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- Center for Interdisciplinary Clinical Research, Würzburg University, Würzburg, Germany (2)
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- Genelux Corporation, San Diego Science Center, 3030 Bunker Hill Street, Suite 310, San Diego, California 92109, USA (1)
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Radiation therapy today, on account of improvements in treatment procedures over the last 60 years, allows precise treatment of static tumors inside the human body. However, irradiation of moving tumors is still a challenging task as moving tumors often leave the treatment beam and the radiation dose delivered to the tumor reduces simultaneously increasing that on healthy tissue. This research work aims to push the frontiers of radiation therapy in order to enable precise treatment of moving tumors with focus on research and development of a unique real-time system enabling active motion compensation through robotic means to compensate tumor motion. During treatment, patients lie on a treatment couch which is normally used for static position corrections of patient set-up errors prior to radiation treatment. The treatment couch used, called HexaPOD, is a parallel manipulator with six degrees of freedom which can precisely position heavy loads inside a small region. Despite the HexaPOD not initially built with dynamics in mind, it is used in this work for sustained motion compensation by moving patients such that tumors stay precisely located at the center of the treatment beam during the complete course of treatment. In order to realize real-time tumor motion compensation by means of the HexaPOD, several challanges need to be addressed. Real-time aspects are covered by the adoption of a hard real-time operation system in combination with measurement and estimation of latencies of all physical quantities in the compensation system such as tumor or breathing position measurements. Accurate timing information is respected consistently in the whole system and all software-induced latencies are adaptively compensated for. This requires knowledge of future tumor positions from predictors. Several predictors for breathing and tumor motion predictions are proposed and evaluated in terms of a variety of different performance metrics. Extensions to prediction algorithms are introduced fusing both breathing and tumor position information to allow for predictions without the need of an explicit correlation model. Predictions determine the future motion path of the HexaPOD in order to compensate for tumor motion. Several control schemes are developed to enable reference tracking for the HexaPOD. Based on linear and non-linear dynamic modelling of the HexaPOD with system identification methods, a first controller is derived in the form of a model predictive controller. A second controller is proposed based on an assumption of the working principle of the HexaPOD's internal controller. Finally, a third controller is derived as combination of the first and second one. For each of these controllers, comparative results with real hardware experiments and humans in the loop as well as choices of free parameters are presented and discussed. Apart from precise tracking, emphasis is placed on patient comfort which is of crucial importance for acceptance of the system. It is demonstrated that smooth trajectories can be realized by the controllers to guarantee that patients feel comfortable while their tumor motion is compensated at sub-millimeter accuracies. Overall errors of the system are analyzed by relating them to tracking and prediction errors. By exploiting the properties of different predictors, it is shown that the startup time until tracking is reached can be reduced to only a few seconds, even in the case of an initially at-rest HexaPOD and with no initial knowledge of tumor motion. This makes the system especially suitable for the relatively short-fractionated treatment sessions for lung tumors. The tumor motion compensation system has been developed solely based on standard clinical hardware, found in most treatment rooms. With a simple and flexible design, existing treatment can be updated in a cost-efficient way to introduce motion compensation capabilities. Simultaneously, the system does not impose any constraints on state-of-the-art treatment types such as intensity modulated radiotherapy or volumetric modulated arc therapy. Supporting different compensation modes, the system can be applied to any moving tumor whether its motion is predictable (lung tumors) or unpredictable (prostate tumors). By integration of adequate tumor position determination methods, the system can be easily extended to other tumors as well.
The SARS virus is the etiological agent of the severe acute respiratory syndrome, a deadly disease that caused more than 700 causalities in 2003. One of its viral proteins, the SARS coronavirus main protease, is considered as a potential drug target and represents an important model system for other coronaviruses. Despite extensive knowledge about this enzyme, it still lacks an effective anti-viral drug. Furthermore, it possesses some unusual features related to its active-site region. This work gives atomistic insights into the SARS coronavirus main protease and tries to reveal mechanistic aspects that control catalysis and inhibition. Thereby, it applies state-of-the-art computational methods to develop models for this enzyme that are capable to reproduce and interpreting the experimental observations. The theoretical investigations are elaborated over four main fields that assess the accuracy of the used methods, and employ them to understand the function of the active-site region, the inhibition mechanism, and the ligand binding. The testing of different quantum chemical methods reveals that their performance depends partly on the employed model. This can be a gas phase description, a continuum solvent model, or a hybrid QM/MM approach. The latter represents the preferred method for the atomistic modeling of biochemical reactions. A benchmarking uncovers some serious problems for semi-empirical methods when applied in proton transfer reactions. To understand substrate cleavage and inhibition of SARS coronavirus main protease, proton transfer reactions between the Cys/His catalytic dyad are calculated. Results show that the switching between neutral and zwitterionic state plays a central role for both mechanisms. It is demonstrated that this electrostatic trigger is remarkably influenced by substrate binding. Whereas the occupation of the active-site by the substrate leads to a fostered zwitterion formation, the inhibitor binding does not mimic this effect for the employed example. The underlying reason is related to the coverage of the active-site by the ligand, which gives new implications for rational improvements of inhibitors. More detailed insights into reversible and irreversible inhibition are derived from in silico screenings for the class of Michael acceptors that follow a conjugated addition reaction. From the comparison of several substitution patterns it becomes obvious that different inhibitor warheads follow different mechanisms. Nevertheless, the initial formation of a zwitterionic catalytic dyad is found as a common precondition for all inhibition reactions. Finally, non-covalent inhibitor binding is investigated for the case of SARS coranavirus main protease in complex with the inhibitor TS174. A novel workflow is developed that includes an interplay between theory and experiment in terms of molecular dynamic simulation, tabu search, and X-ray structure refinement. The results show that inhibitor binding is possible for multiple poses and stereoisomers of TS174.
The neuronal ceroid lipofuscinoses (NCLs) are fatal neurodegenerative disorders in which the visual system is affected in early stages of disease. A typical accompanying feature is neuroinflammation, the pathogenic impact of which is presently unknown. In this study, the role of inflammatory cells in the pathogenesis was investigated in Palmitoyl-protein thioesterase 1-deficient (Ppt1-/-) and Ceroidlipofuscinosis, neuronal 3-deficient (Cln3-/-) mice, models of the infantile and juvenile forms of NCL, respectively. Focusing predominantly on the visual system, an infiltration of CD8+ cytotoxic Tlymphocytes and an activation of microglia/macrophage-like cells was observed early in disease. To analyze the pathogenic impact of lymphocytes, Ppt1-/- mice were crossbred with mice lacking lymphocytes (Rag1-/-) and axonal transport, perturbation and neuronal survival were scored. Lack of lymphocytes led to a significant amelioration of neuronal disease and reconstitution experiments revealed a crucial role of CD8+ cytotoxic T-lymphocytes. Lack of lymphocytes also caused an improved clinical phenotype and extended longevity. To investigate the impact of microglia/macrophage-like cells, Ppt1-/- and Cln3-/- mice were crossbred with mice lacking sialoadhesin (Sn-/-), a monocyte lineage-restricted cell adhesion molecule important for interactions between macrophage-like cells and lymphocytes. Similar to the lack of lymphocytes, absence of sialoadhesin significantly ameliorated the disease in Ppt1-/- and Cln3-/- mice. Taken together, both T-lymphocytes and microglia/macrophage-like cells were identified as pathogenic mediators in two distinct forms of fatal inherited neurodegenerative storage disorders. These studies expand the concept of secondary inflammation as a common pathomechanistic feature in some neurological diseases and provide novel insights that may be crucial for developing treatment strategies for different forms of NCL.
In this thesis we study various aspects of chaos synchronization of time-delayed coupled chaotic maps. A network of identical nonlinear units interacting by time-delayed couplings can synchronize to a common chaotic trajectory. Even for large delay times the system can completely synchronize without any time shift. In the first part we study chaotic systems with multiple time delays that range over several orders of magnitude. We show that these time scales emerge in the Lyapunov spectrum: Different parts of the spectrum scale with the different delays. We define various types of chaos depending on the scaling of the maximum exponent. The type of chaos determines the synchronization ability of coupled networks. This is, in particular, relevant for the synchronization properties of networks of networks where time delays within a subnetwork are shorter than the corresponding time delays between the different subnetworks. If the maximum Lyapunov exponent scales with the short intra-network delay, only the elements within a subnetwork can synchronize. If, however, the maximum Lyapunov exponent scales with the long inter-network connection, complete synchronization of all elements is possible. The results are illustrated analytically for Bernoulli maps and numerically for tent maps. In the second part the attractor dimension at the transition to complete chaos synchronization is investigated. In particular, we determine the Kaplan-Yorke dimension from the spectrum of Lyapunov exponents for iterated maps. We argue that the Kaplan-Yorke dimension must be discontinuous at the transition and compare it to the correlation dimension. For a system of Bernoulli maps we indeed find a jump in the correlation dimension. The magnitude of the discontinuity in the Kaplan-Yorke dimension is calculated for networks of Bernoulli units as a function of the network size. Furthermore the scaling of the Kaplan-Yorke dimension as well as of the Kolmogorov entropy with system size and time delay is investigated. Finally, we study the change in the attractor dimension for systems with parameter mismatch. In the third and last part the linear response of synchronized chaotic systems to small external perturbations is studied. The distribution of the distances from the synchronization manifold, i.e., the deviations between two synchronized chaotic units due to external perturbations on the transmitted signal, is used as a measure of the linear response. It is calculated numerically and, for some special cases, analytically. Depending on the model parameters this distribution has power law tails in the region of synchronization leading to diverging moments. The linear response is also quantified by means of the bit error rate of a transmitted binary message which perturbs the synchronized system. The bit error rate is given by an integral over the distribution of distances and is studied numerically for Bernoulli, tent and logistic maps. It displays a complex nonmonotonic behavior in the region of synchronization. For special cases the distribution of distances has a fractal structure leading to a devil's staircase for the bit error rate as a function of coupling strength. The response to small harmonic perturbations shows resonances related to coupling and feedback delay times. A bi-directionally coupled chain of three units can completely filter out the perturbation. Thus the second moment and the bit error rate become zero.
Medical history of obesity
(2013)
This paper contains the following sections, in approximate chronological order: Early years, Scientific research on energy metabolism, Clinical teaching, Evidence on health risks, Slow recognition of obesity in diabetes, Depression and war, some Obesity research continued in the 1950s and 1960s, New approaches to management, a Universal standard weight for height, Luxuskonsumption, Calories (incompletely) replaced by Joules, Food intakes of obese people, Genetics, unexpected Surge of obesity from 1980, Diabetes, Scarcity of effective, safe drugs for obesity, Leptin and Ghrelin stimulate basic research, Why has the obesity epidemic happened? What is the best weight-reducing diet? Bariatric surgery
Background: Ketogenic diets (KDs) have gained some popularity not only as effective weight-loss diets and treatment options for several diseases, but also among healthy and physically active individuals for various reasons. However, data on the effects of ketosis in the latter group of individuals are scarce. We therefore collected pilot data on the physiological response to a self-prescribed ketogenic diet lasting 5-7 weeks in a small cohort of healthy and physically active individuals. Methods: Twelve subjects (7 males, 5 females, age 24-60 years) who followed moderate to intensive exercise routines underwent blood testing, bioelectrical impedance analysis (BIA) and spiroergometry during an incremental treadmill test. On the next day, they went on a self-prescribed KD for a median of 38 days (range 35-50 days), after which the same tests were performed again. Ketosis was self-monitored by urinary ketone strips. Subjective feeling during the diet was assessed by a questionnaire after the intervention. Due to the small and heterogenous sample, the results are interpreted in the context of the already existing literature. Results: The KDs were tolerated well by the majority of individuals. Impaired recovery from exercise remained the most frequently reported side effect until the end of the study. Most blood parameters remained stable during the intervention. However, there were significant elevations of total and LDL cholesterol concentrations (p<0.01) and a trend towards increased HDL-cholesterol (p=0.05). The drastic reduction of carbohydrates had no statistically significant influence on running performance judged by the time to exhaustion, VO2max and respiratory compensation points. BIA measurements showed significant increases in phase angle (p=0.01) indicating improvements of body composition with an estimated decrease of 3.4 kg of fat mass (p=0.002) and gain of 1.3 kg of fat free mass. We discuss the validity of these estimates taking into account a possibly altered hydration status due to the KD. Conclusions: Active healthy individuals will probably experience no major problems during a short term KD lasting several weeks. The drastically reduced carbohydrate content of the diet seems to be no limiting factor for running performance. In addition, improvements in body composition can be expected. While most biochemical parameters are not influenced by the diet, there seems to be an impact on the blood lipid profile that could be considered problematic with respect to cardiovascular disease risk. However, the predictive role of cholesterol levels alone in individuals undergoing regular physical activity remains to be elucidated.
Neisseria meningitidis is a facultative human pathogen that occasionally shows strong resistance against serum complement exposure. Previously described factors that mediate meningococcal serum resistance are for example the capsule, LPS sialylation, and expression of the factor H binding protein. I aimed for identification of novel serum resistance factors, thereby following two approaches, i) the analysis of the impact of global regulators of gene expression on serum resistance; and ii) a comparative analysis of closely related strains differing in serum resistance. (i) Of six meningococcal global regulators of gene expression studied, only mutation of the zinc uptake regulator Zur reduced complement deposition on meningococci. Little was known about meningococcal Zur and regulatory processes in response to zinc. I therefore elucidated the yet unidentified meningococcal Zur regulon comparing the transcriptional response of the N. meningitidis strain MC58 under zinc-rich and zinc-deficient conditions using a common reference design of microarray analysis. The meningococcal Zur regulon comprises 17 genes, of which 15 genes were repressed and two genes were activated at high zinc condition. Amongst the Zur-repressed genes were genes involved in zinc uptake, tRNA modification, and ribosomal assembly. A 23 bp meningococcal consensus Zur binding motif (Zur box) with a conserved central palindrome was established (TGTTATDNHATAACA) and detected in the promoter region of all regulated transcriptional units (genes/operons). In vitro binding of meningococcal Zur to the Zur box of three selected genes was shown for the first time using EMSAs. Binding of meningococcal Zur to DNA depended specifically on zinc, and mutations in the palindromic sequence constrained Zur binding to the DNA motif. ii) Three closely related strains of ST-41/44 cc from invasive disease and carriage which differed in their resistance to serum complement exposure were analysed to identify novel mediators of serum resistance. I compared the strains’ gene content by microarray analysis which revealed six genes being present in both carrier isolates, but absent in the invasive isolate. Four of them are part of two Islands of horizontally transferred DNA, i.e. IHT-B and –C. The working group furthermore applied a comprehensive screening assay, a transcriptome and a proteome analysis leading to identification of three target proteins. I contributed to establish the role of these three proteins in serum resistance: The adhesin Opc mediates serum resistance by binding of vitronectin, a negative regulator of the complement system; the hypothetical protein NMB0865 slightly contributes to serum resistance by a yet unknown mechanism; and NspA, recently identified to bind the negative complement regulator factor H, led to considerable reduced complement-mediated killing.
Bees have had an intimate relationship with humans for millennia, as pollinators of fruit, vegetable and other crops and suppliers of honey, wax and other products. This relationship has led to an extensive understanding of their ecology and behavior. One of the most comprehensively understood species is the Western honeybee, Apis mellifera. Our understanding of sex-specific investment in other bees, however, has remained superficial. Signals and cues employed in bee foraging and mating behavior are reasonably well understood in only a handful of species and functional adaptations are described in some species. I explored the variety of sensory adaptations in three model systems within the bees. Females share a similar ecology and similar functional morphologies are to be expected. Males, engage mainly in mating behavior. A variety of male mating strategies has been described which differ in their spatiotemporal features and in the signals and cues involved, and thus selection pressures. As a consequence, males’ sensory systems are more diverse than those of females. In the first part I studied adaptations of the visual system in honeybees. I compared sex and caste-specific eye morphology among 5 species (Apis andreniformis, A. cerana, A. dorsata, A. florea, A. mellifera). I found a strong correlation between body size and eye size in both female castes. Queens have a relatively reduced visual system which is in line with the reduced role of visual perception in their life history. Workers differed in eye size and functional morphology, which corresponds to known foraging differences among species. In males, the eyes are conspicuously enlarged in all species, but a disproportionate enlargement was found in two species (A. dorsata, A. florea). I further demonstrate a correlation between male visual parameters and mating flight time, and propose that light intensities play an important role in the species-specific timing of mating flights. In the second study I investigated eye morphology differences among two phenotypes of drones in the Western honeybee. Besides normal-sized drones, smaller drones are reared in the colony, and suffer from reduced reproductive success. My results suggest that the smaller phenotype does not differ in spatial resolution of its visual system, but suffers from reduced light and contrast sensitivity which may exacerbate the reduction in reproductive success caused by other factors. In the third study I investigated the morphology of the visual system in bumblebees. I explored the association between male eye size and mating behavior and investigated the diversity of compound eye morphology among workers, queens and males in 11 species. I identified adaptations of workers that correlate with distinct foraging differences among species. Bumblebee queens must, in contrast to honeybees, fulfill similar tasks as workers in the first part of their life, and correspondingly visual parameters are similar among both female castes. Enlarged male eyes are found in several subgenera and have evolved several times independently within the genus, which I demonstrate using phylogenetic informed statistics. Males of these species engage in visually guided mating behavior. I find similarities in the functional eye morphology among large-eyed males in four subgenera, suggesting convergent evolution as adaptation to similar visual tasks. In the remaining species, males do not differ significantly from workers in their eye morphology. In the fourth study I investigated the sexual dimorphism of the visual system in a solitary bee species. Males of Eucera berlandi patrol nesting sites and compete for first access to virgin females. Males have enlarged eyes and better spatial resolution in their frontal eye region. In a behavioral study, I tested the effect of target size and speed on male mate catching success. 3-D reconstructions of the chasing flights revealed that angular target size is an important parameter in male chasing behavior. I discuss similarities to other insects that face similar problems in visual target detection. In the fifth study I examined the olfactory system of E. berlandi. Males have extremely long antennae. To investigate the anatomical grounds of this elongation I studied antennal morphology in detail in the periphery and follow the sexual dimorphism into the brain. Functional adaptations were found in males (e.g. longer antennae, a multiplication of olfactory sensilla and receptor neurons, hypertrophied macroglomeruli, a numerical reduction of glomeruli in males and sexually dimorphic investment in higher order processing regions in the brain), which were similar to those observed in honeybee drones. The similarities and differences are discussed in the context of solitary vs. eusocial lifestyle and the corresponding consequences for selection acting on males.
This paper presents an alternative approach for obtaining a converse Lyapunov theorem for discrete–time systems. The proposed approach is constructive, as it provides an explicit Lyapunov function. The developed converse theorem establishes existence of global Lyapunov functions for globally exponentially stable (GES) systems and semi–global practical Lyapunov functions for globally asymptotically stable systems. Furthermore, for specific classes of sys- tems, the developed converse theorem can be used to establish non–conservatism of a particular type of Lyapunov functions. Most notably, a proof that conewise linear Lyapunov functions are non–conservative for GES conewise linear systems is given and, as a by–product, tractable construction of polyhedral Lyapunov functions for linear systems is attained.