TY - JOUR A1 - Düking, Peter A1 - Achtzehn, Silvia A1 - Holmberg, Hans-Christer A1 - Sperlich, Billy T1 - Integrated framework of load monitoring by a combination of smartphone applications, wearables and point-of-care testing provides feedback that allows individual responsive adjustments to activities of daily living JF - Sensors N2 - Athletes schedule their training and recovery in periods, often utilizing a pre-defined strategy. To avoid underperformance and/or compromised health, the external load during training should take into account the individual’s physiological and perceptual responses. No single variable provides an adequate basis for planning, but continuous monitoring of a combination of several indicators of internal and external load during training, recovery and off-training as well may allow individual responsive adjustments of a training program in an effective manner. From a practical perspective, including that of coaches, monitoring of potential changes in health and performance should ideally be valid, reliable and sensitive, as well as time-efficient, easily applicable, non-fatiguing and as non-invasive as possible. Accordingly, smartphone applications, wearable sensors and point-of-care testing appear to offer a suitable monitoring framework allowing responsive adjustments to exercise prescription. Here, we outline 24-h monitoring of selected parameters by these technologies that (i) allows responsive adjustments of exercise programs, (ii) enhances performance and/or (iii) reduces the risk for overuse, injury and/or illness. KW - biofeedback KW - eHealth KW - individualized training KW - injury prevention KW - IoT KW - periodization KW - load management Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176506 VL - 18 IS - 5 ER - TY - JOUR A1 - Wevrett, Jill A1 - Fenwick, Andrew A1 - Scuffham, James A1 - Johansson, Lena A1 - Gear, Jonathan A1 - Schlögl, Susanne A1 - Segbers, Marcel A1 - Sjögreen-Gleisner, Katarina A1 - Solný, Pavel A1 - Lassmann, Michael A1 - Tipping, Jill A1 - Nisbet, Andrew T1 - Inter-comparison of quantitative imaging of lutetium-177 (\(^{177}\)Lu) in European hospitals JF - EJNMMI Physics N2 - Background This inter-comparison exercise was performed to demonstrate the variability of quantitative SPECT/CT imaging for lutetium-177 (\(^{177}\)Lu) in current clinical practice. Our aim was to assess the feasibility of using international inter-comparison exercises as a means to ensure consistency between clinical sites whilst enabling the sites to use their own choice of quantitative imaging protocols, specific to their systems. Dual-compartment concentric spherical sources of accurately known activity concentrations were prepared and sent to seven European clinical sites. The site staff were not aware of the true volumes or activity within the sources—they performed SPECT/CT imaging of the source, positioned within a water-filled phantom, using their own choice of parameters and reported their estimate of the activities within the source. Results The volumes reported by the participants for the inner section of the source were all within 29% of the true value and within 60% of the true value for the outer section. The activities reported by the participants for the inner section of the source were all within 20% of the true value, whilst those reported for the outer section were up to 83% different to the true value. Conclusions A variety of calibration and segmentation methods were used by the participants for this exercise which demonstrated the variability of quantitative imaging across clinical sites. This paper presents a method to assess consistency between sites using different calibration and segmentation methods. KW - Lutetium KW - Lu-177 KW - SPECT/CT KW - quantitative imaging KW - PRRT KW - molecular radiotherapy Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-233658 VL - 5 ER - TY - JOUR A1 - Röllig, C. A1 - Kramer, M. A1 - Gabrecht, M. A1 - Hänel, M. A1 - Herbst, R. A1 - Kaiser, U. A1 - Schmitz, N. A1 - Kullmer, J. A1 - Fetscher, S. A1 - Link, H. A1 - Mantovani-Löffler, L. A1 - Krümpelmann, U. A1 - Neuhaus, T. A1 - Heits, F. A1 - Einsele, H. A1 - Ritter, B. A1 - Bornhäuser, M. A1 - Schetelig, J. A1 - Thiede, C. A1 - Mohr, B. A1 - Schaich, M. A1 - Platzbecker, U. A1 - Schäfer-Eckart, K. A1 - Krämer, A. A1 - Berdel, W. E. A1 - Serve, H. A1 - Ehninger, G. A1 - Schuler, U. S. T1 - Intermediate-dose cytarabine plus mitoxantrone versus standard-dose cytarabine plus daunorubicin for acute myeloid leukemia in elderly patients JF - Annals of Oncology N2 - Background: The combination of intermediate-dose cytarabine plus mitoxantrone (IMA) can induce high complete remission rates with acceptable toxicity in elderly patients with acute myeloid leukemia (AML). We present the final results of a randomized-controlled trial comparing IMA with the standard 7+3 induction regimen consisting of continuous infusion cytarabine plus daunorubicin (DA). Patients and methods: Patients with newly diagnosed AML>60 years were randomized to receive either intermediate-dose cytarabine (1000 mg/m(2) twice daily on days 1, 3, 5, 7) plus mitoxantrone (10 mg/m(2) days 1-3) (IMA) or standard induction therapy with cytarabine (100 mg/m(2) continuously days 1-7) plus daunorubicin (45 mg/m(2) days 3-5) (DA). Patients in complete remission after DA received intermediate-dose cytarabine plus amsacrine as consolidation treatment, whereas patients after IMA were consolidated with standard-dose cytarabine plus mitoxantrone. Results: Between February 2005 and October 2009, 485 patients were randomized; 241 for treatment arm DA and 244 for IMA; 76% of patients were >65 years. The complete response rate after DA was 39% [95% confidence interval (95% CI): 33-45] versus 55% (95% CI: 49-61) after IMA (odds ratio 1.89, P = 0.001). The 6-week early-death rate was 14% in both arms. Relapse-free survival curves were superimposable in the first year, but separated afterwards, resulting in 3-year relapse-free survival rates of 29% versus 14% in the DA versus IMA arms, respectively (P = 0.042). The median overall survival was 10 months in both arms (P = 0.513). Conclusion: The dose escalation of cytarabine in induction therapy lead to improved remission rates in the elderly AML patients. This did not translate into a survival advantage, most likely due to differences in consolidation treatment. Thus, effective consolidation strategies need to be further explored. In combination with an effective consolidation strategy, the use of intermediate-dose cytarabine in induction may improve curative treatment for elderly AML patients. KW - acute myeloid leukemia KW - cytarabine dose KW - elderly Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226473 VL - 29 IS - 4 ER - TY - INPR A1 - Werner, Rudolf A. A1 - Bundschuh, Ralph A. A1 - Bundschuh, Lena A1 - Javadi, Mehrbod S. A1 - Leal, Jeffrey P. A1 - Higuchi, Takahiro A1 - Pienta, Kenneth J. A1 - Buck, Andreas K. A1 - Pomper, Martin G. A1 - Gorin, Michael A. A1 - Lapa, Constantin A1 - Rowe, Steven P. T1 - Interobserver Agreement for the Standardized Reporting System PSMA-RADS 1.0 on \(^{18}\)F-DCFPyL PET/CT Imaging T2 - Journal of Nuclear Medicine N2 - Objectives: Recently, the standardized reporting and data system for prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging studies, termed PSMA-RADS version 1.0, was introduced. We aimed to determine the interobserver agreement for applying PSMA-RADS to imaging interpretation of 18F-DCFPyL PET examinations in a prospective setting mimicking the typical clinical work-flow at a prostate cancer referral center. Methods: Four readers (two experienced readers (ER, > 3 years of PSMA-targeted PET interpretation experience) and two inexperienced readers (IR, < 1 year of experience)), who had all read the initial publication on PSMA-RADS 1.0, assessed 50 18F-DCFPyL PET/computed tomography (CT) studies independently. Per scan, a maximum of 5 target lesions were selected by the observers and a PSMA-RADS score for every target lesion was recorded. No specific pre-existing conditions were placed on the selection of the target lesions, although PSMA-RADS 1.0 suggests that readers focus on the most highly avid or largest lesions. An overall scan impression based on PSMA-RADS was indicated and interobserver agreement rates on a target lesion-based, on an organ-based, and on an overall PSMA-RADS score-based level were computed. Results: The number of target lesions identified by each observer were as follows: ER 1, 123; ER 2, 134; IR 1, 123; and IR 2, 120. Among those selected target lesions, 125 were chosen by at least two individual observers (all four readers selected the same target lesion in 58/125 (46.4%) instances, three readers in 40/125 (32%) and two observers in 27/125 (21.6%) instances). The interobserver agreement for PSMA-RADS scoring among identical target lesions was good (intraclass correlation coefficient (ICC) for four, three and two identical target lesions, ≥0.60, respectively). For lymph nodes, an excellent interobserver agreement was derived (ICC=0.79). The interobserver agreement for an overall scan impression based on PSMA-RADS was also excellent (ICC=0.84), with a significant difference for ER (ICC=0.97) vs. IR (ICC=0.74, P=0.005). Conclusions: PSMA-RADS demonstrates a high concordance rate in this study, even among readers with different levels of experience. This suggests that PSMA-RADS can be effectively used for communication with clinicians and can be implemented in the collection of data for large prospective trials. KW - 18F-DCFPyL KW - Positronen-Emissions-Tomografie KW - PSMA-RADS KW - interreader KW - interobserver KW - PSMA KW - prostate cancer KW - RADS KW - reporting and data system KW - PET Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-167788 SN - 0161-5505 N1 - This research was originally published in JNM. Rudolf A. Werner, Ralph A. Bundschuh, Lena Bundschuh, Mehrbod S. Javadi, Jeffrey P. Leal, Takahiro Higuchi, Kenneth J. Pienta, Andreas K. Buck, Martin G. Pomper, Michael A. Gorin, Constantin Lapa and Steven P. Rowe. Interobserver Agreement for the Standardized Reporting System PSMA-RADS 1.0 on 18F-DCFPyL PET/CT Imaging. J Nucl Med 2018;59:1857-1864 © SNMMI. ER - TY - THES A1 - Mühlemann, Markus T1 - Intestinal stem cells and the Na\(^+\)-D-Glucose Transporter SGLT1: potential targets regarding future therapeutic strategies for diabetes T1 - Intestinale Stammzellen und der Na\(^+\)-D-Glukose Transporter SGLT1: potentielle Ansatzpunkte neuartiger Therapien für Diabetes Patienten N2 - The pancreas and the small intestine are pivotal organs acting in close synergism to regulate glucose metabolism. After absorption and processing of dietary glucose within the small intestine, insulin and glucagon are released from pancreatic islet cells to maintain blood glucose homeostasis. Malfunctions affecting either individual, organ-specific functions or the sophisticated interplay of both organs can result in massive complications and pathologic conditions. One of the most serious metabolic diseases of our society is diabetes mellitus (DM) that is hallmarked by a disturbance of blood glucose homeostasis. Type 1 (T1DM) and type 2 (T2DM) are the main forms of the disease and both are characterized by chronic hyperglycemia, a condition that evokes severe comorbidities in the long-term. In the past, several standard treatment options allowed a more or less adequate therapy for diabetic patients. Albeit there is much effort to develop new therapeutic interventions to treat diabetic patients in a more efficient way, no cure is available so far. In view of the urgent need for alternative treatment options, a more systemic look on whole organ systems, their biological relation and complex interplay is needed when developing new therapeutic strategies for DM. T1DM is hallmarked by an autoimmune-mediated destruction of the pancreatic β-cell mass resulting in a complete lack of insulin that is in most patients restored by applying a life-long recombinant insulin therapy. Therefore, novel regenerative medicine-based concepts focus on the derivation of bioartificial β-like cells from diverse stem cell sources in vitro that survive and sustain to secrete insulin after implantation in vivo. In this context, the first part of this thesis analyzed multipotent intestinal stem cells (ISCs) as alternative cell source to derive bioartificial, pancreatic β-like cells in vitro. From a translational perspective, intestinal stem cells pose a particularly attractive cell source since intestinal donor tissues could be obtained via minimal invasive endoscopy in an autologous way. Furthermore, intestinal and pancreatic cells both derive from the same developmental origin, the endodermal gut tube, favoring the differentiation process towards functional β-like cells. In this study, pancreas-specific differentiation of ISCs was induced by the ectopic expression of the pancreatic transcription factor 1 alpha (Ptf1a), a pioneer transcriptional regulator of pancreatic fate. Furthermore, pancreatic lineage-specific culture media were applied to support the differentiation process. In general, ISCs grow in vitro in a 3D Matrigel®-based environment. Therefore, a 2D culture platform for ISCs was established to allow delivery and ectopic expression of Ptf1a with high efficiency. Next, several molecular tools were applied and compared with each other to identify the most suitable technology for Ptf1a delivery and expression within ISCs as well as their survival under the new established 2D conditions. Success of differentiation was investigated by monitoring changes in cellular morphology and induction of pancreatic differentiation-specific gene expression profiles. In summary, the data of this project part suggest that Ptf1a harbors the potential to induce pancreatic differentiation of ISCs when applying an adequate differentiation media. However, gene expression analysis indicated rather an acinar lineage-determination than a pancreatic β-cell-like specification. Nevertheless, this study proved ISCs not only as interesting stem cell source for the generation of pancreatic cell types with a potential use in the treatment of T1DM but alsoPtf1a as pioneer factor for pancreatic differentiation of ISCs in general. Compared to T1DM, T2DM patients suffer from hyperglycemia due to insulin resistance. In T2DM management, the maintenance of blood glucose homeostasis has highest priority and can be achieved by drugs affecting the stabilization of blood glucose levels. Recent therapeutic concepts are aiming at the inhibition of the intestinal glucose transporter Na+-D-Glucose cotransporter 1 (SGLT1). Pharmacological inhibition of SGLT1 results in reduced postprandial blood glucose levels combined with a sustained and increased Glucagon-like peptide 1 (GLP-1) secretion. So far, systemic side effects of this medication have not been addressed in detail. Of note, besides intestinal localization, SGLT1 is also expressed in various other tissues including the pancreas. In context of having a closer look also on the interplay of organs when developing new therapeutic approaches for DM, the second part of this thesis addressed the effects on pancreatic islet integrity after loss of SGLT1. The analyses comprised the investigation of pancreatic islet size, cytomorphology and function by the use of a global SGLT1 knockout (SGLT1-/-) mouse model. As SGLT1-/- mice develop the glucose-galactose malabsorption syndrome when fed a standard laboratory chow, these animals derived a glucose-deficient, fat-enriched (GDFE) diet. Wildtype mice on either standard chow (WTSC) or GDFE (WTDC) allowed the discrimination between diet- and knockout-dependent effects. Notably, GDFE fed mice showed decreased expression and function of intestinal SGLT1, while pancreatic SGLT1 mRNA levels were unaffected. Further, the findings revealed increased isled sizes, reduced proliferation- and apoptosis rates as well as an increased α-cell and reduced β-cell proportion accompanied by a disturbed cytomorphology in islets when SGLT1 function is lost or impaired. In addition, pancreatic islets were dysfunctional in terms of insulin- and glucagon-secretion. Moreover, the release of intestinal GLP-1, an incretin hormone that stimulates insulin-secretion in the islet, was abnormal after glucose stimulatory conditions. In summary, these data show that intestinal SGLT1 expression and function is nutrient dependent. The data obtained from the islet studies revealed an additional and new role of SGLT1 for maintaining pancreatic islet integrity in the context of structural, cytomorphological and functional aspects. With special emphasis on SGLT1 inhibition in diabetic patients, the data of this project indicate an urgent need for analyzing systemic side effects in other relevant organs to prove pharmacological SGLT1 inhibition as beneficial and safe. Altogether, the findings of both project parts of this thesis demonstrate that focusing on the molecular and cellular relationship and interplay of the small intestine and the pancreas could be of high importance in context of developing new therapeutic strategies for future applications in DM patients. N2 - Das komplexe Zusammenspiel zwischen Pankreas und Dünndarm ist von großer Bedeutung für den Zucker Stoffwechsel. Während der Dünndarm Glukose aus der Nahrung absorbiert, sezerniert der Pankreas Insulin und Glukagon für die Regulation des Blutzuckerspiegels. Bereits kleinste Fehlfunktionen in einem der beiden Organe können das fein abgestimmte Zusammenspiel aus der Balance bringen und zu schwerwiegenden Begleiterscheinungen führen. Die bekannteste Krankheit bezüglich eines gestörten Blutzuckerhaushaltes ist Diabetes mellitus (DM). Die wichtigsten Formen sind Typ1 und Typ 2 Diabetes, welche beide durch chronische Hyperglykämie gekennzeichnet sind, einem Zustand der langfristig zu schweren Komplikationen führt. Derzeit ist keine Heilung möglich, jedoch vermindert eine Vielzahl von Medikamenten und Therapien die auftretenden Symptome, was die Lebensqualität der Patienten erheblich verbessert. Für die Entwicklung von neuen Medikamenten und Therapien für DM Patienten, muss der Fokus vermehrt auf die Gesamtheit der Organ-Organ Interaktionen, sowie den entwicklungsbiologischen Ursprung der einzelnen Organe gerichtet werden. Bei Typ 1 Diabetes werden die insulinsekretierende β-Zellen vom Immunsystem zerstört, was zu einem Mangel an Insulin führt. Deshalb ist eine regelmäßige Insulingabe unabdingbar, um eine Hyperglykämie vorzubeugen. Ein vielversprechender Ansatz um fehlendes Insulin zu kompensieren besteht darin aus Stammzellen bioartifizielle, insulinsekretierende Zellen zu generieren. In diesem Zusammenhang ist der biologische Ursprung der zu differenzierenden Zellen von großer Bedeutung. In dieser Arbeit werden daher intestinale Stammzellen (ISZ) als mögliche alternative Zellquelle beschrieben, um insulinsekretierende Zellen zu generieren. Aus medizinischer Sicht eigenen sich ISZ besonders gut für regenerative Therapien, da sie patientenspezifisch durch eine minimal-invasive Endoskopie entnommen werden können. Des Weiteren haben die beiden Organe einen gemeinsamen embryologischen Ursprung, die endodermalen Darmröhre, was die pankreatische Differenzierung begünstigen könnte. Mithilfe der ektopischen Expression des pankreatischen Masterregulators pankreatischer Transkriptionsfaktors 1 alpha (Ptf1a), sollen ISZ in insulinsekretierende β-Zell-ähnliche Zelltypen differenziert werden. Zudem soll ein pankreas-spezifisches Differenzierungsmedium die Effizienz der Differenzierung erhöhen. Da ISZ normalerweise in einer 3D Umgebung kultiviert werden, wurde für diese Arbeit eine 2D Zellkultur etabliert, um eine hocheffiziente genetische Manipulation zur ektopischen Expression von Ptf1a zu garantieren. Im nächsten Schritt wurde die bestmögliche Methode evaluiert um Ptf1a in ISZ zu integrieren, welche gleichzeitig aber das Wachstum und Überleben der Zellen nicht beeinträchtigt. Der Erfolg der angewandten Methode wurde basierend auf der Zellmorphologie, sowie der Transkription von pankreasspezifischen Genen überprüft. Die Ergebnisse dieser Studie haben gezeigt, dass die Ptf1a-induzierte Differenzierung in Verbindung mit der Applikation eines spezifischen Differenzierungsmediums das Genexpressionsprofil von Azinär Zellen induziert und nicht wie erwartet, das von endokrinen β-Zellen. Dies bedeutet, dass Ptf1a die Kapazität aufweist, ISZ in pankreatische Zellen zu konvertieren, jedoch bei der Entwicklung in Richtung insulinsekretierende β-Zellen keine Rolle spielt. Letztendlich zeigen die Ergebnisse dieser Arbeit, dass ISZ eine interessante Alternative zu pluripotenten Stammzellen darstellen. Im Gegensatz zu Typ 1 leiden Typ 2 Diabetes Patienten an Hyperglykämie infolge von Insulinresistenz, welche oft mit blutzuckerregulierenden Medikamenten behandelt werden können. Eine gute Therapiemöglichkeit ist die Inhibition des intestinalen Glukosetransporters SGLT1, was zu einer drastisch reduzierten postprandialen Glukoseaufnahme führt und gleichzeitig die intestinale Sekretion des Inkretins Glukose-like Peptide 1 (GLP-1) erhöht. Beides wirkt sich positiv auf die Blutzuckerregulation unter diabetischen Verhältnissen aus. Obwohl SGLT1 primär im Dünndarm exprimiert ist, wurde dessen Expression auch in anderen Organen, wie dem Gehirn, dem Herz, der Lunge und in pankreatischen α-Zellen nachgewiesen. Im zweiten Teil dieser Arbeit wurde daher der Einfluss des Funktionsverlustes von SGLT1 auf die Integrität pankreatischer Inselzellcluster analysiert. Im diesem Rahmen wurde die Morphologie der pankreatischen Inseln, deren Architektur und Funktion mithilfe eines etablierten murinen SGLT1 Knockout (SGLT1-/-) Modelles untersucht. Da SGLT1-/- Mäuse unter einer Standard Labordiät (SD) ein schweres Glukose-Galaktose Malabsorptions Syndrom entwickeln, erhalten die Tiere eine glukose-freie, fett-angereicherte Diät (GDFE). Um diät- und knockoutspezifische Effekte unterscheiden zu können, wurden als Kontrollen SD- und GDFE-gefütterte Wildtyp Tiere mit den SGLT1-/- Mäusen verglichen. Wildtyptiere unter GDFE Diät zeigten eine verminderte Expression und Funktionalität des intestinalen SGLT1 Transporters, während im Pankreas die SGLT1 mRNA Expression nicht von der Diät beeinflusst wurde. Die Ergebnisse dieser Arbeit haben gezeigt, dass in SGLT1-/- Pankreata, die Inseln größer sind, aber auch die Proliferations- und Apoptoserate in den Inselzellen reduziert ist. Zudem befinden sich in SGLT1-/- Inseln mehr α-Zellen und weniger β-Zellen. Des Weiteren ist die typische Anordnung der endokrinen Zellen gestört. Diese Beobachtungen deuten darauf hin, dass SGLT1 in pankreatischen Inseln eine wichtige Rolle für die strukturelle Organisation der verschiedenen Zelltypen innerhalb der Inseln spielt. Ergänzend wurde gezeigt, dass isolierte SGLT1-/- Inseln in der Gegenwart von Glukose unfähig sind Insulin oder Glukagon zu sezernieren. Weitere Untersuchungen im Tier haben ergeben, dass auch das insulinsekretionsfördernde Hormon GLP-1 in atypischer Art und Weise sekretiert wird. In dieser Arbeit wurde gezeigt, dass die intestinale SGLT1 Expression und Funktion durch Nährstoffe beeinflusst werden kann. Des Weiteren wurde erstmals eine neue Funktion für SGLT1 bezüglich der strukturellen und zellulären Organisation pankreatischer Inselzellcluster beschrieben. Daten zu neuen klinischen SGLT1 Inhibitoren beschreiben lediglich eine intestinale SGLT1 Blockierung, während die Wirkung in weitern Organen nicht berücksichtigt wurde. Die Daten dieser Arbeit liefern klare Indizien dafür, dass starke Nebenwirkungen und Effekte auch in anderen SGLT1-exprimierenden Geweben und Organen auftreten könnten, wenn die SGLT1 Funktion verloren geht. Zusammenfassend konnte in dieser Arbeit gezeigt werden, dass die Regulation des Blutzuckerspiegels auf einem komplexen Zusammenspiel zwischen Dünndarm und Pankreas basiert. Daher sollten bei zukünftigen SGLT1 Inhibitions-Studien im Menschen die Interaktionen zwischen den beiden Organen unbedingt berücksichtigt werden, um die Wirksamkeit und die Sicherheit solcher Medikamente für Diabetes Patienten besser darzulegen. KW - Stammzelle KW - Diabetes mellitus KW - Sglt1 KW - GLP-1 KW - blood glucose regulation KW - Intestinal stem cell KW - Lgr5 KW - islets of Langerhans KW - pancreas KW - glucose KW - insulin Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-169266 ER - TY - JOUR A1 - Gilbert, F. A1 - Eden, L. A1 - Meffert, R. A1 - Konietschke, F. A1 - Lotz, J. A1 - Bauer, L. A1 - Staab, W. T1 - Intra- and interobserver reliability of glenoid fracture classifications by Ideberg, Euler and AO JF - BMC Musculoskeletal Disorders N2 - Background: Representing 3%-5% of shoulder girdle injuries scapula fractures are rare. Furthermore, approximately 1% of scapula fractures are intraarticularfractures of the glenoid fossa. Because of uncertain fracture morphology and limited experience, the treatment of glenoid fossa fractures is difficult. The glenoid fracture classification by Ideberg (1984) and Euler (1996) is still commonly used in literature. In 2013 a new glenoid fracture classification was introduced by the AO. The purpose of this study was to examine the new AO classification in clinical practice in comparison with the classifications by Ideberg and Euler. Methods: In total CT images of 84 patients with glenoid fossa fractures from 2005 to 2018 were included. Parasagittal, paracoronary and axial reconstructions were examined according to the classifications of Ideberg, Euler and the AO by 3 investigators (orthopedic surgeon, radiologist, student of medicine) at three individual time settings. Inter- and intraobserver reliability of the three classification systems were ascertained by computing Inter- and Intraclass (ICCs) correlation coefficients using Spearman's rank correlation coefficient, 95%-confidence intervals as well as F-tests for correlation coefficients. Results: Inter- and intraobserver reliability for the AO classification showed a perspicuous coherence (R = 0.74 and R = 0.79). Low to moderate intraobserver reliability for Ideberg (R = 0.46) and Euler classification (R = 0.41) was found. Furthermore, data show a low Interobserver reliability for both Ideberg and Euler classification (R < 0.2). Both the Inter- and Intraclass reliability using AO is significantly higher than those using Ideberg and Euler (p < 0.05). Using the new AO classification, it was possible to find a proper class for every glenoid fossa fracture. On average, according to Euler classification 10 of 84 fractures were not classifiable whereas to Ideberg classification 21 of 84 fractures were not classifiable. Conclusion: The new AO classification system introduced 2013 facilitates reliable grading of glenoid fossa fractures with high inter- and intraobserver reliability in 84 patients using CT images. It should possibly be applied in order to enable a valid, reliable and consistent academic description of glenoid fossa fractures. The established classifications by Euler and Ideberg are not capable of providing a similar reliability. KW - classification KW - comparison KW - diagnosis KW - fracture KW - scapula Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176482 VL - 19 IS - 89 ER - TY - JOUR A1 - Usman, Muhammad A1 - Reimann, Thomas A1 - Liedl, Rudolf A1 - Abbas, Azhar A1 - Conrad, Christopher A1 - Saleem, Shoaib T1 - Inverse parametrization of a regional groundwater flow model with the aid of modelling and GIS: test and application of different approaches JF - ISPRS International Journal of Geo-Information N2 - The use of inverse methods allow efficient model calibration. This study employs PEST to calibrate a large catchment scale transient flow model. Results are demonstrated by comparing manually calibrated approaches with the automated approach. An advanced Tikhonov regularization algorithm was employed for carrying out the automated pilot point (PP) method. The results indicate that automated PP is more flexible and robust as compared to other approaches. Different statistical indicators show that this method yields reliable calibration as values of coefficient of determination (R-2) range from 0.98 to 0.99, Nash Sutcliffe efficiency (ME) range from 0.964 to 0.976, and root mean square errors (RMSE) range from 1.68 m to 1.23 m, for manual and automated approaches, respectively. Validation results of automated PP show ME as 0.969 and RMSE as 1.31 m. The results of output sensitivity suggest that hydraulic conductivity is a more influential parameter. Considering the limitations of the current study, it is recommended to perform global sensitivity and linear uncertainty analysis for the better estimation of the modelling results. KW - pilot-point-approach KW - inverse parameterization KW - groundwater KW - sensitivity analysis KW - tikhonov regularization KW - PEST Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175721 VL - 7 IS - 1 ER - TY - JOUR A1 - Mall, David A1 - Larsen, Ashley E. A1 - Martin, Emily A. T1 - Investigating the (mis)match between natural pest control knowledge and the intensity of pesticide use JF - Insects N2 - Transforming modern agriculture towards both higher yields and greater sustainability is critical for preserving biodiversity in an increasingly populous and variable world. However, the intensity of agricultural practices varies strongly between crop systems. Given limited research capacity, it is crucial to focus efforts to increase sustainability in the crop systems that need it most. In this study, we investigate the match (or mismatch) between the intensity of pesticide use and the availability of knowledge on the ecosystem service of natural pest control across various crop systems. Using a systematic literature search on pest control and publicly available pesticide data, we find that pest control literature is not more abundant in crops where insecticide input per hectare is highest. Instead, pest control literature is most abundant, with the highest number of studies published, in crops with comparatively low insecticide input per hectare but with high world harvested area. These results suggest that a major increase of interest in agroecological research towards crops with high insecticide input, particularly cotton and horticultural crops such as citrus and high value-added vegetables, would help meet knowledge needs for a timely ecointensification of agriculture. KW - ecological intensification KW - insecticides KW - agroecology KW - agricultural intensity KW - biological pest control KW - crop KW - study system Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158977 VL - 9 IS - 1 ER - TY - THES A1 - Kauk, Michael T1 - Investigating the Molecular Mechanism of Receptor Activation at Muscarinic Receptors by Means of Pathway-Specific Dualsteric Ligands and Partial Agonists T1 - Molekulare Grundlagen der Rezeptoraktivierung von muskarinergen Acetylcholin Rezeptoren durch dualstere Liganden und Partialagonisten N2 - G protein-coupled receptors (GPCRs) form the biggest receptor family that is encoded in the human genome and represent the most druggable target structure for modern therapeutics respectively future drug development. Belonging to aminergic class A GPCRs muscarinic Acetylcholine receptors (mAChRs) are already now of clinical relevance and are also seen as promising future drug targets for treating neurodegenerative diseases like Alzheimer or Parkinson. The mAChR family consist of five subtypes showing high sequence identity for the endogenous ligand binding region and thus it is challenging until now to selectively activate a single receptor subtype. A well accepted method to study ligand binding, dynamic receptor activation and downstream signaling is the fluorescence resonance energy transfer (FRET) application. Here, there relative distance between two fluorophores in close proximity (<10 nm) can be monitored in a dynamic manner. The perquisite for that is the spectral overlap of the emission spectrum of the first fluorophore with the excitation spectrum of the second fluorophore. By inserting two fluorophores into the molecular receptor structure receptor FRET sensors can serve as a powerful tool to study dynamic receptor pharmacology. Dualsteric Ligands consist of two different pharmacophoric entities and are regarded as a promising ligand design for future drug development. The orthosteric part interacts with high affinity with the endogenous ligand binding region whereas the allosteric part binds to a different receptor region mostly located in the extracellular vestibule. Both moieties are covalently linked. Dualsteric ligands exhibit a dynamic ligand binding. The dualsteric binding position is characterized by a simultaneous binding of the orthosteric and allosteric moiety to the receptor and thus by receptor activation. In the purely allosteric binding position no receptor activation can be monitored. In the present work the first receptor FRET sensor for the muscarinic subtype 1 (M1) was generated and characterized. The M1-I3N-CFP sensor showed an unaltered physiological behavior as well as ligand and concentration dependent responses. The sensor was used to characterize different sets of dualsteric ligands concerning their pharmacological properties like receptor activation. It was shown that the hybrids consisting of the synthetic full agonist iperoxo and the positive allosteric modulator of BQCA type is very promising. Furthermore, it was shown for orthosteric as well as dualsteric ligands that the degree of receptor activation is highly dependent on the length of and the chemical properties of the linker moiety. For dualsteric ligands a bell-shaped activation characteristic was reported for the first time, suggesting that there is an optimal linker length for dualsteric ligands. The gained knowledge about hybrid design was then used to generate and characterize the first photo-switchable dualsteric ligand. The resulting hybrids were characterized with the M1-I3N-CFP sensor and were described as photo-inactivatable and dimmable. In addition to the ligand characterization the ligand application methodology was further developed and improved. Thus, a fragment-based screening approach for dualsteric ligands was reported in this study for the first time. With this approach it is possible to investigate dualsteric ligands in greater detail by applying either single ligand fragments alone or in a mixture of building blocks. These studies revealed the insights that the effect of dualsteric ligands on a GPCR can be rebuild by applying the single building blocks simultaneously. The fragment-based screening provides high potential for the molecular understanding of dualsteric ligands and for future screening approaches. Next, a further development of the standard procedure for measuring FRET by sensitized emission was performed. Under normal conditions single cell FRET is measured on glass coverslips. After coating the coverslips surface with a 20 nm thick gold layer an increased FRET efficiency up to 60 % could be reported. This finding was validated in different approaches und in different configurations. This FRET enhancement by plasmonic surfaces was until yet unreported in the literature for physiological systems and make FRET for future projects even more powerful. N2 - G Protein gekoppelte Rezeptoren (GPCRs) bilden die größte Proteinfamilie, die im humanen Genom verschlüsselt ist. Sie sind nicht nur die Zielstruktur für eine Vielzahl von derzeit gebräuchlichen Medikamenten, sondern gehören auch zu den vielversprechendsten Therapieansätzen für die moderne Medikamentenentwicklung. Muskarinerge Acetylcholin Rezeptoren (mAChRs) gehören zu den aminergen Klasse A GPCRs und sind bereits heute von klinischer Relevanz. Die muskarinerge Rezeptorfamilie wird von fünf Subtypen gebildet, die sich besonders durch eine hohe Sequenzidentität in der endogenen Ligandenbindestelle (orthostere Bindestelle) auszeichnen. Aus diesem Grund ist es mit den herkömmlich verwendeten Medikamenten nicht möglich, einen ganz bestimmten Subtyp zu therapieren, ohne auch andere Subtypen zu beeinflussen und so unerwünschte Nebenwirkungen zu erhalten. Eine Möglichkeit Ligandenbindung, dynamische Rezeptoraktivierung oder Signalweiterleitung von GPCRs nach pharmakologischen Gesichtspunkten zu charakterisieren, stellt der Floreszenz Resonanz Energietransfer (FRET) dar. Mit Hilfe dieser Methode kann über kleine Entfernungen (<10 nm) die relative Orientierung von zwei Fluorophoren mit überlappenden Spektralbereichen mit hoher zeitlicher Auflösung verfolgt werden. Integriert man das Fluorophorpaar mit Hilfe gentechnischer Methoden in die Molekülstruktur des Rezeptors, kann man dessen Konformationsänderung bzw. Aktivierung infolge einer Ligandenbindung aufzeichnen. Dualstere Liganden sind eine Substanzklasse von hohem zukünftigen klinischen Potential und zeichnen sich durch die Verknüpfung mehrerer pharmakologisch aktiver Untereinheiten aus. Der orthostere Molekülteil interagiert mit der endogenen Ligandenbindestelle und der allostere Molekülteil interagiert mit einem zweiten Rezeptorabschnitt, der häufig in den extrazellulären Schlaufen des Rezeptors zu finden ist. Diese allosteren Bindestellen zeichnet sich durch eine vergleichsweise geringe Sequenzidentität aus, weswegen allostere Modulatoren auch selektiv an Subtypen binden können. Aufgrund des Aufbaus können dualstere Liganden auf vielfältige Weise mit dem Rezeptor interagieren und dieser Bindemechanismus wurde als dynamische Ligandenbindung beschrieben. Zum einen können beide Molekülteile gleichzeitig mit dem Rezeptor interagieren und ihn aktivieren (dualsterer Bindemodus) und zum anderen findet man einen rein allosteren Bindemodus, der den Rezeptor nicht aktiviert. Der orthostere Molekülteil ist vor allem für die Rezeptoraktivierung zuständig, die sich durch eine hohe Affinität auszeichnet und der allostere Molekülteil kann selektive Rezeptorinteraktionen vermitteln. Da dualstere Moleküle immer Eigenschaften beider Untereinheiten besitzen, werden dualstere Liganden als sehr vielversprechend erachtet, zukünftig subtypselektive Medikamente darzustellen. In dieser Arbeit wurde der erste Rezeptor FRET Sensor für den muskarinergen Subtyp 1 (M1) beschrieben und es konnte gezeigt werden, dass sich dieser Rezeptorsensor in seiner physiologischen Funktion nicht von dem wild Typ unterscheidet. Des Weiteren können mit Hilfe dieses Sensors liganden- und konzentrationsabhängige Rezeptorantworten aufgezeichnet werden. Der M1-I3N-CFP wurde dazu genutzt verschiedene Reihen dualsterer Liganden zu charakterisieren und auf ihre aktivierenden Eigenschaften bezüglich des M1 zu testen. Es wurde gezeigt, dass die Kombination aus dem synthetischen und hochpotenten Agonisten Iperoxo als Orthoster und dem in der Literatur als M1 selektiven positiven allosteren Modulator beschriebenen BQCA als Alloster sehr vielversprechend ist. Es konnte gezeigt werden, dass die rezeptoraktivierenden Eigenschaften sowohl von orthosteren wie auch von dualsteren Liganden stark von der Linkerlänge abhängig sind. Für dualstere Liganden konnte so ein glockenförmiger Zusammenhang zwischen Linkerlänge und Rezeptoraktivierung herausgearbeitet werden. Des Weiteren wurde gezeigt, dass bestimmte Hybride, die den M1 aktivieren, an anderen Subtypen keine Effekte hervorrufen und somit als subtypselektiv beschrieben werden können. Im Anschluss wurde mit Hilfe des gewonnenen Wissens über Iperoxo/BQCA Hybride, das Moleküldesign der dualsteren Liganden weiterentwickelt. So wurden in dieser Arbeit die ersten photo-schaltbaren bzw. photo-dimmbaren dualsteren Liganden beschrieben und charakterisiert. Des Weiteren wurde in dieser Arbeit die herkömmliche Charakterisierung von dualsteren Liganden weiterentwickelt. Es konnte zum ersten Mal gezeigt werden, dass es möglich ist, die Aktivierung eines Rezeptors durch einen dualsteren Liganden nachzustellen, indem die einzelnen Fragmente des ursprünglichen Liganden gleichzeitig appliziert werden. Diese auf Fragmenten basierende Charakterisierung ist die erste Anwendung dieser Art und birgt großes Potential für die zukünftige Suche nach neuen Wirkstoffen. Neben der Untersuchung von pharmakologischen Schwerpunkten wurde auch die Weiterentwicklung der Rezeptor FRET Methodik beschrieben. Die herkömmliche Anwendung der Rezeptor FRET Sensoren geschieht auf Objektträgern aus Quarzglas. In dieser Arbeit wurde diese Anwendung dahingehend weiterentwickelt, dass die Objektträger mit einer 20 nm dicken Goldschicht beschichtet wurden, um den Einfluss von Plasmonoberflächen auf physiologisch relevante FRET Messungen zu untersuchen. Es konnte gezeigt werden, dass mit Hilfe der Goldbeschichtung und in Abhängigkeit des Versuchsaufbaus die Energietransfereffizienz um bis zu 60 % gesteigert werden konnte. Diese Entdeckung zeigt Potential zukünftig die FRET-Reichweite zu erhöhen und so bisher nicht charakterisierbare Sachverhalte aufklären zu können. KW - G-Protein gekoppelte Rezeptoren KW - Muscarinrezeptor KW - Dualsteric Ligands KW - Partial Agonists KW - Dualstere Liganden KW - Partialagonismus Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-173729 N1 - Online-Version enthält nicht den Appendix (Volltexte der Originalveröffentlichungen der Zeitschriftenaufsätze) ER - TY - JOUR A1 - Salgarella, Alice Rita A1 - Zahoranová, Anna A1 - Šrámková, Petra A1 - Majerčíková, Monika A1 - Pavlova, Ewa A1 - Luxenhofer, Robert A1 - Kronek, Juraj A1 - Lacík, Igor A1 - Ricotti, Leonardo T1 - Investigation of drug release modulation from poly(2-oxazoline) micelles through ultrasound JF - Scientific Reports N2 - Among external stimuli used to trigger release of a drug from a polymeric carrier, ultrasound has gained increasing attention due to its non-invasive nature, safety and low cost. Despite this attention, there is only limited knowledge about how materials available for the preparation of drug carriers respond to ultrasound. This study investigates the effect of ultrasound on the release of a hydrophobic drug, dexamethasone, from poly(2-oxazoline)-based micelles. Spontaneous and ultrasound-mediated release of dexamethasone from five types of micelles made of poly(2-oxazoline) block copolymers, composed of hydrophilic poly(2-methyl-2-oxazoline) and hydrophobic poly(2-n-propyl-2-oxazoline) or poly(2-butyl-2-oxazoline-co-2-(3-butenyl)-2-oxazoline), was studied. The release profiles were fitted by zeroorder and Ritger-Peppas models. The ultrasound increased the amount of released dexamethasone by 6% to 105% depending on the type of copolymer, the amount of loaded dexamethasone, and the stimulation time point. This study investigates for the first time the interaction between different poly(2-oxazoline)-based micelle formulations and ultrasound waves, quantifying the efficacy of such stimulation in modulating dexamethasone release from these nanocarriers. KW - Acoustics KW - Biomedical engineering KW - Drug delivery KW - Materials chemistry Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227277 VL - 8 ER -