as the most probable diagnosis 16 out of 18 times; in contrast, non-neuroradiologists only chose 9 out of 18 times. In our series, the foremost important misdiagnosis for pAHT was NAHT (neuroradiologists twice and non-neuroradiologists 5 times). Only victims of motor vehicle accidents were blindly misdiagnosed as pAHT. No usual household NAHT was not misdiagnosed as pAHT. Neuroradiologists correctly ruled out pAHT in all cases of metabolic diseases and BESS.
Conclusion: MRI in cases of suspected AHT should be evaluated by neuroradiologists with experience in pediatric neuroimaging. Neuroradiologists looked beyond the subdural hemorrhage (SDH) and were more precise in the assessment of pAHT and its differential diagnosis than non-neuroradiologists were. It seems that non-neuroradiologists mainly assess whether or not a pAHT is present depending on the presence or absence of SDH.
Background: Due to the difficulties in the definite diagnosis, data on brain imaging in pediatric patients with central nervous system (CNS)-invasive mold infection (IMD) are scarce. Our aim was to describe brain imaging abnormalities seen in immunocompromised children with CNS-IMD, and to analyze retrospectively whether specific imaging findings and sequences have a prognostic value. Methods: In a retrospective study of 19 pediatric patients with proven or probable CNS-IMD, magnetic resonance imaging (MRI)-findings were described and analyzed. The results were correlated with outcome, namely death, severe sequelae, or no neurological sequelae. Results: 11 children and 8 adolescents (11/8 with proven/probable CNS-IMD) were included. Seven of the patients died and 12/19 children survived (63%): seven without major neurological sequelae and five with major neurological sequelae. Multifocal ring enhancement and diffusion restriction were the most common brain MRI changes. Diffusion restriction was mostly seen at the core of the lesion. No patient with disease limited to one lobe died. Perivascular microbleeding seen on susceptibility weighted imaging (SWI) and/or gradient-echo/T2* images, as well as infarction, were associated with poor prognosis. Conclusions: The presence of infarction was related to poor outcome. As early microbleeding seems to be associated with poor prognosis, we suggest including SWI in routine diagnostic evaluation of immunocompromised children with suspected CNS-IMD.
Background: Patient information materials and decision aids are essential tools for helping patients make informed decisions and share in decision-making. The aim of this study was to investigate the quality of the written patient information materials available at general practices in Styria, Austria.
Methods: We asked general practitioners to send in all patient information materials available in their practices and to answer a short questionnaire. We evaluated the materials using the Ensuring Quality Information for Patients (EQIP-36) instrument.
Results: A total of 387 different patient information materials were available for quality assessment. These materials achieved an average score of 39 out of 100. The score was below 50 for 78% of all materials. There was a significant lack of information on the evidence base of recommendations. Only 9 % of the materials provided full disclosure of their evidence sources. We also found that, despite the poor quality of the materials, 89% of general practitioners regularly make active use of them during consultations with patients.
Conclusion: Based on international standards, the quality of patient information materials available at general practices in Styria is poor. The vast majority of the materials are not suitable as a basis for informed decisions by patients. However, most Styrian general practitioners use written patient information materials on a regular basis in their daily clinical practice. Thus, these materials not only fail to help raise the health literacy of the general population, but may actually undermine efforts to enable patients to make shared informed decisions. To increase health literacy, it is necessary to make high quality, evidence-based and easy-to-understand information material available to patients and the public. For this, it may be necessary to set up a centralized and independent clearinghouse.
Background & Aims: Acute‐on‐chronic liver failure (ACLF) is characterized by high short‐term mortality and systemic inflammation (SI). Recently, different cardiodynamic states were shown to independently predict outcomes in cirrhosis. The relationship between cardiodynamic states, SI, and portal hypertension and their impact on ACLF development remains unclear. The aim of this study was therefore to evaluate the interplay of cardiodynamic state and SI on fatal ACLF development in cirrhosis.
Results: At inclusion, hemodynamic measures including cardiac index (CI) and hepatic venous pressure gradient of 208 patients were measured. Patients were followed prospectively for fatal ACLF development (primary endpoint). SI was assessed by proinflammatory markers such as interleukins (ILs) 6 and 8 and soluble IL‐33 receptor (sIL‐33R). Patients were divided according to CI (<3.2; 3.2‐4.2; >4.2 L/min/m2) in hypo‐ (n = 84), normo‐ (n = 69) and hyperdynamic group (n = 55). After a median follow‐up of 3 years, the highest risk of fatal ACLF was seen in hyperdynamic (35%) and hypodynamic patients (25%) compared with normodynamic (14%) (P = .011). Hyperdynamic patients showed the highest rate of SI. The detectable level of IL‐6 was an independent predictor of fatal ACLF development.
Conclusions: Cirrhotic patients with hyperdynamic and hypodynamic circulation have a higher risk of fatal ACLF. Therefore, the cardiodynamic state is strongly associated with SI, which is an independent predictor of development of fatal ACLF.
Hepatic inflammasome activation as origin of Interleukin-1α and Interleukin-1β in liver cirrhosis
(2020)
Background & Aims: Spontaneous portosystemic shunts (SPSS) frequently develop in liver cirrhosis. Recent data suggested that the presence of a single large SPSS is associated with complications, especially overt hepatic encephalopathy (oHE). However, the presence of >1 SPSS is common. This study evaluates the impact of total cross-sectional SPSS area (TSA) on outcomes in patients with liver cirrhosis.
Methods: In this retrospective international multicentric study, CT scans of 908 cirrhotic patients with SPSS were evaluated for TSA. Clinical and laboratory data were recorded. Each detected SPSS radius was measured and TSA calculated. One-year survival was the primary endpoint and acute decompensation (oHE, variceal bleeding, ascites) was the secondary endpoint.
Results: A total of 301 patients (169 male) were included in the training cohort. Thirty percent of all patients presented with >1 SPSS. A TSA cut-off of 83 mm2 was used to classify patients with small or large TSA (S-/L-TSA). Patients with L-TSA presented with higher model for end-stage liver disease score (11 vs. 14) and more commonly had a history of oHE (12% vs. 21%, p <0.05). During follow-up, patients with L-TSA experienced more oHE episodes (33% vs. 47%, p <0.05) and had lower 1-year survival than those with S-TSA (84% vs. 69%, p <0.001). Multivariate analysis identified L-TSA (hazard ratio 1.66; 95% CI 1.02–2.70, p <0.05) as an independent predictor of mortality. An independent multicentric validation cohort of 607 patients confirmed that patients with L-TSA had lower 1-year survival (77% vs. 64%, p <0.001) and more oHE development (35% vs. 49%, p <0.001) than those with S-TSA.
Conclusion: This study suggests that TSA >83 mm2 increases the risk for oHE and mortality in patients with cirrhosis. Our results support the clinical use of TSA/SPSS for risk stratification and decision-making in the management of patients with cirrhosis.
Lay summary: The prevalence of spontaneous portosystemic shunts (SPSS) is higher in patients with more advanced chronic liver disease. The presence of more than 1 SPSS is common in advanced chronic liver disease and is associated with the development of hepatic encephalopathy. This study shows that total cross-sectional SPSS area (rather than diameter of the single largest SPSS) predicts survival in patients with advanced chronic liver disease. Our results support the clinical use of total cross-sectional SPSS area for risk stratification and decision-making in the management of SPSS.
Hintergrund: Die Einnahme vieler Antidepressiva und Antipsychotika in der frühen Schwangerschaft kann nach aktuellem Forschungsstand als sicher bezüglich des Risikos für Fehlbildungen erachtet werden. Daten hinsichtlich der Sicherheit einer Psychopharmakotherapie während der Stillperiode sind hingegen rar. Die meisten Betroffenen würden einerseits gerne ihre Kinder stillen, andererseits wollen sie aber auch sicher sein, dass sie ihrem Nachwuchs dadurch nicht schaden.
Ziele: Unser Ziel war es herauszufinden ob eine Korrelation zwischen der Tagesdosis der Psychopharmaka und der Medikamentenkonzentration im Serum sowie in der Muttermilch (MM) besteht. Weiterhin untersuchten wir, ob es eine allgemeingültige Regeln gibt, wie sich Muttermilchmedikamentenkonzentrationen im Tagesverlauf verhalten. Außerdem wollten wir herausfinden ob die Medikamentenexposition in der Schwangerschaft und/oder Stillperiode einen Einfluss auf die Entwicklung des Kindes in den ersten zwölf Lebensmonaten hat.
Methoden: Wir untersuchten therapeutische Medikamentenspiegel parallel in Serum und MM zu verschiedenen Zeitpunkten um herauszufinden wann die höchsten/niedrigsten Konzentrationen ermittelt werden konnten. Neben dem Talspiegel, nach 12 h oder 24 h (T1), sammelten wir Proben 4 h (T5) und 8 h (T6) nach der Medikamenteneinnahme sowie direkt nach der Medikamenteneinnahme (T2), 1 h nach T2 (T3) und direkt beim nächsten Stillen (T4). Die Messungen wurden im TDM Labor im Zentrum für psychsiche Gesundheit, Universitätsklinikum Würzburg mittels isokratischer reversed-phase high performance liquid Chromatographie durchgeführt. Wir rekrutierten 25 Patientinnen, die in der ambulanten Spezialsprechstunde für psychiatrische Erkrankungen in Schwangerschaft und Stillzeit behandelt wurden. 68% der Patientinnen nahmen in der Schwangerschaft schon ein Psychopharmakon ein. Die Patientinnen litten an unipolaren Depressionen (n = 15), bipolaren Störungen (n = 2), schizoaffektiven Störungen (n = 2) sowie Angst- (n = 4) und Zwangsstörungen (n = 2). Das Spektrum von Antidepressiva und Antipsychotika erstreckte sich von Amitriptylin/Nortriptylin, Clomipramin/N-Desmethyl-Clomipramin, Mirtazapin, Escitalopram, Citalopram, Sertralin, Venlafaxin/ O-Desmethyl-Venlafaxin bis hin zu Lamotrigin und Quetiapin. Weiterhin erfassten wir ob es postnatale Auffälligkeiten sowie im Verlauf Entwicklungsauffälligkeiten bei den exponierten Kinder gab (Daten aus den routinemäßigen U-Untersuchungen der ersten 12 Lebensmonate). Um mehr Daten zur Kindesentwicklung zu sammeln, interviewten wir in einem retrospektiven Unterprojekt 14 weitere Patientinnen, die in der Vergangenheit von der Thematik betroffen waren.
Ergebnisse: Die parallel bestimmten Talspiegel in Serum und MM korrelierten nicht signifikant bei der Analyse aller Medikamente zusammen oder bei der Analyse der einzelnen Medikamente (Spearman Rho Korrelation, p > 0,05). Die Talspiegel im Serum korrelierten weder signifikant mit den Muttermilchkonzentration nach 4 h (T5), noch mit denen nach 8 h (T6) (Spearman Rho Korrelation, p = 0,46; p = 0,08). Die Tagesdosis korrelierte signifikant mit dem Talspiegel im Serum (p = 0,001), jedoch nicht mit den gleichzeitig bestimmten Muttermilchkonzentrationen (p = 0,88). Die Konzentrationen von Venlafaxin in der MM fielen relativ hoch aus. Es zeigte sich eine große interindividuelle Variation der Konzentrationen der unterschiedlichen Medikamente zu verschiedenen Zeitpunkten. Clomipramin und Quetiapin konnten gar nicht oder nur in sehr niedrigen Konzentrationen in der MM gemessen werden (n = 2, n = 4) wie auch Sertralin (ohne Ausreißer-Werte) und Escitalopram. Auch konnte Quetiapin nicht im Serum eines gestillten Kindes nachgewiesen werden, bei dem wir Blutproben gewinnen konnten (n = 1). Keines der gestillten Kinder zeigte negative Auswirkungen aufgrund der Medikation. Die höchste „concentration-bydose-ratio“ (C/D) in der MM wurden für Venlafaxin (n = 4, C/D MM = 5,11) und Lamotrigin (n = 1, C/D MM = 10,0) errechnet, während Clomipramin (n = 2, C/D MM = 0,0), Quetiapin (n = 4, C/D MM = 0,02) und Sertralin (n = 3, C/D MM = 0,03) die niedrigsten Quotienten zeigten. Wir kalkulierten die höchste „milk-to-plasma-ratio“ (M/P) für Mirtazapin (n = 3, M/P = 3,92) und Venlafaxin (n = 2, M/P = 2,4) sowie die niedrigsten für Clomipramin (n = 2, M/P = 0), Quetiapin (n = 3, M/P = 0,03) und Sertralin (n = 3, M/P = 0,08), was für ein niedriges Eindringungsvermögen vom Serum in die MM spricht.
Sei es ein Stadtteil im Nordend oder ein Park samt dazugehörigem Schlösschen – der Name Holzhausen ist in Frankfurt am Main allgegenwärtig. Die von Holzhausen zählen zu den ältesten Familien Frankfurts. Seit der Mitte des 13. Jahrhunderts prägten ihre Vertreter die Geschicke der Stadt, vor allem im Bereich der Politik, aber auch dem der Kultur. Im frühen 19. Jahrhundert teilte sich die Familie in zwei Linien: Der ältere Zweig verblieb in Frankfurt und starb mit Adolph Freiherr von Holzhausen 1923 aus, die jüngere Linie hingegen ist seit der Mitte des 19. Jahrhunderts in Österreich ansässig. Mit dem Tod Adolph von Holzhausens ging das Erbe des Frankfurter Familienzweigs an die Stadt Frankfurt. Adolph von Holzhausens Vorhaben, schon zu seinen Lebzeiten mit dem Erlös aus dem Verkauf der Grundstücke im Holzhausenviertel den Bau der Universitätsbibliothek zu finanzieren, wurde durch die Hyperinflation vereitelt.
Im nachfolgenden Interview spricht Elena Holzhausen über die heutige Rolle ihrer Familie, deren Bezug zu Frankfurt, die Fortführung der Familientradition und das Mäzenatentum. Elena Holzhausen ist Diözesankonservatorin der Erzdiözese Wien und verheiratet mit Georg Holzhausen. Dessen Bruder, der Dokumentarfilmer Johannes Holzhausen, hatte für die im Jahre 2014 im Historischen Museum Frankfurt gezeigte Ausstellung "Die Holzhausen. Frankfurts älteste Familie" einen Film über das gegenwärtige private Leben der Familie gedreht.
Access to specialized care is essential for people with Parkinson´s disease (PD). Given the growing number of people with PD and the lack of general practitioners and neurologists, particularly in rural areas in Germany, specialized PD staff (PDS), such as PD nurse specialists and Parkinson Assistants (PASS), will play an increasingly important role in the care of people with PD over the coming years. PDS have several tasks, such as having a role as an educator or adviser for other health professionals or an advocate for people with PD to represent and justify their needs. PD nurse specialists have been established for a long time in the Netherlands, England, the USA, and Scandinavia. In contrast, in Germany, distinct PDS models and projects have been established. However, these projects and models show substantial heterogeneity in terms of access requirements, education, theoretical and practical skills, principal workplace (inpatient vs. outpatient), and reimbursement. This review provides an overview of the existing forms and regional models for PDS in Germany. PDS reimbursement concepts must be established that will foster an implementation throughout Germany. Additionally, development of professional roles in nursing and more specialized care in Germany is needed.
Unc-51-like kinase 4 (ULK4) is a pseudokinase that has been linked to the development of several diseases. Even though sequence motifs required for ATP binding in kinases are lacking, ULK4 still tightly binds ATP and the presence of the co-factor is required for structural stability of ULK4. Here, we present a high-resolution structure of a ULK4-ATPγS complex revealing a highly unusual ATP binding mode in which the lack of the canonical VAIK motif lysine is compensated by K39, located N-terminal to αC. Evolutionary analysis suggests that degradation of active site motifs in metazoan ULK4 has co-occurred with an ULK4-specific activation loop, which stabilizes the C helix. In addition, cellular interaction studies using BioID and biochemical validation data revealed high confidence interactors of the pseudokinase and armadillo repeat domains. Many of the identified ULK4 interaction partners were centrosomal and tubulin-associated proteins and several active kinases suggesting interesting regulatory roles for ULK4.
Unc-51-like kinase 4 (ULK4) is a pseudokinase that has been linked to the development of several diseases. Even though sequence motifs required for ATP binding in kinases are lacking, ULK4 still tightly binds ATP and the presence of the cofactor is required for structural stability of ULK4. Here we present a high-resolution structure of a ULK4-ATPγS complex revealing a highly unusual ATP binding mode in which the lack of the canonical VAIK motif lysine is compensated by K39, located N-terminal to αC. Evolutionary analysis suggests that degradation of active site motifs in metazoan ULK4 has co-occurred with an ULK4 specific activation loop, which stabilizes the C-helix. In addition, cellular interaction studies using BioID and biochemical validation data revealed high confidence interactors of the pseudokinase and armadillo repeat domains. Many of the identified ULK4 interaction partners were centrosomal and tubulin associated proteins and several active kinases suggesting new roles for ULK4.
Highlights: Structure of the ULK4 ATP complex reveals a unique ATP binding mode.
Disease associated mutations modulate ATP binding and ULK4 stability
Degradation of active site motifs co-occurred in evolution with an ULK4 specific activation loop
BioID suggests a role of ULK4 regulating centrosomal and cytoskeletal functions,
Certain electron-rich 1,4-diborabenzene derivatives efficiently activate single, double, and triple bonds and thereby increasingly compete with transition metals in homogeneous catalysis. This review compares the activation of three model substrates (H2, H2C=CH2, CO2) by (i) 9,10-dihydro-9,10-diboraanthracene dianions, (ii) their neutral carbene-stabilized congeners, (iii) 1,3,2,5-diazadiborinines, and (iv) 1,4,2,5-diazadiborinines. Distinct structure-properties relationships become apparent, the most influential factors being (i) the steric demands of the B-bonded substituents, (ii) the charges on the B-doped (hetero)arenes, (iii) charge polarization as a result of additional N-doping, and (iv) the energies and nodal structures of the frontier orbitals. The observed reactions are explained by a transition metal-like activation mechanism. If the two boron atoms are chemically inequivalent, contributions of a B(+I)/B(+III) mixed-valence state determine the observed regioselectivities when polar substrates are added. The lessons learned from the conversions of the model substrates are subsequently used to rationalize the behavior of the B2 heterocycles also toward more sophisticated substrate molecules. Finally, catalytic cycles based on H2- and H−-transfers, hydroboration reactions, and CO2 reductions will be covered.
Formulation scientists have developed a toolkit of strategies that can improve the solubility and subsequent bioavailability of poorly soluble candidates. Amorphous formulations are especially appealing due to the significant improvement in solubility the amorphous form can provide, but must be stabilized for effective performance (Timpe, 2007).
2. The Importance of Drug Polymer Interactions in Precipitation Inhibition
Polymeric “precipitation inhibitors” have seen widespread usage in the literature (Warren, 2010). The precipitation inhibition effect of polymers on precipitations is related to interference with nucleation and crystal growth (Xu, 2013). Many techniques have been reported in the literature to predict these interactions, however, they are not suitable to screening due to API and time resources required, which are not amenable to early stage pharmaceutical development.
3. Mesoporous Silica: An Emerging Formulation Technology
Mesoporous silicon dioxide has emerged in recent years as a new option for stabilizing the amorphous form. Upon impregnation of the silica with a concentrated drug solution, the drug can be molecularly adsorbed and locally and sterically confined, preventing recrystallization (Ditzinger, 2018). Upon administration of mesoporous silica formulations to the body the amorphous formulation generates supersaturation which must be stabilized using precipitation inhibitors (Guzman, 2007).
4. Co-incorporation: A New Method to Combine Precipitation Inhibitors with Mesoporous Silica
There has been no systematic study of how best to incorporate precipitation inhibitors into mesoporous silica formulations. The current standard practice involves combining inhibitors in a physical mixture with the drug-loaded silica, either by pestle and mortar or overhead stirring. Due to the lack of a defined protocol, there is uncertainty about how reliably the precipitation inhibitor is combined with the drug-loaded silica on a batch to batch basis. In this work, a novel co-incorporated formulation of glibenclamide and the precipitation inhibitor, HPMCAS, onto mesoporous silica was described. By co-incorporating the precipitation inhibitor, the formulation significantly outperformed the commonly applied simple physical blend due to the formation of drug-polymer interactions in the solid state.
5. In Silico Pharmaceutics: A New Method to Select Precipitation Inhibitors for Mesoporous Silica
An approach that can incorporate understanding of the drug-polymer interactions with a quick and efficient screening process would be very useful. The COnductor like Screening MOdel for Real Solvents (COSMO-RS) is a quantum mechanical theory, which can be used to derive thermodynamic properties of interest. (Klamt, 1993, 1995, 2003). We proposed excess mixing enthalpies of drug and polymer could be calculated using the COSMO-RS theory. This new approach was applied to screen precipitation inhibitors for three model compounds, all of which showed a strong positive correlation between the rank assigned based on the calculated free enthalpy of mixing and the overall formulation performance.
6. Conclusion
This body of work aimed to improve the processes underpinning the design and development of mesoporous silica with precipitation inhibitors. Firstly, this involved two extensive literature reviews in the area of solubility enhancement formulation technologies and precipitation inhibition. Secondly, a mechanistic rational and experimental approach was developed to improve the formulation of precipitation inhibitors with mesoporous silica, the “co-incorporation” approach significantly improved process efficiency and formulation performance. Finally, combining insights from the aforementioned review, and learnings from the mechanistic analysis of the “co-incorporation” approach, an in silico screening protocol was developed to calculate the enthalpy of interaction between drug and polymer, to identify the most optimal precipitation inhibitor for a given formulation.
Mesoporous silica has emerged as an enabling formulation for poorly soluble active pharmaceutical ingredients (APIs). Unlike other formulations, mesoporous silica typically does not inhibit precipitation of supersaturated API therefore, a suitable precipitation inhibitor (PI) should be added to increase absorption from the gastrointestinal (GI) tract. However, there is limited research about optimal processes for combining PIs with silica formulations. Typically, the PI is added by simply blending the API-loaded silica mechanically with the selected PI. This has the drawback of an additional blending step and may also not be optimal with regard to release of drug and PI. By contrast, loading PI simultaneously with the API onto mesoporous silica, i.e. co-incorporation, is attractive from both a performance and practical perspective. The aim of this study was to demonstrate the utility of a co-incorporation approach for combining PIs with silica formulations, and to develop a mechanistic rationale for improvement of the performance of silica formulations using the co-incorporation approach. The results indicate that co-incorporating HPMCAS with glibenclamide onto silica significantly improved the extent and duration of drug supersaturation in single-medium and transfer dissolution experiments. Extensive spectroscopic characterization of the formulation revealed that the improved performance was related to the formation of drug-polymer interactions already in the solid state; the immobilization of API-loaded silica on HPMCAS plates, which prevents premature release and precipitation of API; and drug-polymer proximity on disintegration of the formulation, allowing for rapid onset of precipitation inhibition. The data suggests that co-incorporating the PI with the API is appealing for silica formulations from both a practical and formulation performance perspective.
The transcription factor ∆Np63 is a master regulator of epithelial cell identity and essential for the survival of squamous cell carcinoma (SCC) of lung, head and neck, oesophagus, cervix and skin. Here, we report that the deubiquitylase USP28 stabilizes ∆Np63 and maintains elevated ∆NP63 levels in SCC by counteracting its proteasome‐mediated degradation. Impaired USP28 activity, either genetically or pharmacologically, abrogates the transcriptional identity and suppresses growth and survival of human SCC cells. CRISPR/Cas9‐engineered in vivo mouse models establish that endogenous USP28 is strictly required for both induction and maintenance of lung SCC. Our data strongly suggest that targeting ∆Np63 abundance via inhibition of USP28 is a promising strategy for the treatment of SCC tumours.
The policy studies literature is divided on how information processing takes place in policy processes. Punctuated equilibrium theory claims that policymakers tend to process information disproportionately, giving more weight to some incoming signals than to others. By contrast, thermostatic models of policymaking argue that policymakers respond in a more proportionate way. In this paper, we analyse information processing in the adoption of Total Allowable Catches (TACs) under the European Union’s (EU) Common Fisheries Policy. Based on a novel measure for the proportionality of information processing, it shows that over time TACs have become more closely aligned with incoming signals about fish stocks. This development can be explained through a combination of changing discourses around fisheries conservation and institutional adjustments in EU fisheries policy. This analysis has implications for the debate between punctuated equilibrium and thermostatic models of policymaking and our understanding of the effectiveness of EU fisheries policies.
Knowledge on the postmortem interval (PMI) of wild boar (Sus scrofa) carcasses is crucial in the event of an outbreak of African swine fever in a wild boar population. Therefore, a thorough understanding of the decomposition process of this species in different microhabitats is necessary. We describe the decomposition process of carcasses exposed in cages. Trial 1 compared a wild boar and a domestic pig (Sus scrofa domesticus) under similar conditions; Trial 2 was performed with three wild boar piglets in the sunlight, shade, or in a wallow, and Trial 3 with two adult wild boar in the sun or shade. The wild boar decomposed more slowly than the domestic pig, which shows that standards derived from forensic studies on domestic pigs are not directly applicable to wild boar. The carcasses exposed to the sun decomposed faster than those in the shade did, and the decomposition of the carcass in the wallow took longest. To assess the state of decomposition, we adapted an existing total body scoring system originally developed for humans. Based on our studies, we propose a checklist tailored to wild boar carcasses found in the field that includes the most important information for a reliable PMI estimation.
La Escuela de Frankfurt ha jugado un papel determinante en la recepción posterior del Empirismo Lógico. Sin embargo, la revisión histórica del Empirismo Lógico ha revelado que esta visión partía de ciertas simplificaciones que no hacían justicia a la diversidad y complejidad de posturas que el movimiento incluía. En El ataque más reciente a la Metafísica Horkheimer sostiene que el positivismo es necesariamente irreflexivo y ahistórico en su explicación de las ciencias, y que su carencia de una teoría social que las contextualice lo vuelve incapaz de criticar el rol de la ciencia y de la razón instrumental en su aceptación del orden establecido, comprometiéndolo con una visión conservadora de la política. Se problematizará la atribución hecha al Empirismo Lógico de sostener una concepción de “razón instrumental” generalizada, y se sostendrá que, desde la visión de Neurath, el carácter auto-reflexivo de la ciencia admite una consideración crítica de los fines y propósitos del conocimiento.
Background: Ever decreasing costs along with advances in sequencing and library preparation technologies enable even small research groups to generate chromosome-level assemblies today. Here we report the generation of an improved chromosome-level assembly for the Siamese fighting fish (Betta splendens) that was carried out during a practical university Master’s course. The Siamese fighting fish is a popular aquarium fish and an emerging model species for research on aggressive behaviour. We updated the current genome assembly by generating a new long-read nanopore-based assembly with subsequent scaffolding to chromosome-level using previously published HiC data.
Findings: The use of nanopore-based long-read data sequenced on a MinION platform (Oxford Nanopore Technologies) allowed us to generate a baseline assembly of only 1,276 contigs with a contig N50 of 2.1 Mbp, and a total length of 441 Mbp. Scaffolding using previously published HiC data resulted in 109 scaffolds with a scaffold N50 of 20.7 Mbp. More than 99% of the assembly is comprised in 21 scaffolds. The assembly showed the presence of 95.8% complete BUSCO genes from the Actinopterygii dataset indicating a high quality of the assembly.
Conclusion: We present an improved full chromosome-level assembly of the Siamese fighting fish generated during a university Master’s course. The use of ~35× long-read nanopore data drastically improved the baseline assembly in terms of continuity. We show that relatively in-expensive high-throughput sequencing technologies such as the long-read MinION sequencing platform can be used in educational settings allowing the students to gain practical skills in modern genomics and generate high quality results that benefit downstream research projects.
From 1945 to the early 1960s, the US government undertook numerous atomic and hydrogen bomb tests. These full-scale explosions were recorded on film from various angles, and at different speeds. Indeed, it soon became required to obtain images of the very first milli-seconds of the expanding phase of the atomic fireball. Ultrahigh-speed cameras able to produce such images were specifically developed for that purpose. This article explores the different “media-temporalities” that intersect in those images. I focus on the “micro-processes happening on a technical level that are very fast,” and more specifically the ones that go into the “Rapatronic camera” designed by Harold Edgerton (head of the US national defense contractor company EG&G) to record the atomic fireball early formation. The scientific slow-motion films and high-speed photographic images operate at the junction of the micro-scale temporality of the atomic explosions’ early phases, and the macro-scale temporality of the political and ecological implications of these explosions. I argue that these films are the objects and inscriptions of micro-temporalities, macro-history and geological times.
Importance Coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. Case reports of hospitalized patients suggest that COVID-19 prominently affects the cardiovascular system, but the overall impact remains unknown.
Objective To evaluate the presence of myocardial injury in unselected patients recently recovered from COVID-19 illness.
Design, Setting, and Participants In this prospective observational cohort study, 100 patients recently recovered from COVID-19 illness were identified from the University Hospital Frankfurt COVID-19 Registry between April and June 2020.
Exposure Recent recovery from severe acute respiratory syndrome coronavirus 2 infection, as determined by reverse transcription–polymerase chain reaction on swab test of the upper respiratory tract.
Main Outcomes and Measures Demographic characteristics, cardiac blood markers, and cardiovascular magnetic resonance (CMR) imaging were obtained. Comparisons were made with age-matched and sex-matched control groups of healthy volunteers (n = 50) and risk factor–matched patients (n = 57).
Results Of the 100 included patients, 53 (53%) were male, and the mean (SD) age was 49 (14) years. The median (IQR) time interval between COVID-19 diagnosis and CMR was 71 (64-92) days. Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization. At the time of CMR, high-sensitivity troponin T (hsTnT) was detectable (greater than 3 pg/mL) in 71 patients recently recovered from COVID-19 (71%) and significantly elevated (greater than 13.9 pg/mL) in 5 patients (5%). Compared with healthy controls and risk factor–matched controls, patients recently recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, and raised native T1 and T2. A total of 78 patients recently recovered from COVID-19 (78%) had abnormal CMR findings, including raised myocardial native T1 (n = 73), raised myocardial native T2 (n = 60), myocardial late gadolinium enhancement (n = 32), or pericardial enhancement (n = 22). There was a small but significant difference between patients who recovered at home vs in the hospital for native T1 mapping (median [IQR], 1119 [1092-1150] ms vs 1141 [1121-1175] ms; P = .008) and hsTnT (4.2 [3.0-5.9] pg/dL vs 6.3 [3.4-7.9] pg/dL; P = .002) but not for native T2 mapping. None of these measures were correlated with time from COVID-19 diagnosis (native T1: r = 0.07; P = .47; native T2: r = 0.14; P = .15; hsTnT: r = −0.07; P = .50). High-sensitivity troponin T was significantly correlated with native T1 mapping (r = 0.33; P < .001) and native T2 mapping (r = 0.18; P = .01). Endomyocardial biopsy in patients with severe findings revealed active lymphocytic inflammation. Native T1 and T2 were the measures with the best discriminatory ability to detect COVID-19–related myocardial pathology.
Conclusions and Relevance In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.
Short linear motifs (SLiMs) located in disordered regions of multidomain proteins are important for the organization of protein–protein interaction networks. By dynamic association with their binding partners, SLiMs enable assembly of multiprotein complexes, pivotal for the regulation of various aspects of cell biology in higher organisms. Despite their importance, there is a paucity of molecular tools to study SLiMs of endogenous proteins in live cells. LC3 interacting regions (LIRs), being quintessential for orchestrating diverse stages of autophagy, are a prominent example of SLiMs and mediate binding to the ubiquitin-like LC3/GABARAP family of proteins. The role of LIRs ranges from the posttranslational processing of their binding partners at early stages of autophagy to the binding of selective autophagy receptors (SARs) to the autophagosome. In order to generate tools to study LIRs in cells, we engineered high affinity binders of LIR motifs of three archetypical SARs: OPTN, p62, and NDP52. In an array of in vitro and cellular assays, the engineered binders were shown to have greatly improved affinity and specificity when compared with the endogenous LC3/GABARAP family of proteins, thus providing a unique possibility for modulating LIR interactions in living systems. We exploited these novel tools to study the impact of LIR inhibition on the fitness and the responsiveness to cytarabine treatment of THP-1 cells – a model for studying acute myeloid leukemia (AML). Our results demonstrate that inhibition of LIR of a single autophagy receptor is insufficient to sensitize the cells to cytarabine, while simultaneous inhibition of three LIR motifs in three distinct SARs reduces the IC50 of the chemotherapeutic.
Background: Meta-analysis of observational studies concluded that soft drinks may increase the risk of depression, while high consumption of coffee and tea may reduce the risk. Objectives were to explore the associations between the consumption of soft drinks, coffee or tea and: (1) a history of major depressive disorder (MDD) and (2) the severity of depressive symptoms clusters (mood, cognitive and somatic/vegetative symptoms). Methods: Cross-sectional and longitudinal analysis based on baseline and 12-month-follow-up data collected from four countries participating in the European MooDFOOD prevention trial. In total, 941 overweight adults with subsyndromal depressive symptoms aged 18 to 75 years were analyzed. History of MDD, depressive symptoms and beverages intake were assessed. Results: Sugar-sweetened soft drinks were positively related to MDD history rates whereas soft drinks with non-nutritive sweeteners were inversely related for the high vs. low categories of intake. Longitudinal analysis showed no significant associations between beverages and mood, cognitive and somatic/vegetative clusters. Conclusion: Our findings point toward a relationship between soft drinks and past MDD diagnoses depending on how they are sweetened while we found no association with coffee and tea. No significant effects were found between any studied beverages and the depressive symptoms clusters in a sample of overweight adults.
We explore the tilted-pulse-front excitation technique to control the superradiant emission of terahertz (THz) pulses from large-area photonconductive semiconductor switches. Two cases are studied. First, a photoconductive antenna emitting into free space, where the propagation direction of the optically generated THz beam is controlled by the choice of the tilt angle of the pump pulse front. Second, a THz waveguide structure with an integrated photoconductive window for the generation of THz radiation, where the injection of the THz radiation into a waveguide mode is optimized by the pulse front tilt. By providing long interaction lengths, such a waveguide-based optical-pump/THz-probe set-up may provide a new platform for the study of diverse short-lived optically induced excitations.
Background and Aims: Monocyte chemotactic protein-1 (MCP-1) is a potent chemoattractant for monocytes. It is involved in pathogenesis of several inflammatory diseases. Hepatic MCP-1 is a readout of macrophage activation. While inflammation is a major driver of liver disease progression, the origin and role of circulating MCP-1 as a biomarker remains unclear.
Methods: Hepatic CC-chemokine ligand 2 (CCL2) expression and F4/80 staining for Kupffer cells were measured and correlated in a mouse model of chronic liver disease (inhalative CCl4 for 7 weeks). Next, hepatic RNA levels of CCL2 were measured in explanted livers of 39 patients after transplantation and correlated with severity of disease. Changes in MCP-1 were further evaluated in a rat model of experimental cirrhosis and acute-on-chronic liver failure (ACLF). Finally, we analyzed portal and hepatic vein levels of MCP-1 in patients receiving transjugular intrahepatic portosystemic shunt insertion for complications of portal hypertension.
Results: In this mouse model of fibrotic hepatitis, hepatic expression of CCL2 (P = 0.009) and the amount of F4/80 positive cells in the liver (P < 0.001) significantly increased after induction of hepatitis by CCl4 compared to control animals. Moreover, strong correlation of hepatic CCL2 expression and F4/80 positive cells were seen (P = 0.023). Furthermore, in human liver explants, hepatic transcription levels of CCL2 correlated with the MELD score of the patients, and thus disease severity (P = 0.007). The experimental model of ACLF in rats revealed significantly higher levels of MCP-1 plasma (P = 0.028) and correlation of hepatic CCL2 expression (R = 0.69, P = 0.003). Particularly, plasma MCP-1 levels did not correlate with peripheral blood monocyte CCL2 expression. Finally, higher levels of MCP-1 were observed in the hepatic compared to the portal vein (P = 0.01) in patients receiving TIPS. Similarly, a positive correlation of MCP-1 with Child-Pugh score was observed (P = 0.018). Further, in the presence of ACLF, portal and hepatic vein levels of MCP-1 were significantly higher compared to patients without ACLF (both P = 0.039).
Conclusion: Circulating levels of MCP-1 mainly derive from the injured liver and are associated with severity of liver disease. Therefore, liver macrophages contribute significantly to disease progression. Circulating MCP-1 may reflect the extent of hepatic macrophage activation.
Alcoholism is one of the leading and increasingly prevalent reasons of liver associated morbidity and mortality worldwide. Alcoholic hepatitis (AH) constitutes a severe disease with currently no satisfying treatment options. Lipoxin A4 (LXA4), a 15-lipoxygenase (ALOX15)-dependent lipid mediator involved in resolution of inflammation, showed promising pre-clinical results in the therapy of several inflammatory diseases. Since inflammation is a main driver of disease progression in alcoholic hepatitis, we investigated the impact of endogenous ALOX15-dependent lipid mediators and exogenously applied LXA4 on AH development. A mouse model for alcoholic steatohepatitis (NIAAA model) was tested in Alox12/15+/+ and Alox12/15−/− mice, with or without supplementation of LXA4. Absence of Alox12/15 aggravated parameters of liver disease, increased hepatic immune cell infiltration in AH, and elevated systemic neutrophils as a marker for systemic inflammation. Interestingly, i.p. injections of LXA4 significantly lowered transaminase levels only in Alox12/15−/− mice and reduced hepatic immune cell infiltration as well as systemic inflammatory cytokine expression in both genotypes, even though steatosis progressed. Thus, while LXA4 injection attenuated selected parameters of disease progression in Alox12/15−/− mice, its beneficial impact on immunity was also apparent in Alox12/15+/+ mice. In conclusion, pro-resolving lipid mediators may be beneficial to reduce inflammation in alcoholic hepatitis.
Bei der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) handelt es sich um eine hochprävalente Erkrankung, die bisher insbesondere im Erwachsenenalter nur unzureichend berücksichtigt wurde. Neben den Kernsymptomen bestehend aus Einschränkungen in der Aufmerksamkeit sowie einem erhöhten Maß an Hyperaktivität und Impulsivität gilt es, Komorbiditäten und Beeinträchtigungen zu berücksichtigen, die mit dieser Erkrankung einhergehen. In früheren Studien konnte bereits nachgewiesen werden, dass sowohl Kinder als auch Erwachsene mit einer ADHS vermehrte Unfälle und infolgedessen eine erhöhte Rate an stationären Behandlungen aufweisen. Zusätzlich besteht bei ADHS-Betroffenen ein höheres Risiko, frühzeitig zu versterben, wobei Unfälle als unnatürliche Todesursache den häufigsten Grund darstellen. Bisher existieren auf internationaler Ebene einige Studien, die sich mit den Zusammenhängen von adulter ADHS und Unfallraten beschäftigten. Eine differenzierte Betrachtung, die eine deutsche Population einschließt und den Einfluss des Geschlechts auf das Unfallgeschehen bei ADHS-Betroffenen untersucht, wurde bisher nicht realisiert. Aus diesen Gründen führten wir eine Querschnittsstudie auf unfallchirurgischen Stationen an zwei Kliniken in Frankfurt am Main durch. Im Rahmen der Studie sollte die Prävalenz von adulter ADHS bei stationär betreuten Unfallopfern ermittelt und mögliche unfallcharakteristische Unterschiede zwischen den Geschlechtern der ADHS-Positivkohorte erfasst werden.
Mithilfe der etablierten Adult ADHD Self-Report Scale (ASRS v1.1) der WHO wurden alle Unfallopfer, die den Einschlusskriterien entsprachen, auf adulte ADHS gescreent. Bei der Auswertung des ASRS verwendeten wir zwei unterschiedliche Methoden, die bereits in früheren Studien zur Anwendung kamen. Durch einen eigens erstellten Unfallfragebogen konnten Unfallcharakteristika sowie psychische Komorbiditäten der ADHSPositivkohorte erfasst werden. Zusätzlich erhoben wir zum Vergleich die Unfallcharakteristika bei einer nicht von ADHS betroffenen Kontrollgruppe. Bei einem Teil der positiv gescreenten Patienten wurde eine ausführliche Testung in der ADHS Spezialambulanz des Universitätsklinikums Frankfurt am Main vorgenommen. Mittels diagnostischer Interviews und weiteren Selbstauskunftsfragebögen (DIVA, HASE) konnte eine definitive ADHS-Diagnose gestellt und das positive Screeningergebnis verifiziert werden.
Wir stellten fest, dass die Prävalenz adulter ADHS unter Unfallopfern mit 6,89 % bzw. 8,68 % in Abhängigkeit der ASRS Auswertungskriterien im Vergleich zu der Prävalenz der adulten ADHS in der Allgemeinbevölkerung erhöht war. Des Weiteren gab es mehr Männer mit einem positiven ADHS-Screeningergebnis und einem Unfallgeschehen. Es konnten keine signifikanten geschlechtsspezifischen Unterschiede in den Unfallcharakteristika und Unfallorten in der ADHS Positivkohorte festgestellt werden. Auch in dem Vorhandensein psychischer Komorbiditäten unterschieden sich die beiden Geschlechtergruppen der ADHS-Positivkohorte nicht. Unabhängig der Geschlechterzugehörigkeit wurden die meisten Unfälle der ADHS-Positivkohorte im Straßenverkehr verzeichnet und als selbstverschuldet eingestuft. Es konnten signifikant mehr Unfälle außerhalb des Straßenverkehrs in der nicht von ADHS betroffenen Kontrollgruppe im Vergleich zu der ADHS Positivkohorte nachgewiesen werden. Insgesamt war nur bei 14 % aller positiv gescreenten Patienten eine ADHS-Erkrankung bereits bekannt und diagnostiziert worden.
Auf Grundlage der Ergebnisse dieser Studie lässt sich schlussfolgern, dass Menschen mit einer ADHS-Symptomatik vermehrt auf unfallchirurgischen Stationen anzutreffen sind und im Einklang mit früheren Forschungsergebnissen ein erhöhtes Unfall- und Verletzungsrisiko aufweisen. Darüber hinaus folgern wir aus unseren Ergebnissen, dass sich Männer und Frauen mit einer ADHS-Erkrankung hinsichtlich Symptomatik, Komorbidität und spezifischer Unfallcharakteristika ähnlicher sein könnten, als dass sie sich in diesen Bereichen unterscheiden. Im Hinblick auf die geringen vorbestehenden ADHS-Diagnosen in der Positivkohorte erscheint eine Etablierung eines Screeningsystems bei Patienten sinnvoll, die im Rahmen von Unfallgeschehen gehäuft stationär betreut werden müssen. Da ADHS-Betroffene ein erhöhtes Risiko für multiple Unfälle zu haben scheinen, könnte unter diesen Voraussetzungen eine adulte ADHS-Symptomatik früher erkannt und negative Folgen wie eine erhöhte Unfallrate reduziert werden. Methodologische Limitierungen bestanden in unserer Erhebung durch eine geringe Anzahl an ausführlichen Testungen zur Verifizierung der ADHS-Diagnose sowie dem Informationsgewinn auf der Basis einer Selbstauskunft. Um Ergebnisse aussagekräftiger zu gestalten und auch kleinere Unfälle zu erfassen, erscheint eine Ausweitung der Testung in Ambulanzen sinnvoll.
Purpose: To develop and validate a CT-based radiomics signature for the prognosis of loco-regional tumour control (LRC) in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) treated by primary radiochemotherapy (RCTx) based on retrospective data from 6 partner sites of the German Cancer Consortium - Radiation Oncology Group (DKTK-ROG).
Material and methods: Pre-treatment CT images of 318 patients with locally advanced HNSCC were collected. Four-hundred forty-six features were extracted from each primary tumour volume and then filtered through stability analysis and clustering. First, a baseline signature was developed from demographic and tumour-associated clinical parameters. This signature was then supplemented by CT imaging features. A final signature was derived using repeated 3-fold cross-validation on the discovery cohort. Performance in external validation was assessed by the concordance index (C-Index). Furthermore, calibration and patient stratification in groups with low and high risk for loco-regional recurrence were analysed.
Results: For the clinical baseline signature, only the primary tumour volume was selected. The final signature combined the tumour volume with two independent radiomics features. It achieved moderately good discriminatory performance (C-Index [95% confidence interval]: 0.66 [0.55–0.75]) on the validation cohort along with significant patient stratification (p = 0.005) and good calibration.
Conclusion: We identified and validated a clinical-radiomics signature for LRC of locally advanced HNSCC using a multi-centric retrospective dataset. Prospective validation will be performed on the primary cohort of the HNprädBio trial of the DKTK-ROG once follow-up is completed.
Understanding effects of emotional valence and stress on children’s memory is important for educational and legal contexts. This study disentangled the effects of emotional content of to-be-remembered information (i.e., items differing in emotional valence and arousal), stress exposure, and associated cortisol secretion on children’s memory. We also examined whether girls’ memory is more affected by stress induction. A total of 143 6- and 7-year-old children were randomly allocated to the Trier Social Stress Test for Children (n = 103) or a control condition (n = 40). At 25 min after stressor onset, children incidentally encoded 75 objects varying in emotional valence (crossed with arousal) together with neutral scene backgrounds. We found that response bias corrected memory was worse for low-arousing negative items than for neutral and positive items, with the latter two categories not being different from each other. Whereas boys’ memory was largely unaffected by stress, girls in the stress condition showed worse memory for negative items, especially the low-arousing ones, than girls in the control condition. Girls, compared with boys, reported higher subjective stress increases following stress exposure and had higher cortisol stress responses. Whereas a higher cortisol stress response was associated with better emotional memory in girls in the stress condition, boys’ memory was not associated with their cortisol secretion. Taken together, our study suggests that 6- and 7-year-old children, more so girls, show memory suppression for negative information. Girls’ memory for negative information, compared with that of boys, is also more strongly modulated by stress experience and the associated cortisol response.
Understanding effects of emotional valence and stress on children’s memory is important for educational and legal contexts. This study disentangles the effects of emotional content of to-be-remembered information (i.e., items differing in emotional valence and arousal), stress exposure, and associated cortisol secretion on children’s memory. We also examine whether girls’ memory is more affected by stress induction. 143 6-to-7-year-old children were randomly allocated to the Trier Social Stress Test for Children (n = 103) or a control condition (n = 40). 25 minutes after stressor onset, children incidentally encoded 75 objects varying in emotional valence (crossed with arousal) together with neutral scene backgrounds. We found that response-bias corrected memory was worse for low arousing negative items than neutral and positive items, with the latter two categories not being different from each other. Whilst boys’ memory was largely unaffected by stress, girls in the stress condition showed worse memory for negative items, especially the low arousing ones, than girls in the control condition. Girls, compared to boys, reported higher subjective stress increases following stress exposure, and had higher cortisol stress responses. Whilst a higher cortisol stress response was associated with better emotional memory in girls in the stress condition, boys’ memory was not associated with their cortisol secretion. Taken together, our study suggests that 6-to-7-year-old children, more so girls, show memory suppression for negative information. Girls’ memory for negative information, compared to boys, is also more strongly modulated by stress experience and the associated cortisol response.
Over the past two decades, our understanding of Parkinson's disease (PD) has been gleaned from the discoveries made in familial and/or sporadic forms of PD in the Caucasian population. The transferability and the clinical utility of genetic discoveries to other ethnically diverse populations are unknown. The Indian population has been under-represented in PD research. The Genetic Architecture of PD in India (GAP-India) project aims to develop one of the largest clinical/genomic bio-bank for PD in India. Specifically, GAP-India project aims to: (1) develop a pan-Indian deeply phenotyped clinical repository of Indian PD patients; (2) perform whole-genome sequencing in 500 PD samples to catalog Indian genetic variability and to develop an Indian PD map for the scientific community; (3) perform a genome-wide association study to identify novel loci for PD and (4) develop a user-friendly web-portal to disseminate results for the scientific community. Our “hub-spoke” model follows an integrative approach to develop a pan-Indian outreach to develop a comprehensive cohort for PD research in India. The alignment of standard operating procedures for recruiting patients and collecting biospecimens with international standards ensures harmonization of data/bio-specimen collection at the beginning and also ensures stringent quality control parameters for sample processing. Data sharing and protection policies follow the guidelines established by local and national authorities.We are currently in the recruitment phase targeting recruitment of 10,200 PD patients and 10,200 healthy volunteers by the end of 2020. GAP-India project after its completion will fill a critical gap that exists in PD research and will contribute a comprehensive genetic catalog of the Indian PD population to identify novel targets for PD.
Purpose of Review: To provide an overview of current surgical peri-implantitis treatment options.
Recent Findings: Surgical procedures for peri-implantitis treatment include two main approaches: non-augmentative and augmentative therapy. Open flap debridement (OFD) and resective treatment are non-augmentative techniques that are indicated in the presence of horizontal bone loss in aesthetically nondemanding areas. Implantoplasty performed adjunctively at supracrestally and buccally exposed rough implant surfaces has been shown to efficiently attenuate soft tissue inflammation compared to control sites. However, this was followed by more pronounced soft tissue recession. Adjunctive augmentative measures are recommended at peri-implantitis sites exhibiting intrabony defects with a minimum depth of 3 mm and in the presence of keratinized mucosa. In more advanced cases with combined defect configurations, a combination of augmentative therapy and implantoplasty at exposed rough implant surfaces beyond the bony envelope is feasible.
Summary: For the time being, no particular surgical protocol or material can be considered as superior in terms of long-term peri-implant tissue stability.
Onkologische Erkrankungen im Kindesalter und jungen Erwachsenenalter haben nicht selten eine gute Prognose. Entsprechend wird für Betroffene früher oder später die Frage relevant, inwieweit nach einer onkologischen Behandlung die Fertilität beeinträchtigt ist. Nicht nur der Zeitraum der Fertilität, sondern auch die Wahrscheinlichkeit eines vorzeitigen Ovarialversagens mit allen Risiken eines längerfristigen Östrogenmangels ist für die Lebensplanung der Frauen wichtig. Mittlerweile können vor Behandlung fertilitätserhaltende Maßnahmen angeboten werden. Sie bieten manchmal die einzige Chance, auf ovarielle Reserven nach Behandlung zurückgreifen zu können, sind aber nicht immer nötig und von späterem Nutzen. Das Anti-Müller-Hormon (AMH) hat sich als validester Marker für die Beurteilung der ovariellen Reserve herausgestellt. Mithilfe dessen sind Prognosen über die Ovarreserve vor und nach der onkologischen Therapie möglich. Dies erleichtert die Entscheidung für die Indikation für fertilitätserhaltende Maßnahmen und kann wegweisend in der Lebensplanung der Frauen und Familien sein.
We introduce a novel approach based on elas- tic and inelastic scattering rates to extract the hyper-surface of the chemical freeze-out from a hadronic transport model in the energy range from Elab = 1.23 AGeV to √sNN = 62.4 GeV. For this study, the Ultra-relativistic Quantum Molecular Dynamics (UrQMD) model combined with a coarse-graining method is employed. The chemical freeze- out distribution is reconstructed from the pions through sev- eral decay and re-formation chains involving resonances and taking into account inelastic, pseudo-elastic and string excita- tion reactions. The extracted average temperature and baryon chemical potential are then compared to statistical model analysis. Finally we investigate various freeze-out criteria suggested in the literature. We confirm within this micro- scopic dynamical simulation, that the chemical freeze-out at all energies coincides with ⟨E⟩/⟨N⟩ ≈ 1 GeV, while other criteria, like s/T 3 = 7 and nB +nB ̄ ≈ 0.12 fm−3 are limited to higher collision energies.
Bange zeigt mit seiner Studie zum römischen Kreditgeldwesen auf, dass bereits lange vor dem 13. Jahrhundert – so die ‚klassische‘ Einschätzung für das Aufkommen eines modernen Bankwesens – ein Kreditgeldsystem verwendet wurde, und unterstützt eine modernistische Deutung der römischen Wirtschaftsgeschichte. In der Einleitung (S. 14) wendet er sich gegen die negativen Ansichten von Moses I. Finley und steht dabei in mancher Weise in einer Tradition mit anderen geldwirtschaftlichen Forschungsbeiträgen, so etwa mit Sitta von Redens wichtiger Monographie "Money in Classical Antiquity", wobei die schematische bipolare Wahrnehmung primitivistischer oder modernistischer Ansätze an sich in weiten Teilen der aktuellen Wirtschaftsgeschichte als überholt anzusehen ist. Ferner beklagt Bange, dass gerade die numismatische Forschung eine lediglich verengte, letztlich in Übereinstimmung mit Finley vereinfachte "Geld gleich Münze"-Perspektive eingenommen hätte (S. 15). Diese Einschätzung, die sich auf die positivistische Material- bzw. Grundlagenarbeit der Numismatik fokussiert und mit einem Zitat aus Francesco de Martinos Klassiker "Wirtschaftsgeschichte des alten Rom" (1991) unterlegt wird, erscheint als Kritik an numismatischen Beiträgen zur antiken Wirtschaftsgeschichte zu absolut und verallgemeinernd formuliert. ...