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Boric acid (BA) has been used as a transparent glass matrix for optical materials for over 100 years. However, recently, apparent room-temperature phosphorescence (RTP) from BA (crystalline and powder states) was reported (Zheng et al., Angew. Chem. Int. Ed. 2021, 60, 9500) when irradiated at 280 nm under ambient conditions. We suspected that RTP from their BA sample was induced by an unidentified impurity. Our experimental results show that pure BA synthesized from B(OMe)\(_{3}\) does not luminesce in the solid state when irradiated at 250–400 nm, while commercial BA indeed (faintly) luminesces. Our theoretical calculations show that neither individual BA molecules nor aggregates would absorb light at >175 nm, and we observe no absorption of solid pure BA experimentally at >200 nm. Therefore, it is not possible for pure BA to be excited at >250 nm even in the solid state. Thus, pure BA does not display RTP, whereas trace impurities can induce RTP.
Designing highly efficient purely organic phosphors at room temperature remains a challenge because of fast non-radiative processes and slow intersystem crossing (ISC) rates. The majority of them emit only single component phosphorescence. Herein, we have prepared 3 isomers (o, m, p-bromophenyl)-bis(2,6-dimethylphenyl)boranes. Among the 3 isomers (o-, m- and p-BrTAB) synthesized, the ortho-one is the only one which shows dual phosphorescence, with a short lifetime of 0.8 ms and a long lifetime of 234 ms in the crystalline state at room temperature. Based on theoretical calculations and crystal structure analysis of o-BrTAB, the short lifetime component is ascribed to the T\(^M_1\) state of the monomer which emits the higher energy phosphorescence. The long-lived, lower energy phosphorescence emission is attributed to the T\(^A_1\) state of an aggregate, with multiple intermolecular interactions existing in crystalline o-BrTAB inhibiting nonradiative decay and stabilizing the triplet states efficiently.
Persistent room temperature phosphorescent (RTP) luminophores have gained remarkable interest recently for a number of applications in security printing, OLEDs, optical storage, time-gated biological imaging and oxygen sensors. We report the first persistent RTP with lifetimes up to 0.5 s from simple triarylboranes which have no lone pairs. We also have prepared 3 isomeric (o, m, p-bromophenyl)-bis(2,6-dimethylphenyl)boranes. Among the 3 isomers (o-, m- and p-BrTAB) synthesized, the ortho-one is the only one which shows dual phosphorescence, with a short lifetime of 0.8 ms and a long lifetime of 234 ms in the crystalline state at room temperature. At last, we checked the RTP properties from the boric acid. We found that the pure boric acid does not show RTP in the solid state.
(1) Background: To evaluate radiomics features as well as a combined model with clinical parameters for predicting overall survival in patients with bladder cancer (BCa). (2) Methods: This retrospective study included 301 BCa patients who received radical cystectomy (RC) and pelvic lymphadenectomy. Radiomics features were extracted from the regions of the primary tumor and pelvic lymph nodes as well as the peritumoral regions in preoperative CT scans. Cross-validation was performed in the training cohort, and a Cox regression model with an elastic net penalty was trained using radiomics features and clinical parameters. The models were evaluated with the time-dependent area under the ROC curve (AUC), Brier score and calibration curves. (3) Results: The median follow-up time was 56 months (95% CI: 48–74 months). In the follow-up period from 1 to 7 years after RC, radiomics models achieved comparable predictive performance to validated clinical parameters with an integrated AUC of 0.771 (95% CI: 0.657–0.869) compared to an integrated AUC of 0.761 (95% CI: 0.617–0.874) for the prediction of overall survival (p = 0.98). A combined clinical and radiomics model stratified patients into high-risk and low-risk groups with significantly different overall survival (p < 0.001). (4) Conclusions: Radiomics features based on preoperative CT scans have prognostic value in predicting overall survival before RC. Therefore, radiomics may guide early clinical decision-making.
Purpose
Machine learning based on radiomics features has seen huge success in a variety of clinical applications. However, the need for standardization and reproducibility has been increasingly recognized as a necessary step for future clinical translation. We developed a novel, intuitive open-source framework to facilitate all data analysis steps of a radiomics workflow in an easy and reproducible manner and evaluated it by reproducing classification results in eight available open-source datasets from different clinical entities.
Methods
The framework performs image preprocessing, feature extraction, feature selection, modeling, and model evaluation, and can automatically choose the optimal parameters for a given task. All analysis steps can be reproduced with a web application, which offers an interactive user interface and does not require programming skills. We evaluated our method in seven different clinical applications using eight public datasets: six datasets from the recently published WORC database, and two prostate MRI datasets—Prostate MRI and Ultrasound With Pathology and Coordinates of Tracked Biopsy (Prostate-UCLA) and PROSTATEx.
Results
In the analyzed datasets, AutoRadiomics successfully created and optimized models using radiomics features. For WORC datasets, we achieved AUCs ranging from 0.56 for lung melanoma metastases detection to 0.93 for liposarcoma detection and thereby managed to replicate the previously reported results. No significant overfitting between training and test sets was observed. For the prostate cancer detection task, results were better in the PROSTATEx dataset (AUC = 0.73 for prostate and 0.72 for lesion mask) than in the Prostate-UCLA dataset (AUC 0.61 for prostate and 0.65 for lesion mask), with external validation results varying from AUC = 0.51 to AUC = 0.77.
Conclusion
AutoRadiomics is a robust tool for radiomic studies, which can be used as a comprehensive solution, one of the analysis steps, or an exploratory tool. Its wide applicability was confirmed by the results obtained in the diverse analyzed datasets. The framework, as well as code for this analysis, are publicly available under https://github.com/pwoznicki/AutoRadiomics.
Safety behavior prevents the occurrence of threat, thus it is typically considered adaptive. However, safety behavior in anxiety-related disorders is often costly, and persists even the situation does not entail realistic threat. Individuals can engage in safety behavior to varying extents, however, these behaviors are typically measured dichotomously (i.e., to execute or not). To better understand the nuances of safety behavior, this study developed a dimensional measure of safety behavior that had a negative linear relationship with the admission of an aversive outcome. In two experiments, a Reward group receiving fixed or individually calibrated incentives competing with safety behavior showed reduced safety behavior than a Control group receiving no incentives. This allowed extinction learning to a previously learnt warning signal in the Reward group (i.e., updating the belief that this stimulus no longer signals threat). Despite the Reward group exhibited extinction learning, both groups showed a similar increase in fear to the warning signal once safety behavior was no longer available. This null group difference was due to some participants in the Reward group not incentivized enough to disengage from safety behavior. Dimensional assessment revealed a dissociation between low fear but substantial safety behavior to a safety signal in the Control group. This suggests that low-cost safety behavior does not accurately reflect the fear-driven processes, but also other non-fear-driven processes, such as cost (i.e., engage in safety behavior merely because it bears little to no cost). Pinpointing both processes is important for furthering the understanding of safety behavior.
Die Indogermanen sind schuld
(2022)
Virtual reality applications employing avatar embodiment typically use virtual mirrors to allow users to perceive their digital selves not only from a first-person but also from a holistic third-person perspective. However, due to distance-related biases such as the distance compression effect or a reduced relative rendering resolution, the self-observation distance (SOD) between the user and the virtual mirror might influence how users perceive their embodied avatar. Our article systematically investigates the effects of a short (1 m), middle (2.5 m), and far (4 m) SOD between users and mirror on the perception of their personalized and self-embodied avatars. The avatars were photorealistic reconstructed using state-of-the-art photogrammetric methods. Thirty participants repeatedly faced their real-time animated self-embodied avatars in each of the three SOD conditions, where they were repeatedly altered in their body weight, and participants rated the 1) sense of embodiment, 2) body weight perception, and 3) affective appraisal towards their avatar. We found that the different SODs are unlikely to influence any of our measures except for the perceived body weight estimation difficulty. Here, the participants perceived the difficulty significantly higher for the farthest SOD. We further found that the participants’ self-esteem significantly impacted their ability to modify their avatar’s body weight to their current body weight and that it positively correlated with the perceived attractiveness of the avatar. Additionally, the participants’ concerns about their body shape affected how eerie they perceived their avatars. The participants’ self-esteem and concerns about their body shape influenced the perceived body weight estimation difficulty. We conclude that the virtual mirror in embodiment scenarios can be freely placed and varied at a distance of one to four meters from the user without expecting major effects on the perception of the avatar.
Analysis of Drug Impurities by Means of Chromatographic Methods: Targeted and Untargeted Approaches
(2022)
The presented works aimed on the analysis of new impurities in APIs and medicinal products. Different subtypes of LC were coupled to suitable detection methods, i.e. UV and various MS techniques, depending on the chemical natures of the analytes and the analytical task.
Unexpected impurities in medicinal products and APIs caused several scandals in the past, concomitant with fatalities or severe side effects in human and veterinary patients. The detection of nitrosamines in sartans led to the discovery of nitrosamines in various other drugs, of which the antibiotic rifampicin was analyzed in this work. An examination of the synthesis of rifampicin revealed a high potential for the formation of 4-methyl-1-nitrosopiperazine (MeNP). An LC-MS/HRMS method suitable for the quantification of MeNP was applied in the analysis of drugs collected from Brazil, Comoros, India, Nepal, and Tanzania, where a single dose of rifampicin is used in the post-exposure prophylaxis of leprosy. All batches were contaminated with MeNP, ranging from 0.7-5.1 ppm. However, application of rifampicin containing up to 5 ppm MeNP was recommended by the regulatory authorities for the post-exposure prophylaxis of leprosy.
In the 1990s the aminoglycoside antibiotic gentamicin attracted attention after causing fatalities in the USA, but the causative agent was never identified unequivocally. The related substance sisomicin was recognized as a lead impurity by the Holzgrabe lab at the University of Würzburg: sisomicin was accompanied by a variety of other impurities and batches containing sisomicin had caused the fatalities. In 2016, anaphylactic reactions were reported after application of gentamicin. A contamination of the medicinal products with histamine, an impurity of the raw material fish peptone used upon the production, could be identified as the cause of the adverse effects. Batches of gentamicin sulfate, which had been stored at the University of Würzburg since the earlier investigations, were analyzed regarding their contamination with histamine to determine whether the biogenic amine was responsible for the 1990s fatalities as well. Furthermore, a correlation with the lead impurity sisomicin was checked. Histamine could be detected in all analyzed batches, but at a lower level than in the batches responsible for the anaphylactic reactions. Moreover, there is no correlation of histamine with the lead impurity sisomicin. Hence, the causative agent for the 1990s fatalities was not histamine and remains unknown.
Another source of impurities is the reaction of APIs with excipients, e.g. the esterification of naproxen with PEG 600 in soft gel capsules. The influence of the formulation’s composition on this reaction was investigated by means of LC-UV. Therefore, the impurity naproxen-PEG-ester (NPEG) was synthesized and used for the development of a method suitable for the analysis of soft gel capsule formulations. Different formulations were stressed for 7 d at 60 °C and the relative amount of NPEG was determined. The formation of NPEG was influenced by the concentrations of water and lactic acid, the pH, and the drug load of the formulation, which can easily be explained by the chemistry behind esterification reactions.
Keeping in mind the huge variety of sources of impurities, it might be impossible to predict all potential impurities of a drug substance/product. Targeted and untargeted approaches were combined in the impurity profiling of bisoprolol fumarate. Eight versions of an LC-HRMS method were developed to enable the detection of a maximum number of impurities: an acidic and a basic buffered LC was coupled to MS detection applying ESI and APCI, both in positive in negative mode. MS and MS/MS data were acquired simultaneously by information dependent acquisition. In the targeted approach, potential impurities were derived from a reaction matrix based on the synthesis route of the API, while the untargeted part was based on general unknown comparative screening to identify additional signals. 18 and 17 impurities were detected in the targeted and the untargeted approach, respectively. The molecular formulae were assessed based on the exact mass and the isotope pattern. Theoretical fragment spectra generated by in silico fragmentation were matched with experimental data to estimate the plausibility of proposed/elucidated structures. Moreover, the detected impurities were quantified with respect to an internal standard.
Background: Primary cutaneous follicular B-cell lymphoma (PCFBCL) represents an indolent subtype of Non-Hodgkin’s lymphomas, being clinically characterized by slowly growing tumors of the skin and common cutaneous relapses, while only exhibiting a low propensity for systemic dissemination or fatal outcome. Up to now, only few studies have investigated underlying molecular alterations of PCFBCL with respect to somatic mutations. Objectives: Our aim was to gain deeper insight into the pathogenesis of PCFBCL and to delineate discriminatory molecular features of this lymphoma subtype. Methods: We performed hybridization-based panel sequencing of 40 lymphoma-associated genes of 10 cases of well-characterized PCFBCL. In addition, we included two further ambiguous cases of atypical B-cell-rich lymphoid infiltrate/B-cell lymphoma of the skin for which definite subtype attribution had not been possible by routine investigations. Results: In 10 out of 12 analyzed cases, we identified genetic alterations within 15 of the selected 40 target genes. The most frequently detected alterations in PCFBCL affected the TNFRSF14, CREBBP, STAT6 and TP53 genes. Our analysis unrevealed novel mutations of the BCL2 gene in PCFBCL. All patients exhibited an indolent clinical course. Both the included arbitrary cases of atypical B-cell-rich cutaneous infiltrates showed somatic mutations within the FAS gene. As these mutations have previously been designated as subtype-specific recurrent alterations in primary cutaneous marginal zone lymphoma (PCMZL), we finally favored the diagnosis of PCMZL in these two cases based on these molecular findings. Conclusions: To conclude, our molecular data support that PCFBCL shows distinct somatic mutations which may aid to differentiate PCFBCL from pseudo-lymphoma as well as from other indolent and aggressive cutaneous B-cell lymphomas. While the detected genetic alterations of PCFBCL did not turn out to harbor any prognostic value in our cohort, our molecular data may add adjunctive discriminatory features for diagnostic purposes on a molecular level.
Kognitive Beeinträchtigungen sind bei Patient*innen mit chronischer Herzinsuffizienz weit verbreitet. Auswertungen der Beobachtungsstudie „Cognition.Matters-HF“ konnten belegen, dass Patient*innen mit einer Herzschwäche häufig Gedächtnisstörungen und Aufmerksamkeitsdefizite aufweisen. Die Evidenz für einen Zusammenhang zwischen Kognition und Lebensqualität bei Herzinsuffizienz ist jedoch spärlich. Unser Ziel war es zu untersuchen, ob kognitive Einschränkungen Auswirkungen auf die Lebensqualität (HRQL) von Herzinsuffizienzpatient*innen haben. Anhand der Cognition.Matters-HF Kohorte untersuchten wir die HRQL von 148 Patient*innen mit chronischer Herzinsuffizienz und objektivierten kognitiven Beeinträchtigungen, die von keinen bis hin zu schweren Defiziten reichten. Die Lebensqualität der Teilnehmer*innen wurde über die beiden Selbstbeurteilungsfragebögen, Short Form-36 (SF-36) und Kansas City Cardiomyopathy Questionnaire (KCCQ), erfasst. Mit Ausnahme der Selbstwirksamkeitsskala des KCCQ war der Schweregrad der kognitiven Beeinträchtigung nicht mit Einschränkungen in der Lebensqualität bei Patient*innen mit chronischer Herzinsuffizienz verbunden. Der Zusammenhang zwischen Selbstwirksamkeit und Schweregrad der kognitiven Beeinträchtigung blieb auch nach Anpassung für Dauer und Schweregrad der Herzinsuffizienz, Alter und Geschlecht der Teilnehmer signifikant bestehen (p<0,001). Die Selbstwirksamkeitsskala stellt ein vielversprechendes Instrument dar, um Personen zu identifizieren, die nicht in der Lage sind, sich an ein empfohlenes, leitliniengerechtes Behandlungsschema für Herzinsuffizienz zu halten. Diese Patient*innen könnten von einer intensiveren Versorgung, z.B. im Rahmen eines von einer speziell geschulten Herzinsuffizienz-Schwester geleiteten Versorgungsprogramms, deutlich profitieren.
Die Rehabilitation von Gangstörungen bei Patienten mit MS und Schlaganfall erfolgt häufig mithilfe eines konventionellen Laufbandtrainings. Einige Studien haben bereits gezeigt, dass durch eine Erweiterung dieses Trainings um eine virtuelle Realität die Motivation der Patienten gesteigert und die Therapieergebnisse verbessert werden können.
In der vorliegenden Studie wurde eine immersive VR-Anwendung (unter Verwendung eines HMD) für die Gangrehabilitation von Patienten evaluiert. Hierbei wurden ihre Anwendbarkeit und Akzeptanz geprüft sowie ihre Kurzzeiteffekte mit einer semi-immersiven Präsentation (unter Verwendung eines Monitors) und mit einem konventionellen Laufbandtraining ohne VR verglichen. Der Fokus lag insbesondere auf der Untersuchung der Anwendbarkeit beider Systeme und der Auswirkungen auf die Laufgeschwindigkeit und Motivation der Benutzer.
Im Rahmen einer Studie mit Innersubjekt-Design nahmen zunächst 36 gesunde Teilnehmer und anschließend 14 Patienten mit MS oder Schlaganfall an drei experimentellen Bedingungen (VR über HMD, VR über Monitor, Laufbandtraining ohne VR) teil.
Sowohl in der Studie mit gesunden Teilnehmern als auch in der Patientenstudie zeigte sich in der HMD-Bedingung eine höhere Laufgeschwindigkeit als beim Laufbandtraining ohne VR und in der Monitor-Bedingung. Die gesunden Studienteilnehmer berichteten über eine höhere Motivation nach der HMD-Bedingung als nach den anderen Bedingungen. Es traten in beiden Gruppen keine Nebenwirkungen im Sinne einer Simulator Sickness auf und es wurden auch keine Erhöhungen der Herzfrequenzen nach den VR-Bedingungen detektiert. Die Bewertungen des Präsenzerlebens waren in beiden Gruppen in der HMD-Bedingung höher als in der Monitor-Bedingung. Beide VR-Bedingungen erhielten hohe Bewertungen für die Benutzerfreundlichkeit. Die meisten der gesunden Teilnehmer (89 %) und Patienten (71 %) präferierten das HMD-basierte Laufbandtraining unter den drei Trainingsformen und die meisten Patienten könnten sich vorstellen, es häufiger zu nutzen.
Mit der vorliegenden Studie wurde eine strukturierte Evaluation der Anwendbarkeit eines immersiven VR-Systems für die Gangrehabilitation geprüft und dieses erstmals in den direkten Vergleich zu einem semi-immersiven System und einem konventionellen Training ohne VR gesetzt. Die Studie bestätigte die Praktikabilität der Kombination eines Laufbandtrainings mit immersiver VR. Aufgrund ihrer hohen Benutzerfreundlichkeit und der geringen Nebenwirkungen scheint diese Trainingsform besonders für Patienten geeignet zu sein, um deren Trainingsmotivation und Trainingserfolge, wie z. B. die Laufgeschwindigkeit, zu steigern. Da immersive VR-Systeme allerdings nach wie vor spezifische technische Installationsprozeduren erfordern, sollte für die spezifische klinische Anwendung eine Kosten-Nutzen-Bewertung erfolgen.
Medication-related osteonecrosis of the jaw (MRONJ) represents an adverse side effect of antiresorptive and antiangiogenic medications. It is associated with impaired quality of life, oral health, and oral function and can be classified into various stages. The purpose of this prospective clinical study is to evaluate the impact of stages I and II MRONJ on oral-health-related quality of life (OHRQoL) and related parameters. Patients’ OHRQoL, satisfaction with life, oral discomfort, and oral health were assessed using the German version of the Oral Health Impact Profile (OHIP-G49), visual analog scales (VAS), and Satisfaction with Life Scale (SWLS) at baseline (T0), 10 days (T1), and 3 months after treatment (T2) in 36 patients. Data were analyzed using Kolmogorov–Smirnov test, two-way mixed ANOVAs, and follow-up Mann–Whitney U tests. The impact of treatment effects on the original seven OHIP domain structures and the recently introduced four-dimensional OHIP structure were evaluated using linear regression analysis. Thirty-six patients received surgical MRONJ treatment. Before treatment, patients’ perceived OHRQoL, oral discomfort, oral health, and satisfaction with life were negatively affected by MRONJ. Surgical treatment significantly improved OHRQoL and related parameters (all p ≤ 0.012). This improvement was greater in patients with higher impairment at T0. OHRQoL and oral restrictions were still impaired after treatment in patients who needed prosthetic treatment. The four-dimensional structure revealed valuable information beyond the standard seven OHIP domains. Increased awareness of MRONJ risks and an interdisciplinary treatment approach for MRONJ patients are needed.
Mitotane führt zur vermehrten Expression des CHOP-Proteins. Da es ebenfalls gelang weitere Expressionsveränderungen von am ER-Stress-beteiligten Proteinen nachzuweisen, kann von einer ER-Stress-Induktion durch Mitotane ausgegangen werden. Des Weiteren ließ sich zeigen, dass die gesteigerte CHOP-Expression nicht zelltypspezifisch ist, da sie sich ebenfalls in weiteren Zelllinien nachweisen ließ. Hierzu gehörten IMR32-, HeLaz91wt-, HepG2- und HEK293T-Zellen. Zudem kam es durch die Inkubation der NCI H295R-Zellen mit Mitotane zu einer Abnahme der Expression von SREBP 1 sowohl der Vorläuferstufe als auch der aktiven Form. Dies weist auf eine Herunterregulation des Lipidstoffwechsels durch Mitotane hin.
Neben Mitotane gab es mit ATR 101 und AZD 3988 weitere Substanzen, die zu einer Zunahme der CHOP-Expression geführt haben.
Purpose
Definitive fascial closure is an essential treatment objective after open abdomen treatment and mitigates morbidity and mortality. There is a paucity of evidence on factors that promote or prevent definitive fascial closure.
Methods
A multi-center multivariable analysis of data from the Open Abdomen Route of the European Hernia Society included all cases between 1 May 2015 and 31 December 2019. Different treatment elements, i.e. the use of a visceral protective layer, negative-pressure wound therapy and dynamic closure techniques, as well as patient characteristics were included in the multivariable analysis. The study was registered in the International Clinical Trials Registry Platform via the German Registry for Clinical Trials (DRK00021719).
Results
Data were included from 630 patients from eleven surgical departments in six European countries. Indications for OAT were peritonitis (46%), abdominal compartment syndrome (20.5%), burst abdomen (11.3%), abdominal trauma (9%), and other conditions (13.2%). The overall definitive fascial closure rate was 57.5% in the intention-to-treat analysis and 71% in the per-protocol analysis. The multivariable analysis showed a positive correlation of negative-pressure wound therapy (odds ratio: 2.496, p < 0.001) and dynamic closure techniques (odds ratio: 2.687, p < 0.001) with fascial closure and a negative correlation of intra-abdominal contamination (odds ratio: 0.630, p = 0.029) and the number of surgical procedures before OAT (odds ratio: 0.740, p = 0.005) with DFC.
Conclusion
The clinical course and prognosis of open abdomen treatment can significantly be improved by the use of treatment elements such as negative-pressure wound therapy and dynamic closure techniques, which are associated with definitive fascial closure.
The solvatochromic behavior of two donor-π bridge-acceptor (D-π-A) compounds based on the 2-(3-boryl-2-thienyl)thiazole π-linker and indandione acceptor moiety are investigated. DFT/TD-DFT calculations were performed in combination with steady-state absorption and emission measurements, along with electrochemical studies, to elucidate the effect of two different strongly electron-donating hydrazonyl units on the solvatochromic and fluorescence behavior of these compounds. The Lippert–Mataga equation was used to estimate the change in dipole moments (Δµ) between ground and excited states based on the measured spectroscopic properties in solvents of varying polarity with the data being supported by theoretical studies. The two asymmetrical D-π-A molecules feature strong solvatochromic shifts in fluorescence of up to ~4300 cm\(^{−1}\) and a concomitant change of the emission color from yellow to red. These changes were accompanied by an increase in Stokes shift to reach values as large as ~5700–5800 cm\(^{−1}\). Quantum yields of ca. 0.75 could be observed for the N,N-dimethylhydrazonyl derivative in nonpolar solvents, which gradually decreased along with increasing solvent polarity, as opposed to the consistently reduced values obtained for the N,N-diphenylhydrazonyl derivative of up to ca. 0.20 in nonpolar solvents. These two push–pull molecules are contrasted with a structurally similar acceptor-π bridge-acceptor (A-π-A) compound.
Landslide susceptibility assessment in the Chiconquiaco Mountain Range area, Veracruz (Mexico)
(2022)
In Mexico, numerous landslides occur each year and Veracruz represents the state with the third highest number of events. Especially the Chiconquiaco Mountain Range, located in the central part of Veracruz, is highly affected by landslides and no detailed information on the spatial distribution of existing landslides or future occurrences is available. This leaves the local population exposed to an unknown threat and unable to react appropriately to this hazard or to consider the potential landslide occurrence in future planning processes.
Thus, the overall objective of the present study is to provide a comprehensive assessment of the landslide situation in the Chiconquiaco Mountain Range area. Here, the combination of a site-specific and a regional approach enables to investigate the causes, triggers, and process types as well as to model the landslide susceptibility for the entire study area.
For the site-specific approach, the focus lies on characterizing the Capulín landslide, which represents one of the largest mass movements in the area. In this context, the task is to develop a multi-methodological concept, which concentrates on cost-effective, flexible and non-invasive methods. This approach shows that the applied methods complement each other very well and their combination allows for a detailed characterization of the landslide.
The analyses revealed that the Capulín landslide is a complex mass movement type. It comprises rotational movement in the upper parts and translational movement in the lower areas, as well as flow processes at the flank and foot area and therefore, is classified as a compound slide-flow according to Cruden and Varnes (1996). Furthermore, the investigations show that the Capulín landslide represents a reactivation of a former process. This is an important new information, especially with regard to the other landslides identified in the study area. Both the road reconstructed after the landslide, which runs through the landslide mass, and the stream causing erosion processes at the foot of the landslide severely affect the stability of the landslide, making it highly susceptible to future reactivation processes. This is particularly important as the landslide is located only few hundred meters from the village El Capulín and an extension of the landslide area could cause severe damage.
The next step in the landslide assessment consists of integrating the data obtained in the site-specific approach into the regional analysis. Here, the focus lies on transferring the generated data to the entire study area. The developed methodological concept yields applicable results, which is supported by different validation approaches.
The susceptibility modeling as well as the landslide inventory reveal that the highest probability of landslides occurrence is related to the areas with moderate slopes covered by slope deposits. These slope deposits comprise material from old mass movements and erosion processes and are highly susceptible to landslides. The results give new insights into the landslide situation in the Chiconquiaco Mountain Range area, since previously landslide occurrence was related to steep slopes of basalt and andesite.
The susceptibility map is a contribution to a better assessment of the landslide situation in the study area and simultaneously proves that it is crucial to include specific characteristics of the respective area into the modeling process, otherwise it is possible that the local conditions will not be represented correctly.
Die vorliegende Arbeit beschäftigt sich mit der volumenbildgebenden Untersuchung von mechanischen Ermüdungsprozessen in Titan-Zahnimplantaten. Im Vordergrund steht die Entwicklung einer neuen Messmethode der In-situ-Mikrotomografie am Synchrotron.
Zahnimplantate werden beim Gebrauch mechanisch wiederholt belastet (Wechsellast). Nach vielen zyklischen Belastungen können aufgrund von mikroplastische Verformungen Ermüdungsschäden auftreten. Diese können im Extremfall zum Versagen und Verlust eines Implantats führen. Die Computertomographie ist eine sehr geeignete zerstörungsfrei Prüfmethode, um Zahnimplantate zu untersuchen. Diese Arbeit erweitert die bisherige CT-Methode insofern, dass In-situ-Beobachtungen bei mechanischer Belastung möglich sind.
Die in dieser Arbeit untersuchten Zahnimplantate weisen an der Implantat-Abutment-Grenzfläche bei eintretender Ermüdung einen Mikrospalt auf. Dieser wird als Indikator für einsetzende Fatigue- Prozesse benutzt. Der in der Synchrotron CT verfügbare Inlinephasenkontrast ermöglicht eine verbesserte Bestimmung der Mikrospaltgröße. Da die schnellen Bewegungen der Ermüdungsprüfung mittels Standard-CT-Verfahren schwer zu erfassen sind, war die stroboskopische Aufnahmemethode das zielführende Messverfahren, um in-situ-Prüfung zu ermöglichen.
Die 4 kommerziellen Zahnimplantattypen werden neben der In-situ-Fatigue Prüfung auch mittels klassischer Ermüdungsprüfung untersucht und mit der Neuen Messmethode verglichen. Die hier entwickelte In-situ-Fatigue-Prüfstation kann Proben bis zu 345 N tomographisch untersuchen. Neben den experimentellen Untersuchungen wird eine statische FEM-Betrachtung durchgeführt und mit experimentellen Messdaten verglichen. Zuletzt wird mit der entwickelten Messtation Knochenrisse in der Implantat Umgebung untersucht.
Lack of acid sphingomyelinase (ASM) activity, either through genetic deficiency or through pharmacological inhibition, is linked with increased activity and frequency of Foxp3+ regulatory T cells (Treg) among cluster of differentiation (CD) 4+ T cells in mice in vivo and in vitro1. Thus, pharmacological blockade of ASM activity, which catalyzes the cleavage of sphingomyelin to ceramide and phosphocholine, might be used as a new therapeutic mechanism to correct numeric and/ or functional Treg de-ficiencies in diseases like multiple sclerosis or major depression.
In the present study, the effect of pharmacological inhibition of ASM in humans, in vitro and in vivo, was analyzed. In the in vitro experiments, peripheral blood mono-nuclear cells (PBMC) of healthy human blood donors were treated with two widely prescribed antidepressants with high (sertraline, Ser) or low (citalopram, Cit) capaci-ty to inhibit ASM activity. Similar to the findings in mice an increase in the frequency of Treg among human CD4+ T cells upon inhibition of ASM activity was observed. For the analysis in vivo, a prospective study of the composition of the CD4+ T cell com-partment of patients treated for major depression was done. The data show that pharmacological inhibition of ASM activity was superior to antidepressants with little or no ASM-inhibitory activity in increasing CD45RA- CD25high effector Treg (efTreg) frequencies among CD4+ T cells to normal levels. Independently of ASM inhibition, correlating the data with the clinical response, i.e. improvement of the Hamilton rat-ing scale for depression (HAMD) by at least 50 per cent (%) after four weeks of treatment, it was found that an increase in efTreg frequencies among CD4+ cells dur-ing the first week of treatment identified patients with a clinical response.
Regarding the underlying mechanism, it could be found that the positive effect of ASM inhibition on Treg required CD28 co-stimulation suggesting that enhanced CD28 co-stimulation was the driver of the observed increase in the frequency of Treg among human CD4+ T cells. Inhibition of ASM activity was further associated with changes in the expression and shuttling of CTLA-4, a key inhibitory molecule ex-pressed by Treg, between cellular compartments but the suppressive activity of CTLA-4 through its transendocytosis activity was unaffected by the inhibition of ASM activity.
In summary, the frequency of (effector) Treg among CD4+ T cells in mice and in hu-mans is increased after inhibition of ASM activity suggesting that ASM blockade might beneficially modulate autoimmune diseases and depression-promoting in-flammation.
With the increasing adaptability and complexity of advisory artificial intelligence (AI)-based agents, the topics of explainable AI and human-centered AI are moving close together. Variations in the explanation itself have been widely studied, with some contradictory results. These could be due to users’ individual differences, which have rarely been systematically studied regarding their inhibiting or enabling effect on the fulfillment of explanation objectives (such as trust, understanding, or workload). This paper aims to shed light on the significance of human dimensions (gender, age, trust disposition, need for cognition, affinity for technology, self-efficacy, attitudes, and mind attribution) as well as their interplay with different explanation modes (no, simple, or complex explanation). Participants played the game Deal or No Deal while interacting with an AI-based agent. The agent gave advice to the participants on whether they should accept or reject the deals offered to them. As expected, giving an explanation had a positive influence on the explanation objectives. However, the users’ individual characteristics particularly reinforced the fulfillment of the objectives. The strongest predictor of objective fulfillment was the degree of attribution of human characteristics. The more human characteristics were attributed, the more trust was placed in the agent, advice was more likely to be accepted and understood, and important needs were satisfied during the interaction. Thus, the current work contributes to a better understanding of the design of explanations of an AI-based agent system that takes into account individual characteristics and meets the demand for both explainable and human-centered agent systems.
Background and purpose
Pediatric adrenocortical carcinoma (pACC) is a rare disease with poor prognosis. Publications on radiotherapy (RT) are scarce. This review summarizes the current data on RT for pACC and possibly provides first evidence to justify its use in this setting.
Materials and methods
We searched the PubMed and Embase database for manuscripts regarding RT for pACC.
Results
We included 17 manuscripts reporting on 76 patients treated with RT, after screening 2961 references and 269 full articles. In addition, we added data of 4 unreported pACC patients treated by co-authors. All reports based on retrospective data. Median age at first diagnosis was 11.1 years (70% female); 78% of patients presented with hormonal activity. RT was mostly performed for curative intent (78%). 88% of RT were administered during primary therapy. The site of RT was predominantly the local tumor bed (76%). Doses of RT ranged from 15 to 62 Gy (median 50 Gy). Information on target volumes or fractionation were lacking. Median follow-up was 6,9 years and 64% of the patients died of disease, with 33% alive without disease. In 16 of 48 patients with available follow-up data after adjuvant RT (33%) no recurrence was reported and in 3 of 9 patients palliative RT seemed to induce some benefit for the patient.
Conclusions
Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.
Hintergrund. Training an Simulatoren ist eine effektive Methode zum Erlernen laparoskopischer Fertigkeiten. Dennoch besteht weiterhin die Notwendigkeit, Lehrmethoden zu optimieren, um praktischen Übungsaufwand zu reduzieren. In dieser Studie wurde die Auswirkung der mentalen Übung "deconstruction into key steps" (DIKS) auf die für den Erwerb laparoskopischer Fertigkeiten benötigte Zeit untersucht.
Methoden. Medizinstudierende des 10. Fachsemesters nahmen an einem Laparoskopiekurs teil und wurden in zwei Gruppen randomisiert. Dabei wurde in der Experimentalgruppe (EG) eine Verkürzung der praktischen Übungszeit um 58% im Vergleich zur KG zu Gunsten des mentalen Trainings DIKS untersucht. Die laparoskopischen Eingangsfertigkeiten wurden an Simulatoren getestet (t0). Anschließend wurde der Lernerfolg in einer zweiten Prüfung kontrolliert (t1). Nach neun Tagen erfolgte eine dritte Prüfung (t2). Alle Messzeitpunkte wurden per Videomittschnitt nach validierten Kriterien bewertet. Potenzielle Prädiktoren wurden mit Hilfe eines Fragebogens standardisiert erhoben.
Ergebnisse. Sowohl die EG (n=58) als auch die KG (n=58) wiesen einen signifikanten Lernzuwachs auf (p<0,001). Es zeichnete sich jedoch ein signifikanter Unterschied im Lernzuwachs in bestimmten Zeitabschnitten ab. Die KG zeigte einen signifikant höheren Lernzuwachs von t0-t1. Nach einer Woche wurde der Vorsprung der KG bei einem signifikant besseren Lernzuwachs der EG im zweiten Abschnitt egalisiert. Motivierte sowie geschickte Studierende zeigten eine signifikant bessere Leistung in Qualität und Quantität. Männern war es möglich eine signifikant bessere Leistung in Qualität und Quantität zu erzielen.
Schlussfolgerung. Während initial ein verlängertes praktisches Üben zu einer unmittelbaren Leistungssteigerung führte, wurde durch die zusätzliche mentale Übung ’DIKS‘ bei gleichzeitig verkürzter praktischer Übungszeit ein gleichwertiges Ergebnis erreicht.
Robotic-assisted colon surgery may contain advantages over the laparoscopic approach, but clear evidence is sparse. This study aimed to analyze postoperative inflammation status, short-term outcome and cost-effectiveness of robotic-assisted versus laparoscopic left hemicolectomy. All consecutive patients who received minimal-invasive left hemicolectomy at the Department of Surgery I at the University Hospital of Wuerzburg in 2021 were prospectively included. Importantly, no patient selection for either procedure was carried out. The robotic-assisted versus laparoscopic approaches were compared head to head for postoperative short-term outcomes as well as cost-effectiveness. A total of 61 patients were included, with 26 patients having received a robotic-assisted approach. Baseline characteristics did not differ among the groups. Patients receiving a robotic-assisted approach had a significantly decreased length of hospital stay as well as lower rates of complications in comparison to patients who received laparoscopic surgery (n = 35). In addition, C-reactive protein as a marker of systemic stress response was significantly reduced postoperatively in patients who were operated on in a robotic-assisted manner. Consequently, robotic-assisted surgery could be performed in a cost-effective manner. Thus, robotic-assisted left hemicolectomy represents a safe and cost-effective procedure and might improve patient outcomes in comparison to laparoscopic surgery.
The COVID-19 pandemic has resulted in large numbers of patients requiring critical care management. With the established association between severe respiratory virus infection and invasive pulmonary aspergillosis (7.6% for COVID-19-associated pulmonary aspergillosis (CAPA)), the pandemic places a significant number of patients at potential risk from secondary invasive fungal disease. We described a case of CAPA with substantial supporting mycological evidence, highlighting the need to employ strategic diagnostic algorithms and weighted definitions to improve the accuracy in diagnosing CAPA.
Ziel der Arbeit war die Bestimmung der Haftfestigkeit und des Debondingverhaltens verschiedener Bracket- und Adhäsivsysteme unter Berücksichtigung eines neu entwickelten Basisdesigns. Hierbei wurden zwei unterschiedliche Testmethoden sowie differierende Untergrundmaterialien verwendet.
Zur Prüfung des Verbundes zwischen Bracket, Adhäsiv und Untergrund wurden gemäß der DIN 13990-2 die Brackets Bio Quick (Forestadent), Micro Sprint (Forestadent), Micro Sprint mit neu entwickelter Stotzenbasis (Forestadent), Equilibrium mini (Dentaurum) und In-Ovation mini (Dentsply) im Abscher- und Abzugversuch getestet. Sie wurden mit den Adhäsiven Transbond XT, Kurasper F und GC Ortho Connect auf bovine Zähne sowie auf PMMA-Ringe geklebt und anschließend hinsichtlich ihrer Haftfestigkeit untersucht. Vergleiche konnten außerdem zwischen den Testmethoden der Abscher- und Abzugtests wie auch der Untergrundmaterialien Zahn und Ring angestellt werden. Die Menge des Restadhäsivs auf der Bracketbasis wurde anschließend mikroskopisch bestimmt und anhand des Adhesive Remnant Index (ARI) dargestellt.
Im Vergleich der Abscher- und Abzugprüfungen sowie der Untergründe Zahn und Ring konnten beim Abscheren der Brackets und der Anbringung auf Zähnen signifikant höhere Haftwerte erzielt werden. Unabhängig der Brackets ist auf den Zähnen kein signifikanter Unterschied zwischen den Adhäsiven zu erkennen, auf den Ringen hingegen erreicht GC Ortho Connect signifikant geringere Haftfestigkeiten. Die höchsten Haftfestigkeitswerte (in MPa) erreichten beim Abscheren vom Zahn und bei beiden Debondingmethoden vom Ring das Equilibrium mini in Kombination mit den Adhäsiven Kurasper auf dem Ring (Abscher 23,4 MPa/Abzug 8,1 MPa) und GC Ortho Connect auf dem Zahn (23,55 MPa). Beim Abzug vom Zahn erreichte das Micro Sprint mit Stotzenbasis in Kombination mit Transbond XT die höchste Haftfestigkeit (8,02 MPa). In der Untersuchung des ARI verblieb größtenteils mehr als 50% Restadhäsiv auf der Bracketbasis.
Background
Student performance is a mirror of teaching quality. The pre-/post-test design allows a pragmatic approach to comparing the effects of interventions. However, the calculation of current knowledge gain scores introduces varying degrees of distortion. Here we present a new metric employing a linear weighting coefficient to reduce skewness on outcome interpretation.
Methods
We compared and contrasted a number of common scores (raw and relative gain scores) with our new method on two datasets, one simulated and the other empirical from a previous intervention study (n = 180) employing a pre-/post-test design.
Results
The outcomes of the common scores were clearly different, demonstrating a significant dependency on pre-test scores. Only the new metric revealed a linear relationship to the knowledge baseline, was less skewed on the upper or lower extremes, and proved well suited to allow the calculation of negative learning gains. Employing the empirical dataset, the new method also confirmed the interaction effect of teaching formats with specific subgroups of learner characteristics.
Conclusion
This work introduces a new weighted metric enabling meaningful comparisons between interventions based on a linear transformation. This method will form the basis to intertwine the calculation of test performance closely with the outcome of learning as an important factor reflecting teaching quality and efficacy. Its regular use can improve the transparency of teaching activities and outcomes, contribute to forming rounded judgements of students' acquisition of knowledge and skills and enable valuable feedforward to develop and enhance curricular concepts.
Arteriosklerose ist eine chronisch inflammatorische Erkrankung der Gefäßwand. Nach aktuellem Wissensstand sind Dendritische Zellen (DCs) maßgeblich an der Entstehung und dem Fortschreiten von Arteriosklerose beteiligt. In der Vergangenheit konnten für DCs unterschiedliche Subsets beschreiben werden, die sowohl proinflammatorische als auch immunregulatorische Funktionen übernehmen können. Die systematische Charakterisierung von DCs in der gesunden Aorta, sowie während der Entstehung von Arteriosklerose ist jedoch noch ausstehend.
In der vorliegenden Arbeit wurde zunächst die systematische Einteilung von DCs in vitro mit Hilfe von DCs aus Flt3L-Knochenmarkskulturen durchgeführt. Aufbauend darauf erfolgte die systematische Analyse aortaler DCs durch tierexperimentelle Untersuchungen an gesunden C57BL/6J Mäusen, sowie Apolipoprotein E-defizienten (ApoE-/-) Mäusen und low-density-lipoprotein-receptor-defizienten (Ldlr-/-) Mäusen während der Atherogenese. Mittels immunhistochemischer Untersuchungen von CD11cYFPreporter Mäusen konnten zudem korrelierend DCs in der Gefäßwand der murinen Aorta lokalisiert werden.
Zusammenfassend gibt die vorliegende Arbeit erstmalig einen systematischen Überblick über die einzelnen DC-Subsets in der gesunden Aorta und während der Atherogenese. Dies trägt zu einem besseren Verständnis der Rolle der einzelnen DC Subsets während der Entstehung der Arteriosklerose bei und bietet eine mögliche Grundlage für zukünftige Behandlungsstrategien.
Die Ergebnisse dieser Arbeit wurden im Februar 2014 als Originalarbeit in geteilter Erstautorenschaft von Martin Busch, Thilo Westhofen und Miriam Koch unter dem Titel Dendritic Cell Subset Distributions in the Aorta in Healthy and Atherosclerotic Mice im Plos One publiziert (1). Die Originalpublikation findet sich im Folgenden unter Absatz 11. Die Ergebnisse dieser Publikation wurden modifiziert unter 6.1-6.5 dargelegt und unter 7.1-7.5 im Kontext der aktuellen Literatur diskutiert. Sofern nicht anders angegeben, wurden alle Experimente von Thilo Westhofen geplant, durchgeführt und ausgewertet.
Numerous experiments have shown that an evaluative and passive process, known as validation, accompanies activation and integration, which are fundamental processes of text comprehension. During the construction of a mental model, validation implicitly assesses the plausibility of incoming information by checking its consistency with world knowledge, prior beliefs, and contextual information (e.g., the broader discourse context). However, research on potential influences that shape validation processes has just started. One branch of research is investigating how world knowledge and contextual information contribute to integration and validation. World knowledge usually influences validation more strongly because information plausibility is the primary criterion for validation, but strong contextual information can yield influences as well.
Contextual information that may be specifically relevant for routine validation is the credibility of a source providing text information. Source credibility bears a strong conceptual relationship to the validity of information. However, a dearth of research has investigated joint effects of plausibility and source credibility for routine validation. To fill this research gap, the aim of the present dissertation was to examine the role of source credibility in routine validation processes of text information. This dissertation argues that both source credibility and plausibility are considered in these processes. In particular, information plausibility is proposed as the primary criterion, but source credibility may modulate validation as an additional criterion. To this end, three studies with five self-paced reading experiments were conducted in which reading times served as an implicit indicator of validation and plausibility judgments as an explicit indicator, and the convergence or divergence between the two indicators was interpreted.
The first study examined the interplay of plausibility and source credibility for the validation of world-knowledge consistent versus inconsistent text information embedded in short narratives. This highly plausible or highly implausible information was provided by a high- or low-expertise source. In Study 1, plausibility dominated validation as suggested by faster reading times and higher plausibility judgments for world-knowledge consistent information. Importantly, source credibility modulated the validation of highly implausible information but seemed to not matter for plausible information. High-credible sources increased the implausibility of highly implausible information to a greater extent compared with low-credible sources as indicated by longer reading times and lower plausibility judgments. These results diverged from recent findings from Foy et al. (2017).
The second study investigated whether the modulating role of source credibility depends on the degree of implausibility of an information. Thus, Study 2 extended Study 1 by an intermediate, somewhat implausible level of plausibility (comparable to the implausible claims in Foy et al., 2017). Similar to Study 1, plausibility dominated validation as indicated by lower reading times and plausibility judgments with higher world-knowledge inconsistency. Again, source credibility had no effect on the routine validation of plausible information. However, high-credible sources mitigated the implausibility of somewhat implausible information as indicated by faster reading times and higher plausibility judgments but exacerbated the implausibility of highly implausible information as indicated by slower reading times and lower plausibility judgments.
In short, Study 2 findings not only integrates the seemingly divergent results of Study 1 and Foy et al. (2017) but also provides strong support for the assumption that the degree of implausibility determines the modulating role of source credibility for validation.
The third study examined the relationship of source credibility and plausibility in an ecologically valid social media setting with short Twitter messages varying in world-knowledge and text-belief consistency by trustworthy and untrustworthy sources. In sum, plausibility and to a lesser extent source credibility mattered for routine validation and explicit evaluation of text information as indicated by reading times and plausibility judgments. However, the pattern partly diverged from Study 1 and 2, possibly because the source information was more salient.
In sum, the present dissertation yielded three insights. First, the findings further extends evidence for routine validation based on world-knowledge and prior beliefs. Second, the studies suggest that source credibility can modulate validation. Readers used source credibility cues for routine validation and the explicit evaluation of text information in all studies. Third, the impact of source credibility seems to depend on the degree of implausibility of information.
The present findings have theoretical implications for theories of validation and text comprehension as well as practical implications for targeting threats associated with the prevalence of inaccurate information, for example, on the World Wide Web. Future research using eye-tracking methodology could further disentangle the routine and strategic underlying processes of the relationship between source credibility and plausibility.
Deep convolutional generative adversarial networks (GAN) allow for creating images from existing databases. We applied a modified light-weight GAN (FastGAN) algorithm to cerebral blood flow SPECTs and aimed to evaluate whether this technology can generate created images close to real patients. Investigating three anatomical levels (cerebellum, CER; basal ganglia, BG; cortex, COR), 551 normal (248 CER, 174 BG, 129 COR) and 387 pathological brain SPECTs using N-isopropyl p-I-123-iodoamphetamine (123I-IMP) were included. For the latter scans, cerebral ischemic disease comprised 291 uni- (66 CER, 116 BG, 109 COR) and 96 bilateral defect patterns (44 BG, 52 COR). Our model was trained using a three-compartment anatomical input (dataset ‘A’; including CER, BG, and COR), while for dataset ‘B’, only one anatomical region (COR) was included. Quantitative analyses provided mean counts (MC) and left/right (LR) hemisphere ratios, which were then compared to quantification from real images. For MC, ‘B’ was significantly different for normal and bilateral defect patterns (P < 0.0001, respectively), but not for unilateral ischemia (P = 0.77). Comparable results were recorded for LR, as normal and ischemia scans were significantly different relative to images acquired from real patients (P ≤ 0.01, respectively). Images provided by ‘A’, however, revealed comparable quantitative results when compared to real images, including normal (P = 0.8) and pathological scans (unilateral, P = 0.99; bilateral, P = 0.68) for MC. For LR, only uni- (P = 0.03), but not normal or bilateral defect scans (P ≥ 0.08) reached significance relative to images of real patients. With a minimum of only three anatomical compartments serving as stimuli, created cerebral SPECTs are indistinguishable to images from real patients. The applied FastGAN algorithm may allow to provide sufficient scan numbers in various clinical scenarios, e.g., for “data-hungry” deep learning technologies or in the context of orphan diseases.
This paper presents a novel approach to Thrust Vector Control (TVC) for small Unmanned Aerial Vehicles (UAVs). The difficulties associated with conventional feed-forward TVC are outlined, and a practical solution to conquer these challenges is derived. The solution relies on observing boom deformations that are created by different thrust vector directions and high-velocity air inflow. The paper describes the required measurement electronics as well as the implementation of a dedicated testbed that allows the evaluation of mid-flight force measurements. Wind-tunnel tests show that the presented method for active thrust vector determination is able to quantify the disturbances due to the incoming air flow.
Backround: In February 2021, the first formal evidence and consensus-based (S3) guidelines for the inpatient treatment of patients with COVID-19 were published in Germany and have been updated twice during 2021. The aim of the present study is to re-evaluate the dissemination pathways and strategies for ICU staff (first evaluation in December 2020 when previous versions of consensus-based guidelines (S2k) were published) and question selected aspects of guideline adherence of standard care for patients with COVID-19 in the ICU. Methods: We conducted an anonymous online survey among German intensive care staff from 11 October 2021 to 11 November 2021. We distributed the survey via e-mail in intensive care facilities and requested redirection to additional intensive care staff (snowball sampling). Results: There was a difference between the professional groups in the number, selection and qualitative assessment of information sources about COVID-19. Standard operating procedures were most frequently used by all occupational groups and received a high quality rating. Physicians preferred sources for active information search (e.g., medical journals), while nurses predominantly used passive consumable sources (e.g., every-day media). Despite differences in usage behaviour, the sources were rated similarly in terms of the quality of the information on COVID-19. The trusted organizations have not changed over time. The use of guidelines was frequently stated and highly recommended. The majority of the participants reported guideline-compliant treatment. Nevertheless, there were certain variations in the use of medication as well as the criteria chosen for discontinuing non-invasive ventilation (NIV) compared to guideline recommendations. Conclusions: An adequate external source of information for nursing staff is lacking, the usual sources of physicians are only appropriate for the minority of nursing staff. The self-reported use of guidelines is high.
Background
The GMP-compliant production of radiopharmaceuticals has been performed using disposable units (cassettes) with a dedicated synthesis module. To expand this “plug ‘n’ synthesize” principle to a broader scope of modules we developed a pressure controlled setup that offers an alternative to the usual stepper motor controlled rotary valves. The new concept was successfully applied to the synthesis of N-methyl-[\(^{11}\)C]choline, L-S-methyl-[\(^{11}\)C]methionine and [11C]acetate.
Results
The target gas purification of cyclotron produced [\(^{11}\)C]CO\(_2\) and subsequent conversion to [\(^{11}\)C]MeI was carried out on a TRACERlab Fx C Pro module. The labelling reactions were controlled with a TRACERlab Fx FE module. With the presented modular principle we were able to produce N-methyl-[\(^{11}\)C]choline and L-S-methyl-[\(^{11}\)C]methionine by loading a reaction loop with neat N,N'-dimethylaminoethanol (DMAE) or an ethanol/water mixture of NaOH and L-homocysteine (L-HC), respectively and a subsequent reaction with [\(^{11}\)C]MeI. After 18 min N-methyl-[\(^{11}\)C]choline was isolated with 52% decay corrected yield and a radiochemical purity of > 99%. For L-S-methyl-[\(^{11}\)C]methionine the total reaction time was 19 min reaction, yielding 25% of pure product (> 97%). The reactor design was used as an exemplary model for the technically challenging [\(^{11}\)C]acetate synthesis. The disposable unit was filled with 1 mL MeMgCl (0.75 M) in tetrahydrofuran (THF) bevore [\(^{11}\)C]CO\(_2\) was passed through. After complete release of [\(^{11}\)C]CO\(_2\) the reaction mixture was quenched with water and guided through a series of ion exchangers (H\(^+\), Ag\(^+\) and OH\(^−\)). The product was retained on a strong anion exchanger, washed with water and finally extracted with saline. The product mixture was acidified and degassed to separate excess [\(^{11}\)C]CO\(_2\) before dispensing. Under these conditions the total reaction time was 18 ± 2 min and pure [\(^{11}\)C]acetate (n = 10) was isolated with a decay corrected yield of 51 ± 5%.
Conclusion
Herein, we described a novel single use unit for the synthesis of carbon-11 labelled tracers for preclinical and clinical applications of N-methyl-[\(^{11}\)C]choline, L-S-methyl-[\(^{11}\)C]methionine and [11C]acetate.
Background: Eosinophils appear to contribute to the efficacy of immunotherapy and their frequency was suggested as a predictive biomarker. Whether this observation could be transferred to patients treated with targeted therapy remains unknown. Methods: Blood and serum samples of healthy controls and 216 patients with advanced melanoma were prospectively and retrospectively collected. Freshly isolated eosinophils were phenotypically characterized by flow cytometry and co-cultured in vitro with melanoma cells to assess cytotoxicity. Soluble serum markers and peripheral blood counts were used for correlative studies. Results: Eosinophil-mediated cytotoxicity towards melanoma cells, as well as phenotypic characteristics, were similar when comparing healthy donors and patients. However, high relative pre-treatment eosinophil counts were significantly associated with response to MAPKi (p = 0.013). Eosinophil-mediated cytotoxicity towards melanoma cells is dose-dependent and requires proximity of eosinophils and their target in vitro. Treatment with targeted therapy in the presence of eosinophils results in an additive tumoricidal effect. Additionally, melanoma cells affected eosinophil phenotype upon co-culture. Conclusion: High pre-treatment eosinophil counts in advanced melanoma patients were associated with a significantly improved response to MAPKi. Functionally, eosinophils show potent cytotoxicity towards melanoma cells, which can be reinforced by MAPKi. Further studies are needed to unravel the molecular mechanisms of our observations.
The extragalactic gamma-ray sky is dominated by blazars, active galactic nuclei (AGN) with a relativistic jet that is closely aligned with the line of sight. Galaxies develop an active nucleus if the central supermassive black hole (BH) accretes large amounts of ambient matter and magnetic flux. The inflowing mass accumulates around the plane perpendicular to the accretion flow's angular momentum. The flow is heated through viscous friction and part of the released energy is radiated as blackbody or non-thermal radiation, with luminosities that can dominate the accumulated stellar luminosity of the host galaxy. A fraction of the accretion flow luminosity is reprocessed in a surrounding field of ionised gas clouds. These clouds, revolving around the central BH, emit Doppler-broadened atomic emission lines. The region where these broad-line-emitting clouds are located is called broad-line region (BLR).
About one in ten AGN forms an outflow of radiation and relativistic particles, called a relativistic jet. According to the Blandford-Znajek mechanism, this is facilitated through electromagnetic processes in the magnetosphere of a spinning BH. The latter induces a magnetospheric poloidal current circuit, generating a decelerating torque on the BH and inducing a toroidal magnetic field. Consequently, rotational energy of the BH is converted to Poynting flux streaming away mainly along the rotational axis and starting the jet. One possibility for particle acceleration near the jet base is realised by magnetospheric vacuum gaps, regions temporarily devoid of plasma, such that an intermittent electric field arises parallel to the magnetic field lines, enabling particle acceleration and contributing to the mass loading of the jets.
Magnetised structures, containing bunches of relativistic electrons, propagate away from the galactic nucleus along the jets. Assuming that these electrons emit synchrotron radiation and that they inverse-Compton (IC) up-scatter abundant target photons, which can either be the synchrotron photons themselves or photons from external emitters, the emitted spectrum can be theoretically determined. Additionally taking into account that these emission regions move relativistically themselves and that the emission is Doppler-boosted and beamed in forward direction, the typical two-hump spectral energy distribution (SED) of blazars is recovered.
There are however findings that challenge this well-established model. Short-time variability, reaching down to minute scales at very high energy gamma rays, is today known to be a widespread phenomenon of blazars, calling for very compact emission regions. In most models of such optically thick emission regions, the gamma-ray flux is usually pair-absorbed exponentially, without considering the cascade evolving from the pair-produced electrons. From the observed flux, it is often concluded that emission emanates from larger distances where the region is optically thin, especially from outside of the BLR. Only in few blazars gamma-ray attenuation associated with pair absorption in the BLR was clearly reported.
With the advent of sophisticated high-energy or very high energy gamma-ray detectors, like the Fermi Large Area Telescope or the Major Atmospheric Gamma-ray Imaging Cherenkov telescopes, besides the extraordinarily fast variability spectral features have been found that cannot be explained by conventional models reproducing the two-hump SED. Two such narrow spectral features are discussed in this work. For the nearby blazar Markarian 501, hints to a sharp peak around 3 TeV have been reported from a multi-wavelength campaign carried out in July 2014, while for 3C 279 a spectral dip was found in 2018 data, that can hardly be described with conventional fitting functions. In this work it is examined whether these spectral peculiarities of blazar jet emission can be explained, if the full radiation reprocessing through an IC pair cascade is accounted for.
Such a cascade is the multiple concatenation of IC scattering events and pair production events. In the cascades generally considered in this work, relativistic electrons and high-energy photons are injected into a fixed soft target photon field. A mathematical description for linear IC pair cascades with escape terms is delivered on the basis of preliminary works. The steady-state kinetic equations for the electrons and for the photons are determined, whereby it is paid attention to an explicit formulation and to motivating the correct integration borders of all integrals from kinematic constraints. In determining the potentially observable gamma-ray flux, both the attenuated injected flux and the flux evolving as an effect of IC up-scattering, pair absorption and escape are incorporated, giving the emerging spectra very distinct imprints.
Much effort is dedicated to the numerical solution of the electrons' kinetic equation via iterative schemes. It is explained why pointwise iteration from higher to lower Lorentz factors is more efficient than iterating the whole set of sampling points. The algorithm is parallelised at two positions. First, several workers can perform pointwise iterations simultaneously. Second, the most demanding integral is cut into a number of part integrals which can be determined by multiple workers. Through these measures, the Python code can be readily applied to simulate steady-state IC pair cascades with escape.
In the case of Markarian 501 the developed framework is as follows. The AGN hosts an advection-dominated accretion flow with a normalised accretion rate of several \(10^{-4}\) and an electron temperature near \(10^{10}\) K. On the one hand, the accretion flow illuminates the few ambient gas clouds with approximate radius \(10^{11}\) m, which reprocess a fraction 0.01 of the luminosity into hydrogen and helium emission lines. On the other hand, the gamma rays from the accretion flow create electrons and positrons in a sporadically active vacuum gap in the BH magnetosphere. In the active gap, a power of roughly 0.001 of the Blandford-Znajek power is extracted from the rotating BH through a gap potential drop of several \(10^{18}\) V, generating ultra-relativistic electrons, which subsequently are multiplied by a factor of about \(10^6\) through interaction with the accretion flow photons. This electron beam propagates away from the central engine and encounters the photon field of one passing ionised cloud. The resulting IC pair cascade is simulated and the evolving gamma-ray spectrum is determined. Just above the absorption troughs due to the hydrogen lines, the spectrum exhibits a narrow bump around 3 TeV. When the cascaded emission is added to the emission generated at larger distances, the observed multi-wavelength SED including the sharp peak at 3 TeV is reproduced, underlining that radiation processes beyond conventional models are motivated by distinct spectral features.
The dip in the spectrum of 3C 279 is addressed by a similar cascade model. Three types of injection are considered, varying in the ratio of the photon density to the electron density and varying in the spectral shape. The IC pair cascade is assumed to happen either in the dense BLR photon field with a luminosity of several \(10^{37}\) W and a radial size of few \(10^{14}\) m or in the diluted photon field outside of the BLR. The latter scenario is however rejected as the spectral slope around several 100 MeV and the dip at few 10 GeV cannot be reconciled within this model. The radiation cascaded in the BLR can explain the observational data, irrespective of the assumed injected rate. It is therefore concluded that for this period of gamma-ray emission, the radiation production happens at the edge of the BLR of 3C 279.
Both investigations show that IC pair cascades can account for fine structure seen in blazar SEDs. It is insufficient to restrict the radiation transport to pure exponential absorption of an injection term. Pair production and IC up-scattering by all generations of photons and electrons in the optically thick regime critically shape the emerging spectra. As the advent of future improved detectors will provide more high-precision spectra, further observations of narrow spectral features can be expected. It seems therefore recommendable to incorporate cascading into conventional radiation production models or to extend the model developed in this work by synchrotron radiation.
Im Rahmen eines selbst-konsistenten Outer-Gap-Modells der Pulsar-Magnetosphäre wurde die elektromagnetische sehr hochenergetische Strahlung des Crab-Pulsars simuliert. Dies wurde parallel anhand zweier verschiedener Fälle getan, die sich in den angenommenen Gleichungen für die elektrische Feldstärke und für den Krümmungsradius der magnetischen Feldlinien unterscheiden. Die Kinetik der geladenen Teilchen bei ihrer Propagation durch die Outer Gap wurde unter Einbeziehung von Krümmungsstrahlung, inverser Compton-Streuung und Triple Paarbildung betrachtet. Das theoretisch simulierte Spektrum wird mit von Fermi-LAT und von den MAGIC Teleskopen gemessenen Daten verglichen.
Methionine is the first amino acid of every newly synthesised protein. In combination with its role as precursor for the vital methyl-group donor S-adenosylmethionine, methionine is essential for every living cell. The opportunistic human pathogen Staphylococcus aureus is capable of synthesising methionine de novo, when it becomes scarce in the environment. All genes required for the de novo biosynthesis are encoded by the metICFE-mdh operon, except for metX. Expression is controlled by a hierarchical network with a methionyl-tRNA-specific T-box riboswitch (MET-TBRS) as centrepiece, that is also referred to as met leader (RNA). T-box riboswitches (TBRS) are regulatory RNA elements located in the 5’-untranslated region (5’-UTR) of genes. The effector molecule of T-box riboswitches is uncharged cognate tRNA. The prevailing mechanism of action is premature termination of transcription of the nascent RNA in the absence of the effector (i.e. uncharged cognate tRNA) due to formation of a hairpin structure, the Terminator stem. In presence of the effector, a transient stabilisation of the alternative structure, the Antiterminator, enables transcription of the downstream genes (‘read-through’). Albeit, after the read-through the thermodynamically more stable Terminator eventually forms. The Terminator and the Antiterminator are two mutually exclusive structures. Previous work of the research group showed that in staphylococci the MET-TBRS ensures strictly methionine-dependent control of met operon expression. Uncharged methionyl-tRNA that activates the system is only present in sufficient amounts under methionine-deprived conditions. In contrast to other bacterial TBRS, the staphylococcal MET-TBRS has some characteristic features regarding its length and predicted secondary structure whose relevance for the function are yet unkown.
Aim of the present thesis was to experimentally determine the structure of the met leader RNA and to investigate the stability of the met operon-specific transcripts in the context of methionine biosynthesis control. Furthermore, the yet unknown function of the mdh gene within the met operon was to be determined.
In the context of this thesis, the secondary structure of the met leader was determined employing in-line probing. The structural analysis revealed the presence of almost all highly conserved T-box riboswitch structural characteristics. Furthermore, three additional stems, absent in all T-box riboswitches analysed to date, could be identified. Particularly remarkable is the above average length of the Terminator stem which renders it a potential target of the double-strand-specific endoribonuclease III (RNase III). The RNase III-dependent cleavage of the met leader could be experimentally verified by the use of suitable mutants. Moreover, the exact cleavage site within the Terminator was determined.
The unusual immediate separation of the met leader from the met operon mRNA via the RNase III cleavage within the Terminator stem induces the rapid degradation of the met leader RNA and, most likely, that of the 5’-region of the met mRNA. The met mRNA is degraded from its 5’-end by the exoribonuclease RNase J. The stability of the met mRNA was found to vary over the length of the transcript with an instable 5’-end (metI and metC) and a longer half-life towards the 3’-end (metE and mdh). The varying transcript stability is reflected by differences in the available cellular protein levels. The obtained data suggest that programmed mRNA degradation is another level of regulation in the complex network of staphylococcal de novo methionine biosynthesis control.
In addition, the MET-TBRS was studied with regard to a future use as a drug target for novel antimicrobial agents. To this end, effects of a dysregulated methionine biosynthesis on bacterial growth and survival were investigated in met leader mutants that either caused permanent transcription of the met operon (‘ON’) or prevented operon transcription (‘OFF’), irrespective of the methionine status in the cell. Methionine deprivation turned out to be a strong selection pressure, as ‘OFF’ mutants acquired adaptive mutations within the met leader to restore met operon expression that subsequently re-enabled growth.
The second part of the thesis was dedicated to the characterisation of the Mdh protein that is encoded by the last gene of the met operon and whose function is unknown yet. At first, co-transcription and -expression with the met operon could be demonstrated. Next, the Mdh protein was overexpressed and purified and the crystal structure of Mdh was solved to high resolution by the Kisker research group (Rudolf-Virchow-Zentrum Würzburg). Analysis of the structure revealed the amino acid residues crucial for catalytic activity, and zinc was identified as a co-factor of Mdh. Also, Mdh was shown to exist as a dimer. However, identification of the Mdh substrate was, in the context of this thesis, (still) unsuccessful. Nevertheless, interactions of Mdh with enzymes of the met operon could be demonstrated by employing the bacterial two-hybrid system. This fact and the high conservation of mdh/Mdh on nucleotide and amino acid level among numerous staphylococcal species suggests an important role of Mdh within the methionine metabolism that should be a worthwhile subject of future research.
This work investigates the correlations between spin states and the light emission properties of organic light-emitting diodes (OLEDs), which are based on the principle of thermally activated delayed fluorescence. The spin-spin interactions responsible for this mechanism are investigated in this work using methods based on spin-sensitive electron paramagnetic resonance (EPR). In particular, this method has been applied to electrically driven OLEDs. The magnetic resonance has been detected by electroluminescence, giving this method its name: electroluminescence detected magnetic resonance (ELDMR).
Initial investigations on a novel deep blue TADF emitter were performed. Furthermore, the ELDMR method was used in this work to directly detect the spin states in the OLED. These measurements were further underlined by time-resolved experiments such as transient electro- and photoluminescence.
Purpose
Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over- and under-corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three-dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO.
Methods
From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes-Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional-Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center.
Results
From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes-Group compared to a significant increase in the Conventional-Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre- and postoperatively. The number of over- and under-corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau.
Conclusion
The 3-triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO.
To slow down the spread of the SARS-Cov-2 virus, countries worldwide severely restricted public and social life. In addition to the physical threat posed by the viral disease (COVID-19), the pandemic also has implications for psychological well-being. Using a small sample (N = 51), we examined how Big Five personality traits relate to coping with contact restrictions during three consecutive weeks in the first wave of the COVID-19 pandemic in Germany. We showed that extraversion was associated with suffering from severe contact restrictions and with benefiting from their relaxation. Individuals with high neuroticism did not show a change in their relatively poor coping with the restrictions over time, whereas conscientious individuals seemed to experience no discomfort and even positive feelings during the period of contact restrictions. Our results support the assumption that neuroticism is a vulnerability factor in relation to psychological wellbeing but also show an influence of contact restrictions on extraverted individuals.
Despite its negative reputation, egoism – the excessive concern for one’s own welfare – can incite prosocial behavior. So far, however, egoism-based prosociality has received little attention. Here, we first provide an overview of the conditions under which egoism turns into a prosocial motive, review the benefits and limitations of egoism-based prosociality, and compare them with empathy-driven prosocial behavior. Second, we summarize studies investigating the neural processing of egoism-based prosocial decisions, studies investigating the neural processing of empathy-based prosocial decisions, and the small number of studies that compared the neural processing of prosocial decisions elicited by the different motives. We conclude that there is evidence for differential neural networks involved in egoism and empathy-based prosocial decisions. However, this evidence is not yet conclusive, because it is mainly based on the comparison of different experimental paradigms which may exaggerate or overshadow the effect of the different motivational states. Finally, we propose paradigms and research questions that should be tackled in future research that could help to specify how egoism can be used to enhance other prosocial behavior and motivation, and the how it could be tamed.
The immune system plays a vital role in maintaining tissue integrity and organismal homeostasis. The sudden stress caused by myocardial infarction (MI) poses a significant challenge for the immune system: it must quickly substitute dead myocardial with fibrotic tissue while controlling overt inflammatory responses. In this review, we will discuss the central role of myocardial regulatory T-cells (Tregs) in orchestrating tissue repair processes and controlling local inflammation in the context of MI. We herein compile recent advances enabled by the use of transgenic mouse models with defined cardiac antigen specificity, explore whole-heart imaging techniques, outline clinical studies and summarize deep-phenotyping conducted by independent labs using single-cell transcriptomics and T-cell repertoire analysis. Furthermore, we point to multiple mechanisms and cell types targeted by Tregs in the infarcted heart, ranging from pro-fibrotic responses in mesenchymal cells to local immune modulation in myeloid and lymphoid lineages. We also discuss how both cardiac-specific and polyclonal Tregs participate in MI repair. In addition, we consider intriguing novel evidence on how the myocardial milieu takes control of potentially auto-aggressive local immune reactions by shaping myosin-specific T-cell development towards a regulatory phenotype. Finally, we examine the potential use of Treg manipulating drugs in the clinic after MI.
Xylem embolism resistance has been identified as a key trait with a causal relation to drought-induced tree mortality, but not much is known about its intra-specific trait variability (ITV) in dependence on environmental variation. We measured xylem safety and efficiency in 300 European beech (Fagus sylvatica L.) trees across 30 sites in Central Europe, covering a precipitation reduction from 886 to 522 mm year−1. A broad range of variables that might affect embolism resistance in mature trees, including climatic and soil water availability, competition, and branch age, were examined. The average P50 value varied by up to 1 MPa between sites. Neither climatic aridity nor structural variables had a significant influence on P50. However, P50 was less negative for trees with a higher soil water storage capacity, and positively related to branch age, while specific conductivity (Ks) was not significantly associated with either of these variables. The greatest part of the ITV for xylem safety and efficiency was attributed to random variability within populations. We conclude that the influence of site water availability on P50 and Ks is low in European beech, and that the high degree of within-population variability for P50, partly due to variation in branch age, hampers the identification of a clear environmental signal.
Das Urothelkarzinom ist das zweithäufigste urologische Malignom mit weltweit steigender Inzidenz. Nach initial kurativ intendierter transurethraler Resektion des Tumors zeigt bislang immer noch jeder vierte Patient einen Progress im Verlauf mit einem erhöhten Risiko einer Metastasierung, ohne dass hierfür verlässliche prognostische Marker zur Verfügung stehen. Mithilfe eines solchen (Bio)markers könnte beim Urothelkarzinom eine frühzeitige Diagnostik von Hochrisikokarzinomen ermöglicht, die Therapieplanung verbessert und somit das Risiko einer Metastasierung und erhöhten Mortalität gesenkt werden. Als mögliche Biomarker rücken micro-RNAs über ihre posttranskriptionelle Regulierung in den Fokus onkologischer Forschung. Mithilfe einer Datenbankrecherche wurden 7 verschiedene micro-RNAs (miR-9, -21, -29c, -145, -200c, -205, -221) selektioniert, welchen bereits in unterschiedlichen Malignomen eine Rolle in der Karzinogenese nachgewiesen werden konnte. Ein Einfluss dieser miRs im Urothelkarzinom war bislang noch nicht suffizient beschrieben, sodass anhand einer Expressionsanalyse in der vorliegenden Arbeit ein Biomarker für einen Progress untersucht werden sollte. Hierfür wurde ein archiviertes Gewebekollektiv, bestehend aus NMIBC, MIBC und benignem Referenzmaterial verwendet und die mittels RT-PCR ermittelte miR-Expression mit klinischen Parametern sowie Follow-up-Daten korreliert.
Letztlich konnte für unterschiedliche micro-RNAs ein Einfluss auf das Urothelkarzinom im untersuchten Kollektiv nachgewiesen werden und somit deren Bedeutung als Onko-miRs im Urothelkarzinom gestärkt werden. Aufbauend auf diesen Ergebnissen wurden die NMIBC retrospektiv anhand der Follow-up-Daten in zwei prognostisch unterschiedliche Subgruppen unterteilt und die Expressionsdaten miteinander verglichen. Es konnte gezeigt werden, dass sowohl miR-29c als auch miR-145 in prognostisch ungünstigeren NMIBC mit einem muskelinvasiven Rezidiv im Verlauf eine signifikant niedrigere Expression im untersuchten Kollektiv aufwiesen. Anhand eines in der Regressionsanalyse ermittelten Schwellenwertes konnte in der Kaplan-Meier-Analyse sowohl ein erhöhtes progressionsfreies Überleben als auch eine niedrigere tumorassoziierte Mortalität in den NMIBC mit einer miR-Expression unterhalb des ermittelten Schwellenwertes gezeigt werden. Somit wurde im untersuchten Kollektiv ein Marker ermittelt, welcher anhand der miR-29c und -145-Expression eine Unterteilung in prognostisch günstige und ungünstige Gruppen ermöglicht. In einem zweiten unabhängigen Validierungskollektiv wurden miR-29c und -145 auf ihre zuvor erhobene prognostische Aussagekraft untersucht. Hierbei konnte miR-145 als prognoserelevanter Biomarker nicht validiert werden. Für miR-29c konnte hingegen erneut eine niedrige Expression mit einer schlechteren klinischen Prognose assoziiert werden. Zudem konnte der zuvor ermittelte Schwellenwert auch in dem zweiten Kollektiv und miR-29c somit als Prognosemarker in den untersuchten Kollektiven validiert werden.
In der Zellkultur konnte die tumorsuppressive Funktion der miR-29c weiter bestätigt werden. So zeigte sich in ektopisch miR-29c-überexprimierten Urothelkarzinomzellen eine signifikant niedrigere Proliferations- und Migrationsrate. Um die posttranskriptionelle Funktion der tumorsuppressiven miR-29c weiter abzuklären, konnte LOXL2 als ein solides Zielgen der miR-29c mittels RT-PCR-Analysen identifiziert werden.
Anhand dieser Ergebnisse konnten vor allem miR-29c tumorsuppressive Eigenschaften im Urothelkarzinom zugeschrieben werden. Im untersuchten Gewebekollektiv stellt die miR-29c einen relevanten Progressionsmarker dar, welcher im Rahmen prospektiver Studien weiter validiert werden könnte. Eine Implementierung der miR-29c-Expressionsanalyse in die Diagnostik der NMIBC ist somit insgesamt ein vielversprechender Ansatz um eine rasche Diagnose von Hochrisikokarzinomen zu stellen und folglich einer frühzeitigen Therapie zugänglich zu machen.
Indirekte Charakterisierung trägt zu einem großen Teil zur Gesamtcharakteristik von Figuren bei, ist bisher aber dennoch vergleichsweise wenig erforscht. Diese Arbeit nähert sich dem Phänomen der indirekten Figurencharakterisierung durch eine eigene Explikation theoretisch an, nennt verschiedene Repräsentationsformen von indirekter Charakterisierung und führt die Theorie dann in Bezug auf Redewiedergabe anhand zahlreicher Beispiele aus. Der Untersuchung wird ein Korpus realistischer Erzähltexte zugrunde gelegt und darin manuell Formen der Redewiedergabe annotiert, um in einem späteren Schritt computergestützt einige Experimente mit den Annotationen durchzuführen. In ihrem Aufbau entspricht diese Arbeit dadurch einem Mixed-Methods-Design von qualitativer und quantitativer Literaturwissenschaft.
In recent decades, hybrid characterization systems have become pillars in the study of cellular biomechanics. Especially, Atomic Force Microscopy (AFM) is combined with a variety of optical microscopy techniques to discover new aspects of cell adhesion. AFM, however, is limited to the early-stage of cell adhesion, so that the forces of mature cell contacts cannot be addressed. Even though the invention of Fluidic Force Microscopy (FluidFM) overcomes these limitations by combining the precise force-control of AFM with microfluidics, the correlative investigation of detachment forces arising from spread mammalian cells has been barely achieved. Here, a novel multifunctional device integrating Fluorescence Microscopy (FL) into FluidFM technology (FL-FluidFM) is introduced, enabling real-time optical tracking of entire cell detachment processes in parallel to the undisturbed acquisition of force-distance curves. This setup, thus, allows for entailing two pieces of information at once. As proof-of-principle experiment, this method is applied to fluorescently labeled rat embryonic fibroblast (REF52) cells, demonstrating a precise matching between identified force-jumps and visualized cellular unbinding steps. This study, thus, presents a novel characterization tool for the correlated evaluation of mature cell adhesion, which has great relevance, for instance, in the development of biomaterials or the fight against diseases such as cancer.
The extracellular matrix (ECM) of soft tissues in vivo has remarkable biological and structural properties. Thereby, the ECM provides mechanical stability while it still can be rearranged via cellular remodeling during tissue maturation or healing processes. However, modern synthetic alternatives fail to provide these key features among basic properties. Synthetic matrices are usually completely degraded or are inert regarding cellular remodeling. Based on a refined electrospinning process, a method is developed to generate synthetic scaffolds with highly porous fibrous structures and enhanced fiber‐to‐fiber distances. Since this approach allows for cell migration, matrix remodeling, and ECM synthesis, the scaffold provides an ideal platform for the generation of soft tissue equivalents. Using this matrix, an electrospun‐based multilayered skin equivalent composed of a stratified epidermis, a dermal compartment, and a subcutis is able to be generated without the use of animal matrix components. The extension of classical dense electrospun scaffolds with high porosities and motile fibers generates a fully synthetic and defined alternative to collagen‐gel‐based tissue models and is a promising system for the construction of tissue equivalents as in vitro models or in vivo implants.
Mit jährlich circa 11 Millionen Fällen weltweit, stellen schwere Brandwunden bis heute einen großen Anteil an Verletzungen dar, die in Kliniken behandelt werden müssen. Während leichte Verbrennungen meist problemlos heilen, bedarf die Behandlung tieferer Verbrennungen medizinischer Intervention. Zellbasierte Therapeutika zeigen hier bereits große Erfolge, aufgrund der eingeschränkten Übertragbarkeit von Ergebnissen aus Tiermodellen ist jedoch sowohl die Testung neuer Produkte, als auch die Erforschung der Wundheilung bei Brandwunden noch immer schwierig.
Aufgrund dessen wurden in dieser Arbeit zwei Ziele verfolgt: Die Etablierung von Methoden, um ein zellbasiertes Therapeutikum produzieren zu können und die Entwicklung eines Modells zur Untersuchung von Verbrennungswunden. Zunächst wurden hierfür die Kulturbedingungen und -protokolle zur Isolation und Expansion von Keratinozyten so angepasst, dass sie gängigen Regularien zur Produktion medizinischer Produkte entsprechen. Hier zeigten die Zellen auch in anschließenden Analysen, dass charakteristische Merkmale nicht verloren hatten. Darüber hinaus gelang es, die Zellen mithilfe verschiedener protektiver Substanzen erfolgreich einzufrieren und zu konservieren.
Des Weiteren konnte ein Modell etabliert werden, das eine Verbrennung ersten Grades widerspiegelt. Über einen Zeitraum von zwei Wochen wurde seine Regeneration hinsichtlich verschiedener Aspekte, wie der Histomorphologie, dem Metabolismus und der Reepithelialisierungsrate, untersucht. Die Modelle zeigten hier viele Parallelen zur Wundheilung in vivo auf. Um die Eignung der Modelle zur Testung von Wirkstoffen zu ermitteln wurde außerdem eine Behandlung mit 5% Dexpanthenol getestet. Sie resultierte in einer verbesserten Histomorphologie und einer erhöhten Anzahl an proliferativen Zellen in den Modellen, beschleunigte jedoch die Reepithelialisierung nicht. Zusammengefasst konnten in dieser Arbeit zunächst Methoden etabliert werden, um ein medizinisches Produkt aus Keratinozyten herzustellen und zu charakterisieren. Außerdem wurde ein Modell entwickelt, anhand dessen die Wundheilung und Behandlung von Verbrennungen ersten Grades untersucht werden kann und welches als Basis zur Entwicklung von Modellen von tieferen Verbrennungen dienen kann.
Aim
This study evaluated the oral health status of adult patients with hypophosphatasia (HPP).
Materials and Methods
Parameters of oral health assessment comprised decayed/missing/filled teeth (DMFT) index, probing pocket depth and clinical attachment level (CAL) as well as documentation of tooth loss and periodontal health status according to CCD/AAP criteria. Findings were compared with national reference data (DMS V survey) reporting oral health status in age‐related controls. Within‐group comparisons were made between the HPP patients harbouring one versus two alkaline phosphatase liver/bone/kidney type (ALPL) gene variants.
Results
Of 80 HPP patients (64 female) with a mean age of 46.4 years (range 24–78) and one (n = 55) or two (n = 18) variants (n = 7 lacking testing) within the ALPL gene, those with two variants displayed substantially higher tooth loss rate (14.0 ± 9.3) than those affected by only one ALPL variant (4.1 ± 5.4), who did not differ substantially from healthy DMS V controls. While DMFT score and severe periodontal diseases (PDs) of HPP patients with one variant only increased with progressing age, the two‐variant sub‐cohort age independently exhibited increased DMFT scores and a higher rate of severe PDs.
Conclusions
HPP patients affected by two variants of the ALPL gene exhibited a higher risk of periodontitis and tooth loss than the general population, while patients with one variant developed clinically relevant oral disease symptoms with progressing ageing.
Purpose
For somatostatin receptor (SSTR)-positron emission tomography/computed tomography (PET/CT), a standardized framework termed SSTR-reporting and data system (RADS) has been proposed. We aimed to elucidate the impact of a RADS-focused training on reader’s anxiety to report on SSTR-PET/CT, the motivational beliefs in learning such a system, whether it increases reader’s confidence, and its implementation in clinical routine.
Procedures
A 3-day training course focusing on SSTR-RADS was conducted. Self-report questionnaires were handed out prior to the course (Pre) and thereafter (Post). The impact of the training on the following categories was evaluated: (1) test anxiety to report on SSTR-PET/CT, (2) motivational beliefs, (3) increase in reader’s confidence, and (4) clinical implementation. To assess the effect size of the course, Cohen’s d was calculated (small, d = 0.20; large effect, d = 0.80).
Results
Of 22 participants, Pre and Post were returned by 21/22 (95.5%). In total, 14/21 (66.7%) were considered inexperienced (IR, < 1 year experience in reading SSTR-PET/CTs) and 7/21 (33.3%) as experienced readers (ER, > 1 year). Applying SSTR-RADS, a large decrease in anxiety to report on SSTR-PET/CT was noted for IR (d = − 0.74, P = 0.02), but not for ER (d = 0.11, P = 0.78). For the other three categories motivational beliefs, reader’s confidence, and clinical implementation, agreement rates were already high prior to the training and persisted throughout the course (P ≥ 0.21).
Conclusions
A framework-focused reader training can reduce anxiety to report on SSTR-PET/CTs, in particular for inexperienced readers. This may allow for a more widespread adoption of this system, e.g., in multicenter trials for better intra- and interindividual comparison of scan results.