@phdthesis{Chaudhari2013, author = {Chaudhari, Sweena M.}, title = {Role of Hypoxia-Inducible Factor (HIF) 1α in Dendritic Cells in Immune Regulation of Atherosclerosis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-91853}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {Atherosclerosis is the underlying cause of cardiovascular diseases and a major threat to human health worldwide. It involves not only accumulation of lipids in the vessel wall but a chronic inflammatory response mediated by highly specific cellular and molecular responses. Macrophages and dendritic cells (DCs) play an essential role in taking up modified lipids and presenting them to T and B lymphocytes, which promote the immune response. Enhanced activation, migration and accumulation of inflammatory cells at the local site leads to formation of atherosclerotic plaques. Atherosclerotic plaques become hypoxic due to reduced oxygen diffusion and high metabolic demand of accumulated cells. The various immune cells experience hypoxic conditions locally and inflammatory stimuli systemically, thus up-regulating Hypoxia-inducible factor 1α. Though the role of HIF1α in macrophages and lymphocytes has been elucidated, its role in DCs still remains controversial, especially with respect to atherosclerosis. In this project work, the role of HIF1α in DCs was investigated by using a cell specific knockout mouse model where HIF1α was deleted in CD11c+ cells. Aortic root sections from atherosclerotic mice showed presence of hypoxia and up-regulation of HIF1α which co-localized with CD11c+ cells. Atherosclerotic splenic DCs also displayed enhanced expression of HIF1α, proving non-hypoxic stimulation of HIF1α due to systemic inflammation. Conditional knockout (CKO) mice lacking HIF1α in CD11c+ cells, under baseline conditions did not show changes in immune responses suggesting effects of HIF1α only under inflammatory conditions. When these mice were crossed to the Ldlr-/- line and placed on 8 weeks of high fat diet, they developed enhanced plaques with higher T-cell infiltration as compared to the wild-type (WT) controls. The plaques were of a complex phenotype, defined by increased percent of smooth muscle cells (SMCs) and necrotic core area and reduced percent of macrophages and DCs. The mice also displayed enhanced T-cell activation and a Th1 bias in the periphery. The CKO DCs themselves exhibited increased expression of IL 12 and a higher capacity to proliferate and polarize naive T cells to the Th1 phenotype in vitro. The DCs also showed decreased expression of STAT3, in line with the inhibitory effects of STAT3 on DC activation seen in previous studies. When STAT3 was overexpressed in DCs in vitro, IL 12 was down-regulated, but its expression increased significantly on STAT3 inhibition using a mutant vector. In addition, when STAT3 was overexpressed in DCs in vivo using a Cre regulated lentiviral system, the mice showed decreased plaque formation compared to controls. Interestingly, the effects of STAT3 modulation were similar in WT and CKO mice, intending that STAT3 lies downstream of HIF1α. Finally, using a chromatin immunoprecipitation assay (ChIP), it was confirmed that HIF1α binds to hypoxia responsive elements (HREs) in the Stat3 gene promoter thus regulating its expression. When DCs lack HIF1α, STAT3 expression is not stimulated and hence IL 12 production by DCs is uninhibited. This excessive IL 12 can activate naive T cells and polarize them to the Th1 phenotype, thereby enhancing atherosclerotic plaque progression. This project thus concludes that HIF1α restrains DC activation via STAT3 generation and prevents excessive production of IL 12 that helps to keep inflammation and atherosclerosis under check.}, subject = {Dendritische Zelle}, language = {en} } @article{ShityakovBroscheitFoerster2013, author = {Shityakov, Sergey and Broscheit, Jens and F{\"o}rster, Carola}, title = {Multidrug resistance protein P-gp interaction with nanoparticles (fullerenes and carbon nanotube) to assess their drug delivery potential: a theoretical molecular docking study.}, series = {International journal of computational biology and drug design}, volume = {6}, journal = {International journal of computational biology and drug design}, number = {4}, doi = {10.1504/IJCBDD.2013.056801}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132089}, pages = {343-357}, year = {2013}, abstract = {P-glycoprotein (P-gp)-mediated efflux system plays an important role to maintain chemical balance in mammalian cells for endogenous and exogenous chemical compounds. However, despite the extensive characterisation of P-gp potential interaction with drug-like molecules, the interaction of carbon nanoparticles with this type of protein molecule is poorly understood. Thus, carbon nanoparticles were analysed, such as buckminsterfullerenes (C20, C60, C70), capped armchair single-walled carbon nanotube (SWCNT or C168), and P-gp interactions using different molecular docking techniques, such as gradient optimisation algorithm (ADVina), Lamarckian genetic algorithm (FastDock), and shape-based approach (PatchDock) to estimate the binding affinities between these structures. The theoretical results represented in this work show that fullerenes might be P-gp binders because of low levels of Gibbs free energy of binding (ΔG) and potential of mean force (PMF) values. Furthermore, the SWCNT binding is energetically unfavourable, leading to a total decrease in binding affinity by elevation of the residual area (Ares), which also affects the π-π stacking mechanisms. Further, the obtained data could potentially call experimental studies using carbon nanostructures, such as SWCNT for development of drug delivery vehicles, to administer and assess drug-like chemical compounds to the target cells since organisms probably did not develop molecular sensing elements to detect these types of carbon molecules.}, language = {en} } @phdthesis{Mishra2013, author = {Mishra, Shambhavi}, title = {Structural and Functional Characterization of the Enzymes Involved in the Menaquinone Biosynthesis and Benzoate Degradation}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-90848}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {The present work illustrates the structural and biochemical characterization of two diverse proteins, BadI and MenD from Rhodopseudomonas palustris and Staphylococcus aureus, respectively. BadI or 2-ketocyclohexanecarboxyl-CoA is one of the key enzymes involved in the anaerobic degradation of aromatic compounds. The degradation of aromatic compounds is a vital process for the maintenance of the biogeochemical carbon cycle and bioremediation of xenobiotic compounds, which if present at higher concentrations can cause potential hazards to humans. Due to the relatively inert nature of aromatic compounds, enzymes catalyzing their degradation are of special interest for industrial applications. BadI is one of the key enzymes involved in the anaerobic degradation of aromatic compounds into an aliphatic moiety. The major focus of this study was to provide mechanistic insights into the reaction catalyzed by BadI. BadI belongs to the crotonase superfamily and shares high sequence homology with the family members of MenB or dihydroxynaphthoate synthase. BadI is known to catalyze the cleavage of the cyclic ring of 2-ketocyclohexane carboxyl-CoA by hydrolyzing the C-C bond leading to the formation of the aliphatic compound pimelyl CoA. On the other hand MenB catalyzes the condensation reaction of o-succinylbenzoyl-CoA to dihydroxylnaphthoyl-CoA. A comprehensive amino acid sequence analysis between BadI and MenB showed that the active site residues of MenB from Mycobacterium tuberculosis (mtMenB) are conserved in BadI from Rhodopseudomonas palustris. MenB is involved in the menaquinone biosynthesis pathway and is a potential drug target against Mycobacterium tuberculosis as it has no known human homologs. Due to the high homology between MenB and BadI and the inability to obtain MenB-inhibitor complex structures we extended our interest to BadI to explore a potential substitute model for mtMenB as a drug target. In addition, BadI possesses some unique mechanistic characteristics. As mentioned before, it hydrolyzes the substrate via a retro Dieckmann's reaction contrasting its closest homolog MenB that catalyzes a ring closing reaction through a Dieckmann's reaction. Nevertheless the active site residues in both enzymes seem to be highly conserved. We therefore decided to pursue the structural characterization of BadI to shed light on the similarities and differences between BadI and MenB and thereby provide some insights how they accomplish the contrasting reactions described above. We determined the first structures of BadI, in its apo and a substrate mimic bound form. The crystal structures revealed that the overall fold of BadI is similar to other crotonase superfamily members. However, there is no indication of domain swapping in BadI as observed for MenB. The absence of domain swapping is quite remarkable because the domain swapped C-terminal helical domain in MenB provides a tyrosine that is imperative for catalysis and is also conserved in the BadI sequence. Comparison of the active sites revealed that the C-terminus of BadI folds onto its core in such a way that the conserved tyrosine is located in the same position as in MenB and can form interactions with the ligand molecule. The structure of BadI also confirms the role of a serine and an aspartate in ligand interaction, thus validating that the conserved active site triad participates in the enzymatic reaction. The structures also reveal a noteworthy movement of the active site aspartate that adopts two major conformations. Structural studies further illuminated close proximity of the active site serine to a water and chlorine molecule and to the carbon atom at which the carbonyl group of the true substrate would reside. Biochemical characterization of BadI using enzyme kinetics validated that the suggested active site residues are involved in substrate interaction. However, the role of these residues is very distinct, with the serine assuming a major role. Thus, the present work ascertain the participation of putative active site residues and demonstrates that the active site residues of BadI adopt very distinctive roles compared to their closest homolog MenB. The MenD protein also referred to as SEPHCHC (2-succinyl-5-enolpyruvyl-6- hydroxy-3-cyclohexene-1-carboxylic acid) synthase is one of the enzymes involved in menaquinone biosynthesis in Staphylococcous aureus. Though S. aureus is usually considered as a commensal it can act as a remarkable pathogen when it crosses the epithelium, causing a wide spectrum of disorders ranging from skin infection to life threatening diseases. Small colony variants (SCVs), a slow growing, small sized subpopulation of the bacteria has been associated with persistent, recurrent and antibiotic resistant infections. These variants show autotrophy for thiamine, menaquinone or hemin. Menaquinone is an essential component in the electron transport pathway in gram-positive organisms. Therefore, enzymes partaking in this pathway are attractive drug targets against pathogens such as Mycobacterium tuberculosis and Bacillus subtilis. MenD, an enzyme catalyzing the first irreversible step in the menaquinone biosynthetic pathway has been implicated in the SCV phenotype of S. aureus. In the present work we explored biochemical and structural properties of this important enzyme. Our structural analysis revealed that despite its low sequence identity of 28\%, the overall fold of staphylococcal MenD (saMenD) is similar to Escherichia coli MenD (ecMenD) albeit with some significant disparities. Major structural differences can be observed near the active site region of the protein and are profound in the C-terminal helix and a loop near the active site. The loop contains critical residues for cofactor binding and is well ordered only in the ecMenD-ThDP structure, while in the apo and substrate bound structures of ecMenD the loop is primarily disordered. In our saMenD structure the loop is for the first time completely ordered in the apo form and displays a novel conformation of the cofactor-binding loop. The loop adopts an unusual open conformation and the conserved residues, which are responsible for cofactor binding are located too far away to form a productive complex with the cofactor in this conformation. Additionally, biochemical studies in conjugation with the structural data aided in the identification of the substrate-binding pocket and delineated residues contributing to its binding and catalysis. Thus the present work successfully divulged the unique biochemical and structural characteristics of saMenD.}, subject = {Benzoate}, language = {en} } @phdthesis{Paknia2013, author = {Paknia, Elham}, title = {Identification of a quality control check-point for the assembly of mRNA-processing snRNPs}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-98744}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {An essential step in eukaryotic gene expression is splicing, i.e. the excision of non-coding sequences from pre-mRNA and the ligation of coding-sequences. This reaction is carried out by the spliceosome, which is a macromolecular machine composed of small nuclear ribonucleoproteins (snRNPs) and a large number of proteins. Spliceosomal snRNPs are composed of one snRNA (or two in case of U4/6 snRNPs), seven common Sm proteins (SmD1, D2, D3, B, E, F, G) and several particle-specific proteins. The seven Sm proteins form a ring shaped structure on the snRNA, termed Sm core domain that forms a structural framework of all spliceosomal snRNPs. In the toroidal Sm core domain, the individual Sm proteins are arranged in the sequence SmE-SmG-SmD3-SmB- SmD1-SmD2-SmF from the first to the seventh nucleotide of the Sm site, respectively. The individual positions of Sm proteins in the Sm core domain are not interchangeable. snRNPs are formed in vivo in a step-wise process, which starts with the export of newly transcribed snRNA to the cytoplasm. Within this compartment, Sm proteins are synthesized and subsequently transferred onto the snRNA. Upon formation of the Sm core and further modifications of snRNA, the snRNP is imported into the nucleus to join the spliceosome. Prior to assembly into snRNPs, Sm proteins exist as specific hetero-oligomers in the cytoplasm. The association of these proteins with snRNA occurs spontaneously in vitro but requires the assistance of two major units, PRMT5- and SMN- complexes, in vivo. The early phase of assembly is critically influenced by the assembly chaperone pICln. This protein pre-organizes Sm proteins to functional building blocks and enables their recruitment onto the PRMT5 complex for methylation. Sm proteins are subsequently released from the PRMT5 complex as pICln bound entities and transferred onto the SMN-complex. The SMN complex then liberates the Sm proteins from the pICln-induced kinetic trap and allows their transfer onto the snRNA. Although the principal roles of SMN- and PRMT5 complexes in the assembly of snRNPs have been established, it is still not clear how newly translated Sm proteins are guided into the assembly line. In this thesis, I have uncovered a new facet of pICln function in the assembly of snRNPs. I have shown that newly synthesized Sm proteins are retained at the ribosome upon termination of translation. Their release is facilitated by pICln, which interacts with the cognate Sm protein hetero-oligomers at their site of synthesis on the ribosome and recruits them into the assembly pathway. Additionally, I have been able to show that the early engagement of pICln with the Sm proteins ensures the flawless oligomerization of Sm proteins and prevents any non-chaperoned release and diffusion of Sm proteins in the cytoplasm. In a second project, I have studied the mechanism of U7 snRNP assembly. This particle is a major component of the 3' end processing machinery of replication dependent histone mRNAs. A biochemical hallmark of U7 is its unique Sm core in which the two canonical Sm proteins D1 and D2 are replaced by so-called "like Sm proteins". The key question I addressed in my thesis was, how this "alternative" Sm core is assembled onto U7 snRNA. I have provided experimental evidence that the assembly route of U7 snRNPs and spliceosomal snRNPs are remarkably similar: The assembly of both particles depends on the same assembly factors and the mechanistic details are similar. It appears that formation of the U7- or spliceosomal- core specific 6S complex is the decisive step in assembly.}, subject = {Small nuclear RNP}, language = {en} } @article{ErtlGiesterSchuessleretal.2013, author = {Ertl, Andreas and Giester, Gerald and Sch{\"u}ssler, Ulrich and Br{\"a}tz, Helene and Okrusch, Martin and Tillmanns, Ekkehart and Bank, Hermann}, title = {Cu- and Mn-bearing tourmalines from Brazil and Mozambique: crystal structures, chemistry and correlations}, series = {Mineralogy and Petrology}, volume = {107}, journal = {Mineralogy and Petrology}, number = {2}, doi = {10.1007/s00710-012-0234-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-127296}, pages = {265-279}, year = {2013}, abstract = {Cu- and Mn-bearing tourmalines from Brazil and Mozambique were characterised chemically (EMPA and LA-ICP-MS) and by X-ray single-crystal structure refinement. All these samples are rich in Al, Li and F (fluor-elbaite) and contain significant amounts of CuO (up to ~1.8 wt\%) and MnO (up to ~3.5 wt\%). Structurally investigated samples show a pronounced positive correlation between the distances and the (Li + Mn\(^{2+}\) + Cu + Fe\(^{2+}\)) content (apfu) at this site with R\(^2\) = 0.90. An excellent negative correlation exists between the distances and the Al\(_2\)O\(_3\) content (R\(^2\) = 0.94). The samples at each locality generally show a strong negative correlation between the X-site vacancies and the (MnO + FeO) content. The Mn content in these tourmalines depends on the availability of Mn, on the formation temperature, as well as on stereochemical constraints. Because of a very weak correlation between MnO and CuO we believe that the Cu content in tourmaline is essentially dependent on the availability of Cu and on stereochemical constraints.}, language = {en} } @phdthesis{Schmitt2013, author = {Schmitt, Peter}, title = {MR imaging of tumors: Approaches for functional and fast morphological characterization}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135967}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {The subject of this work was to develop, implement, optimize and apply methods for quantitative MR imaging of tumors. In the context of functional and physiological characterization, this implied transferring techniques established in tumor model research to human subjects and assessing their feasibility for use in patients. In the context of the morphologic assessment and parameter imaging of tumors, novel concepts and techniques were developed, which facilitated the simultaneous quantification of multiple MR parameters, the generation of "synthetic" MR images with various contrasts, and the fast single-shot acquisition of purely T2-weighted images.}, subject = {Kernspintomografie}, language = {en} } @article{CorneliusLeingaertnerHoissetal.2013, author = {Cornelius, Christine and Leing{\"a}rtner, Annette and Hoiss, Bernhard and Krauss, Jochen and Steffan-Dewenter, Ingolf and Menzel, Annette}, title = {Phenological response of grassland species to manipulative snowmelt and drought along an altitudinal gradient}, series = {Journal of Experimental Botany}, volume = {64}, journal = {Journal of Experimental Botany}, number = {1}, doi = {10.1093/jxb/ers321}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126888}, pages = {241-251}, year = {2013}, abstract = {Plant communities in the European Alps are assumed to be highly affected by climate change, as the temperature rise in this region is above the global average. It is predicted that higher temperatures will lead to advanced snowmelt dates and that the number of extreme weather events will increase. The aims of this study were to determine the impacts of extreme climatic events on flower phenology and to assess whether those impacts differed between lower and higher altitudes. In 2010, an experiment simulating advanced and delayed snowmelt as well as a drought event was conducted along an altitudinal transect approximately every 250 m (600-2000 m above sea level) in the Berchtesgaden National Park, Germany. The study showed that flower phenology was strongly affected by altitude; however, there were few effects of the manipulative treatments on flowering. The effects of advanced snowmelt were significantly greater at higher than at lower sites, but no significant difference was found between both altitudinal bands for the other treatments. The response of flower phenology to temperature declined through the season and the length of flowering duration was not significantly influenced by treatments. The stronger effect of advanced snowmelt at higher altitudes may be a response to differences in treatment intensity across the gradient. Consequently, shifts in the date of snowmelt due to global warming may affect species more at higher than at lower altitudes, as changes may be more pronounced at higher altitudes. These data indicate a rather low risk of drought events on flowering phenology in the Bavarian Alps.}, language = {en} } @article{HolzschuhDormannTscharntkeetal.2013, author = {Holzschuh, Andrea and Dormann, Carsten F. and Tscharntke, Teja and Steffan-Dewenter, Ingolf}, title = {Mass-flowering crops enhance wild bee abundance}, series = {Oecologia}, volume = {172}, journal = {Oecologia}, number = {2}, doi = {10.1007/s00442-012-2515-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132149}, pages = {477-484}, year = {2013}, abstract = {Although agricultural habitats can provide enormous amounts of food resources for pollinator species, links between agricultural and (semi-)natural habitats through dispersal and foraging movements have hardly been studied. In 67 study sites, we assessed the interactions between mass-flowering oilseed rape fields and semi-natural grasslands at different spatial scales, and their effects on the number of brood cells of a solitary cavity-nesting bee. The probability that the bee Osmia bicornis colonized trap nests in oilseed rape fields increased from 12 to 59 \% when grassland was nearby, compared to fields isolated from grassland. In grasslands, the number of brood cells of O. bicornis in trap nests was 55 \% higher when adjacent to oilseed rape compared to isolated grasslands. The percentage of oilseed rape pollen in the larval food was higher in oilseed rape fields and grasslands adjacent to oilseed rape than in isolated grasslands. In both oilseed rape fields and grasslands, the number of brood cells was positively correlated with the percentage of oilseed rape pollen in the larval food. We show that mass-flowering agricultural habitats—even when they are intensively managed—can strongly enhance the abundance of a solitary bee species nesting in nearby semi-natural habitats. Our results suggest that positive effects of agricultural habitats have been underestimated and might be very common (at least) for generalist species in landscapes consisting of a mixture of agricultural and semi-natural habitats. These effects might also have—so far overlooked—implications for interspecific competition and mutualistic interactions in semi-natural habitats.}, language = {en} } @article{SchaefferKuehnSchmittetal.2013, author = {Schaeffer, Evelin L. and K{\"u}hn, Franziska and Schmitt, Angelika and Gattaz, Wagner F. and Gruber, Oliver and Schneider-Axmann, Thomas and Falkai, Peter and Schmitt, Andrea}, title = {Increased cell proliferation in the rat anterior cingulate cortex following neonatal hypoxia: relevance to schizophrenia}, series = {Journal of Neural Transmission}, volume = {120}, journal = {Journal of Neural Transmission}, number = {1}, doi = {10.1007/s00702-012-0859-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125890}, pages = {187-195}, year = {2013}, abstract = {As a consequence of obstetric complications, neonatal hypoxia has been discussed as an environmental factor in the pathophysiology of schizophrenia. However, the biological consequences of hypoxia are unclear. The neurodevelopmental hypothesis of schizophrenia suggests that the onset of abnormal brain development and neuropathology occurs perinatally, whereas symptoms of the disease appear in early adulthood. In our animal model of chronic neonatal hypoxia, we have detected behavioral alterations resembling those known from schizophrenia. Disturbances in cell proliferation possibly contribute to the pathophysiology of this disease. In the present study, we used postnatal rats to investigate cell proliferation in several brain areas following neonatal hypoxia. Rats were repeatedly exposed to hypoxia (89 \% N2, 11 \% O2) from postnatal day (PD) 4-8. We then evaluated cell proliferation on PD 13 and 39, respectively. These investigations were performed in the anterior cingulate cortex (ACC), caudate-putamen (CPU), dentate gyrus, and subventricular zone. Rats exposed to hypoxia exhibited increased cell proliferation in the ACC at PD 13, normalizing at PD 39. In other brain regions, no alterations have been detected. Additionally, hypoxia-treated rats showed decreased CPU volume at PD 13. The results of the present study on the one hand support the assumption of chronic hypoxia influencing transient cell proliferation in the ACC, and on the other hand reveal normalization during ageing.}, language = {en} } @article{DuernerReineckerCsef2013, author = {D{\"u}rner, Julia and Reinecker, Hans and Csef, Herbert}, title = {Individual quality of life in patients with multiple myeloma}, series = {SpringerPlus}, volume = {2}, journal = {SpringerPlus}, number = {397}, doi = {10.1186/2193-1801-2-397}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130529}, year = {2013}, abstract = {Objective: The situation of patients with multiple myeloma, whose treatment often implies high-dose chemotherapy and stem cell transplantation that can be associated with severe symptoms and psychological distress, has gained attention in recent psychooncological research. This study followed an idiographic approach in order to identify the areas of life most relevant for the interviewed myeloma patients' quality of life (QoL) as well as their current satisfaction with these. Methods: 64 patients took part in semi-structured interviews according to the SEIQoL-DW Manual (Schedule for the Evaluation of Individual Quality of Life - Direct Weighting). Visual analogue scales (VAS) were used to gain additional information about a general assessment of the present QoL. Qualitative data evaluation preceded quantitative processing. Groups were compared according to the time elapsed since diagnosis regarding specified areas of life, satisfaction with these and their relative weighting. SEIQoL-DW-indices were correlated to the VAS to reflect on an interindividually comparable parameter. Results: Personal social relationships were mentioned significantly more often as important for QoL than healthrelated aspects, and in direct comparison were weighted significantly stronger. Regarding the change of areas relevant for QoL over the time elapsed since diagnosis, there was a significant difference between groups concerning the area of spirituality. Satisfaction differed significantly between groups for the field of leisure. Conclusion: The results for the interviewed patients with multiple myeloma point out the need to take into account the importance of social and individual aspects when reflecting on QoL. Similar findings have been reported for different samples. The relevance of an individualized approach is illustrated by the fact that individually named areas of life were rated comparatively strongly in their importance for the patients' QoL. An overall assessment for the current QoL by means of VAS is regarded as an adequate supplement to the SEIQoL-Profile and an alternative to the SEIQoL-DW-Index.}, language = {en} }