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COVID-19 pandemic has underlined the impact of emergent pathogens as a major threat for human health. The development of quantitative approaches to advance comprehension of the current outbreak is urgently needed to tackle this severe disease. In this work, several mathematical models are proposed to represent SARS-CoV-2 dynamics in infected patients. Considering different starting times of infection, parameters sets that represent infectivity of SARS-CoV-2 are computed and compared with other viral infections that can also cause pandemics.
Based on the target cell model, SARS-CoV-2 infecting time between susceptible cells (mean of 30 days approximately) is much slower than those reported for Ebola (about 3 times slower) and influenza (60 times slower). The within-host reproductive number for SARS-CoV-2 is consistent to the values of influenza infection (1.7-5.35). The best model to fit the data was including immune responses, which suggest a slow cell response peaking between 5 to 10 days post onset of symptoms. The model with eclipse phase, time in a latent phase before becoming productively infected cells, was not supported. Interestingly, both, the target cell model and the model with immune responses, predict that virus may replicate very slowly in the first days after infection, and it could be below detection levels during the first 4 days post infection. A quantitative comprehension of SARS-CoV-2 dynamics and the estimation of standard parameters of viral infections is the key contribution of this pioneering work.
Current research on medical biomaterials have shown that the physical and chemical characteristics of biomaterials determine the body inflammatory cellular reaction after their implantation. The aim of this study was to evaluate the individual effects of the physical characteristics over the initial biomaterial-cellular interaction and the inflammatory cellular reaction. For this purpose, an equine-derived collagen hemostatic sponge (E-CHS) was modified by pressing and evaluated using ex vivo, in vitro and in vivo methods.
The E-CHS was pressed by applying constant pressure (6.47± 0.85 N) for 2 min using a sterile stainless-steel cylinder and cut in segments of 1cm2. Subsequently, E-CHS and the pressed equine-derived collagen hemostatic sponge (P-E-CHS) were studied as two independent biomaterials and compared to a control group (CG).
A blood concentrate containing inflammatory cells known as platelet rich fibrin (PRF) was used to mimic the initial biomaterial-cell interaction and to measure the absorption coefficient of the biomaterials to liquid PRF (iPAC). Additionally, the biomaterials were cultivated together with PRF for 3 and 6 days to measure the induction of pro-inflammatory cytokines (TNF-α and IL-8). The results were obtained through enzyme-linked immunosorbent assay (ELISA) and histological methods. PRF cultivated without biomaterials served as the CG. Additionally, the biomaterials were evaluated in vivo using a subcutaneous model in Wistar rats and compared to sham operated animals (CG) representing physiologic wound healing. After 3, 15 and 30 days, the explanted samples were evaluated using histochemical and immunohistochemical (IHC) staining using the following markers: CD68 (pan macrophages), CCR7 (pro-inflammatory macrophages, M1), CD206 (pro-wound healing macrophages, M2) and α-Smooth Muscle Actin (α-SMA; vessel identification).
After the mixture of liquid PRF with both biomaterials for 15 minutes, the ex vivo results showed that E-CHS was penetrated by cells, whereas P-E-CHS was cell-occlusive. Additionally, P-E-CHS induced a higher release of pro-inflammatory cytokines compared to liquid PRF alone (CG) and E-CHS after 3 days (P< 0.05). Although the biomaterial was pressed, the difference of the iPAC value did not show statistical differences. In vivo, the CG induced at day 3 a higher inflammatory response compared to the experimental groups (EG) (P< 0.05). The intergroup comparison showed that P-E-CHS induced a higher presence of macrophages (CD68+/CC7+) compared to E-CHS at day 3 (P< 0.05). Only CD68+/CCR7+ mononuclear cells (MNCs) were observed without multinucleated giant cells (MNGCs). After 15 days, the presence of macrophages (CD68+ P<0.01 /CCR7+ P<0.001 /CD206+ P<0.05) reduced considerably in the CG. On the contrary, the inflammatory response increased in the EGs (CD68+/CCR7+). The intergroup comparison showed that this increment was statistically significant when comparing E-CHS and P-E-CHS to the CG at day 15 (P<0.01 and P< 0.05 respectively). At this time point, a reduced number of MNGCs were observed in the EGs. In the CG no MNGCs were observed. Furthermore, E-CHS showed a faster degradation rate and was fully invaded by cells and vessels formed in its interior region. On the other hand, P-E-CHS remained occlusive to cell penetration and vessels were formed only in the periphery. After 30 days, the cellular reaction shifted to a higher number of M2 macrophages (CD260+) in all groups and a reduced presence of CD68+ and CCR7+ MNCs. Both biomaterials degraded and only small fragments were found in the implantation bed surrounded by MNGCs (CCR7+).
These results are of high clinical relevance and show that changes in biomaterial properties have a significant impact on their interaction with the body. They also serve as insight into the possibility to develop versatile biomaterials with different applications. For example, E-CHs can be applied to support hemostasis in a bleeding alveolar socket and P-E-CHs by being cell occlusive and having a delayed degradation rate can be applied for guided bone and tissue regeneration.
Herrera-Vizcaino, Carlos ; Seifert, Lukas Benedikt ; Berdan, Mehmet Yakup ; Ghanaati, Shahram Michael ; Klos, Michelle ; Landes, Constantin ; Sader, Robert Alexander
Background: The high-oblique sagittal osteotomy (HOSO) is an alternative to a bilateral sagittal split osteotomy (BSSO). Due to its novelty, there are no long-term studies which have focused on describing the incidence and type of complications encountered in the post-operative follow-up. The aim of this retrospective study is to analyze patients operated on with this surgical technique and the post-operative complications encountered. Patient and methods: The electronic medical records of all patients treated with orthognathic surgery at the Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany, between the years 2009 and 2016 were retrospectively reviewed. Results: A total of 116 patients fulfilled the inclusion criteria. The cases operated on with the standard osteosynthesis (X, Y, and straight) showed a complication rate of 36.37% (n = 4/11). The cases operated on with the HOSO-dedicated plates (HOSO-DP) showed, in total, a complication rate of 6.67% (n = 7/105). The most common post-operative complication resulting from both fixation methods was a reduction in mouth opening and TMJ pain for 4.3%. During the first years of performing the surgery (2009–211), a variety of standard plates had material failure causing non-union or pseudarthrosis. No cases of material failure were observed in the cases operated on with the HOSO-DP. The statistical results showed a highly significant dependence of a reduction in OP-time over the years, when the HOSO was performed without additional procedures (R2 > 0.83, P < 0.0015). Conclusion: The rate of complications in the HOSO were shown to be comparable to the rate of complications from the BSSO reported in the literature. Moreover, the use of the ramus dedicated plate appears to provide enough stability to the bone segments, making the surgery safer. Clinical relevance: The HOSO needs to be considered by surgeons as an alternative to BSSO. Once the use of the HOSO-DP was established, the rate of complications and the operation time reduced considerably.
External linkages allow nascent ventures to access crucial resources during the process of new product development. Forming external linkages can substantially contribute to a venture’s performance. However, little is known about the paths of external linkage formation, as well as the circumstances that drive the choice to pursue one rather than another path. This gap deserves further investigation, because we do not know whether insights developed for incumbent firms also apply to nascent ventures: To address this gap, we explore a novel dataset of 370 venture creation processes. Using sequence analyses based on optimal matching techniques and cluster analyses, we reveal that nascent ventures pursue one of overall four distinct paths of linkage formation activities during new product development. Contrary to the findings of the strategy literature, we find that if nascent ventures engage in external linkages at all, they do not combine exploration- and exploitation-oriented linkages but form either exploration- or exploitation-oriented linkages. Additional regression analyses highlight the circumstances that lead nascent ventures to pursue one rather than the other pathways. Taken together, our analyses point out that resource scarcity constitutes an important factor shaping the linkage formation activities of nascent ventures. Accordingly, we show that nascent ventures tend not to optimize by adding complementary knowledge to the firm’s knowledge base but rather to extend the existing knowledge base—a strategy which we call bricolage.
Animal tracking and biologging devices record large amounts of data on individual movement behaviors in natural environments. In these data, movement ecologists often view unexplained variation around the mean as “noise” when studying patterns at the population level. In the field of behavioral ecology, however, focus has shifted from population means to the biological underpinnings of variation around means. Specifically, behavioral ecologists use repeated measures of individual behavior to partition behavioral variability into intrinsic among-individual variation and reversible behavioral plasticity and to quantify: a) individual variation in behavioral types (i.e. different average behavioral expression), b) individual variation in behavioral plasticity (i.e. different responsiveness of individuals to environmental gradients), c) individual variation in behavioral predictability (i.e. different residual within-individual variability of behavior around the mean), and d) correlations among these components and correlations in suites of behaviors, called ‘behavioral syndromes’. We here suggest that partitioning behavioral variability in animal movements will further the integration of movement ecology with other fields of behavioral ecology. We provide a literature review illustrating that individual differences in movement behaviors are insightful for wildlife and conservation studies and give recommendations regarding the data required for addressing such questions. In the accompanying R tutorial we provide a guide to the statistical approaches quantifying the different aspects of among-individual variation. We use movement data from 35 African elephants and show that elephants differ in a) their average behavior for three common movement behaviors, b) the rate at which they adjusted movement over a temporal gradient, and c) their behavioral predictability (ranging from more to less predictable individuals). Finally, two of the three movement behaviors were correlated into a behavioral syndrome (d), with farther moving individuals having shorter mean residence times. Though not explicitly tested here, individual differences in movement and predictability can affect an individual’s risk to be hunted or poached and could therefore open new avenues for conservation biologists to assess population viability. We hope that this review, tutorial, and worked example will encourage movement ecologists to examine the biology of individual variation in animal movements hidden behind the population mean.
1. Recent research highlights the ecological importance of individual variation in behavioural predictability. Individuals may not only differ in their average expression of a behavioural trait (their behavioural type) and in their ability to adjust behaviour to changing environmental conditions (individual plasticity), but also in their variability around their average behaviour (predictability). However, quantifying behavioural predictability in the wild has been challenging due to limitations of acquiring sufficient repeated behavioural measures.
2. We here demonstrate how common biologging data can be used to detect individual variation in behavioural predictability in the wild and reveal the coexistence of highly predictable individuals along with unpredictable individuals within the same population.
3. We repeatedly quantified two behaviours—daily movement distance and diurnal activity—in 62 female brown bears Ursus arctos tracked across 187 monitoring years. We calculated behavioural predictability over the short term (50 consecutive monitoring days within 1 year) and long term (across monitoring years) as the residual intra-individual variability (rIIV) of behaviour around the behavioural reaction norm. We tested whether predictability varies systematically across average behavioural types and whether it is correlated across functionally distinct behaviours, that is, daily movement distance and amount of diurnal activity.
4. Brown bears showed individual variation in behavioural predictability from predictable to unpredictable individuals. For example, the standard deviation around the average daily movement distance within one monitoring year varied up to fivefold from 1.1 to 5.5 km across individuals. Individual predictability for both daily movement distance and diurnality was conserved across monitoring years. Individual predictability was correlated with behavioural type where individuals which were on average more diurnal and mobile were also more unpredictable in their behaviour. In contrast, more nocturnal individuals moved less and were more predictable in their behaviour. Finally, individual predictability in daily movement distance and diurnality was positively correlated, suggesting that individual predictability may be a quantitative trait in its own regard that could evolve and is underpinned by genetic variation.
5. Unpredictable individuals may cope better with stochastic events and unpredictability may hence be an adaptive behavioural response to increased predation risk.
Herzer, Kerstin ; Sterneck, Martina ; Welker, Martin-Walter ; Nadalin, Silvio ; Kirchner, Gabriele ; Braun, Felix ; Malessa, Christina ; Herber, Adam ; Pratschke, Johann ; Weiss, Karl Heinz ; Jäckel, Elmar ; Tacke, Frank
Improving long-term patient and graft survival after liver transplantation (LT) remains a major challenge. Compared to the early phase after LT, long-term morbidity and mortality of the recipients not only depends on complications immediately related to the graft function, infections, or rejection, but also on medical factors such as de novo malignancies, metabolic disorders (e.g., new-onset diabetes, osteoporosis), psychiatric conditions (e.g., anxiety, depression), renal failure, and cardiovascular diseases. While a comprehensive post-transplant care at the LT center and the connected regional networks may improve outcome, there is currently no generally accepted standard to the post-transplant management of LT recipients in Germany. We therefore described the structure and standards of post-LT care by conducting a survey at 12 German LT centers including transplant hepatologists and surgeons. Aftercare structures and form of cost reimbursement considerably varied between LT centers across Germany. Further discussions and studies are required to define optimal structure and content of post-LT care systems, aiming at improving the long-term outcomes of LT recipients.
Introduction: From the beginning of the corona pandemic until August 19, 2020, more than 21,989,366 cases have been reported worldwide – 228,495 in Germany alone, including 12,648 children aged 0–14. In many countries, the proportion of infected children in the total population is comparatively low; in addition, children often have no or milder symptoms and are less likely to transmit the pathogen to adults than the other way round. Based on the registration data in Frankfurt am Main, Germany, the symptoms of children in comparison with adults and the likely routes of transmission are presented below.
Materials and methods: The documentation of the mandatory reports includes personal data (name, date of birth, gender, place of residence), disease characteristics (date of report, date of onset of the disease, symptoms), possible contact persons (family, others) and i.a. possible activity or care in children’s community facilities. All reports were viewed, especially with regard to likely transmission routes.
Results: From March 1 to July 31, 2020, 1,977 infected people were reported, including 138 children between the ages of 0 and 14 years. Children had fewer and milder symptoms than adults. None of the children experienced severe respiratory symptoms or the need for ventilation. 62% of the children had no symptoms at all (19% adults), 5% of the children were hospitalized (24% adults), and none of the children died (3.8% adults).
After excluding a cluster of 34 children from refugee accommodations and 14 children from a parish, 78% of the remaining 90 children had been infected by an adult within the family, and only 4% were likely to have a reverse transmission route. In 5.5% of cases, transmission in a community facility was likely.
Discussion: The results of the registration data from Frankfurt am Main, Germany confirm the results published in other countries: Children are less likely to become infected, and if infected, their symptoms are less severe than in adults, and they are apparently not the main drivers of virus transmission. Therefore, scientific medical associations strongly recommend reopening schools.
Heyl, Andreas Stephan ; Luu, Brigitte ; Wieszner, Markus ; Nikkhoo, Aria ; Seeger, Florian Hartmut ; Hemmann, Katrin ; Aßmus, Birgit ; Kaess, Bernhard ; Zeiher, Andreas M. ; Walther, Claudia ; Fichtlscherer, Stephan ; Honold, Jörg Florian Hannes
Background: MitraClip ® (MC) is an established procedure for severe mitral regurgitation (MR) in patients deemed unsuitable for surgery. Right ventricular dysfunction (RVD) is associated with a higher mortality risk. The prognostic accuracy of heart failure risk scores like the Seattle heart failure model (SHFM) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in pts undergoing MC with or without RVD has not been investigated so far. Methods: SHFM and MAGGIC score were calculated retrospectively. RVD was determined as tricuspid annular plane systolic excursion (TAPSE) ≤15 mm. Area under receiver operating curves (AUROC) of SHFM and MAGGIC were performed for one-year all-cause mortality after MC. Results: N = 103 pts with MR III° (73 ± 11 years, LVEF 37 ± 17%) underwent MC with a reduction of at least I° MR. One-year mortality was 28.2%. In Kaplan-Meier analysis, one- year mortality was significantly higher in RVD-pts (34.8% vs 2.8%, p = 0.009). Area under the Receiver Operating Characteristic (AUROC) for SHFM and MAGGIC were comparable for both scores (SHFM: 0.704, MAGGIC: 0.692). In pts without RVD, SHFM displayed a higher AUROC and therefore better diagnostic accuracy (SHFM: 0.776; MAGGIC: 0.551, p < 0.05). In pts with RVD, MAGGIC and SHFM displayed comparable AUROCs. Conclusion: RVD is an important prognostic marker in pts undergoing MC. SHFM and MAGGIC displayed adequate over-all prognostic power in these pts. Accuracy differed in pts with and without RVD, indicating higher predictive power of the SHFM score in pts without RVD.
Hiebel, Christof ; Stürner, Elisabeth ; Hoffmeister, Meike ; Tascher, Georg ; Schwarz, Mario ; Nagel, Heike ; Behrends, Christian ; Münch, Christian ; Behl, Christian
The multifunctional HSP70 co-chaperone BAG3 (BCL-2-associated athanogene 3) represents a key player in the quality control of the cellular proteostasis network. In response to stress, BAG3 specifically targets aggregation-prone proteins to the perinuclear aggresome and promotes their degradation via BAG3-mediated selective macroautophagy. To adapt cellular homeostasis to stress, BAG3 modulates and functions in various cellular processes and signaling pathways. Noteworthy, dysfunction and deregulation of BAG3 and its pathway are pathophysiologically linked to myopathies, cancer, and neurodegenerative disorders. Here, we report a BAG3 proteomic signature under proteostasis stress. To elucidate the dynamic and multifunctional action of BAG3 in response to stress, we established BAG3 interactomes under basal and proteostasis stress conditions by employing affinity purification combined with quantitative mass spectrometry. In addition to the identification of novel potential BAG3 interactors, we defined proteins whose interaction with BAG3 was altered upon stress. By functional annotation and protein-protein interaction enrichment analysis of the identified potential BAG3 interactors, we confirmed the multifunctionality of BAG3 and highlighted its crucial role in diverse cellular signaling pathways and processes, ensuring cellular proteostasis and cell viability. These include protein folding and degradation, gene expression, cytoskeleton dynamics (including cell cycle and transport), as well as granulostasis, in particular.
Hildebrand, Sven ; Schueth, Anna ; Wangenheim, Klaus von ; Mattheyer, Christian ; Pampaloni, Francesco ; Bratzke, Hansjürgen ; Roebroeck, Alard F. ; Galuske, Ralf
Here, we describe a new immersion-based clearing method suitable for optical clearing of thick adult human brain samples while preserving its lipids and lipophilic labels such as 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (DiI). This clearing procedure is simple, easy to implement, and allowed for clearing of 5 mm thick human brain tissue samples within 12 days. Furthermore, we show for the first time the advantageous effect of the Periodate-Lysine-Paraformaldehyde (PLP) fixation as compared to the more commonly used 4% paraformaldehyde (PFA) on clearing performance.
Hilger, Kirsten ; Sassenhagen, Jona ; Kühnhausen, Jan ; Reuter, Merle ; Schwarz, Ulrike ; Gawrilow, Caterina ; Fiebach, Christian
Children with attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms of inattention, impulsivity, and hyperactivity. Neurophysiological correlates of ADHD include changes in the P3 component of event-related brain potentials (ERPs). Motivated by recent advances towards a more dimensional understanding of ADHD, we investigate whether ADHD-related ERP markers relate to continuous variations in attention and executive functioning also in typically-developing children. ERPs were measured while 31 school children (9–11 years) completed an adapted version of the Continuous Performance Task that additionally to inhibitory processes also isolates effects of physical stimulus salience. Children with higher levels of parent-reported ADHD symptoms did not differ in task performance, but exhibited smaller P3 amplitudes related to stimulus salience. Furthermore, ADHD symptoms were associated with the variability of neural responses over time: Children with higher levels of ADHD symptoms demonstrated lower variability in inhibition- and salience-related P3 amplitudes. No effects were observed for ERP latencies and the salience-related N2. By demonstrating that ADHD-associated neurophysiological mechanisms of inhibition and salience processing covary with attention and executive functioning in a children community sample, our study provides neurophysiological support for dimensional models of ADHD. Also, temporal variability in event-related potentials is highlighted as additional indicator of ADHD requiring further investigation.
Hilger, Kirsten ; Winter, Nils R. ; Leenings, Ramona ; Sassenhagen, Jona ; Hahn, Tim ; Basten, Ulrike ; Fiebach, Christian
A positive association between brain size and intelligence is firmly established, but whether region-specific anatomical differences contribute to general intelligence remains an open question. Results from voxel-based morphometry (VBM) - one of the most widely used morphometric methods - have remained inconclusive so far. Here, we applied cross-validated machine learning-based predictive modeling to test whether out-of-sample prediction of individual intelligence scores is possible on the basis of voxel-wise gray matter volume. Features were derived from structural magnetic resonance imaging data (N = 308) using (a) a purely data-driven method (principal component analysis) and (b) a domain knowledge-based approach (atlas parcellation). When using relative gray matter (corrected for total brain size), only the atlas-based approach provided significant prediction, while absolute gray matter (uncorrected) allowed for above-chance prediction with both approaches. Importantly, in all significant predictions, the absolute error was relatively high, i.e., greater than ten IQ points, and in the atlas-based models, the predicted IQ scores varied closely around the sample mean. This renders the practical value even of statistically significant prediction results questionable. Analyses based on the gray matter of functional brain networks yielded significant predictions for the fronto-parietal network and the cerebellum. However, the mean absolute errors were not reduced in contrast to the global models, suggesting that general intelligence may be related more to global than region-specific differences in gray matter volume. More generally, our study highlights the importance of predictive statistical analysis approaches for clarifying the neurobiological bases of intelligence and provides important suggestions for future research using predictive modeling.
Hiller, Jan ; Mohammed, Nour-Eldin Abdelrehim Nour-Eldin ; Gruber-Rouh, Tatjana ; Burck, Iris ; Harth, Marc ; Stöver, Timo ; Vogl, Thomas J. ; Naguib, Nagy Naguib Naeem
The aim of the study was to obtain volumetric data of the components of the inner ear using three-dimensional reconstruction of high-resolution cone-beam computed tomography (CBCT) images. Two hundred three CBCT image series of the temporal bone from 118 anatomically normal patients (55 women and 63 men; mean age: 49.4 ± 20.4 years) with different suspected disorders were included in this study. Normative volumetric measurements of the inner ear, the cochlea, the semicircular canals (SSC), and the vestibule were determined using a semi-automated reconstruction method of the Workstation. Volumetric measurements were successfully completed in all 118 patients. Mean inner ear, cochlear, and vestibule volumes were statistically significantly larger in males than in females on both sides (p < 0.001). Regarding the semicircular canals, no statistically significant (p = 0.053) volume difference was found. The difference between the volumes on both sides was not significant. No correlation between the patient’s age and the volume of the compartments was seen (p > 0.05). There was no significant difference between mean bony inner ear volumes when the clinical diagnoses were compared (p > 0.05 for all clinical diagnoses and volumes). Our study concluded that three-dimensional reconstruction and assessment of the volumetric measurements of the inner ear can be obtained using high-resolution CBCT imaging.
THE PROLIFERATION OF THE INTERNET HAS ENABLED PLATFORM INTERMEDIARIES TO CREATE TWO-SIDED MARKETS IN MANY INDUSTRIES. IN SUCH MARKETS, NETWORK EFFECTS OFTEN OCCUR WHICH CAN DIFFER FOR NEW AND EXISTING CUSTOMERS. THE AUTHORS DEVELOP AN INFLUX-OUTFLOW MODEL TO INVESTIGATE THE CONDITIONS UNDER WHICH THE ESTIMATION OF SAME-SIDE AND CROSS-SIDE NETWORK EFFECTS SHOULD DISTINGUISH BETWEEN ITS IMPACT ON THE NUMBER OF NEW CUSTOMERS (I.E., ACQUISITION) AND EXISTING CUSTOMERS (I.E., THEIR ACTIVITY).
Metabolic differences between symbiont subpopulations in the deep-sea tubeworm Riftia pachyptila
(2020)
Hinzke, Tjorven ; Kleiner, Manuel ; Meister, Mareike ; Schlüter, Rabea ; Hentschker, Christian ; Pané-Farré, Jan ; Hildebrandt, Petra ; Felbeck, Horst ; Sievert, Stefan M. ; Bonn, Florian ; Völker, Uwe ; Becher, Dörte ; Schweder, Thomas ; Markert, Stephanie
The hydrothermal vent tube worm Riftia pachyptila lives in intimate symbiosis with intracellular sulfur-oxidizing gammaproteobacteria. Although the symbiont population consists of a single 16S rRNA phylotype, bacteria in the same host animal exhibit a remarkable degree of metabolic diversity: They simultaneously utilize two carbon fixation pathways and various energy sources and electron acceptors. Whether these multiple metabolic routes are employed in the same symbiont cells, or rather in distinct symbiont subpopulations, was unclear. As Riftia symbionts vary considerably in cell size and shape, we enriched individual symbiont cell sizes by density gradient centrifugation in order to test whether symbiont cells of different sizes show different metabolic profiles. Metaproteomic analysis and statistical evaluation using clustering and random forests, supported by microscopy and flow cytometry, strongly suggest that Riftia symbiont cells of different sizes represent metabolically dissimilar stages of a physiological differentiation process: Small symbionts actively divide and may establish cellular symbiont-host interaction, as indicated by highest abundance of the cell division key protein FtsZ and highly abundant chaperones and porins in this initial phase. Large symbionts, on the other hand, apparently do not divide, but still replicate DNA, leading to DNA endoreduplication. Highest abundance of enzymes for CO2 fixation, carbon storage and biosynthesis in large symbionts indicates that in this late differentiation stage the symbiont’s metabolism is efficiently geared towards the production of organic material. We propose that this division of labor between smaller and larger symbionts benefits the productivity of the symbiosis as a whole.
As fossil resources are diminishing, environmental concerns arise and chemical synthesis often involves expensive catalysts or extensive extraction procedures, the demand for production of industrially relevant compounds from renewable resources increases. In this context, engineering microorganisms for production of specialty chemicals, such as 3-alkylphenols, presents an attractive, environmental-friendly approach. 3-alkylphenols have various applications: due to their antiseptic and stabilizing properties many 3-alkylphenols, including 3-methylphenol (3-MP), are utilized as additives in disinfectant reagents and biological products, while they can be also implemented as platform chemicals for production of lubricating oil additives or flavors. Some 3-akylphenols have potential for transmission control of the disease sleeping sickness that is transmitted by tsetse flies in sub-saharan Africa, since 3-ethylphenol (3-EP) and 3-propylphenol (3-PP) and to a lesser degree 3-MP were found to attract tsetse flies and improved catch rates in impregnated tsetse fly traps. Microbial fermentation of 3-alkylphenols would provide a simple and inexpensive way for local communities in Africa to produce these compounds and prepare their own tsetse fly traps.
Some molds synthesize 3-MP as an intermediate during biosynthesis of the mycotoxin patulin. However, the heterologous host Saccharomyces cerevisiae has advantageous traits for industrial application, since it is well characterized, robust, simple to handle and easily genetically accessible. In this thesis, genetical engineering approaches were utilized to establish the yeast S. cerevisiae for biotechnological production of 3-alkylphenols. As a proof of concept, the iterative polyketide synthase from Penicillium patulum, 6-methylsalicylic acid synthase (MSAS), and 6-methylsalicylic acid (6-MSA) decarboxylase PatG from Aspergillus clavatus were heterologously expressed in S. cerevisiae resulting in the first reported de novo biosynthesis of 3-MP via 6-MSA in yeast from sugars (Hitschler & Boles, 2019). It was shown that codon-optimization and genomic integration of heterologous genes, high initial cell densities and a balanced expression of PatG were beneficial for heterologous production of up to 589 mg/L 3-MP in S. cerevisiae. However, toxicity of 3-MP limited higher product accumulation.
Different in vivo detoxification strategies were implemented to face this bottleneck. Growth tests revealed that 3-methylanisole (3-MA) is less toxic to the yeast cells than 3-MP. Expression of an orcinol-O-methyltransferase from chinese rose hybrids (OOMT2) was combined with in situ extraction converting the toxic 3-MP product into the volatile 3-MA and accumulating up to 211 mg/L 3-MA in the dodecane phase. Alternatively, up to 533 mg/L 3-MP glucoside were synthesized by expression of a UDP-glycosyltransferase (UGT72B27) from Vitis vinifera in the 3-MP producing strain, revealing saccharose as beneficial carbon source and ethanol growth phase as essential for high 3-MP production, although 3-MP conversions were not yet complete. Both detoxification strategies allowed circumvention of the toxicity imposed limited product accumulation. This was demonstrated when both detoxification strategies were combined with redirection of the carbon flux through deletion of phosphoglucose isomerase gene PGI1 and feeding a mixture of fructose and glucose leading to majorly improved product formation, with up to 899 mg/L 3-MA/3-MP and 873 mg/L 3-MP/3-MP glucoside, compared to less than 313 mg/L product titers in the wild type controls (Hitschler & Boles, 2020).
For provision of the tsetse fly attractants 3-EP from propionyl-CoA and 3-PP from butyryl-CoA, the substrate promiscuities of MSAS and PatG were exploited. However, slower formation rates with the alternative substrates propionyl-CoA and butyryl-CoA suggested that competing formation of 6-MSA from the preferred priming unit acetyl-CoA was dominating in vivo. Indeed, 3-EP or 3-PP formation was not observed in 3-MP producing yeast strains. Assuming that intracellular levels of propionyl-CoA and butyryl-CoA were limiting 3-EP and 3-PP formation, different strategies were implemented to raise the supply of these alternative priming units and successfully compete with acetyl-CoA for MSAS priming.
Supplementation of propionate increased propionyl-CoA levels by endogenous pathways sufficiently to enable 3-EP formation in yeast mediated by MSAS and PatG. Deletion of the 2-methylcitrate synthases CIT2 and CIT3 revealed that degradation of propionyl-CoA was not limiting 3-EP formation at this stage. In order to raise propionyl-CoA levels further, a heterologous propionyl-CoA synthase (PrpE) was expressed in the 3-MP producing yeast strain leading to up to 12.5 mg/L 3-EP with propionate feeding and blockage of degradation. Moreover, PrpE enabled also 3-EP formation without propionate supplementation suggesting that an endogenous supply of propionate existed that was reactivated by PrpE. As threonine or 2-ketobutyrate feeding increased 3-EP titers in combination with PrpE, this indicated that threonine degradation via 2-ketobutyrate was responsible for the endogenous propionate supply. Moreover, expression of branched-chain ketoacid dehydrogenase complex from Pseudomonas putida combined with PrpE provided propionyl-CoA from endogenous 2-ketobutyrate and raised 3-EP titers up to 5.9 mg/L compared to 2.8 mg/L with only PrpE indicating a potential route for optimization of 3-EP titers independent of propionate or threonine feeding.
For 3-PP production from butyryl-CoA, a heterologous ‘reverse ß-oxidation’ pathway was introduced in the 3-MP producing yeast strain providing sufficient butyryl-CoA for biosynthesis of up to 2 mg/L 3-PP. Degradation of the precursor via ß-oxidation was slightly limiting, since deletion of fatty acyl-CoA oxidase POX1 increased 3-PP titers slightly to 2.6 mg/L.
As the concentrations of 3-alkylphenols are close to the concentrations implemented in tsetse fly traps, the engineered yeast strains have the potential for simple and inexpensive on-site production of 3-alkylphenols as tsetse fly attractants by local rural communities in Africa. In spite of this success, 3-MP remained the main product in the developed yeast strains. Since 3-EP and 3-PP are more efficient tsetse fly attractants, a shift in substrate specificities of MSAS and PatG is desirable for a more favorable 3-EP/3-MP and 3-PP/3-MP product ratio regarding tsetse fly attraction. During rational engineering of MSAS, the MSASQ625A/I752V mutant showed a beneficial shift of product ratios with up to 11 mg/L 3-EP/63 mg/L 3-MP and 4.5 mg/L 3-PP/116 mg/L 3-MP, compared to a higher proportion of 3-MP with up to 343 mg/L, 11 mg/L 3-EP and 1.5 mg/L 3-PP in the wild type controls. Further engineering of MSAS and PatG might majorly improve production of 3-EP and 3-PP.
In summary, this thesis successfully established the yeast S. cerevisiae as cell factory for production of different 3-alkylphenols optimizing expression of the heterologous production pathway, elucidating means to detoxify products and establishing different approaches to increase intracellular levels of acyl-CoA precursors. The engineered yeast strains can be potentially implemented for simple and inexpensive fermentation of tsetse fly attractants in Africa.
Tsetse flies are the transmitting vector of trypanosomes causing human sleeping sickness and animal trypanosomiasis in sub-saharan Africa. 3-alkylphenols are used as attractants in tsetse fly traps to reduce the spread of the disease. Here we present an inexpensive production method for 3-ethylphenol (3-EP) and 3-propylphenol (3-PP) by microbial fermentation of sugars. Heterologous expression in the yeast Saccharomyces cerevisiae of phosphopantetheinyltransferase-activated 6-methylsalicylic acid (6-MSA) synthase (MSAS) and 6-MSA decarboxylase converted acetyl-CoA as a priming unit via 6-MSA into 3-methylphenol (3-MP). We exploited the substrate promiscuity of MSAS to utilize propionyl-CoA and butyryl-CoA as alternative priming units and the substrate promiscuity of 6-MSA decarboxylase to produce 3-EP and 3-PP in yeast fermentations. Increasing the formation of propionyl-CoA by expression of a bacterial propionyl-CoA synthetase, feeding of propionate and blocking propionyl-CoA degradation led to the production of up to 12.5 mg/L 3-EP. Introduction of a heterologous ‘reverse ß-oxidation’ pathway provided enough butyryl-CoA for the production of 3-PP, reaching titers of up to 2.6 mg/L. As the concentrations of 3-alkylphenols are close to the range of the concentrations deployed in tsetse fly traps, the yeast broths might become promising and inexpensive sources for attractants, producible on site by rural communities in Africa.
Freshwater is one of the most fundamental resources for life and is the habitat for a wide diversity of species. One of the most diverse aquatic insect taxa is Trichoptera Kirby, 1813, caddisflies. These semi-aquatic insects have aquatic larvae and terrestrial adults and are found all around the globe in freshwater habitats. Water is also one of the most important natural resources for the human population, but alarmingly, freshwaters are among the most threatened natural habitats. Thus, the monitoring and preservation of the quality of freshwater habitats should have a high priority. In order to track changes in the biota a baseline reference is necessary, but freshwater biodiversity is under-studied in many parts of the Earth such as the biodiversity hotspots of the Himalaya and the Hengduan Mountains. This thesis treats the trichopteran genus Himalopsyche Banks, 1940 (Rhyacophilidae) which has its diversity center in the Himalayas and the Hengduan Mountains. Himalopsyche larvae are large and conspicuous and only occur in clean, unpolluted streams. This makes Himalopsyche potentially suited as indicator organisms for freshwater quality monitoring, but taxonomic knowledge is yet insufficient. Based on samples from a field survey in the Hengduan Mountains targeting both larvae and adults I uncovered three new Himalopsyche species which are described in this thesis (Chapter II), and with the aid of molecular data I associated larvae of Himalopsyche to adult species (Chapter I). The molecular association enabled the first comparative morphological study of Himalopsyche species in the larval stage, and the morphological study in Chapter II revealed that there are four distinct larval types of Himalopsyche. However, no diagnostic characters to identify Himalopsyche larvae to species level were found. To understand Himalopsyche larval morphology from an evolutionary perspective, I reconstructed the first molecular phylogeny of the genus (Chapter III). This demonstrated that each larval type corresponds to a deep phylogenetic split, indicating that larval types evolved early in Himalopsyche evolution and remained constant since. Based on the phylogenetic results as well as larval and adult morphology, I re-defined five species groups of Himalopsyche: H. kuldschensis Group, H. lepcha Group, H. navasi Group, H. phryganea Group, and H. tibetana Group. The species groups differ with respect to their diversity centers. The monotypic H. lepcha Group resides in the Himalayas, and the monotypic H. phryganea Group inhabits Western Nearctic. The H. kuldschensis and H. tibetana Groups are geographically overlapping with distributions in the Himalayas, but the distribution of H. kuldschensis Group stretches more to the west to include the Tian Shan, and the H. tibetana Group is more concentrated around the eastern Himalayas and the Hengduan Mountains. The H. navasi Group has a more eastern distribution than most Himalopsyche including isolated areas such as Japan and Indonesia. The earliest split in Himalopsyche divides the H. navasi Group from remaining Himalopsyche, suggesting a more eastern area of origin of Himalopsyche than its current diversity center, with subsequent radiations in the Himalayas and Hengduan Mountains. In addition to the three chapters, in this thesis I discuss further aspects of Himalopsyche biology including genital evolution, species complexes, and Himalopsyche ecology.
We study online secretary problems with returns in combinatorial packing domains with n candidates that arrive sequentially over time in random order. The goal is to determine a feasible packing of candidates of maximum total value. In the first variant, each candidate arrives exactly twice. All 2n arrivals occur in random order. We propose a simple 0.5‐competitive algorithm. For the online bipartite matching problem, we obtain an algorithm with ratio at least 0.5721 − o(1), and an algorithm with ratio at least 0.5459 for all n ≥ 1. We extend all algorithms and ratios to k ≥ 2 arrivals per candidate. In the second variant, there is a pool of undecided candidates. In each round, a random candidate from the pool arrives. Upon arrival a candidate can be either decided (accept/reject) or postponed. We focus on minimizing the expected number of postponements when computing an optimal solution. An expected number of Θ(n log n) is always sufficient. For bipartite matching, we can show a tight bound of O(r log n), where r is the size of the optimum matching. For matroids, we can improve this further to a tight bound of O(r′ log(n/r′)), where r′ is the minimum rank of the matroid and the dual matroid.
Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality in patient groups at risk. We have previously shown that the anti-CMV IgG seroprevalence in an urban region of Germany has changed over the last decades. Overall, a decline from 63.7 to 57.25% had been observed between 1988–1997 and 1998–2008 (p < 0,001). Here, we continuously follow the trends to the most recent decade 2009 to 2018. In a retrospective analysis, we determined the seroprevalence of CMV IgG antibodies in our patient cohort, stratified by gender and selected groups at risk (e.g., patients with HIV infection; women of childbearing age). The overall prevalence of anti-CMV IgG non-significantly declined further from 57.25% in 1998–2008 to 56.48% in 2009–2018 (p = 0.881). Looking at gender differences, overall CMV seroprevalence in males declined to 52.82% (from 55.54% in 1998–2008; p = 0.0254), while it non-significantly increased in females to 59.80%. The high seroprevalence in patients with a known HIV infection further increased from 87.46% in 1998–2008 to 92.93% in the current period (p = 0.9999). In women of childbearing age, no significant changes over the last three decades could be observed. The CMV seroprevalence in oncological patients was determined to be 60.64%. Overall, the former significant decline of CMV seroprevalence between the decades 1988–1997 and 1998–2008 in this urban region of Germany slowed down to a non-significant decrease of 0.77% (1998–2008 vs. 2009–2018). This might be an indicator that CMV seroprevalence has reached a plateau.
Hoehl, Sebastian ; Karaca, Onur ; Kohmer, Niko ; Westhaus, Sandra ; Graf, Jürgen ; Götsch, Udo ; Ciesek, Sandra
This case series assessed a commercial airline flight from Tel Aviv, Israel, to Frankfurt, Germany, that occurred on March 9th, 2020. Among 102 passengers on a Boeing 737-900 aircraft were 24 members of a tourist group. Starting 7 days earlier, the group had contact with a hotel manager who later received a diagnosis of coronavirus disease 2019 (COVID-19). No member of the group had received a diagnosis of COVID-19 before the flight, and no measures to prevent transmission (eg, wearing of masks) had been applied. The flight duration was 4 hours 40 minutes.
Considering the microbiome in stress-related and neurodevelopmental trajectories to schizophrenia
(2020)
Hoffman, Kevin W. ; Lee, Jakleen J. ; Corcoran, Cheryl M. ; Kimhy, David ; Kranz, Thorsten Manfred ; Malaspina, Dolores
Early life adversity and prenatal stress are consistently associated with an increased risk for schizophrenia, although the exact pathogenic mechanisms linking the exposures with the disease remain elusive. Our previous view of the HPA stress axis as an elegant but simple negative feedback loop, orchestrating adaptation to stressors among the hypothalamus, pituitary, and adrenal glands, needs to be updated. Research in the last two decades shows that important bidirectional signaling between the HPA axis and intestinal mucosa modulates brain function and neurochemistry, including effects on glucocorticoid hormones and brain-derived neurotrophic factor (BDNF). The intestinal microbiome in earliest life, which is seeded by the vaginal microbiome during delivery, programs the development of the HPA axis in a critical developmental window, determining stress sensitivity and HPA function as well as immune system development. The crosstalk between the HPA and the Microbiome Gut Brain Axis (MGBA) is particularly high in the hippocampus, the most consistently disrupted neural region in persons with schizophrenia. Animal models suggest that the MGBA remains influential on behavior and physiology across developmental stages, including the perinatal window, early childhood, adolescence, and young adulthood. Understanding the role of the microbiome on critical risk related stressors may enhance or transform of understanding of the origins of schizophrenia and offer new approaches to increase resilience against stress effects for preventing and treating schizophrenia.
Hoffmann, Jedrzej ; Luxán, Guillermo ; Abplanalp, Wesley Tyler ; Glaser, Simone F. ; Rasper, Tina ; Fischer, Ariane ; Muhly-Reinholz, Marion ; John, David ; Aßmus, Birgit ; Zeiher, Andreas M. ; Dimmeler, Stefanie
Bone vasculature provides protection and signals necessary to control stem cell quiescence and renewal1. Specifically, type H capillaries, which highly express Endomucin, constitute the endothelial niche supporting a microenvironment of osteoprogenitors and long-term hematopoietic stem cells2–4. The age-dependent decline in type H endothelial cells was shown to be associated with bone dysregulation and accumulation of hematopoietic stem cells, which display cell-intrinsic alterations and reduced functionality3. The regulation of bone vasculature by chronic diseases, such as heart failure is unknown. Here, we describe the effects of myocardial infarction and post-infarction heart failure on the vascular bone cell composition. We demonstrate an age-independent loss of type H bone endothelium in heart failure after myocardial infarction in both mice and in humans. Using single-cell RNA sequencing, we delineate the transcriptional heterogeneity of human bone marrow endothelium showing increased expression of inflammatory genes, including IL1B and MYC, in ischemic heart failure. Inhibition of NLRP3-dependent IL-1β production partially prevents the post-myocardial infarction loss of type H vasculature in mice. These results provide a rationale for using anti-inflammatory therapies to prevent or reverse the deterioration of vascular bone function in ischemic heart disease.
Hoffmann, Jedrzej ; Mas-Peiro, Silvia ; Berkowitsch, Alexander ; Böckling, Felicitas Juana ; Rasper, Tina ; Pieszko, Konrad ; De Rosa, Roberta ; Hiczkiewicz, Jarosław ; Burchardt, Paweł ; Fichtlscherer, Stephan ; Zeiher, Andreas M. ; Dimmeler, Stefanie ; Vasa-Nicotera, Mariuca
Aims: Systemic inflammatory response, identified by increased total leucocyte counts, was shown to be a strong predictor of mortality after transcatheter aortic valve implantation (TAVI). Yet the mechanisms of inflammation-associated poor outcome after TAVI are unclear. Therefore, the present study aimed at investigating individual inflammatory signatures and functional heterogeneity of circulating myeloid and T-lymphocyte subsets and their impact on 1 year survival in a single-centre cohort of patients with severe aortic stenosis undergoing TAVI. Methods and results: One hundred twenty-nine consecutive patients with severe symptomatic aortic stenosis admitted for transfemoral TAVI were included. Blood samples were obtained at baseline, immediately after, and 24 h and 3 days after TAVI, and these were analysed for inflammatory and cardiac biomarkers. Myeloid and T-lymphocyte subsets were measured using flow cytometry. The inflammatory parameters were first analysed as continuous variables; and in case of association with outcome and area under receiver operating characteristic (ROC) curve (AUC) ≥ 0.6, the values were dichotomized using optimal cut-off points. Several baseline inflammatory parameters, including high-sensitivity C-reactive protein (hsCRP; HR = 1.37, 95% CI: 1.15–1.63; P < 0.0001) and IL-6 (HR = 1.02, 95% CI: 1.01–1.03; P = 0.003), lower counts of Th2 (HR = 0.95, 95% CI: 0.91–0.99; P = 0.009), and increased percentages of Th17 cells (HR = 1.19, 95% CI: 1.02–1.38; P = 0.024) were associated with 12 month all-cause mortality. Among postprocedural parameters, only increased post-TAVI counts of non-classical monocytes immediately after TAVI were predictive of outcome (HR = 1.03, 95% CI: 1.01–1.05; P = 0.003). The occurrence of SIRS criteria within 48 h post-TAVI showed no significant association with 12 month mortality (HR = 0.57, 95% CI: 0.13–2.43, P = 0.45). In multivariate analysis of discrete or dichotomized clinical and inflammatory variables, the presence of diabetes mellitus (HR = 3.50; 95% CI: 1.42–8.62; P = 0.006), low left ventricular (LV) ejection fraction (HR = 3.16; 95% CI: 1.35–7.39; P = 0.008), increased baseline hsCRP (HR = 5.22; 95% CI: 2.09–13.01; P < 0.0001), and low baseline Th2 cell counts (HR = 8.83; 95% CI: 3.02–25.80) were significant predictors of death. The prognostic value of the linear prediction score calculated of these parameters was superior to the Society of Thoracic Surgeons score (AUC: 0.88; 95% CI: 0.78–0.99 vs. 0.75; 95% CI: 0.64–0.86, respectively; P = 0.036). Finally, when analysing LV remodelling outcomes, ROC curve analysis revealed that low numbers of Tregs (P = 0.017; AUC: 0.69) and increased Th17/Treg ratio (P = 0.012; AUC: 0.70) were predictive of adverse remodelling after TAVI. Conclusions: Our findings demonstrate an association of specific pre-existing inflammatory phenotypes with increased mortality and adverse LV remodelling after TAVI. Distinct monocyte and T-cell signatures might provide additive biomarkers to improve pre-procedural risk stratification in patients referred to TAVI for severe aortic stenosis.
Downy mildew of common sage (Salvia officinalis), caused by Peronospora salviae-officinalis, has become a serious problem in sage production worldwide. The causal agent of the disease belongs to the Pe. belbahrii species complex and was described as a species of its own in 2009. Nevertheless, very little is known about its infection biology and epidemiology. The aims of the current study were therefore to unravel the life cycle of this downy mildew and gain deeper insights into the epidemiology of the disease, as well as to clarify the species boundaries in the Pe. belbahrii species complex.
Infection studies showed that temperatures between 15 and 20 °C were most favourable for infection and disease progress. At 5 °C Pe. salviae-officinalis is still able to infect sage plants, but sporulation was only observed at higher temperatures. Furthermore, Pe. salviae-officinalis needs two events of leaf wetness or high humidity, a first one of at least three hours for conidial germination and penetration of the host, and a second one for sporulation. Additionally, contamination of sage seeds by Pe. salviae-officinalis was proven by seed washing and by PCR and DNA sequence comparisons, suggesting that infested seeds might play a major role in the fast spread of sage downy mildew, which is an important finding for phytosanitary or quarantine measures.
A protocol for fluorescence staining and confocal laser scanning microscopy was established and the whole life cycle of Pe. salviae-officinalis was tracked including oospore formation. The method was also used to examine samples of Pe. lamii on Lamium purpureum and Pe. belbahrii on Ocimum basilicum demonstrating the usefulness of this method for studying the infection process of downy mildews in general.
Peronospora species parasitizing S. sclarea, S. pratensis, O. basilicum, and Plectranthus scutellarioides were studied using light microscopy and molecular phylogenetic analyses based on six loci (ITS rDNA, cox1, cox2, ef1a, hsp90 and β-tubulin). The downy mildew on S. pratensis was shown to be distinct from Pe. salviae-officinalis and closely related to Pe. glechomae, and is herein described as a new taxon, Peronospora salviae-pratensis. The downy mildew on S. sclarea was found to be caused by Peronospora salviae-officinalis. The multi-gene phylogeny revealed that the causal agent of downy mildew on coleus is distinct from Pe. belbahrii on basil, and is herein described as a new taxon, Pe. choii.
Peronospora salviae‐officinalis, the causal agent of downy mildew on common sage, is an obligate biotrophic pathogen. It grows in the intercellular spaces of the leaf tissue of sage and forms intracellular haustoria to interface with host cells. Although P. salviae‐officinalis was described as a species of its own 10 years ago, the infection process remains obscure. To address this, a histological study of various infection events, from the adhesion of conidia on the leaf surface to de novo sporulation is presented here. As histological studies of oomycetes are challenging due to the lack of chitin in their cell wall, we also present an improved method for staining downy mildews for confocal laser scanning microscopy as well as evaluating the potential of autofluorescence of fixed nonstained samples. For staining, a 1:1 mixture of aniline blue and trypan blue was found most suitable and was used for staining of oomycete and plant structures, allowing discrimination between them as well as the visualization of plant immune responses. The method was also used to examine samples of Peronospora lamii on Lamium purpureum and Peronospora belbahrii on Ocimum basilicum, demonstrating the potential of the presented histological method for studying the infection processes of downy mildews in general.
Seit Wochen nun beobachten wir, wie Menschen auf sehr unterschiedliche Weise auf die COVID-19-Pandemie reagieren. Die unmittelbare Gefahrenursache ist zwar für das bloße Auge nicht sichtbar. Sichtbar hingegen sind die von der Weltgesundheitsorganisation, der Johns Hopkins Universität oder dem Robert-Koch-Institut veröffentlichten Daten. Täglich steigende Zahlen von Infizierten, täglich steigende Zahlen von Toten. Vielleicht ist es nachvollziehbar, dass "in diesen Zeiten" Regelungsmaßnahmen "mit heißer Nadel gestrickt" (noch so eine Phrase) sind. Selbst wenn in der Theorie Krisenszenarien vielleicht irgendwann einmal durchgespielt worden sind (siehe BT Drs. 17/12051, S. 57 ff.), lässt sich nicht jede Variante einer Krise antizipieren – genauso wenig wie der tatsächliche Stressmodus, in dem andere und man selbst sich befinden werden. In diesem Modus sind nun Entscheidungen getroffen worden. Entscheidungen, deren Konsequenzen ohne jegliche Übertreibung als der "massivste kollektive Grundrechtseingriff in der Geschichte der Bundesrepublik" bezeichnet werden können. ...
In power systems, flow allocation (FA) methods enable to allocate the usage and costs of the transmission grid to each single market participant. Based on predefined assumptions, the power flow is split into isolated generator-specific or producer-specific sub-flows. Two prominent FA methods, Marginal Participation (MP) and Equivalent Bilateral Exchanges (EBEs), build upon the linearized power flow and thus on the Power Transfer Distribution Factors (PTDFs). Despite their intuitive and computationally efficient concepts, they are restricted to networks with passive transmission elements only. As soon as a significant number of controllable transmission elements, such as high-voltage direct current (HVDC) lines, operate in the system, they lose their applicability. This work reformulates the two methods in terms of Virtual Injection Patterns (VIPs), which allows one to efficiently introduce a shift parameter q to tune contributions of net sources and net sinks in the network. In this work, major properties and differences in the methods are pointed out, and it is shown how the MP and EBE algorithms can be applied to generic meshed AC-DC electricity grids: by introducing a pseudo-impedance ω¯ , which reflects the operational state of controllable elements and allows one to extend the PTDF matrix under the assumption of knowing the current flow in the system. Basic properties from graph theory are used to solve for the pseudo-impedance in dependence of the position within the network. This directly enables, e.g., HVDC lines to be considered in the MP and EBE algorithms. The extended methods are applied to a low-carbon European network model (PyPSA-EUR) with a spatial resolution of 181 nodes and an 18% transmission expansion compared to today’s total transmission capacity volume. The allocations of MP and EBE show that countries with high wind potentials profit most from the transmission grid expansion. Based on the average usage of transmission system expansion, a method of distributing operational and capital expenditures is proposed. In addition, it is shown how injections from renewable resources strongly drive country-to-country allocations and thus cross-border electricity flows.
Hofmann, Wolf-Peter ; Buggisch, Peter ; Schubert, Lisa ; Dikopoulos, Nektarios ; Schwenzer, Jeannette ; Muche, Marion ; Felten, Gisela ; Heyne, Renate ; Ingiliz, Patrick Philipp ; Schmidt, Anna ; Stein, Kerstin ; Wedemeyer, Heiner ; Berg, Thomas ; Wiegand, Johannes ; Lammert, Frank ; Zeuzem, Stefan ; Schattenberg, Jörn Markus
Background & Aims: NAFLD is a growing health concern. The aim of the Fatty Liver Assessment in Germany (FLAG) study was to assess disease burden and provide data on the standard of care from secondary care. Methods: The FLAG study is an observational real-world study in patients with NAFLD enrolled at 13 centres across Germany. Severity of disease was assessed by non-invasive surrogate scores and data recorded at baseline and 12 months. Results: In this study, 507 patients (mean age 53 years; 47% women) were enrolled. According to fibrosis-4 index, 64%, 26%, and 10% of the patients had no significant fibrosis, indeterminate stage, and advanced fibrosis, respectively. Patients with advanced fibrosis were older, had higher waist circumferences, and higher aspartate aminotransferase and gamma-glutamyltransferase as well as ferritin levels. The prevalence of obesity, arterial hypertension, and type 2 diabetes increased with fibrosis stages. Standard of care included physical exercise >2 times per week in 17% (no significant fibrosis), 19% (indeterminate), and 6% (advanced fibrosis) of patients. Medication with either vitamin E, silymarin, or ursodeoxycholic acid was reported in 5%. Approximately 25% of the patients received nutritional counselling. According to the FibroScan-AST score, 17% of patients presented with progressive non-alcoholic steatohepatitis (n = 107). On follow-up at year 1 (n = 117), weight loss occurred in 47% of patients, of whom 17% lost more than 5% of body weight. In the weight loss group, alanine aminotransferase activities were reduced by 20%. Conclusions: This is the first report on NAFLD from a secondary-care real-world cohort in Germany. Every 10th patient presented with advanced fibrosis at baseline. Management consisted of best supportive care and lifestyle recommendations. The data highlight the urgent need for systematic health agenda in NAFLD patients. Lay summary: FLAG is a real-world cohort study that examined the liver disease burden in secondary and tertiary care. Herein, 10% of patients referred to secondary care for NAFLD exhibited advanced liver disease, whilst 64% had no significant liver scarring. These findings underline the urgent need to define patient referral pathways for suspected liver disease.
Knowledge of consumers' willingness to pay (WTP) is a prerequisite to profitable price-setting. To gauge consumers' WTP, practitioners often rely on a direct single question approach in which consumers are asked to explicitly state their WTP for a product. Despite its popularity among practitioners, this approach has been found to suffer from hypothetical bias. In this paper, we propose a rigorous method that improves the accuracy of the direct single question approach. Specifically, we systematically assess the hypothetical biases associated with the direct single question approach and explore ways to de-bias it. Our results show that by using the de-biasing procedures we propose, we can generate a de-biased direct single question approach that is accurate enough to be useful for managerial decision-making. We validate this approach with two studies in this paper.
In vitro release testing as an alternative to establishing bioequivalence of drug products in vivo
(2020)
Generische Arzneimittel werden als Arzneimittel definiert, die im Vergleich zu einem Referenzarzneimittel hinsichtlich der meisten pharmazeutischen Aspekte identisch sind.
Um die therapeutische Äquivalenz zum Referenzprodukt sicherzustellen, sind Bioverfügbarkeitsstudien erforderlich. Für Arzneimittel, die als feste, perorale, schnell freisetzende Darreichungsformen formuliert sind, kann auf den Nachweis der Bioäquivalenz in vivo zugunsten eines vergleichenden Freisetzungstests in vitro im Rahmen eines sogenannten Biopharmaceutics Classification System (BCS) basierten Biowaivers verzichtet werden.
Der BCS-basierte Biowaiver ist ein vielversprechendes Instrument, welches Kosteneinsparungen sowie eine Verringerung des regulatorischen Aufwands im Zuge der behördlichen Zulassung von Generika ermöglicht und dazu beitragen kann, die Zugänglichkeit unentbehrlicher Arzneimittel zu verbessern. Dabei gibt es jedoch auch Hürden, welche die weitläufige Anwendung des Verfahrens verhindern: Unklare Löslichkeits- und Permeabilitätsklassifizierungen von Wirkstoffen, Arzneimittel, welche die in vitro Freisetzungskriterien nicht erfüllen, sowie Zweifel an der Eignung der regulatorischen Spezifikationen, Freisetzungsunterschiede in vitro erfassen zu können, die für das Verhalten in vivo relevant sind.
In der vorliegenden Dissertation werden diese Probleme thematisiert, indem eine umfassende Bewertung der Anwendbarkeit und Einschränkungen des BCS-basierten Biowaivers in seinem aktuell regulatorisch vorgeschriebenen Ablauf vorgenommen wird. Mögliche Anpassungen des Verfahrens wurden auf der Grundlage experimenteller in vitro Daten untersucht, bewertet und mithilfe von in silico Simulationsmodellen auf die Situation in vivo extrapoliert.
Hohnloser, Stefan H. ; Camm, Alan John ; Cappato, Riccardo ; Diener, Hans-Christoph ; Heidbuchel, Hein ; Mont, Lluís ; Morillo, Carlos A ; Lanz, Hans-Joachim ; Rauer, Heiko ; Reimitz, Paul-Egbert ; Smolnik, Rüdiger ; Kautzner, Josef
Aims: This post hoc analysis of ELIMINATE-AF evaluated requirements of unfractionated heparin (UFH) and procedure-related bleeding in atrial fibrillation (AF) patients undergoing ablation with uninterrupted edoxaban or vitamin K antagonist (VKA) therapy.
Methods and results: Patients were randomized 2:1 to once-daily edoxaban 60 mg (or dose-reduced 30 mg) or dose-adjusted VKA (target international normalized ratio: 2.0–3.0). Uninterrupted anticoagulation was mandated for 21–28 days’ pre-ablation and 90 days’ post-ablation. During ablation, UFH administration targeted an activated clotting time (ACT) of 300–400 s. Periprocedural bleeding was differentiated between procedure-related (bleeding at puncture side, cardiac tamponade) and unrelated events. Of 614 randomized patients, 553 received study drug and underwent catheter ablation (edoxaban n = 375; VKA n = 178). The median (Q1–Q3) time from last dose to ablation procedure was 14.8 (13.3–16.5) vs. 16.5 (14.8–19.5) h (edoxaban vs. VKA group, respectively). Mean ACT (SD) ≥300 s was observed in 52% edoxaban- vs. 76% VKA-treated patients, despite a higher mean (SD) UFH dose in the edoxaban vs. VKA group [14 261 (6397) IU vs. 11 473 (4300) IU; exploratory P-value < 0.0001]. In the edoxaban group, 13 patients (3.5%) had procedure-related bleeds of whom 9 had received an UFH dose above the median (13 000 IU). In the VKA arm, 7 patients (3.9%) had procedure-related bleeds of whom 3 had received an UFH dose above the median (10 225 IU).
Conclusion: The rate of procedure-related major/clinically relevant non-major bleeding did not differ between the treatment arms despite higher doses of UFH used with edoxaban vs. VKA to achieve a target ACT during AF ablation.
The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.
Einleitung: Die Obduktion nimmt einen wichtigen Stellenwert in der Medizin ein, da sie nicht nur der Klärung der Todesart und -ursache eines Verstorbenen dient, sondern auch zum Verständnis der Pathophysiologie von Erkrankungen beiträgt. In diesem zweiten Teil der Studie wurden aktuelle Normwerte für das Gewicht für die folgenden adulten Organe entwickelt: Leber, Lunge, Milz, Nieren. Zudem wurden Zusammenhänge zwischen Organgewichten und der Todesart untersucht. Material und Methoden: Die im Dreijahreszeitraum von 2011 bis 2013 im Institut für Rechtsmedizin in Frankfurt am Main durchgeführten Obduktionen wurden retrospektiv ausgewertet. Die statistischen Berechnungen erfolgten mithilfe des Programmes „BiAS. für Windows“ (epsilon-Verlag GbR, Hochheim-Darmstadt, Deutschland). Ergebnisse: Folgende Normwerte bzw. -bereiche wurden an der Studienpopulation erhoben: Leber 1047,0–2740,0 g (♂, n = 191) bzw. 749,0–2182,0 g (♀, n = 115), linke Lunge 230,0–840,0 g (♂, n = 119) bzw. 186,8–891,3 g (♀, n = 97), rechte Lunge 249,3–1005,8 g (♂, n = 116) bzw. 215,3–907,5 g (♀, n = 100), Milz 55,0–373,2 g (♂, n = 306) bzw. 50,0–355,0 g (♀, n = 204), linke Niere 110,0–255,0 g (♂, n = 258) bzw. 71,8–215,0 g (♀, n = 137), rechte Niere 100,0–270,0 g (♂, n = 266) bzw. 75,0–212,1 g (♀, n = 140). Für die am stärksten mit Organgewichten korrelierenden Körpermaße, nämlich Body-Mass-Index (BMI), Körperoberfläche („body surface area“, BSA) und Körpergewicht, wurden nach Subgruppen getrennte Normwerte ermittelt. Ein signifikanter Unterschied des Organgewichtes je nach Todesart lag bei Männern bei der Milz und bei den Nieren vor. Bei Frauen war bei keinem der Organe ein von der Todesart abhängiger signifikanter Gewichtsunterschied feststellbar. Außerdem wurden Organindizes entwickelt, mittels derer der Anwender berechnen kann, ob ein Organgewicht, Körpermaßen bzw. Alter entsprechend, im Normbereich liegt. Diskussion: Organgewichte unterliegen wie Körpermaße einem säkularen Trend, welcher jedoch nicht linear und für jedes Organ individuell verläuft. Für die Auswertung von Organgewichten im Rahmen der Obduktion werden deshalb aktuelle, an einer vergleichbaren Population erhobene Normtabellen benötigt. Bei deren Erstellung können sowohl Fälle mit natürlichem als auch mit nichtnatürlichem Tod unter weitestgehendem Ausschluss pathologisch veränderter Organe herangezogen werden.
Einleitung: Begehen zwei Menschen infolge einer gemeinsamen Entscheidung Suizid, wird dies als Doppelsuizid oder gemeinschaftlicher Suizid definiert. Die rechtsmedizinische Begutachtung hängt von den Umständen des konkreten Einzelfalls ab und kann für die rechtliche Würdigung insbesondere bei Konstellationen, bei denen ein Beteiligter überlebt hat, wichtige Hinweise liefern.
Material und Methoden: Für einen 25-Jahres-Zeitraum von 1995 bis 2019 wurden retrospektiv alle Sektionsfälle mit vollendeten und versuchten Doppelsuiziden analysiert und, soweit erhältlich, mit den Ermittlungsakten abgeglichen.
Ergebnisse: Unter den erhobenen 23 Doppelsuizidfällen fanden sich 16 vollendete sowie 7 Fälle mit jeweils einem Überlebenden. In 83 % der Fälle handelte es sich um Ehepaare bzw. eingetragene Lebensgemeinschaften, in 13 % um Personen, die sich zuvor in einer psychiatrischen Einrichtung, und in 4 % um Personen, die sich in einem „Suizidforum“ im Internet kennengelernt hatten. Der Mittelwert des Sterbealters betrug bei den Männern 57,8 und bei den Frauen 63,4 Jahre. In etwa zwei Drittel der Fälle wurden Erkrankungen als vorherrschendes Suizidmotiv angegeben. Als häufigste Methode wurde eine Intoxikation gewählt. Am zweithäufigsten fanden Schusswaffen Anwendung, wobei ausnahmslos der Mann zuerst einen oder mehrere Kopfschüsse auf seine Frau abgab, bevor er sich suizidierte. Der häufigste Sterbe- und Auffindeort war das gemeinsame Bett der Suizidenten.
Diskussion: Im Gegensatz zu Suiziden i. Allg. wurden die Doppelsuizide am häufigsten mittels einer Intoxikation als sogenannte weiche Methode verübt. In Anlehnung an die rechtsmedizinische Literatur werden für einen Doppelsuizid typische Merkmale herausgearbeitet.
Schlussfolgerung: Doppelsuizide stellen seltene Fälle in der rechtsmedizinischen Praxis dar, wobei die Abgrenzung zu einem erweiterten Suizid (Homizid-Suizid) schwierig werden kann und zugleich unabdingbar ist. Hierfür ist eine ganzheitliche Berücksichtigung der Vorgeschichte, der rechtsmedizinisch erhobenen Befunde und der kriminalistischen Umstände erforderlich.
Muskelskeletterkrankungen (MSE) sind die Hauptursache für Arbeitsunfähigkeit bei Büroangestellten in Deutschland. Die Produktionsausfallkosten für MSE beliefen sich im Jahre 2017 auf 17,2 Milliarden Euro. Neben haltungsbezogenen Risikofaktoren wie die statische Körperhaltung am Büroarbeitsplatz, konnten zunehmend psychische Stressoren wie Termin- und Leistungsdruck als Risikofaktoren identifiziert werden. Arbeitgeber versuchen mittels verhaltens- und verhältnispräventiven Maßnahmen im Rahmen der (BGF) am Arbeitsplatz zur Prävention beizutragen. Insbesondere Bewegungsprogramme führen nachweislich zu einer Verringerung von MSE und Stress sowie zu einer Verbesserung der Lebensqualität. Vielversprechend sind untere andrem auch Dehninterventionen wie die wenigen bislang veröffentlichten Studien zeigen. Das „five-Business“ Dehnprogramm, dass an einem Gerät durchgeführt wird, wurde speziell für die Anwendung im Büro konzipiert und beinhaltet fünf einfache Übungen für den Rumpf. Ziel dieser Studie war es daher, die Auswirkungen des "five-Business" Trainingsprogramms für Büroangestellte auf MSE, die Lebensqualität und die Beweglichkeit zu untersuchen.
Im Rahmen der hier vorgestellten Promotionsarbeit wurde zunächst eine konkrete Methode entwickelt (Publikation 1) und anschließend der Effekt dieses Dehntrainings auf die Lebensqualität untersucht (Publikation 2). Insgesamt nahmen 313 Büroangestellte (173m/137f) mit einem Durchschnittsalter von 43,37 ± 11,24 (SD) Jahren, einer Körpergröße von 175,37 ± 9,35 cm und einem Gewicht von 75,76 ± 15,23 kg sowie einem durchschnittlichen BMI von 24,5 ± 3,81 kg/m2 freiwillig an dieser Interventionskontrollstudie teil. Die 158 Teilnehmenden der Interventionsgruppe absolvierten das Dehntraining zweimal wöchentlich für etwa zehn Minuten über eine Dauer von 12 Wochen. Die Kontrollgruppe hingegen sollte ihrem gewöhnlichen Alltag weiter nachgehen. Der Short-Form-36 Fragebogen (SF-36) wurde verwendet, um die Effekte der Intervention zu Beginn und nach 12 Wochen auf die gesundheitsbezogene Lebensqualität zu evaluieren. Nach 12 Wochen Dehntraining traten signifikante Verbesserungen in den Bereichen mentaler Summenscore (p=0,008), körperliche Funktionsfähigkeit (p<0,001), körperliche Schmerzen (p=0,01), Vitalität (p=0,025), Rolleneinschränkungen aufgrund körperlicher Probleme (p=0,018) und psychische Gesundheit (p=0,012) auf. Die Ergebnisse zeigen, dass das Dehntraining nicht nur physische Gesundheitsparameter beeinflusst, sondern ebenfalls positive Effekte bei psychischen Gesundheitsparametern hervorruft. Das Dehntraining ermöglicht demnach sowohl auf physischer als auch auf psychischer Ebene eine Entspannung. Daher deuten die Ergebnisse insgesamt darauf hin, dass ein 12-wöchiges Dehnprogramm geeignet ist, die gesundheitsbezogene Lebensqualität von Büroangestellten zu verbessern. Es kann geschlussfolgert werden, dass ein solches Dehnprogramm als präventive und rehabilitative Maßnahme in der betrieblichen Gesundheitsförderung geeignet sein kann, um aktuelle Herausforderungen des zunehmenden Wettbewerbs und steigenden Produktivitätsanforderungen am Arbeitsplatz entgegenzuwirken.
Holzgreve, Fabian Christian ; Maltry, Laura ; Hänel, Jasmin ; Schmidt, Helmut ; Bader, Andreas ; Frei, Markus ; Filmann, Natalie ; Groneberg, Jan David Alexander ; Ohlendorf, Daniela Maren ; Mark, Anke van
In the context of workplace health promotion, physical activity programs have been shown to reduce musculoskeletal diseases and stress, and to improve the quality of life. The aim of this study was to examine the effects of using the “five-Business” stretch training device for office workers on their quality of life. A total of 313 office workers (173m/137f) participated voluntarily in this intervention–control study with an average age of 43.37 ± 11.24 (SD) years, 175.37 ± 9.35 cm in height and 75.76 ± 15.23 kg in weight, with an average BMI of 24.5 ± 3.81 kg/m2. The participants completed the stretch training twice a week for approximately 10 minutes for a duration of 12 weeks. The SF-36 questionnaire was used to evaluate the effectiveness of the intervention at baseline and after 12 weeks. Significantly improved outcomes in mental sum score (p = 0.008), physical functioning (p < 0.001), bodily pain (p = 0.01), vitality (p = 0.025), role limitations due to physical problems (p = 0.018) and mental health (p = 0.012) were shown after the stretching training. The results suggest that a 12-week stretching program for office desk workers is suitable to improve significantly their health-related quality of life.
Holzgreve, Fabian Christian ; Maurer-Grubinger, Christian ; Isaak, J. ; Kokott, Pascal ; Mörl-Kreitschmann, Manja ; Polte, Levent ; Solimann, A. ; Weßler, Lena ; Filmann, Sonja Natalie ; Mark, Anke van ; Fräulin, Laura ; Groneberg, Jan David Alexander ; Ohlendorf, Daniela Maren
In the application of range of motion (ROM) tests there is little agreement on the number of repetitions to be measured and the number of preceding warm-up protocols. In stretch training a plateau in ROM gains can be seen after four to five repetitions. With increasing number of repetitions, the gain in ROM is reduced. This study examines the question of whether such an effect occurs in common ROM tests. Twenty-two healthy sport students (10 m/12 f.) with an average age of 25.3 ± 1.94 years (average height 174.1 ± 9.8 cm; weight 66.6 ± 11.3 kg and BMI 21.9 ± 2.0 kg/cm2) volunteered in this study. Each subject performed five ROM tests in a randomized order—measured either via a tape measure or a digital inclinometer: Tape measure was used to evaluate the Fingertip-to-Floor test (FtF) and the Lateral Inclination test (LI). Retroflexion of the trunk modified after Janda (RF), Thomas test (TT) and a Shoulder test modified after Janda (ST) were evaluated with a digital inclinometer. In order to show general acute effects within 20 repetitions we performed ANOVA/Friedman-test with multiple comparisons. A non-linear regression was then performed to identify a plateau formation. Significance level was set at 5%. In seven out of eight ROM tests (five tests in total with three tests measured both left and right sides) significant flexibility gains were observed (FtF: p < 0.001; LI-left/right: p < 0.001/0.001; RF: p = 0.009; ST-left/right: p < 0.001/p = 0.003; TT-left: p < 0.001). A non-linear regression with random effects was successfully applied on FtF, RF, LI-left/right, ST-left and TT-left and thus, indicate a gradual decline in the amount of gained ROM. An acute effect was observed in most ROM tests, which is characterized by a gradual decline of ROM gain. For those tests, we can state that the acute effect described in the stretching literature also applies to the performance of typical ROM tests. Since a non-linear behavior was shown, it is the decision of the practitioner to weigh up between measurement accuracy and expenditure. Researchers and practitioners should consider this when applying ROM assessments to healthy young adults.
Hoppe, Kerstin ; Sartorius, Tina ; Chaiklieng, Sunisa ; Wietzorrek, Georg ; Ruth, Peter ; Jurkat-Rott, Karin ; Wearing, Scott ; Lehmann-Horn, Frank ; Klingler, Werner
Reduced Cl− conductance causes inhibited muscle relaxation after forceful voluntary contraction due to muscle membrane hyperexcitability. This represents the pathomechanism of myotonia congenita. Due to the prevailing data suggesting that an increased potassium level is a main contributor, we studied the effect of a modulator of a big conductance Ca2+- and voltage-activated K+ channels (BK) modulator on contraction and relaxation of slow- and high-twitch muscle specimen before and after the pharmacological induction of myotonia. Human and murine muscle specimens (wild-type and BK−/−) were exposed to anthracene-9-carboxylic acid (9-AC) to inhibit CLC-1 chloride channels and to induce myotonia in-vitro. Functional effects of BK-channel activation and blockade were investigated by exposing slow-twitch (soleus) and fast-twitch (extensor digitorum longus) murine muscle specimens or human musculus vastus lateralis to an activator (NS1608) and a blocker (Paxilline), respectively. Muscle-twitch force and relaxation times (T90/10) were monitored. Compared to wild type, fast-twitch muscle specimen of BK−/− mice resulted in a significantly decreased T90/10 in presence of 9-AC. Paxilline significantly shortened T90/10 of murine slow- and fast-twitch muscles as well as human vastus lateralis muscle. Moreover, twitch force was significantly reduced after application of Paxilline in myotonic muscle. NS1608 had opposite effects to Paxilline and aggravated the onset of myotonic activity by prolongation of T90/10. The currently used standard therapy for myotonia is, in some individuals, not very effective. This in vitro study demonstrated that a BK channel blocker lowers myotonic stiffness and thus highlights its potential therapeutic option in myotonia congenital (MC).
Horn, Tabea ; Ludwig, Michael ; Eickmeier, Olaf ; Neerinex, Anne H. ; Maitland-van der Zee, Anke Hilse ; Smaczny, Christina ; Wagner, Thomas O. F. ; Schubert, Ralf ; Zielen, Stefan ; Majoor, Christof ; Bos, Lieuwe D. ; Schmitt-Grohé, Sabina
Background: Lung disease phenotype varies widely even in the F508del (homozygous) genotype. Leukocyte-driven inflammation is important for pulmonary disease pathogenesis in cystic fibrosis (CF). Blood cytokines correlate negatively with pulmonary function in F508del homozygous patients, and gap junction proteins (GJA) might be related to the influx of blood cells into the lung and influence disease course. We aimed to assess the relationship between GJA1/GJA4 genotypes and the clinical disease phenotype. Methods: One-hundred-and-sixteen homozygous F508del patients (mean age 27 years, m/f 66/50) were recruited from the CF centers of Bonn, Frankfurt, and Amsterdam. Sequence analysis was performed for GJA1 and GJA4. The clinical disease course was assessed over 3 years using pulmonary function tests, body mass index, Pseudomonas aeruginosa colonization, diabetes mellitus, survival to end-stage lung disease, blood and sputum inflammatory markers. Results: Sequence analysis revealed one clinically relevant single nucleotide polymorphism. In this GJA4 variant (rs41266431), homozygous G variant carriers (n = 84/116; 72.4%) had poorer pulmonary function (FVC% pred: mean 78/86, p < 0.040) and survival to end-stage lung disease was lower (p < 0.029). The frequency of P. aeruginosa colonization was not influenced by the genotype, but in those chronically colonized, those with the G/G genotype had reduced pulmonary function (FVC% pred: mean 67/80, p < 0.049). Serum interleukin-8 (median: 12.4/6.7 pg/ml, p < 0.052) and sputum leukocytes (2305/437.5 pg/ml, p < 0.025) were higher for the G/G genotype. Conclusions: In carriers of the A allele (27.6%) the GJA4 variant is associated with significantly better protection against end-stage lung disease and superior pulmonary function test results in F508del homozygous patients. This SNP has the potential of a modifier gene for phenotyping severity of CF lung disease, in addition to the CFTR genotype.
Clinical Trial Registration: The study was registered with ClinicalTrials.gov, number NCT04242420, retrospectively on January 24th, 2020.
The present paper aims at providing empirical evidence for dialectal variation concerning the perception of the central vowel [ɐ] in European Portuguese (EP). More concretely, this study compares the perception of the contrast between [a] and [ɐ] by native speakers of two varieties of EP: 23 speakers of a northern Portuguese dialect (from the city of Braga) and 23 speakers of the Littoral Center variety of EP (from the city of Lisbon, defined as Standard European Portuguese (SEP)). Based on a discrimination test, the results show that the two groups of speakers differ with respect to the perception of the contrast between the two central vowels under investigation. The speakers of the northern variety differentiate less between the two central vowels compared to the speakers from Lisbon.
The US Treasury recently permitted deferred longevity income annuities to be included in pension plan menus as a default payout solution, yet little research has investigated whether more people should convert some of the $18 trillion they hold in employer-based defined contribution plans into lifelong income streams. We investigate this innovation using a calibrated lifecycle consumption and portfolio choice model embodying realistic institutional considerations. Our welfare analysis shows that defaulting a modest portion of retirees’ 401(k) assets (over a threshold) is an attractive way to enhance retirement security, enhancing welfare by up to 20% of retiree plan accruals.
In a 40-year-old caucasian patient with stress incontinence was a TVT operation performed with an autologous semitendinosus tendon transplant. The operation was done with spinal anesthesia. The tendon of the right musculus semitendinosus was stripped from the popliteal fossa and used instead of a synthetic tape as midurethral sling, as it is done in a classical retropubic TVT procedure. The operation was performed successfully. On the first day after the operation the transurethral catheter was removed, continence was reached, and no urinary retention was seen. Mobility and power of the affected leg did not change.
Horst, Klemens ; Greven, Johannes ; Lüken, Hannah ; Zhi, Qiao ; Pfeifer, Roman ; Simon, Tim-Philipp ; Relja, Borna ; Marzi, Ingo ; Pape, Hans-Christoph ; Hildebrand, Frank
Background: Extremity fracture is frequently seen in multiple traumatized patients. Local post-traumatic inflammatory reactions as well as local and systemic interactions have been described in previous studies. However, trauma severity and its impact on the local immunologic reaction remains unclear. Therefore, fracture-associated local inflammation was investigated in a porcine model of isolated and combined trauma to gain information about the early inflammatory stages.
Material and Methods: Polytrauma (PT) consisted of lung contusion, liver laceration, femur fracture, and controlled hemorrhage. Monotrauma (MT) consisted of femur fracture only. The fracture was operatively stabilized and animals were monitored under ICU-standard for 72 h. Blood, fracture hematoma (FH) as well as muscle samples were collected throughout the experimental period. Levels of local and systemic pro- and anti-inflammatory as well as angiogenetic cytokines were measured by ELISA.
Results: Both groups showed a significant decrease in pro-inflammatory IL-6 in FH over time. However, concentrations in MT were significantly higher than in PT. The IL-8 concentrations initially decreased in FH, but recovered by the end of the observation period. These dynamics were only statistically significant in MT. Furthermore, concentrations measured in muscle tissue showed inverse kinetics compared to those in FH. The IL-10 did not present statistical resilient dynamics over time, although a slight increase in FH was seen by the end of the observation time in the MT group.
Conclusions: Time-dependent dynamics of the local inflammatory response were observed. Trauma severity showed a significant impact, with lower values in pro- as well as angiogenetic mediators. Fracture repair could be altered by these trauma-related changes of the local immunologic milieu, which might serve as a possible explanation for the higher rates of delayed or non-union bone repair in polytraumatised patients.