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As women's labor-force participation and earnings have grown, so has the likelihood that wives outearn their husbands. A common concern is that these couples may be at heightened risk of divorce. Yet with the rise of egalitarian marriage, wives' relative earnings may be more weakly associated with divorce than in the past. We examine trends in the association between wives' relative earnings and marital dissolution using data from the 1968–2009 Panel Study of Income Dynamics. We find that wives' relative earnings were positively associated with the risk of divorce among couples married in the late 1960s and 1970s, and that this was especially true for wives who outearned their husbands, but this was no longer the case for couples married in the 1990s. Change was concentrated among middle-earning husbands and those without college degrees, a finding consistent with the economic squeeze of the middle class over this period.
Background/Objectives: Sharing the bed with a partner is common among adults and impacts sleep quality with potential implications for mental health. However, hitherto findings are contradictory and particularly polysomnographic data on co-sleeping couples are extremely rare. The present study aimed to investigate the effects of a bed partner's presence on individual and dyadic sleep neurophysiology.
Methods: Young healthy heterosexual couples underwent sleep-lab-based polysomnography of two sleeping arrangements: individual sleep and co-sleep. Individual and dyadic sleep parameters (i.e., synchronization of sleep stages) were collected. The latter were assessed using cross-recurrence quantification analysis. Additionally, subjective sleep quality, relationship characteristics, and chronotype were monitored. Data were analyzed comparing co-sleep vs. individual sleep. Interaction effects of the sleeping arrangement with gender, chronotype, or relationship characteristics were moreover tested.
Results: As compared to sleeping individually, co-sleeping was associated with about 10% more REM sleep, less fragmented REM sleep (p = 0.008), longer undisturbed REM fragments (p = 0.0006), and more limb movements (p = 0.007). None of the other sleep stages was significantly altered. Social support interacted with sleeping arrangement in a way that individuals with suboptimal social support showed the biggest impact of the sleeping arrangement on REM sleep. Sleep architectures were more synchronized between partners during co-sleep (p = 0.005) even if wake phases were excluded (p = 0.022). Moreover, sleep architectures are significantly coupled across a lag of ± 5min. Depth of relationship represented an additional significant main effect regarding synchronization, reflecting a positive association between the two. Neither REM sleep nor synchronization was influenced by gender, chronotype, or other relationship characteristics.
Conclusion: Depending on the sleeping arrangement, couple's sleep architecture and synchronization show alterations that are modified by relationship characteristics. We discuss that these alterations could be part of a self-enhancing feedback loop of REM sleep and sociality and a mechanism through which sociality prevents mental illness.
Limbic encephalitis (LE) is an autoimmune syndrome often associated with temporal lobe epilepsy. Recent research suggests that particular structural changes in LE depend on the type of the associated antibody and occur in both mesiotemporal gray matter and white matter regions. However, it remains questionable to what degree conventional diffusion tensor imaging (DTI)-methods reflect alterations in white matter microstructure, since these methods do not account for crossing fibers. To address this methodological shortcoming, we applied fixel-based analysis as a novel technique modeling distinct fiber populations. For our study, 19 patients with LE associated with autoantibodies against glutamic acid decarboxylase 65 (GAD-LE, mean age = 35.9 years, 11 females), 4 patients with LE associated with autoantibodies against leucine-rich glioma-inactivated 1 (LGI1-LE, mean age = 63.3 years, 2 females), 5 patients with LE associated with contactin-associated protein-like 2 (CASPR2, mean age = 57.4, 0 females), 20 age- and gender-matched control patients with hippocampal sclerosis (19 GAD-LE control patients: mean age = 35.1 years, 11 females; 4 LGI1-LE control patients: mean age = 52.6 years, 2 females; 5 CASPR2-LE control patients: mean age = 42.7 years, 0 females; 10 patients are included in more than one group) and 33 age- and gender-matched healthy control subjects (19 GAD-LE healthy controls: mean age = 34.6 years, 11 females; 8 LGI1-LE healthy controls: mean age = 57.0 years, 4 females, 10 CASPR2-LE healthy controls: mean age = 57.2 years, 0 females; 4 subjects are included in more than one group) underwent structural imaging and DTI at 3 T and neuropsychological testing. Patient images were oriented according to lateralization in EEG resulting in an affected and unaffected hemisphere. Fixel-based metrics fiber density (FD), fiber cross-section (FC), and fiber density and cross-section (FDC = FD · FC) were calculated to retrieve information about white matter integrity both on the micro- and the macroscale. As compared to healthy controls, patients with GAD-LE showed significantly (family-wise error-corrected, p < 0.05) lower FDC in the superior longitudinal fascicle bilaterally and in the isthmus of the corpus callosum. In CASPR2-LE, lower FDC in the superior longitudinal fascicle was only present in the affected hemisphere. In LGI1-LE, we did not find any white matter alteration of the superior longitudinal fascicle. In an explorative tract-based correlation analysis within the GAD-LE group, only a correlation between the left/right ratio of FC values of the superior longitudinal fascicle and verbal memory performance (R = 0.64, Holm-Bonferroni corrected p < 0.048) remained significant after correcting for multiple comparisons. Our results underscore the concept of LE as a disease comprising a broad and heterogeneous group of entities and contribute novel aspects to the pathomechanistic understanding of this disease that may strengthen the role of MRI in the diagnosis of LE.
Advertising arbitrage
(2020)
Arbitrageurs with a short investment horizon gain from accelerating price discovery by advertising their private information. However, advertising many assets may overload investors' attention, reducing the number of informed traders per asset and slowing price discovery. So arbitrageurs optimally concentrate advertising on just a few assets, which they overweight in their portfolios. Unlike classic insiders, advertisers prefer assets with the least noise trading. If several arbitrageurs share information about the same assets, inefficient equilibria can arise, where investors' attention is overloaded and substantial mispricing persists. When they do not share, the overloading of investors' attention is maximal.
In fifteen European countries, China, and the US, stocks and business equity as a share of total household assets are represented by an increasing and convex function of income/wealth. A parsimonious model fitted to the data shows why background labor- income risk can explain much of this risk-taking pattern. Uncontrollable labor-income risk stresses middle-income households more because labor income is a larger fraction of their total lifetime resources compared with the rich. In response, middle-income households re-duce (controllable) financial risk. Richer households, having less pressure, can afford more risk-taking. The poor take low risk because they avoid jeopardizing their subsistence consumption.
Die wesentliche Glaubenslehre des Islam ist das Bekenntnis der Einheit Gottes (Tawḥīd). Jalāluddīn Rūmī (g. 1273) erzählt in einer der längsten Geschichten seiner Maṯnawī die geistige Entwicklung des Menschen, bis er von Zwiespalt, Zweifel und Sorge befreit wird und so Tawḥīd, d.h. Einheit und Frieden in sich erreicht. Die Geschichte des Wüstenarabers (A‛rābī) und seiner Frau, welche in diesem Artikel behandelt wird, legt die Stufen der geistigen Reise, das Voranschreiten der Seele zur Einheit und hierbei das Verhältnis von Vernunft und Seele des Menschen, die als ein Ehepaar versinnbildlicht werden, dar.
The innate immune system is the first line of host defense that senses invading pathogens by various surveillance mechanisms, involving pattern recognition receptors (PRRs) such as Toll-like receptors (TLRs). Furthermore, in response to stress, tissue injury or ischemia, cells release endogenous danger-associated molecular patterns (DAMPs) which activate PRRs in order to prompt an effective immune response. Activation of PRRs by DAMPs initiates signaling transduction pathways which drive sterile inflammation by the production of pro-inflammatory effector molecules. Biglycan, a class I small leucine-rich proteoglycan (SLRP), is proteolytically released from the extracellular matrix (ECM) in response to tissue stress and injury or de novo synthesized by activated macrophages. In its soluble form, biglycan operates as an ECM-derived DAMP and triggers a potent inflammatory response by engaging TLR2 and TLR4 on immune cells. By selective utilization of TLR2/4 and the TLR adaptor molecules adaptor molecule myeloid differentiation primary response gene 88 (MyD88) or TIR domain-containing adaptor-inducing interferon-β (TRIF) biglycan differentially regulates the production of TLR downstream mediators or inflammatory molecules. In this way, biglycan triggers the activation of mitogen-activated protein kinase (MAPK) p38, extracellular signal-regulated kinase (Erk) and nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB) in a primarily MyD88-dependent manner. In contrast, biglycan induces the expression of (C–C motif) ligand (CCL)5 and chemokine (C-X-C motif) ligand (CXCL)10 over TLR4/TRIF, heat shock protein 70 (HSP70) production over TLR2 and the synthesis of tumor necrosis factor (TNF)-α, CCL2 and CCL20 by utilizing TLR2/4/MyD88. As a consequence, biglycan promotes the recruitment of immune cells such as neutrophils, T cells, B cells and macrophages into the inflamed tissue. Research over the past years showed that biglycan-induced inflammation is involved in the pathogenesis of various inflammatory diseases such as lupus nephritis (LN), sepsis and renal ischemia/reperfusion injury (IRI), whereby genetic deletion of biglycan or TLR2/4 alleviated disease outcome. Unfortunately, the selective interaction of biglycan to TLRs and TLR adaptors complicates the identification of an efficient pharmacological target in biglycan-mediated inflammation. Yet, the necessity of possible co-receptors in biglycan signaling such as cluster of differentiation 14 (CD14) which was found in a high molecular complex with biglycan was not addressed so far.
In the first part of the present study, by utilizing primary peritoneal murine macrophages we demonstrated that the biglycan-induced expression and synthesis of TNF-α and CCL2 via TLR2/4/MyD88, CCL5 through TLR4/TRIF and HSP70 over TLR2 is blunted in CD14 deficient mice, proving that CD14 is essential in TLR2- and TLR4-mediated biglycan signaling. Pre-incubation of macrophages with an anti-CD14 antibody significantly reduced the protein levels of TNF-α, CCL2, CCL5 and HSP70. In line with these data, pharmacological inhibition of CD14 alleviated the transcriptional activation of NF-κB by biglycan in HEK-Blue cells expressing hTLR2/CD14 as well as hTLR4/CD14/MD2 supporting CD14-dependency for biglycan/TLR2/4 signaling. Western blot analysis of phosphorylated p38, p44/42 and NF-κB in WT and CD14 deficient mice revealed that activation of biglycan-mediated TLR downstream signaling is CD14-dependent. Accordingly, biglycan-induced activation and nuclear translocation of p38, p44/42 and NF-κB was blocked in Cd14-/- mice as analyzed by confocal microscopy. Co-immunoprecipitation studies combined with microscale thermophoresis analysis showed that biglycan is in complex with CD14 in macrophages and in vitro binds directly with high affinity to CD14, thereby sustaining the concept that CD14 is a novel co-receptor in biglycan-mediated inflammation. Additionally, we provided proof-of-principle of our concept in an in vivo mouse model of renal IRI. Transient overexpression of biglycan in WT mice exacerbated the expression and production of TNF-α, CCL2, CCL5 and HSP70 in a CD14-dependent manner. Interestingly, pLIVE or pLIVE-hBGN-injected Cd14-/- mice displayed lower chemo- and cytokine levels in reperfused kidneys as compared to respective WT controls during renal IRI (30 h), indicating a renoprotective effect by CD14 deficiency. Flow cytometry analysis of kidney homogenates underlined the pivotal effect of CD14 in biglycan signaling as biglycan-mediated infiltration of CD11b- and F4/80-positive renal macrophages was abolished in Cd14-/- mice. Additionally, pLIVE or pLIVE-hBGN-injected CD14 deficient mice displayed lower numbers of renal CD11b- and F4/80-positive cells during renal IRI compared to WT mice. Analysis of F4/80- and CD38-positive cells isolated from mononuclear cell extracts from kidney homogenates of pLIVE or pLIVE-hBGN-injected WT and Cd14-/- mice revealed that biglycan triggers the polarization of pro-inflammatory M1 macrophages in a CD14-dependent manner. In line with this, Cd14-/- mice, either injected with pLIVE or pLIVE-hBGN, showed less F4/80- and CD38-positive cells during renal IRI than the respective WT control. As a corroboration of our data PAS-stained renal sections of pLIVE- or pLIVE-hBGN-injected WT or Cd14-/- mice uncovered that biglycan worsens tubular damage in IRI-subjected mice via CD14. At the same time, tubular damage was significantly reduced in IRI-subjected Cd14-/- mice as compared to WT mice. In correlation with these data, serum creatine levels were increased in pLIVE-hBGN-injected WT mice during renal IRI. In contrast, serum creatine levels were significantly less increased in pLIVE- or pLIVE-hBGN-injected Cd14-/- mice than in WT littermate controls. In conclusion we demonstrated that CD14 is a new high affinity ligand for biglycan-mediated pro-inflammatory signaling over TLR2 and TLR4 in macrophages. In vivo, soluble biglycan triggers the expression of various inflammatory mediators by utilizing the co-receptor CD14. Ablation of CD14 abolishes biglycan-induced renal macrophage infiltration and M1 macrophage polarization as well as overall kidney function by reduced tubular damage and serum creatinine levels. Therefore, this study identifies CD14 as a promising therapeutic target to ameliorate biglycan-induced inflammation.
...
Chiralität ist in der belebten Natur ein omnipräsentes Phänomen und beschreibt die Symmetrieeigenschaft eines Objektes, dass dieses von seinem Spiegelbild unterscheidbar ist. Die bisherigen Untersuchungen der Wechselwirkung zwischen chiralen Molekülen und Licht fokussieren sich auf das Regime der Ein- und Multiphoton-Ionisation und wird mit dieser Arbeit um Untersuchungen im Starkfeldregime erweitert. Im Rahmen dieser Arbeit wurden Experimente an einzelnen chiralen Molekülen in starken Laserfeldern vorbereitet, durchgeführt, analysiert und alle geladenen Fragmente in Koinzidenz untersucht.
Die Präsentation der Ergebnisse orientierte sich an der Reihenfolge, in der auch die Datenauswertung von Vielteilchenaufbrüchen vonstattengeht: Zunächst wurde der Dichroismus in den Photoionen (PICD) auf chirale Signale in integraler differentieller Form untersucht, dann wurde die Asymmetrien in den Elektronenverteilungen vorgestellt und abschließend die Zusammenhänge zwischen den Ionen- und Elektronenverteilungen aufgezeigt.
Kapitel 6 untersuchte die (differentielle) Ionisations- und Fragmentationswahrscheinlichkeit von verschiedenen chiralen Molekülen. Die in Kapitel 6.1 präsentierten Daten verknüpften erstmals den bereits in der Literatur diskutierten Zirkulardichroismus in den Zählraten von Photoionen (PICD) mit dem signalstärkeren differentiellen PICD in der Einfachionisation von Methyloxiran. Dissoziiert das Molekül nach der Ionisation rasch genug, gewährt der Impulsvektor des geladenen Fragments Zugang zu einer Fragmentationsachse. Durch die Auflösung nach einer Molekülachse ist der beobachtete PICD fast eine Größenordnung stärker, als der über alle Raumrichtungen integrierte.
In steigender Komplexität wurde in Kapitel 6.2 eine Fragmentation in vier Teilchen von Molekülen aus einem racemischen Gemisch von CHBrClF untersucht. Über die Auswertung eines Spatproduktes aus den Impulsvektoren konnte für jedes Molekül dessen Händigkeit bestimmt und der vollständig differentielle PICD untersucht werden. Durch das Festhalten einer Fragmentationsachse (analog zu Kapitel 6.1) konnten um einen Faktor vier stärkere PICD-Signale und durch das Auflösen nach der vollständigen Molekülorientierung die Signalstärke des PICD um einen Faktor von etwa 16 in den Bereich einiger Prozente gebracht werden. Leider übersteigt die theoretische Beschreibung dieses Prozesses den aktuellen Stand der Forschung weit. Daher kann nicht ausgeschlossen werden, dass nicht ein Beitrag zur PICD-Signalverstärkung auch aus der Dynamik der sequentiellen vielfachen Ionisation stammt.
Die untersuchte Reaktion in Kapitel 6.3 war der Fünf-Teilchenaufbruch der achiralen Ameisensäure. In der Messung aller ionischen Fragmente konnten analog zu dem vorherigen Kapitel die internen Koordinaten sowie die Orientierung des Moleküls ermittelt werden. Tatsächlich wurde von einer chiralen Fragmentation der achiralen Ameisensäure berichtet. Welches Enantiomer in der Fragmentation beobachtet wird, hängt maßgeblich von der Molekülorientierung relativ zum ionisierenden Laserpuls ab. Diese Erkenntnis könnte zu neuen Ansätzen für Laserkatalysierte enantioselektive Reaktionen führen. Darüber hinaus konnte gezeigt werden, dass die beobachtete Händigkeit des Moleküls nicht nur von seiner Orientierung, sondern auch von der Helizität des ionisierenden Laserpulses abhängt. Dieser differentielle PICD an der Ameisensäure zeigte sich neben einer sehr großen Signalstärke von über 20 % auch als sensitive Probe für die molekulare Struktur.
In Kapitel 7 wurden die Untersuchungen an den 3-dimensionalen Impulsverteilungen der Photoelektronen vorgestellt. Zunächst wird hierzu auf die allgemeine Form des Dichroismus in den Photoelektronen (PECD) im Starkfeldregime eingegangen und die vorherrschenden Symmetrien des Ionisationsregimes herausgearbeitet (Kapitel 7.1). Mit leicht steigender Komplexität konnte eine klare Verbindung zwischen der Asymmetrie in der Elektronenverteilung und dem Schicksal des zurückbleibenden molekularen Ions anhand der Einfachionisation von Methyloxiran herausgearbeitet werden (Kapitel 7.2). Dies hat eine wichtige Auswirkung auf die Nutzbarkeit des PECD im Starkfeldregime als Analysemethode für Chemie und Pharmazie: Der über alle Fragmentationskanäle integrierte PECD ist sensitiv auf die Gewichtung der Fragmente und damit auch auf beispielsweise die maximale Laserintensität. Die Daten legen nahe, dass die Abhängigkeit des PECD von dem Fragmentationskanal auf die unterschiedliche Auswahl von Subensembles molekularer Orientierungen zurückzuführen ist.
Bei Verwendung von elliptisch polarisiertem Licht treten gegenüber der zirkularen Polarisation eine Reihe neuer Effekte auf (Kapitel 7.3). Zunächst zeigt der PECD auch im Starkfeldregime eine nicht lineare Sensitivität auf den Polarisationszustand, welche sich auch als Funktion des Elektronentransversalimpulses und dem Fragmentationskanal ändert. Somit ist die Verwendung von elliptisch polarisiertem Licht bestens für die chirale Erkennung geeignet, wie inzwischen auch in der Literatur bestätigt wurde. Darüber hinaus führt die gebrochene Rotationssymmetrie bei elliptisch polarisiertem Licht zu einer Elektronenimpulsverteilung, welche selbst chiral ist: Der PECD variiert je nach Winkel φ in der Polarisationsebene, wobei die Extrema des PECD nicht mit den Maxima der Zählraten übereinstimmen. Als neue chirale Beobachtungsgröße konnten wir eine enantiosensitive und vorwärts-/rückwärtsasymmetrische Rotation der Zählratenmaxima einführen. Als abgeleitete Größe aus derselben drei-dimensionalen Elektronenverteilung ist diese Beobachtungsgröße jedoch untrennbar verknüpft mit dem ϕ-abhängigen PECD.
Kapitel 8 verknüpfte das (partielle) Wissen um die molekulare Orientierung und den PICD mit den Asymmetrien der Elektronenverteilung für die Messung der fünffach-Ionisation von Ameisensäure (Kapitel 8.1), der vierfach-Ionisation von CHBrClF (Kapitel 8.2) und der Einfachionisation von Methyloxiran (Kapitel 8.3). Im Datensatz der Ameisensäure und dem des CHBrClF zeigte die molekulare Orientierung einen größeren Einfluss auf die Asymmetrie in der Elektronenverteilung als das Enantiomer oder die Helizität des Lichtes. Diese Verknüpfung zwischen Molekülorientierung und Elektronenasymmetrie überträgt die Asymmetrien des PICD auf die Elektronenverteilung. Die Messung an Methyloxiran relativiert diesen Zusammenhang jedoch in dem dieser in dieser Stärke nur bei manchen Fragmentationskanälen auftritt. Offenbar ist die Übertragung der Asymmetrie der differentiellen Ionisationswahrscheinlichkeit nur einer der Mechanismen, welcher zu Elektronasymmetrien im Starkfeldregime führt.
Gliflozins are inhibitors of the renal proximal tubular sodium-glucose co-transporter-2 (SGLT-2), that inhibit reabsorption of urinary glucose and they are able to reduce hyperglycemia in patients with type 2 diabetes. A renoprotective function of gliflozins has been proven in diabetic nephropathy, but harmful side effects on the kidney have also been described. In the current project, primary highly purified human renal proximal tubular epithelial cells (PTCs) have been shown to express functional SGLT-2, and were used as an in vitro model to study possible cellular damage induced by two therapeutically used gliflozins: empagliflozin and dapagliflozin. Cell viability, proliferation, and cytotoxicity assays revealed that neither empagliflozin nor dapagliflozin induce effects in PTCs cultured in a hyperglycemic environment, or in co-medication with ramipril or hydro-chloro-thiazide. Oxidative stress was significantly lowered by dapagliflozin but not by empagliflozin. No effect of either inhibitor could be detected on mRNA and protein expression of the pro-inflammatory cytokine interleukin-6 and the renal injury markers KIM-1 and NGAL. In conclusion, empa- and dapagliflozin in therapeutic concentrations were shown to induce no direct cell injury in cultured primary renal PTCs in hyperglycemic conditions.
In higher concentrations, the blood pressure regulating hormone angiotensin II leads to vasoconstriction, hypertension, and oxidative stress by activating NADPH oxidases which are a major enzymatic source of reactive oxygen species (ROS). With the help of knockout animals, the impact of the three predominant NADPH oxidases present in the kidney, i.e., Nox1, Nox2 and Nox4 on angiotensin II-induced oxidative damage was studied. Male wildtype (WT) C57BL/6 mice, Nox1-, Nox2- and Nox4-deficient mice were equipped with osmotic minipumps, delivering either vehicle (PBS) or angiotensin II, for 28 days. Angiotensin II increased blood pressure and urinary albumin levels significantly in all treated mouse strains. In Nox1 knockout mice these increases were significantly lower than in WT, or Nox2 knockout mice. In WT mice, angiotensin II also raised systemic oxidative stress, ROS formation and DNA lesions in the kidney. A local significantly increased ROS production was also found in Nox2 and Nox4 knockout mice but not in Nox1 knockout mice who further had significantly lower systemic oxidative stress and DNA damage than WT animals. Nox2 and Nox4 knockout mice had increased basal DNA damage, concealing possible angiotensin II-induced increases. In conclusion, in the kidney, Nox1 seemed to play a role in angiotensin II-induced DNA damage.
The specific temporal evolution of bacterial and phage population sizes, in particular bacterial depletion and the emergence of a resistant bacterial population, can be seen as a kinetic fingerprint that depends on the manifold interactions of the specific phage–host pair during the course of infection. We have elaborated such a kinetic fingerprint for a human urinary tract Klebsiella pneumoniae isolate and its phage vB_KpnP_Lessing by a modeling approach based on data from in vitro co-culture. We found a faster depletion of the initially sensitive bacterial population than expected from simple mass action kinetics. A possible explanation for the rapid decline of the bacterial population is a synergistic interaction of phages which can be a favorable feature for phage therapies. In addition to this interaction characteristic, analysis of the kinetic fingerprint of this bacteria and phage combination revealed several relevant aspects of their population dynamics: A reduction of the bacterial concentration can be achieved only at high multiplicity of infection whereas bacterial extinction is hardly accomplished. Furthermore the binding affinity of the phage to bacteria is identified as one of the most crucial parameters for the reduction of the bacterial population size. Thus, kinetic fingerprinting can be used to infer phage–host interactions and to explore emergent dynamics which facilitates a rational design of phage therapies.
Background: Ataxia telangiectasia (A-T) is a rare autosomal-recessive multisystem disorder characterized by pronounced cerebellar ataxia, telangiectasia, cancer predisposition and altered body composition. In addition, evidence is rising for endocrine dysfunction.
Objectives: To determine the evolution of diabetes and its prevalence in a larger A-T cohort.
Methods: A retrospective analysis of the patient charts of 39 subjects from the Frankfurt A-T cohort was performed between August 2002 and 2018 concerning HbA1c and oral glucose tolerance (OGTT). The median follow-up period was 4 years (1–16 years). In addition, in 31 A-T patients aged 1 to 38 years HbA1c and fasting glucose were studied prospectively from 2018 to 2019.
Results: In the retrospective analysis, we could demonstrate a longitudinal increase of HbA1c. The prospective analysis showed a significant increase of HbA1c and fasting glucose with age (r = 0.79, p ≤ 0.0001). OGTT has a good sensitivity for insulin resistance screening, whereas HbA1c can be used to evaluate individual courses and therapy response. Seven out of 39 (17.9%) patients suffered from diabetes. Metformin did not always lead to sufficient diabetes control; one patient was treated successfully with repaglinide.
Conclusion: Diabetes is a common finding in older A-T patients and often starts in puberty. Our data clearly demonstrate the need for an annual diabetes screening in patients > 12 years.
Background: The newly introduced German pediatric screening examination at the end of the third year of life (U7a) incorporates visual function testing in particular; there is no ophthalmic screening during childhood in Germany. The purpose of this study is to investigate the relationship between participation in U7a and visual function at the preschool health examination (PHE) in the sixth year of life. Methods: This study evaluated PHE data from school enrollment years 2009/2010 to 2014/2015 of Rhineland-Palatinate, Germany. Visual acuity (VA) at PHE was assessed with Rodenstock visual acuity test device (tumbling E) wearing glasses if present. The relationship between participation in U7a and VA <0.7 at PHE was calculated for reduced monocular and binocular VA using multiple logistic regression adjusted for potential confounders. Results: Data from 189,704 children (91,041 girls) in 35 out of 36 districts were included. The first children to participate in U7a were enrolled in 2011/2012 school year. In total, 90,339 children (47.6%) had U7a before PHE, while 99,365 (52.4%) had not. VA <0.7 in at least one eye was measured at PHE in 8429 (4.4%) children, and in both eyes in 4345 (2.3%) children. Participation in U7a was not associated with VA <0.7 at PHE (odds ratio 0.99; 95% confidence interval: 0.94–1.04). Conclusions: The proportion of children with VA <0.7 at PHE was high. No beneficial effect of newly introduced German U7a pediatric screening examination was found for reduced VA at PHE.
Background: Children who are frequently aggressive or lack empathy show various deficits in their social information processing. Several findings suggest that children with conduct problems (CP) show a tendency to interpret ambiguous situations as hostile (hostile attribution bias) and have difficulties to disengage from negative stimuli (attentional bias). The role that additional callous-unemotional traits (CU-traits) play in these biases is yet unclear. Investigating both attentional and attributional aspects of social information processing in children can help us to understand where anomalies in the processing pathway occur and whether the biases are associated with CP and CU-traits separately or in an interactive manner.
Methods: We compared three groups of children: (a) 25 children with CP and low levels of CU-traits (b) 25 children with CP and elevated levels of CU-traits (c) 50 gender (68% male), age (8–17 years) and intelligence score-matched typically developing children, on a pictorial emotional stroop task and a hostile attribution bias task.
Results: In contrast to our predictions, there were no significant group differences regarding attentional biases or hostile attribution biases. Boys with CP and high levels of CU-traits showed a significantly higher hostile attribution bias compared to girls with CP and high levels of CU-traits. The attention bias to angry stimuli significantly correlated with the hostile attribution bias. Compared to the control group the CP group with low levels of CU-traits showed a significantly stronger association between the attention bias to angry stimuli and the hostile attribution bias.
Conclusions: The current study provides evidence that boys with CP and high levels of CU-traits interpret ambiguous situations as more hostile than girls do. Our results further provide indications that the interaction of attentional and attributional biases in children with CP might contribute to their increased aggressive behavior.
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.
Mutations in the actively expressed, maternal allele of the imprinted KCNK9 gene cause Birk-Barel intellectual disability syndrome (BBIDS). Using a BBIDS mouse model, we identify here a partial rescue of the BBIDS-like behavioral and neuronal phenotypes mediated via residual expression from the paternal Kcnk9 (Kcnk9pat) allele. We further demonstrate that the second-generation HDAC inhibitor CI-994 induces enhanced expression from the paternally silenced Kcnk9 allele and leads to a full rescue of the behavioral phenotype suggesting CI-994 as a promising molecule for BBIDS therapy. Thus, these findings suggest a potential approach to improve cognitive dysfunction in a mouse model of an imprinting disorder.
Über problematische Straßennamen und Denkmäler wird politisch debattiert. Wie der öffentliche Raum aussieht, wird gemeinhin nicht als juristische Frage behandelt. Trotzdem taucht die Frage, was die Gesellschaft im öffentlichen Raum sehen will, auch als rechtliches Argument auf. Wann erkennt der Diskurs solche Fragen politischer Ästhetik als juristisches Argument an? Und welche Bedingungen entscheiden darüber?
In Offenbach am Main wurde im Herbst 2018 eine Fahrradstraßen-Teststrecke eröffnet, die Teil des Vorhabens ist, die Stadt fahrradfreundlicher zu gestalten. Um herauszufinden, inwiefern das Design dieser Teststrecke einen Einfluss darauf ausübt, wie die Fahrradstraße von den Verkehrsteilnehmenden wahrgenommen und genutzt wird, wurden im Rahmen dieser Forschungsarbeit im Mai 2019 zwei Fokusgruppengespräche mit Nutzer*innen durchgeführt. In den Fokusgruppen wurden unter der Betrachtung der Fragestellung unterschiedliche Konzeptvorschläge der Offenbacher Hochschule für Gestaltung (HfG) thematisiert. In der Forschungsarbeit wird herausgearbeitet, wieso es sinnvoll ist, das Design der gebauten Umwelt näher zu betrachten und vor allem es gezielt zu verändern, wenn es darum geht, mehr Stadtbewohner*innen zum Fahrradfahren und hiermit zu einem umweltfreundlicheren Fortbewegen zu motivieren. Basierend auf den Ausführungen von JENSEN (2014, 2016) zum Mobilitätsdesign und unter Verwendung seines staging mobilities frameworks konnten die Erfahrungen der Teilnehmenden der Fokusgruppen ausgewertet und erste Aussagen über den Einfluss des Designs auf die Wahrnehmung und Nutzung der Teststrecke getroffen werden.
Die Hippocampusformation ist eine wichtige Hirnstruktur für die Gedächtnisakquisition und -konsolidierung, insbesondere beim räumlichen Lernen spielt sie eine essentielle Rolle. Langzeitpotenzierung (LTP) gilt als das elektrophysiologische Korrelat der synaptischen Plastizität, dem langfristigen Umbau synaptischer Verbindungen, der letztlich zur Ausbildung stabiler, langanhaltender Erinnerungen führt. Signalübertragung über den cAMP/PKA/MAPK/CREB-Weg stellt den wichtigsten molekularen Mechanismus der Langzeitpotenzierung dar, CREB gilt als die zentrale Komponente und Schnittstelle dieser Übertragung. Neuronale Plastizität ist abhängig von de-novo-Pro-teinbiosynthese, an deren Regulation Veränderungen der Chromatinstruktur durch Histonmodifikationen beteiligt ist, in die der genannte Signalweg mündet.
Circadiane Rhythmen sind in den meisten Spezies in vielen verschiedenen Organen und Geweben nachgewiesen und manifestieren sich als Einflüsse auf zahlreiche Parameter des Verhaltens, so auch auf die Leistung beim Erlernen neuer Information. Ihr zentraler Taktgeber ist der Nucleus suprachiasmaticus (SCN). Melatonin ist ein wichtiges Effektorsignal des circadianen Systems und hat gleichzeitig Rückkopplungsfunktion. Seine unmittelbare Wirkung übt es über die beiden G-Protein-gekoppelten Melatonin-rezeptoren MT1 und MT2 aus. Es hat direkten Einfluss auf das Lernen und stellt damit einen Schnittpunkt zwischen Signalwegen der synaptischen Plastizität und des circadianen Systems dar.
Der Lernerfolg vieler Tierarten ist bekanntermaßen während deren subjektivem Tag höher als während der Nacht. In dieser Arbeit konnte gezeigt werden, dass beim räumlichen Lernen bereits ein einmaliger Stimulus ausreicht, um im Hippocampus der verwendeten C3H-Mäuse eine stabile Induktion der Phosphorylierung von CREB sowie der transkriptionsaktivierenden Histonmodifikationen H3K9ac und H3K14ac zu erzeugen. Ein einmaliger Stimulus hat also verstärkte Signaltransduktion und Protein-syntheseaktivität als Zeichen synaptischer Plastizität zur Folge. Dies geschieht nur tagsüber, nachts zeigt sich kein Effekt. Somit spiegelt sich der Phänotyp in diesen molekularen Markern wider. Anhand eines Mausmodells mit genetischem Knockout der beiden membrangebundenen Melatoninrezeptoren MT1 und MT2 (MT1/2−/−) wurde der Einfluss von Melatonin auf die molekularen Prozesse des hippocampalen Lernens näher beleuchtet. Über MT1/2−/−-Mäuse ist bekannt, dass ihr Lernerfolg in den benutzten Verhaltensversuchen zu jeder Tageszeit auf dem Niveau der C3H-Mäuse während der Nacht liegt. Zunächst zeigt sich, dass in MT1/2−/−-Mäusen die Grundrhythmen der meisten untersuchten Proteine und Histonmodifikationen verändert, teilweise phasenverschoben und abgeflacht sind. Eine Induktion von pCREB und H3K9ac und H3K14ac ist in diesen Tieren nicht mehr erreichbar und somit nach einem einmaligen Lernstimulus keine vermehrte Signalübertragung oder synaptischer Umbau nachweisbar. Auch hier besteht eine gute Korrelation mit dem Lernphänotyp. Weiterhin wurden Unterschiede im Aktivitätsmuster der beiden Mäusestämme gezeigt, MT1/2−/−-Mäuse sind abhängig von der Situation weniger oder gleich aktiv wie C3H-Tiere. Im Angstverhalten als möglichem Störfaktor besteht kein Unterschied zwischen beiden Tierstämmen.
Melatoninrezeptoren wirken über inhibitorische G-Proteine auf die Adenylatcyclase und hemmen den cAMP/CREB-Signalübertragung, was die schlechtere Lernperformance während der Nacht erklärt, wenn der Melatoninspiegel seinen natürlichen Höhepunkt erreicht. Durch Melatonin lassen sich auch tagsüber bei Mäusen und Zebrafischen LTP und räumliches Lernen unterdrücken. Jedoch lässt sich durch diese akute Wirkung von Melatonin nur ein Teil der Ergebnisse erklären, so zum Beispiel die veränderte Aktivität von PKA und PKC. Um das scheinbar paradoxe verschlechterte Lernverhalten der MT1/2−/−-Mäuse und die fehlende Induzierbarkeit von pCREB und Chromatinremodelling zu erklären, muss ein längerfristiger Effekt von Melatonin bestehen, der über dessen maximale Konzentration hinaus anhält und in seiner Abwesenheit zu verbesserter Signalübertragung führt. Hierfür ist eine Sensibilisierung der Adenylatcyclase durch prolongierte Melatoninexposition, wie sie beispielsweise in Zellen der Pars tuberalis nachgewiesen wurde, beschrieben worden. Es konnte in dieser Arbeit gezeigt werden, dass Melatonin vielfältigen Einfluss auf das hippocampale Lernen hat und dieses mit der inneren Uhr verbindet.
Esta investigación, titulada “La colonialidad de las metáforas: Las representaciones del VIH/sida y de los sujetos vinculados con la ‘enfermedad’, en los discursos periodístico y médico costarricenses (1983-1990) y en la narrativa nacional (1989-1999)”, consta de cuatro capítulos. En el primero, se presenta el tema de estudio y sus interrogantes, las aproximaciones teóricas, los aspectos metodológicos y la estructura del texto. En relación con los enfoques teóricos, se consideran las contribuciones de Paul Ricœur, Hans Blumenberg y Michel Foucault. Así, primero hay una reflexión sobre la metáfora, la narración y el pensamiento (Ricœur y Blumenberg). Segundo, se estudian los símbolos primarios del mal: la mancilla, el pecado y culpabilidad (Ricœur). Tercero, se analiza el concepto de biopolítica y el papel social de la medicina (Foucault). En la metodología, se parte de algunos principios de la Sociocrítica (relacionados con las nociones de texto, contexto y representación) y se propone, nuevamente con Foucault, un análisis del discurso en términos históricos. Asimismo, se introducen unas explicaciones de Philipp Sarasin, con el fin de resaltar la importancia de estudiar las metáforas, los símbolos, las tramas, etc. Para el caso específico de los textos literarios, se toman en cuenta otras posibilidades de análisis semiótico (aunque los textos literarios también son asumidos como parte de un corpus discursivo amplio, con un común denominador: el VIH/sida).
Los siguientes capítulos (II, III y IV) corresponden con el desarrollo de la investigación. Así, en los capítulos II y III, se reflexiona sobre las representaciones que los discursos periodístico y médico movilizaron durante la primera (1983-1986) y la segunda (1987-1990) mitades de la década de los años ochenta. Los discursos periodístico y médico son trabajados en conjunto, ya que las interacciones que se dieron entre estos campos fueron constantes. En total, se recabaron 490 noticias, artículos de opinión, reportajes, etc., publicados en el periódico La Nación. Además, se consideraron los múltiples aportes hechos por los médicos y especialistas, tanto en dicho diario como en diferentes trabajos académicos y en publicaciones institucionales (son alrededor de 38 textos más, entre libros, ensayos, informes, etc.). En el capítulo IV, se analizan los textos literarios sobre el VIH/sida que surgieron, entre los años ochenta y los noventa, en Costa Rica: el libro Tiempos del SIDA: Relatos de la vida real (1989), de Myriam Francis; la novela Paisaje con tumbas pintadas en rosa (1998), de José Ricardo Chaves; y los cuentos de Alfonso Chase, “Antes y ahora” y “Carpe Diem”, publicados en el libro Cara de santo, uñas de gato (1999).
Inhibitor-kappaB kinase epsilon (IKKε) and TANK-binding kinase 1 (TBK1) are non-canonical IκB kinases, both described as contributors to tumor growth and metastasis in different cancer types. Several hints indicate that they are also involved in the pathogenesis of melanoma; however, the impact of their inhibition as a potential therapeutic measure in this “difficult-to-treat” cancer type has not been investigated so far. We assessed IKKε and TBK1 expression in human malignant melanoma cells, primary tumors and the metastasis of melanoma patients. Both kinases were expressed in the primary tumor and in metastasis and showed a significant overexpression in tumor cells in comparison to melanocytes. The pharmacological inhibition of IKKε/TBK1 by the approved drug amlexanox reduced cell proliferation, migration and invasion. Amlexanox did not affect the cell cycle progression nor apoptosis induction but significantly suppressed autophagy in melanoma cells. The analysis of potential functional downstream targets revealed that NF-кB and ERK pathways might be involved in kinase-mediated effects. In an in vivo xenograft model in nude mice, amlexanox treatment significantly reduced tumor growth. In conclusion, amlexanox was able to suppress tumor progression potentially by the inhibition of autophagy as well as NF-кB and MAP kinase pathways and might therefore constitute a promising candidate for melanoma therapy.
Mon intention première était de comprendre la façon dont la République romaine avait sombré. Mais lorsque j’ai examiné dans ce but les explications les plus sérieuses qui avaient déjà été avancées, sa faillite m’a toutefois paru moins étonnante que sa très longue existence. Au point que, progressivement, une deuxième question a pris le pas sur la première, celle de savoir comment cette chose commune [Gemeinwesen], cette res publica amissa avait pu fonctionner si longtemps. Je me suis donc concentré sur sa structure. ...
The macrophage-inducible C-type lectin (mincle) is part of the innate immune system and acts as a pattern recognition receptor for pathogen-associated molecular patterns (PAMPS) and damage-associated molecular patterns (DAMPs). Ligand binding induces mincle activation which consequently interacts with the signaling adapter Fc receptor, SYK, and NF-kappa-B. There is also evidence that mincle expressed on macrophages promotes intestinal barrier integrity. However, little is known about the role of mincle in hepatic fibrosis, especially in more advanced disease stages. Mincle expression was measured in human liver samples from cirrhotic patients and donors collected at liver transplantation and in patients undergoing bariatric surgery. Human results were confirmed in rodent models of cirrhosis and acute-on-chronic liver failure (ACLF). In these models, the role of mincle was investigated in liver samples as well as in peripheral blood monocytes (PBMC), tissues from the kidney, spleen, small intestine, and heart. Additionally, mincle activation was stimulated in experimental non-alcoholic steatohepatitis (NASH) by treatment with mincle agonist trehalose-6,6-dibehenate (TDB). In human NASH, mincle is upregulated with increased collagen production. In ApoE deficient mice fed high-fat western diet (NASH model), mincle activation significantly increases hepatic collagen production. In human cirrhosis, mincle expression is also significantly upregulated. Furthermore, mincle expression is associated with the stage of chronic liver disease. This could be confirmed in rat models of cirrhosis and ACLF. ACLF was induced by LPS injection in cirrhotic rats. While mincle expression and downstream signaling via FC receptor gamma, SYK, and NF-kappa-B are upregulated in the liver, they are downregulated in PBMCs of these rats. Although mincle expressed on macrophages might be beneficial for intestinal barrier integrity, it seems to contribute to inflammation and fibrosis once the intestinal barrier becomes leaky in advanced stages of chronic liver disease.
Die durch das Zweite Corona-Steuerhilfegesetz erfolgte Ausweitung des Verlustrücktrags ist dem Grunde nach ein hochgradig geeignetes und insbesondere breitenwirksames Mittel zur Stützung der Konjunktur. Das vorliegende Policy White Paper legt dar, dass allerdings Art und Umfang der gewählten Ausweitung unzureichend sind. Hierzu analysieren die Verfasser, wie sich die Ausweitung auf Unternehmen unterschiedlicher Größe und Rechtsform auswirkt. Auf Basis dieser Analyse zei-gen sie sodann, dass gemessen an den verfolgten konjunkturpolitischen Zielen es geboten gewesen wäre und weiterhin geboten ist, den Verlustrücktrag auf die Gewerbesteuer zu erstrecken.
Software updates are a critical success factor in mobile app ecosystems. Through publishing regular updates, platform providers enhance their operating systems for the benefit of both end users and third-party developers. It is also a way of attracting new customers. However, this platform evolution poses the risk of inadvertently introducing software problems, which can severely disturb the ecosystem’s balance by compromising its foundational technologies. So far, little to no research has addressed this issue from a user-centered perspective. The thesis at hand draws on IS post-adoption literature to investigate the potential negative influences of operating system updates on mobile app users. The release of Apple’s iOS 13 update serves as research object. Based on over half a million user reviews from the AppStore, data mining techniques are applied to study the impact of the new platform version. The results show that iOS 13 caused complications with a large number of popular apps, leading to a significant decline in user ratings and an uptrend in negative sentiment. Feature requests, functional complaints, and device compatibility are identified as the three major issue categories. These issue types are compared in terms of their quantifiable negative effect on users’ continuance intention. In essence, the findings contribute to IS research on post-adoption behavior and provide guidance to ecosystem participants in dealing with update-induced platform issues.
Cerebral lesions may cause degeneration and neuroplastic reorganization in both the ipsi- and the contralesional hemisphere, presumably creating an imbalance of primarily inhibitory interhemispheric influences produced via transcallosal pathways. The two hemispheres are thought to mutually hamper neuroplastic reorganization of the other hemisphere. The results of preceding degeneration and neuroplastic reorganization of white matter may be reflected by Diffusion Tensor Imaging-derived diffusivity parameters such as fractional anisotropy (FA). In this study, we applied Diffusion Tensor Imaging (DTI) to contrast the white matter status of the contralesional hemisphere of young lesioned brains with and without contralateral influences by comparing patients after hemispherotomy to those who had not undergone neurosurgery. DTI was applied to 43 healthy controls (26 females, mean age ± SD: 25.07 ± 11.33 years) and two groups of in total 51 epilepsy patients with comparable juvenile brain lesions (32 females, mean age ± SD: 25.69 ± 12.77 years) either after hemispherotomy (30 of 51 patients) or without neurosurgery (21 of 51 patients), respectively. FA values were compared between these groups using the unbiased tract-based spatial statistics approach. A voxel-wise ANCOVA controlling for age at scan yielded significant group differences in FA. A post hoc t-test between hemispherotomy patients and healthy controls revealed widespread supra-threshold voxels in the contralesional hemisphere of hemispherotomy patients indicating comparatively higher FA values (p < 0.05, FWE-corrected). The non-surgery group, in contrast, showed extensive supra-threshold voxels indicating lower FA values in the contralesional hemisphere as compared to healthy controls (p < 0.05, FWE-corrected). Whereas lower FA values are suggestive of pronounced contralesional degeneration in the non-surgery group, higher FA values in the hemispherotomy group may be interpreted as a result of preceding plastic remodeling. We conclude that, whether juvenile brain lesions are associated with contralesional degeneration or reorganization partly depends on the ipsilesional hemisphere. Contralesional reorganization as observed in hemispherotomy patients was most likely enabled by the complete neurosurgical deafferentation of the ipsilesional hemisphere and, thereby, the disinhibition of the neuroplastic potential of the contralesional hemisphere. The main argument of this study is that hemispherotomy may be seen as a major plastic stimulus and as a prerequisite for contralesional neuroplastic remodeling in patients with juvenile brain lesions.
Die kulturanthropologische Studie beschäftigt sich mit der pädagogischen Nutzung von Wäldern. Sie betrachtet dieses Phänomen vor dem Hintergrund zweier Entwicklungen: Zum einen wird die Zunahme von gesellschaftlichen Bedürfnissen an den Wald betrachtet etwa aus den Bereichen Freizeit, Sport, Gesundheit oder Bildung. Zum anderen wird die Zuspitzung des Nutzungskonflikts zwischen Forst- und Naturschutzakteuren im Wald in den Blick genommen. Im Zentrum der Arbeit stehen daher sowohl der Prozess der pädagogischen Inwertsetzung des Waldes als auch die Frage, wie sich der Nutzungskonflikt in der pädagogischen Praxis widerspiegelt. Eine empirisch-ethnografische Feldforschung im Nationalpark Kellerwald-Edersee und im Jugendwaldheim des Forstbetriebs des Landes Hessen im Jahr 2014 bilden das Fundament der Studie.
Die Ergebnisse machen den Prozess der pädagogischen Inwertsetzung transparent: Sie verweisen auf einzelne Praktiken, auf beteiligte Akteure und stellen dar, wie das Bild vom Wald als pädagogisch wertvoller Raum gesellschaftlich Fuß fasst. Sie zeigen darüber hinaus, dass Naturschutz- und Forstakteure die Bildungspraktiken nutzen, um ihre jeweiligen Vorstellungen zur Nutzung des Waldes gesellschaftlich durchzusetzen. Vor allem machen die Ergebnisse deutlich, dass durch die pädagogischen Inwertsetzung einerseits und die Instrumentalisierung der Bildung andererseits Diskussionen über die Funktion und den Stellenwert der pädagogischen Nutzung von Wäldern ausgelöst werden. Die Studie zeigt, dass im Rahmen dieser Debatten die gesellschaftlichen Wünsche gegenüber den bislang dominierenden forstwirtschaftlichen und naturschutzfachlichen Aspekten an Relevanz gewinnen.
Das Versprechen der Demokratie ist nicht, dass dem Willen des Volkes Geltung verschafft wird. Denn den Willen des Volkes gibt es nicht. Es gibt vielmehr nur unzählige Kombinationen von Meinungen und Interessen, aus denen jeweils von neuem ein dem Volk zurechenbarer Wille gebildet werden muss. In dem so gebildeten Willen werden sich nie alle wieder finden. Das Versprechen der Demokratie ist aber, dass alle bei der Bildung des Willens mitwirken und also Einfluss auf das Ergebnis nehmen können und dass der jeweiligen Mehrheit nicht alles erlaubt ist, insbesondere nicht, die Minderheit um ihre Chancen zu bringen, selbst Mehrheit zu werden, samt den Voraussetzungen, die dafür nötig sind.
Multicentre comparison of quantitative PCR-based assays to detect SARS-CoV-2, Germany, March 2020
(2020)
Containment strategies and clinical management of coronavirus disease (COVID-19) patients during the current pandemic depend on reliable diagnostic PCR assays for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we compare 11 different RT-PCR test systems used in seven diagnostic laboratories in Germany in March 2020. While most assays performed well, we identified detection problems in a commonly used assay that may have resulted in false-negative test results during the first weeks of the pandemic.
Chronic coronary artery disease remains an unconquered clinical problem, affecting an increasing number of people worldwide. Despite the improved understanding of the disease development, the implementation of the many advances in diagnosis and therapy is lacking. Many clinicians continue to rely on patient's symptoms and diagnostic methods, which do not enable optimal clinical decisions. For example, echocardiography and invasive coronary catheterisation remain the mainstay investigations for stable angina patients in many places, despite the evidence on their limitations and availability of better diagnostic options. Cardiac MRI is a powerful diagnostic method, supporting robust measurements of crucial markers of cardiac structure and function, myocardial perfusion and scar, as well as providing detailed insight into myocardial tissue. Accurate and informative diagnostic readouts can help with guiding therapy, monitoring disease progress and tailoring the response to treatment. In this article, the authors outline the evidence supporting the state-of-art applications based on cardiovascular magnetic resonance, allowing the clinician optimal use of this insightful diagnostic method in everyday clinical practice.
Purpose: The prevalence of "ocal allergic rhinitis" within individuals suffering from perennial rhinitis remains uncertain, and patients usually are diagnosed with non-allergic rhinitis. The aim of this study was to evaluate the prevalence of a potential "local allergic rhinitis" in subjects suffering from non-allergic rhinitis in a non-selected group of young students.
Methods: 131 students (age 25.0 ± 5.1 years) with a possible allergic rhinitis and 25 non-allergic controls without rhinitis symptoms (age 22.0 ± 2.0 years) were recruited by public postings. 97 of 131 students with rhinitis were tested positive (≥3 mm) to prick testing with 17 frequent allergens at visit 1. Twenty-four 24 subjects with a house dust mite allergy, 21 subjects with a non-allergic rhinitis, and 18 non-allergic controls were further investigated at visit 2. Blood samples were taken, and nasal secretion was examined. In addition, all groups performed a nasal provocation test with house dust mite (HDM).
Results: In serum and nasal secretion, total IgE and house dust mite specific IgE significantly differed between HDM positive subjects and controls. However, no differences between non-allergic subjects and control subjects were quantifiable. Neither a nasal provocation test nor a nasal IgE to HDM allergens showed a measurable positive response in any of the non-allergic rhinitis subjects as well as the healthy controls, whilst being positive in 13 subjects with HDM allergy.
Conclusions: Nasal IgE is present in subjects with HDM allergy, but not in non-allergic rhinitis. In the investigated non-selected population, exclusive local production of IgE is absent. By implication, therefore, our findings challenge the emerging concept of local allergic rhinitis.
Study identifier at ClinicalTrials.gov: NCT 02810535.
The novel coronavirus SARS-CoV-2 is the causative agent of the acute respiratory disease COVID-19, which has become a global concern due to its rapid spread. Meanwhile, increased demand for testing has led to a shortage of reagents and supplies and compromised the performance of diagnostic laboratories in many countries. Both the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) recommend multi-step RT-PCR assays using multiple primer and probe pairs, which might complicate the interpretation of the test results, especially for borderline cases. In this study, we describe an alternative RT-PCR approach for the detection of SARS-CoV-2 RNA that can be used for the probe-based detection of clinical isolates in diagnostics as well as in research labs using a low-cost SYBR green method. For the evaluation, we used samples from patients with confirmed SARS-CoV-2 infections and performed RT-PCR assays along with successive dilutions of RNA standards to determine the limit of detection. We identified an M-gene binding primer and probe pair highly suitable for the quantitative detection of SARS-CoV-2 RNA for diagnostic and research purposes.
Eine mobile Welt, Lebensläufe, die uns mal hierhin, mal dorthin führen und dann noch die globale Pandemie: Auch kleine Kunstprojekte müssen sich damit auseinandersetzen, wie sie ihren kreativen Prozess in räumlicher Entfernung organisieren. Welche digitalen Werkzeuge können helfen? Was das Projekt vi·son in den letzten Monaten über kreative Online-Zusammenarbeit gelernt hat.
The Wirecard scandal is a wake-up call alerting German politics to the importance of securities market integrity. The role of market supervision is to ensure the smooth functioning of capital markets and their integrity, creating trust among and acceptance by investors locally and globally. The existing patchwork of national supervisory practice in Europe is under discussion today, in the wake of Brexit that will end the role of London as a de-facto lead supervisor in stock and bond markets. A fundamental overhaul of a fragmented securities markets supervisory regime in Europe would offer the potential to lead to the establishment of an independent European Single Market Supervisor (ESMS). Endowed with strong enforcement powers, and supported by the existing national agencies, the ESMS would be entrusted with ensuring a uniform market standard as to transparency and other issues of market integrity across Europe. This would not rule out maintaining a variety of market organization structures at the national level. The ESMS would need executive powers in the world of markets (i.e. securities and trading), much like the SSM in the world of banking. To fill this new role, ESMS would have to be established as a new, independent institution, including an enormously scaled up staff if compared, e.g., to ESMA.
Accounting for financial stability: Bank disclosure and loss recognition in the financial crisis
(2020)
This paper examines banks’ disclosures and loss recognition in the financial crisis and identifies several core issues for the link between accounting and financial stability. Our analysis suggests that, going into the financial crisis, banks’ disclosures about relevant risk exposures were relatively sparse. Such disclosures came later after major concerns about banks’ exposures had arisen in markets. Similarly, the recognition of loan losses was relatively slow and delayed relative to prevailing market expectations. Among the possible explanations for this evidence, our analysis suggests that banks’ reporting incentives played a key role, which has important implications for bank supervision and the new expected loss model for loan accounting. We also provide evidence that shielding regulatory capital from accounting losses through prudential filters can dampen banks’ incentives for corrective actions. Overall, our analysis reveals several important challenges if accounting and financial reporting are to contribute to financial stability.
Background/aims: Hepatocellular carcinoma (HCC) is a leading indication for liver transplantation (LT) worldwide. Early identification of patients at risk for HCC recurrence is of paramount importance since early treatment of recurrent HCC after LT may be associated with increased survival. We evaluated incidence of and predictors for HCC recurrence, with a focus on the course of AFP levels.
Methods: We performed a retrospective, single-center study of 99 HCC patients who underwent LT between January 28th, 1997 and May 11th, 2016. A multi-stage proportional hazards model with three stages was used to evaluate potential predictive markers, both by univariate and multivariable analysis, for influences on 1) recurrence after transplantation, 2) mortality without HCC recurrence, and 3) mortality after recurrence.
Results: 19/99 HCC patients showed recurrence after LT. Waiting time was not associated with overall HCC recurrence (HR = 1, p = 0.979). Similarly, waiting time did not affect mortality in LT recipients both with (HR = 0.97, p = 0.282) or without (HR = 0.99, p = 0.685) HCC recurrence. Log10-transformed AFP values at the time of LT (HR 1.75, p = 0.023) as well as after LT (HR 2.07, p = 0.037) were significantly associated with recurrence. Median survival in patients with a ratio (AFP at recurrence divided by AFP 3 months before recurrence) of 0.5 was greater than 70 months, as compared to a median of only 8 months in patients with a ratio of 5.
Conclusion: A rise in AFP levels rather than an absolute threshold could help to identify patients at short-term risk for HCC recurrence post LT, which may allow intensification of the surveillance strategy on an individualized basis.
Background: Fingolimod is used for immune therapy in patients with multiple sclerosis. Long-term treatment is associated with a small increase in the risk of herpes virus reactivation and respiratory tract infections. Patients with coronavirus disease 2019 (COVID-19) under Fingolimod treatment have not been described.
Methods and results. We report a 57-year old female patient with a relapsing remitting multiple sclerosis under fingolimod treatment who experienced a severe COVID-19 infection in March 2020 (Extended Disability Status Scale: 2.0). Having peripheral lymphopenia typical for fingolimod treatment (total lymphocytes 0.39/nL [reference range 1.22-3.56]), the patient developed bilateral interstitial pneumonia with multiple ground-glass opacities on chest CT. Fingolimod medication was stopped. On the intensive care unit, non-invasive ventilation was used to provide oxygen and ventilation support regularly. Over the following two days, oxygenation improved, and the patient was transferred to a normal ward five days after admission.
Conclusion: The implications fingolimod has on COVID-19 are complex. As an S1P analogue, fingolimod might enhance lung endothelial cell integrity. In addition, in case of a so-called cytokine storm, immunomodulation might be beneficial to reduce mortality. Future studies are needed to explore the risks and therapeutic effects of fingolimod in COVID-19 patients.
Microthlaspi erraticum is widely distributed in temperate Eurasia, but restricted to Ca2+-rich habitats, predominantly on white Jurassic limestone, which is made up by calcium carbonate, with little other minerals. Thus, naturally occurring Microthlaspi erraticum individuals are confronted with a high concentration of Ca2+ ions while Mg2+ ion concentration is relatively low. As there is a competitive uptake between these two ions, adaptation to the soil condition can be expected. In this study, it was the aim to explore the genomic consequences of this adaptation by sequencing and analysing the genome of Microthlaspi erraticum. Its genome size is comparable with other diploid Brassicaceae, while more genes were predicted. Two Mg2+ transporters known to be expressed in roots were duplicated and one showed a significant degree of positive selection. It is speculated that this evolved due to the pressure to take up Mg2+ ions efficiently in the presence of an overwhelming amount of Ca2+ ions. Future studies on plants specialized on similar soils and affinity tests of the transporters are needed to provide unequivocal evidence for this hypothesis. If verified, the transporters found in this study might be useful for breeding Brassicaceae crops for higher yield on Ca2+-rich and Mg2+ -poor soils.