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- Graduate School of Life Sciences (85)
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- Institut für Anorganische Chemie (60)
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- Institut für Organische Chemie (37)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (37)
Schriftenreihe
Sonstige beteiligte Institutionen
- DFG Forschungsgruppe 2757 / Lokale Selbstregelungen im Kontext schwacher Staatlichkeit in Antike und Moderne (LoSAM) (2)
- Siemens AG (2)
- Agricultural Center, BASF SE, 67117 Limburgerhof, Germany (1)
- Akademie der Wissenschaften und der Literatur, Mainz (1)
- Bayer AG, Research & Development, Pharmaceuticals, Investigational Toxicology (1)
- Betriebsärztlicher Dienst der Universität Würzburg (1)
- Center of Excellence for Science and Technology - Integration of Mediterranean region (STIM), Faculty of Science, University of Split, Poljička cesta 35, 2100 Split, Croatia (1)
- Comprehensive Cancer Center Mainfranken (1)
- Core Unit Systemmedizin (1)
- Departamento de Química, Facultad de Ciencias, Universidad Autónoma de Madrid, 28049 Madrid, Spain (1)
Background and Objective
The aim of this single‐centre, two‐arm, parallel‐group, double‐blinded, randomised controlled trial was to investigate the disputed specific effectiveness of acupuncture by comparing acupuncture on specific and non‐specific points among patients with non‐chronic, painful TMDs.
Methods
Following predefined eligibility criteria, 49 consecutive patients of both sexes were recruited to the study. All subjects were diagnosed with a non‐chronic (Graded Chronic Pain Scale grade <3) painful TMD, as assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Patients were randomly assigned to group A (acupuncture on specific points) or group B (acupuncture on non‐specific points) after the initial examination (T0). Both acupuncture treatment sessions were conducted by a trained dentist once a week for four weeks. The examination was repeated five weeks (T5) after T0 by one calibrated examiner who was unaware of the study groups. Characteristic pain intensity (CPI) was evaluated as the main outcome criterion and compared between times and treatment groups by means of non‐parametric tests (significance level set at P = .05). Secondary outcomes comprised the maximum corrected active mouth‐opening without pain (MAO); patients’ expectations regarding acupuncture treatment and pain development; depressivity; and oral health‐related quality of life (OHRQoL).
Results
A total of 41 patients (38 female) successfully completed the study (mean age: 40.17 ± 16.61). The two groups did not differ significantly at any time in terms of age and CPI. However, CPI was significantly (P < .05) lower at T5 than at T0 for both groups (29.66 and 30.35% lower in group A and group B, respectively). An increase in MAO was observed at T5 for both groups but was significant for group B only (P = .016). All patients had positive expectations of acupuncture therapy, and the two groups did not differ significantly at T5 with regard to the extent to which their expectations had been fulfilled by the treatment (P = .717). Comparison of T0 and T5 showed a statistically significant reduction of depressivity for group A (P = .0205), but no significant change for group B (P = .329). At T5, OHRQoL had improved significantly for both groups (group A, P = .018; group B, P < .001) compared with at T0.
Conclusions
Acupuncture on both specific and non‐specific points reduces the non‐dysfunctional pain of TMD patients. The effect of acupuncture on painful TMD cannot be attributed to the specific point selection.
Objective: We investigated cerebral opioid receptor binding potential in patients with fibromyalgia syndrome (FMS) using positron-emission-tomography (PET) and correlated our results with patients’ systemic interleukin-4 (IL-4) gene expression.
Methods: In this pilot study, seven FMS patients (1 man, 6 women) agreed to participate in experimental PET scans. All patients underwent neurological examination, were investigated with questionnaires for pain, depression, and FMS symptoms. Additionally, blood for IL-4 gene expression analysis was withdrawn at two time points with a median latency of 1.3 years. Patients were investigated in a PET scanner using the opioid receptor ligand F-18-fluoro-ethyl-diprenorphine ([18F]FEDPN) and results were compared with laboratory normative values.
Results: Neurological examination was normal in all FMS patients. Reduced opioid receptor binding was found in mid cingulate cortex compared to healthy controls (p < 0.005). Interestingly, three patients with high systemic IL-4 gene expression had increased opioid receptor binding in the fronto-basal cortex compared to those with low IL-4 gene expression (p < 0.005).
Conclusion: Our data give further evidence for a reduction in cortical opioid receptor availability in FMS patients as another potential central nervous system contributor to pain in FMS.
Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.
Im Rahmen der vorliegenden Dissertation werden mit unterschiedlichen Analysemethoden die Korrelationen zwischen den strukturellen, elektronischen und magnetischen Eigenschaften von Selten Erd-basierten intermetallischen Oberflächenlegierungen anhand der beiden Probensysteme LaPt$_5$/Pt(111) und CePt$_5$/Pt(111) untersucht. Darüber hinaus werden die strukturellen Eigenschaften von Adsorbat-induzierten Oberflächenrekonstruktionen im sub-ML Bereich in reduzierten Dimensionen auf der Halbleiteroberfläche Si(111) anhand der beiden Materialsysteme Si(111)-(5$\times$2)-Au und Si(111)-($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Sn mit der Methode LEED-IV analysiert.
Das erste experimentelle Kapitel dieser Arbeit behandelt die intermetallische Oberflächenlegierung LaPt$_5$/Pt(111), die sich ausbildet wenn La-Atome auf einem sauberen Pt(111)-Substrat abgeschieden werden und anschließend thermische Energie hinzugefügt wird. Die Dicke der gebildeten Legierung lässt sich über die zuvor angebotene Menge an La-Atomen variieren und resultiert aufgrund der Gitterfehlanpassung von Pt(111) und den obenauf liegenden LaPt$_5$-Filmen in sechs unterschiedliche Beugungsmuster im LEED, deren Überstrukturvektoren durch zwei unterschiedliche Rotationsausrichtungen in Bezug auf das Gitter des Substrats und unterschiedlichen lateralen Gitterkonstanten der Filme gekennzeichnet sind. Die atomare Struktur kann auf eine gemeinsame Kristallstruktur zurückgeführt werden, deren Stöchiometrie aus dickenabhängigen AES-Messungen zu LaPt$_5$ mit einer Pt-reichen Oberflächenabschlusslage bestimmt werden konnte. Die Ergebnisse einer durchgeführten LEED-IV Studie bestätigen das Wachstum der Filme in der CaCu$_5$-Struktur, wobei die Oberflächenterminierungslage im Vergleich zum Volumengitter ein zusätzliches Pt-Atom pro Einheitszelle aufweist, das zusätzlich um einen Wert von \unit{0.26}{\angstrom} aus der Oberfläche hervorsteht. Die La-Atome, die direkt unterhalb der Terminierungslage liegen, erfahren eine Verschiebung in entgegengesetzter Richtung, so dass im Vergleich zum Volumen der Filme eine lokal veränderte Symmetrie im oberflächennahen Bereich vorherrscht und sich auf die elektronischen Eigenschaften der LaPt$_5$-Filme auswirkt. Darüber hinaus wurden die Schwingungseigenschaften der LaPt$_5$-Filme mittels der polarisierten in situ Raman-Spektroskopie bestimmt, bei der die auftretenden Schwingungspeaks durch die Kenntnis der atomaren Struktur und mit Überlegungen aus der Gruppentheorie unterschiedlichen Tiefenbereichen der LaPt$_5$-Filme (Volumen und Oberfläche) zugewiesen werden konnten.
Im zweiten experimentellen Kapitel liegt der Fokus auf der atomaren Struktur sowie auf den elektronischen und magnetischen Eigenschaften des Kondo- und Schwerfermionensystems CePt$_5$/Pt(111). In Abhängigkeit von der vor dem Legierungsprozess angebotenen Menge an Ce-Atomen auf dem Pt(111)-Substrat konnten insgesamt sieben verschiedene LEED-Phasen der CePt$_5$-Filme identifiziert werden, deren jeweilige Oberflächenrekonstruktionen durch eine unterschiedliche Rotationsausrichtung in Bezug auf das Pt(111)-Substrat gekennzeichnet sind. Zusätzlich ist die laterale Gitterkonstante einem Prozess aus Verspannung und Dehnung aufgrund der Gitterfehlanpassung von Film und Substrat ausgesetzt. Eine durchgeführte LEED-IV Analyse bestätigt das Wachstum der Filme in der CaCu$_5$-Struktur mit einer Pt-reichen Oberflächenabschlusslage, deren Pt$_3$-Kagom\'{e}-Lage im Vergleich zum Volumengitter mit einem zusätzlichen Pt-Atom pro Einheitszelle gefüllt ist. Die strukturellen Ergebnisse stimmen mit erzielten Resultaten aus früheren Arbeiten überein und verdeutlichen zudem die isostrukturellen Eigenschaften zur intermetallischen Oberflächenlegierung LaPt$_5$/Pt(111). Dies ermöglicht durch geeignete Vergleichsexperimente an LaPt$_5$/Pt(111) die induzierten Phänomene der $4f$-Elektronen bezüglich des Kondo- und Schwerfermionenverhaltens bei CePt$_5$/Pt(111) zu bestimmen, da La-Atome in ihrem atomaren Aufbau keine $4f$-Elektronen beherbergen. Mit der polarisierten in situ Raman-Spektroskopie aufgenommene Spektren anhand von unterschiedlich dicken CePt$_5$-Filmen beinhalten sowohl charakteristische Schwingungspeaks als auch elektronische Übergänge. Das spektroskopische Verhalten der Schwingungspeaks zeigt dabei nicht nur Gemeinsamkeiten zu LaPt$_5$/Pt(111) bei der Zuweisung der Schwingungsmoden zu den jeweiligen Tiefenbereichen in den CePt$_5$-Filmen, sondern es treten auch Unterschiede auf, da eine CePt$_5$-Schwingungsmode einem anormalen Temperaturverhalten unterliegt, das auf die Wechselwirkung mit den $4f$-Elektronen zurückzuführen ist. Weitere spezifische Raman-Signaturen, die elektronischen Übergängen in Form von Kristallfeldniveauaufspaltungen der $4f$-Elektronen von Ce zugewiesen werden konnten, resultieren ebenfalls aus unterschiedlichen Regionen der CePt$_5$-Filme (Oberfläche, inneres Volumen, Interface). Die magnetischen Eigenschaften der CePt$_5$-Filme wurden mit XAS und XMCD an den Ce M$_{4,5}$-Kanten in Abhängigkeit von der Temperatur, dem Einfallswinkel, der Filmdicke und der Stärke des Magnetfelds analysiert. Die markanten Übergänge zwischen unterschiedlichen Curie-Weiss-Regimen in der inversen Suszeptibilität erlauben Rückschlüsse über das Kristallfeldaufspaltungsschema, die Kondo- und die RKKY-Wechselwirkung und korrelieren mit der Ce-Valenz. Zudem konnte bei tiefen Temperaturen ein Übergang in den kohärenten Schwerfermionen-Zustand für alle untersuchten CePt$_5$-Filmdicken in dieser Arbeit nachgewiesen werden. Durch die Vorhersage eines metamagnetischen Lifshitz-Übergangs für diese Filme, der sich in der Magnetfeldabhängigkeit des magnetischen Moments äußert, konnte durch die Aufnahme von Magnetisierungskurven bei tiefen Temperaturen und hohen Magnetfeldern auf zwei weitere charakteristische Energieskalen der renormalisierten Bandstruktur zugegriffen werden.
Das dritte experimentelle Kapitel widmet sich der mit LEED und LEED-IV durchgeführten Aufklärung der atomaren Struktur eines quasi-eindimensionalen Elektronensystems, bei dem sich die gebildeten Au-Nanodrähte auf der Si(111)-Oberfläche durch eine Si(111)-(5$\times$2)-Au Rekonstruktion beschreiben lassen. Die aufgenommenen LEED-Bilder mit ihren markanten Beugungsreflexen und sogenannten Streifen deuten auf drei gleichwertige Rotationsdomänen, die jeweils um einen Winkel von \unit{120}{\degree} gegeneinander gedreht sind, auf der Oberfläche hin. Zudem konnte aus einer Simulation der Beugungsbilder das Auftreten von Streifen durch drei zusätzliche Spiegeldomänen, die eine Phasenverschiebung von einem halben Überstrukturvektor einführen und bei einer sorgfältigen LEED-IV Analyse ebenfalls berücksichtigt werden sollten, erklärt werden. Aus den in der Literatur nach einer zweiten Rekalibrierung der nötigen Menge an Au-Atomen zur Ausbildung der Si(111)-(5$\times$2)-Au Rekonstruktion in den letzten Jahren heftig diskutierten Strukturmodellen gibt das von Kwon und Kang aufgestellte Geometriemodell (KK-Modell) die beobachteten energieabhängigen Intensitätsmodulationen in den experimentellen Daten beim Vergleich mit theoretisch berechneten IV-Kurven am besten wieder. Für dieses Modell nimmt der R-Faktor nach Pendry bei den unabhängig voneinander betrachteten drei Energieserien unter verschiedenen Einfallswinkeln der Elektronen auf die Probenoberfläche stets den kleinsten Wert an. Unter der expliziten Berücksichtigung von Si-Adatomen, die sich zusätzlich auf der Oberfläche befinden und in einer (5$\times$4)-Einheitszelle beschrieben werden können, bleibt das KK-Modell das zu präferierende Strukturmodell zur Beschreibung der ausgebildeten Au-Ketten und der Si-Honigwabenstruktur bei der Si(111)-(5$\times$2)-Au Oberflächenrekonstruktion.
Im letzten experimentellen Kapitel wird ein zweidimensionales Elektronensystem -- die $\alpha$-Si(111)-($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Sn Oberflächenrekonstruktion, die sich bei 1/3 ML an Sn-Adsorbaten auf dem Si(111)-Substrat ausbildet -- im Hinblick auf die atomare Struktur bei Raumtemperatur mit LEED und LEED-IV untersucht. Aus den insgesamt sechs in die Analyse aufgenommenen Strukturmodellen, bei denen die Sn-Atome innerhalb der rekonstruierten ($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Einheitszelle unterschiedliche Adsorptionsplätze auf einer ideal terminierten Si(111)-Oberfläche einnehmen, konnte ein Legierungsverhalten, wie es bei der $\gamma$-Si(111)-($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Sn Phase auftritt, ausgeschlossen werden. Die Sn-Atome ordnen sich ausschließlich auf der Oberfläche neu an und führen zu einer Relaxation des darunterliegenden Substrats, deren atomare Verschiebungen sich bis in die sechste Si-Lage nachverfolgen lassen. Im Vergleich zu früheren Strukturaufklärungen an diesem Materialsystem bestätigt diese Analyse, dass sich die abgeschiedenen Sn-Atome auf T$_4$-Adsorptionsplätzen energetisch günstig anlagern, wobei die bei drei unterschiedlichen Einfallswinkeln aufgenommenen experimentellen Daten an unterschiedlichen Probenpositionen auf ein vorhandenes bzw. fehlendes Si-Atom auf einem S$_5$-Gitterplatz im darunterliegenden Si(111)-Substrat hindeuten. Außerdem konnte das theoretisch vorhergesagte dynamische Fluktuations-Modell aufgrund der sehr stark erhöhten thermischen Auslenkungen der Sn-Atome aus ihrer Gleichgewichtslage in den Modellrechnungen zur dynamischen Streutheorie nachgewiesen werden. Dies könnte neben den unregelmäßig angeordneten Si-Fehlstellen eine Ursache für das Ausbleiben des strukturell reversiblen Phasenübergangs von einer ($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Phase zu einer (3$\times$3)-Phase bei tiefen Temperaturen, wie er beispielsweise beim elektronisch vergleichbaren Adsorbatsystem Ge(111)-($\sqrt{3}\times\sqrt{3}$)R30${\degree}$-Sn auftritt, sein.
The eukaryotic parasite Trypanosoma brucei has evolved sophisticated strategies to persist within its mammalian host. Trypanosomes evade the hosts' immune system by antigenic variation of their surface coat, consisting of variant surface glycoproteins (VSGs). Out of a repertoire of thousands of VSG genes, only one is expressed at any given time from one of the 15 telomeric expression sites (ES). The VSG is stochastically exchanged either by a transcriptional switch of the active ES (in situ switch) or by a recombinational exchange of the VSG within the active ES. However, for infections to persist, the parasite burden has to be limited. The slender (sl) bloodstream form secretes the stumpy induction factor (SIF), which accumulates with rising parasitemia. SIF induces the irreversible developmental transition from the proliferative sl to the cell cycle-arrested but fly-infective stumpy (st) stage once a concentration threshold is reached. Thus, antigenic variation and st development ensure persistent infections and transmissibility. A previous study in monomorphic cells indicated that the attenuation of the active ES could be relevant for the development of trypanosomes. The present thesis investigated this hypothesis using the inducible overexpression of an ectopic VSG in pleomorphic trypanosomes, which possess full developmental competence. These studies revealed a surprising phenotypic plasticity: while the endogenous VSG was always down-regulated upon induction, the ESactivity determined whether the VSG overexpressors arrested in growth or kept proliferating. Full ES-attenuation induced the differentiation of bona fide st parasites independent of the cell density and thus represents the sole natural SIF-independent differentiation trigger to date. A milder decrease of the ES-activity did not induce phenotypic changes, but appeared to prime the parasites for SIF-induced differentiation. These results demonstrate that antigenic variation and development are linked and indicated that the ES and the VSG are independently regulated. Therefore, I investigated in the second part of my thesis how ES-attenuation and VSG-silencing can be mediated. Integration of reporters with a functional or defective VSG 3'UTR into different genomic loci showed that the maintenance of the active state of the ES depends on a conserved motif within the VSG 3'UTR. In situ switching was only triggered when the telomere-proximal motif was partially deleted, suggesting that it serves as a DNA-binding motif for a telomere-associated protein. The VSG levels seem to be additionally regulated in trans based on the VSG 3'UTR independent of the genomic context, which was reinforced by the regulation of a constitutively expressed reporter with VSG 3' UTR upon ectopic VSG overexpression.
Diabetes mellitus Typ 1 ist eine chronische Autoimmunerkrankung, die über eine Zerstörung pankreatischer Beta-Zellen der Langerhans-Inseln zu einem absoluten Insulinmangel führt. Ursächlich für die Zerstörung des Pankreasgewebes sind autoreaktive T-Zellen, die eine Entzündungsreaktion (Insulitis) im Pankreas bewirken.
Zentrales Thema der Promotionsarbeit ist die Erforschung grundlegender quantitativer
und qualitativer Eigenschaften von T-Zellen von Diabetikern im Vergleich zu gesunden, alters-gleichen Kontrollpersonen. Der Fokus der Arbeit liegt dabei auf der Analyse von naiven T-Zellen und ihrer Polarisierbarkeit in proinflammatorische Th17 (Interleukin-17-produzierende) Zellen und regulatorische T-Zellen (Tregs), die die Inflammation unterdrücken können. Voruntersuchungen der Arbeitsgruppe zeigten tendenziell eine proportionale Vermehrung von proinflammatorischen T-Zellen (Th17 Zellen) im peripheren Blut von Typ1 Diabetikern.
Aus dem Vollblut wurden mittels Ficoll-Dichtezentrifugation periphere mononukleäre
Zellen des Blutes (PBMC) gewonnen. Über magnetisch aktivierte Zell-Separation (MACS) wurden naive T-Zellen (CD4+CD45RA+CD27+) aus den PBMCs isoliert. Diese naiven Zellen wurden angeregt sich zu adulten, immunkompetenten Zellen zu differenzieren. Die Antigenstimulation der T-Zellen wurde imitiert durch Aktivierung mit Antikörpern gegen die Moleküle CD3 und CD28 oder einem C. albicans-Antigen. Die Stimulation wurde unter Co-Kultivierung mit autologen antigenpräsentierenden Zellen durchgeführt. Die Richtung der Differenzierung wurde durch Zugabe verschiedener Zytokin-Cocktails beeinflusst. Nach Abschluss der Kultivierung wurde sowohl der Phänotyp der Zellen als auch deren Fähigkeit bestimmte Zytokine zu produzieren mittels Durchflusszytometrie (FACS) bestimmt. Weiterhin wurden Suppressionsassays durchgeführt, bei denen die Suppressionsfähigkeit von aus naiven T-Zellen induzierten Tregs auf autologe PBMCs von Typ 1 Diabetes Patienten überprüft wurde. In dem zunächst durchgeführten Vergleich von Kindern mit einer Erstmanifestation mit gesunden Kontrollen konnte eine stärkere IFN-Produktion gezeigt
werden mit signifikanten Unterschieden innerhalb der Ki67+ Zellen. Interessanterweise zeigte sich diese stärkere IFN Sekretion der T-Zellen der Diabetiker unter Bedingungen, die die Expression von TH17-Zellen fördern sollten. Zusätzlich konnten T-Zellen nachgewiesen werden, die für IFN und IL17 doppelt positiv waren. In weiteren Versuchen wurden auch Vergleiche zwischen längere Zeit an Diabetes erkrankten Kindern und erwachsenen Diabetikern mit gesunden Kontrollen durchgeführt.
Bei den erwachsenen Diabetikern konnten dabei mehr IFN+/IL17+ T Zellen innerhalb der Ki67+ T-Zellen nachgewiesen werden als bei den Kontrollen. Die Zellkulturexperimente wurden im Weiteren mit C. albicans-Antigen als einem spezifischen Stimulus des Immunsystems durchgeführt. Die Untersuchung zeigte zunächst einmal, dass das C. albicans-Antigen bezüglich Proliferation und T-Zell-Differenzierung ein deutlich schwächerer Stimulus im Vergleich zur Stimulation mit aCD3/aCD28 war. Beobachtet werden konnte allerdings, dass es durch Stimulation mit dem C. albicans-Antigen insgesamt zu einer stärkeren Aktivierung des TH17-Zell-Systems kam mit Ausnahme der längere Zeit an einem Diabetes
erkrankten Kinder, die eine geringere IL17-Produktion im Vergleich zu den Kontrollen aufwiesen.
Insgesamt zeigten sich teils deutliche Unterschiede zwischen den Gruppen der Diabetiker, so dass von einer Beeinflussung der Ergebnisse durch Krankheitsdauer, Krankheitsaktivität, Alter der Probanden und Therapiedauer ausgegangen werden muss.
Die Untersuchung des Proliferationsverhaltens ergab sowohl bei den proinflammatorischen
T-Zellen als auch bei den Tregs keine Unterschiede zwischen den Diabetikern und den Kontrollpatienten, ebenso wie die quantitative Untersuchung der Ausbildung von CD25+FOXP3+ Tregs aus den naiven T-Zellen unter unspezifischer Stimulation. Unter spezifischer Stimulation hingegen zeigten sich mehr Tregs bei den Kindern mit einer Erstmanifestation und den erwachsenen Diabetikern.
Ebenfalls unter Stimulation mit dem C. albicans-Antigen zeigten sich unter proinflammatorischen Bedingungen bei den Kindern mit einer Erstmanifestation und unter antiinflammatorischen Bedingungen bei den erwachsenen Diabetikern ein signifikant höherer Anteil CD127- Tregs (CD25+FOXP3+) im Vergleich zu den Kontrollprobanden.
Interessanterweise zeigte sich bei den erwachsenen Diabetikern sowohl bei spezifischer
als auch bei unspezifischer Stimulation eine stärkere Produktion von IL17 durch die Tregs.
Die Untersuchung der Expression des Homing-Rezeptors CD62L auf den Tregs ergab keine signifikanten Unterschiede, aber eine höhere Expression bei allen Diabetikern im Vergleich zu den jeweiligen Kontrollgruppen und die Untersuchung des IFN-Rezeptors erbrachte keine signifikanten Unterschiede zwischen den Gruppen, allerdings zeigten sich die Mediane und Mittelwerte bei den Kindern mit einer Erstmanifestation im Vergleich zu den Kontrollen bei unspezifischer Stimulation erhöht.
Zur Ergänzung der Zellkulturexperimente wurden im Weiteren Suppressionsversuche mit aus naiven T-Zellen induzierten Tregs durchgeführt. Die Suppressionsversuche konnten eine geringere Hemmung der Proliferation durch die induzierten Tregs der Diabetiker zeigen und damit auf eine mögliche Dysfunktion der Tregs deuten.
Um Möglichkeiten der Beeinflussung des Immunsystems zu untersuchen wurden die Zellkulturen erneut unter Blockade von IFNy und Zugabe von TGFb durchgeführt. Die Blockade von IFNy führte zu einer geringer ausgeprägten Differenzierung und Proliferation der T-Zellen. Weiterhin konnten in der intrazellulären Färbung weniger IFN positive T-Zellen gefunden werden und es zeigte sich eine stärkere Expression des IFN-Rezeptors. Bei den Kindern mit einer Erstmanifestation zeigte sich zusätzlich auch eine geringere Ausprägung der IL17+ T-Zellen. Hier ergaben sich keine Unterschiede in der Quantität der Tregs. Die erwachsenen Diabetiker zeigten hier weniger Tregs, dafür aber eine stärkere Proliferation innerhalb der Tregs. Bei den Kindern mit einem längere Zeit bestehenden Diabetes hingegen zeigten sich keine quantitativen Unterschiede.
Die Beeinflussung durch Zugabe von TGFb bei den erwachsenen Diabetikern und den Kindern mit einer Erstmanifestation führte zu einer geringeren T-Zell Differenzierung mit mehr naiven T-Zellen und weniger Memory-T-Zellen sowie zu einer geringeren IFNy Expression. Bei den Erwachsenen zeigte sich ebenso eine geringere Proliferation, geringe Anzahlen für Tregs sowie eine geringe Ausprägung der Expression von CD62L und der Produktion von IL17 durch Tregs.
Insgesamt konnte gezeigt werden, dass es Unterschiede zwischen den proinflammatorischen
T-Zellen sowie den induzierten Tregs der Diabetiker im Vergleich zu den gesunden Kontrollen gibt. Insbesondere die Bedeutung von IFNy bei den Erstmanifestation konnte gezeigt werden. Aber auch die Sekretion von IL17 oder die Expression von CD62L auf den Tregs stellen interessante Ansatzpunkte zur weiteren Erforschung des Diabetes dar. Weiterhin zeigten die Suppressionsversuche eine gestörte Regulation durch die induzierten Tregs bei den Diabetikern. Sowohl die Blockade von IFNy als auch die Zugabe von TGFb zeigten inflammationshemmende Wirkung bei den Lymphozyten der Diabetiker in vitro und stellen
interessante Ansatzpunkt für eine mögliche Therapie dar.
Die Rückkehr des Realen
(2020)
We are witnessing a return of the real which philosophy seems illequipped to handle. I argue (1) that this return of the real must be read as a rejection of those philosophical tendencies which were prevalent in the past decades and which I call philosophies of mediation: They supplanted all references to something real by the sole reference to those processes in which reality was supposed to be given or shaped (in interpretations, linguistic structures, historical or social conditions, media…). The current urgency of the question of the real indicates that those philosophies have lost credibility. On the other hand (2), the contemporary attempts to resuscitate philosophical realism cannot be considered satisfactory either. It is curiously the real itself they fail to fully appreciate. All in all (3), the return of the real has to be interpreted as the effect of an event that has little to do with philosophy, namely the return of politics.
Statistical modeling of phenology in Bavaria based on past and future meteorological information
(2020)
Plant phenology is well known to be affected by meteorology. Observed changes in the occurrence of phenological phases arecommonly considered some of the most obvious effects of climate change. However, current climate models lack a representationof vegetation suitable for studying future changes in phenology itself. This study presents a statistical-dynamical modelingapproach for Bavaria in southern Germany, using over 13,000 paired samples of phenological and meteorological data foranalyses and climate change scenarios provided by a state-of-the-art regional climate model (RCM). Anomalies of severalmeteorological variables were used as predictors and phenological anomalies of the flowering date of the test plantForsythiasuspensaas predictand. Several cross-validated prediction models using various numbers and differently constructed predictorswere developed, compared, and evaluated via bootstrapping. As our approach needs a small set of meteorological observationsper phenological station, it allows for reliable parameter estimation and an easy transfer to other regions. The most robust andsuccessful model comprises predictors based on mean temperature, precipitation, wind velocity, and snow depth. Its averagecoefficient of determination and root mean square error (RMSE) per station are 60% and ± 8.6 days, respectively. However, theprediction error strongly differs among stations. When transferred to other indicator plants, this method achieves a comparablelevel of predictive accuracy. Its application to two climate change scenarios reveals distinct changes for various plants andregions. The flowering date is simulated to occur between 5 and 25 days earlier at the end of the twenty-first century comparedto the phenology of the reference period (1961–1990).
SLC2A3 encodes the predominantly neuronal glucose transporter 3 (GLUT3), which facilitates diffusion of glucose across plasma membranes. The human brain depends on a steady glucose supply for ATP generation, which consequently fuels critical biochemical processes, such as axonal transport and neurotransmitter release. Besides its role in the central nervous system, GLUT3 is also expressed in nonneural organs, such as the heart and white blood cells, where it is equally involved in energy metabolism. In cancer cells, GLUT3 overexpression contributes to the Warburg effect by answering the cell's increased glycolytic demands. The SLC2A3 gene locus at chromosome 12p13.31 is unstable and prone to non‐allelic homologous recombination events, generating multiple copy number variants (CNVs) of SLC2A3 which account for alterations in SLC2A3 expression. Recent associations of SLC2A3 CNVs with different clinical phenotypes warrant investigation of the potential influence of these structural variants on pathomechanisms of neuropsychiatric, cardiovascular, and immune diseases. In this review, we accumulate and discuss the evidence how SLC2A3 gene dosage may exert diverse protective or detrimental effects depending on the pathological condition. Cellular states which lead to increased energetic demand, such as organ development, proliferation, and cellular degeneration, appear particularly susceptible to alterations in SLC2A3 copy number. We conclude that better understanding of the impact of SLC2A3 variation on disease etiology may potentially provide novel therapeutic approaches specifically targeting this GLUT.
Der Einsatz von Regionalanästhesien nahm in den letzten Jahren stark zu. Durch die Blockade von spannungsabhängigen Natriumkanälen verhindern Lokalanästhetika eine Depolarisation sowie die neuronale Fortleitung der Schmerzimpulse. In höheren Dosierungen kann es jedoch zu ausgedehnten Blockaden im Myokard mit toxischen Wirkungen auf die Funktion der Muskelzellen kommen. Bis zur Einführung der Lipidemulsionen als Behandlungsoption bei einer Lokalanästhetikaintoxikation war eine prolongierte kardio-pulmonale Reanimation die einzige therapeutische Option.
In dieser Arbeit wurden die aktuell häufig verwendeten langwirksamen Substanzen Bupivacain und Ropivacain hinsichtlich einer divergierenden Kardiotoxizität verglichen und die Präinkubation mit Lipofundin® als Möglichkeit zur Reduktion der Kardiotoxizität getestet.
Mit Zustimmung der Ethikkommission wurden insgesamt 46 humane Herzmuskelbündel in einem Organbad untersucht.
Es erfolgte im Abstand von drei Minuten eine Inkubation mit Koffein in steigenden Konzentrationen (0,5; 1,0; 1,5; 2,0; 3,0; 4,0 mmol/l) und nachfolgend die Applikation von handelsüblichen Lösungen von Lokalanästhetika
(50 – 100 – 150 µl). Es wurden entweder Bupivacain (0,25, 0,5, 0,75 mg), Ropivacain (0,375, 0,75, 1,125 mg) oder Ropivacain in Kombination mit Lipofundin® 20% N (200µl in Verdünnung 1:100) appliziert. Abschließend erfolgte die hochdosierte Gabe von Koffein (Gesamtkonzentration 32 mmol/l), um eine maximale Kontraktur auszulösen.
Es zeigte sich kein signifikanter Unterschied zwischen Bupivacain und Ropivacain hinsichtlich der Kontraktionsamplitude und der Grundspannung bei ähnlichem Verhalten in beiden Gruppen. Die Präinkubation mit Lipofundin® ergab im Vergleich zur Kontrollgruppe keinen signifikanten Effekt.
Eine signifikante konzentrationsabhängige Abnahme der Kontraktionsamplitude und der Grundspannung zeigte sich während der initialen Inkubation mit Koffein.
Initiale Schädigungen, passagere Ermüdungserscheinungen oder hypoxische Stoffwechselzustände könnten trotz bestmöglicher Bedingungen die Ergebnisse beeinträchtigt haben. Die vorliegenden in-vitro-Ergebnisse lassen sich nur limitiert auf in-vivo-Bedingungen übertragen und verlangen nach weiteren Studien, die eine differenzierte und präzise Wirkweise sowie Dosierung von Lipidemulsionen evaluieren.
Blumeria graminis, the obligate biotrophic grass powdery mildew, is a highly pathogenic fungus capable of inflicting foliar diseases and of causing severe yield losses. There is asexual and sexual propagation in the life cycle of B. graminis. In the epidemiological processes of this pathogen, both types of spores - asexual conidia and sexual ascospores – are crucial.
Conidia of B. graminis are demonstrated to perceive cuticular very-long-chain aldehydes as molecular signal substances notably promoting germination and differentiation of the infection structure (the appressorium) – the prepenetration processes – in a concentration- and chain-length-dependent manner. Conidial germination and appressorium formation are known to be dramatically impeded by the presence of free water on the host surface. However, sexually formed ascospores are reported to easily germinate immersed in water. There are abundant assays on conidial prepenetration processes. However, with respect to the stimulating effects of very-long-chain aldehydes and to the influence of the presence of free water, ascosporic prepenetration processes are still obscure.
In order to study the effects of very-long-chain aldehydes on the ascosporic prepenetration processes of wheat powdery mildew fungus B. graminis f. sp. tritici, Formvar®-based in vitro systems were applied to exclude the secondary host effects (such as host resistance) and to reproducibly provide homogeneous hydrophobic substratum surfaces. By the presence of even-numbered very-long-chain aldehydes (C22 - C30), the appressorium formation of the ascospores was notably triggered in a chain-length dependent manner. N-octacosanal (C28) was the most inducing aldehyde tested. Unlike conidia, ascospores could easily differentiate immersed in water and showed a more variable differentiation pattern even with a single germ tube differentiating an appressorium.
To evaluate the alternative management against barley powdery mildew fungus Blumeria graminis f. sp. hordei, the suppressing effects of UV-C irradiation on the developmental processes of conidia on artificial surfaces (in vitro) and on host leaf surfaces (in vivo) were assayed. In vitro and in vivo, a single dose of 100 J m-2 UV-C was adequate to decrease conidial germination to < 20 % and to reduce appressorium formation to values < 5 %. UV-C irradiation negatively affected colony pustule size and vegetative propagation. Under photoperiodic conditions of 2h light/16h dark, 6h dark/12h light or 6h dark/18h light, UV-C-treated conidia showed photoreactivation (photo-recovery). White light-mediated photoreactivation was most effective immediately after UV-C irradiation, suggesting that a prolonged phase of darkness after UV-C application increased the efficacy of management against B. graminis. UV-C irradiation increased transcript levels of three putative photolyase genes in B. graminis, indicating those were probably involved in photoreactivation processes. However, mere white light or blue light (wavelength peak, 475 nm) could not induce the up-regulation of these genes.
To determine whether visible light directly impacted the prepenetration and penetration processes of this powdery mildew pathogen, conidia of Blumeria graminis f. sp. hordei and Blumeria graminis f. sp. tritici were inoculated onto artificial surfaces and on host leaf surfaces. Samples were analyzed after incubation periods under light conditions (white light intensity and spectral quality). Increasing white light intensities directly impaired conidial prepenetration processes in vitro but not in vivo. Applying an agar layer under the wax membrane compensated for conidial water loss as a consequence of high white light irradiation. Light stimulated in vitro and in vivo the appressorium elongation of B. graminis in a wavelength-dependent manner. Red light was more effective to trigger the elongation of appressorium than blue light or green light assayed.
Taken together, the findings of this study demonstrate that 1) a host surface recognition principle based on cuticular very-long-chain aldehydes is a common feature of B. graminis f. sp. tritici ascospores and conidia; 2) the transcriptional changes of three putative photolyase genes in B. graminis are mediated in a UV-C-dependent manner; 3) light directly affected the (pre)penetration processes of B. graminis.
We herein report the case of a 73‐year‐old male patient who was diagnosed with leukemic non‐nodal MCL. This patient had received six cycles of bendamustine, which resulted in a transient remission, and a second‐line therapy with ibrutinib, which unfortunately failed to induce remission. We started a treatment with single‐agent obinutuzumab at a dose of 20 mg on day 1, 50 mg on day 2‐4, 330 mg on day 5, and 1000 mg on day 6. The laboratory analysis showed a rapid decrease of leukocyte count. Four weeks later, we repeated the treatment with obinutuzumab at a dose of 1000 mg q4w and started a therapy with venetoclax at a dose of 400 mg qd, which could be increased to 800 mg qd from the third cycle. This combination therapy was well tolerated. The patient achieved a complete remission (CR) after three cycles of obinutuzumab and venetoclax. To date, the patient has a progression‐free survival of 17 months under ongoing obinutuzumab maintenance q4w. This is the first report about obinutuzumab and venetoclax induced CR in rituximab‐intolerant patient with an ibrutinib‐resistant MCL. This case suggests that obinutuzumab‐ and venetoclax‐based combination therapy might be salvage therapy in patients with ibrutinib‐resistant MCL.
Background
Even in the era of novel immunotherapies for multiple myeloma (MM), treatment of late‐stage relapsed/refractory (RR) patients remains challenging. The aim of our study was to analyze the efficacy and safety of the five‐drug combination pomalidomide, bortezomib, doxorubicin, dexamethasone, and daratumumab (“Pom‐PAD‐Dara”) in RRMM.
Methods
We retrospectively analyzed data of 56 patients with RRMM who received Pom‐PAD‐Dara between September 2016 and May 2019.
Results
Patients were heavily pretreated with a median of four prior lines of therapy, including autologous and allogenic stem cell transplant in 50 (89%) and six (11%) patients, respectively. The overall response rate (ORR) was 78% and we observed partial remission, very good partial remission, and complete remission in 27 (48%), 13 (23%) and four (7%) patients, respectively. Median progression‐free survival was 7 months (95% CI, 3.3‐10.7) and the median overall survival was not reached at 24 months. Adverse events grade ≥ 3 were observed 41 (73%) patients and included neutropenia (n = 28, 50%), anemia (n = 22, 39%), thrombocytopenia (n = 21, 38%), and pneumonia (n = 6, 11%).
Conclusion
Pom‐PAD‐Dara represents a promising multiagent regimen in heavily pretreated RRMM patients with high ORR and an acceptable safety profile.
In the last few years, monoclonal antibodies (mAbs) such as elotuzumab and daratutumab have brought the treatment of multiple myeloma (MM) into the new era of immunotherapy. More recently, chimeric antigen receptor (CAR) modified T cell, a novel cellular immunotherapy, has been developed for treatment of relapsed/refractory (RR) MM, and early phase clinical trials have shown promising efficacy of CAR T cell therapy. Many patients with end stage RRMM regard CAR T cell therapy as their “last chance” and a “hope of cure”. However, severe adverse events (AEs) and even toxic death related to CAR T cell therapy have been observed. The management of AEs related to CAR T cell therapy represents a new challenge, as the pathophysiology is not fully understood and there is still no well-established standard of management. With regard to CAR T cell associated toxicities in MM, in this review, we will provide an overview of experience from clinical trials, pathophysiology, and management strategies.
Published experience with carfilzomib in patients with relapsed/refractory multiple myeloma (RRMM) and extramedullary disease (EMD) is still limited. The current study aimed to assess the efficacy and safety of carfilzomib containing therapy regimens in EMD. We retrospectively analyzed 45 patients with extramedullary RRMM treated with carfilzomib from June 2013 to September 2019. The median age at the start of carfilzomib was 64 (range 40–80) years. Twenty (44%) and 25 (56%) patients had paraosseous manifestation and EMD without adjacency to bone, respectively. The serological overall response rate (ORR) was 59%. Extramedullary response was evaluable in 33 patients, nine (27%) of them achieved partial remission (PR) (ORR = 27%). In 15 (33%) patients, we observed no extramedullary response despite serological response. The median progression-free survival (PFS) and overall survival (OS) were five (95% CI, 3.5–6.5) and ten (95% CI, 7.5–12.5) months, respectively. EMD without adjacency to bone was associated with a significantly inferior PFS (p = 0.004) and OS (p = 0.04) compared to paraosseous lesions. Carfilzomib based treatment strategies showed some efficacy in heavily pretreated patients with extramedullary RRMM but could not overcome the negative prognostic value of EMD. Due to the discrepancy between serological and extramedullary response, evaluation of extramedullary response using imaging is mandatory in these patients.
Utilizing 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), we performed this pilot study to evaluate the link between cytogenetic/genomic markers and imaging patterns in relapsed/refractory (RR) multiple myeloma (MM). We retrospectively analyzed data of 24 patients with RRMM who were treated at our institution between November 2018 and February 2020. At the last relapse/progression, patients had been treated with a median of three (range 1–10) lines of therapy. Six (25%) patients showed FDG avid extramedullary disease without adjacency to bone. We observed significantly higher maximum standardized uptake values (SUV\(_{max}\)) in patients harboring del(17p) compared with those without del(17p) (p = 0.025). Moreover, a high SUV\(_{max}\) of >15 indicated significantly shortened progression-free survival (PFS) (p = 0.01) and overall survival (OS) (p = 0.0002). One female patient exhibited biallelic TP53 alteration, i.e., deletion and mutation, in whom an extremely high SUV\(_{max}\) of 37.88 was observed. In summary, this pilot study suggested a link between del(17p)/TP53 alteration and high SUV\(_{max}\) on 18F-FDG PET/CT in RRMM patients. Further investigations are highly warranted at this point.
This study aimed to explore the correlation between imaging patterns and clinical features in patients with smoldering multiple myeloma (SMM) who simultaneously underwent 18F-FDG, 11C-Methionine, and 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT). We retrieved and analyzed clinical characteristics and PET imaging data of 10 patients with SMM. We found a significant correlation between bone marrow (BM) plasma cell (PC) infiltration and mean standardized uptake values (SUV\(_{mean}\)) of lumbar vertebrae L2-L4 on 11C-Methionine PET/CT scans (r = 0.676, p = 0.031) and 68Ga-Pentixafor PET/CT scans (r = 0.839, p = 0.002). However, there was no significant correlation between BM involvement and SUV\(_{mean}\) of lumbar vertebrae L2-L4 on 18F-FDG PET/CT scans (r = 0.558, p = 0.093). Similarly, mean target-to-background ratios (TBR\(_{mean}\)) of lumbar vertebrae L2-L4 also correlated with bone marrow plasma cell (BMPC) infiltration in 11C-Methionine PET/CT (r = 0.789, p = 0.007) and 68Ga-Pentixafor PET/CT (r = 0.724, p = 0.018) PET/CT. In contrast, we did not observe a significant correlation between BMPC infiltration rate and TBR\(_{mean}\) in 18F-FDG PET/CT (r = 0.355, p = 0.313). Additionally, on 11C-Methionine PET/CT scans, we found a significant correlation between BMPC infiltration and TBR\(_{max}\) of lumbar vertebrae L2-L4 (r = 0.642, p = 0.045). In conclusion, 11C-Methionine and 68Ga-Pentixafor PET/CT demonstrate higher sensitivity than 18F-FDG PET/CT in detecting BM involvement in SMM.
Die Gottesknechtslieder gehören zu den Texten des Alten Testaments, die sehr häufig interpretiert worden sind. Das liegt zweifelsohne an der besonderen christlichen Rezeption, aber auch an der literaturgeschichtlichen und theologischen Bedeutung der Kapitel Jes 40–55. Eine weitere Studie dazu könnte in der Tat als Zeit- und Ressourcenverschwendung gewertet werden, wäre da nicht die theologisch herausragende Bedeutung der Gottesknechtslieder über den literarischen Horizont Deuterojesaja hinaus.
Spätestens seit den Arbeiten von Ulrich Berges steht die lange Zeit angenommene Eigenständigkeit der Textgruppe Gottesknechtslieder in Frage. Diese Sichtweise eröffnet einerseits die Möglichkeit, die Funktionalität der Lieder innerhalb Deuterojesajas neu zu beschreiben, andererseits vernachlässigt sie eine genauere Beschreibung der Funktion des Gottesknechts im historischen Kontext des zu Ende gehenden babylonischen Exils.
Diese Arbeit versucht mit den Methoden der historisch-kritischen Exegese zu rekonstruieren, wie eine prophetische Figur vom exilierten Teil Israels erwartet, als Gottesknecht zu wirken, aber zur Kenntnis nehmen muss, dass ihre Zeitgenossen dazu nicht bereit sind. Nach ihrem Scheitern, das in den Gottesknechtslieder verarbeitet ist, wird das prophetische Tun dieser Figur allerdings als Verwirklichung des Knechtsauftrags gedeutet. Die Besonderheit dieser Deutung des Knechtsauftrags im Kontext des Werkes Jes 40–55 liegt in seiner Erklärung des Leidens des Knechts: Der Knecht leidet wegen der Vergehen seiner Zeitgenossen. Innerhalb des alttestamentlichen Diskurses zum Problem der Theodizee liegt somit das Modell einer synchronen Schuldverkettung vor. Diese Bedeutung, die dem Tod des Knechts zugeschrieben wird, führt sogar im klassischen Tun-Ergehen-Zusammenhang zur Vorstellung eines guten Ergehens des Knechts im Jenseits. Die erste Vorstellung von Auferstehung kann somit im 4. Gottesknechtslied verortet werden.
Die Besonderheit des Knechtsauftrags zeigt eine weitere bedeutende theologische Weichenstellung im Alten Testament: Der Knechtsauftrag beinhaltet die Etablierung der göttlichen Rechts- und Heilsordnung für alle Nationen, dessen Licht der Knecht ist. Die Gottesknechtslieder sind also auch unverzichtbarer Bestandteil in der Wende zur Vorstellung eines Heilsuniversalismus. Diese Arbeit bietet demzufolge nicht nur eine Synthese der wichtigsten Forschungsfragen in Bezug auf die Gottesknechtslieder, sondern beschreibt ausführlich die Relevanz dieser Textzeugnisse innerhalb alttestamentlicher Theologie.
Marine organisms and their associated microbes are rich in diverse chemical leads. With the development of marine biotechnology, a considerable number of research activities are focused on marine bacteria and fungi-derived bioactive compounds. Marine bacteria and fungi are ranked on the top of the hierarchy of all organisms, as they are responsible for producing a wide range of bioactive secondary metabolites with possible pharmaceutical applications. Thus, they have the potential to provide future drugs against challenging diseases, such as cancer, a range of viral diseases, malaria, and inflammation. This review aims at describing the literature on secondary metabolites that have been obtained from Scleractinian-associated organisms including bacteria, fungi, and zooxanthellae, with full coverage of the period from 1982 to 2020, as well as illustrating their biological activities and structure activity relationship (SAR). Moreover, all these compounds were filtered based on ADME analysis to determine their physicochemical properties, and 15 compounds were selected. The selected compounds were virtually investigated for potential inhibition for SARS-CoV-2 targets using molecular docking studies. Promising potential results against SARS-CoV-2 RNA dependent RNA polymerase (RdRp) and methyltransferase (nsp16) are presented.
Die nicht-invasive Gefäßdiagnostik stellt einen wichtigen Pfeiler in der Prävention von Herz-Kreislauferkrankungen dar. Während lange Zeit die sonographische Messung der cIMT, als morphologisches Korrelat der Gefäßalterung, als Goldstandard galt, ist in den letzten Jahren in Gestalt der Pulswellenanalyse/PWV-Messung eine Technik weiterentwickelt worden, die, als funktionelles Korrelat der Gefäßalterung, aufgrund der leichteren Durchführbarkeit und geringerer Untersucherabhängigkeit und Kosten vielversprechend ist. So erlaubt die Messung der Pulswelle mittels gewöhnlicher Blutdruckmanschetten, genau wie die cIMT, die Berechnung des individuellen Gefäßalters und die Diagnostik für das Vorliegen eines Endorganschadens der Blutgefäße.
Um die Messergebnisse der beiden Untersuchungen miteinander zu vergleichen, wurden beide in der EUROASPIRE-IV Studie an Patienten mit koronarer Herzkrankheit durchgeführt. Die Auswertung der Messergebnisse der mit dem Vascular Explorer durchgeführten Pulswellenanalyse/PWV-Messung ergab überraschenderweise, dass die Mehrheit der herzkranken Patienten weder eine vaskuläre Voralterung noch einen Endorganschaden der Blutgefäße aufweisen. Im Falle der cIMT-Messung war Gegenteiliges der Fall, was trotz der medikamentösen Therapie der Patienten so zu erwarten war. Weiterhin zeigte sich lediglich eine geringe Korrelation zwischen den Messergebnissen beider Untersuchungen. Die Determinanten der einzelnen Messwerte aus cIMT und Pulswellenanalyse/PWV-Messung waren deckungsgleich mit den in der Literatur beschriebenen Faktoren, wenn auch viele der sonst signifikanten Regressoren das Signifikanzniveau in unserer Auswertung nicht unterschritten.
Eine Limitation der funktionellen Gefäßdiagnostik liegt derzeit darin, dass die Messergebnisse stark von dem verwendeten Messgerät abhängen. Es liegen noch zu wenig Vergleichsstudien vor, um die Messergebnisse, speziell von neueren Geräten wie dem Vascular Explorer, auf andere zu übertragen. Bei der Berechnung des Gefäßalters sollten daher optimalerweise gerätespezifische Normwerte vorliegen, was beim Vascular Explorer nicht der Fall ist. Gleiches gilt für die Verwendung des PWVcf-Grenzwerts für die Diagnose eines Endorganschadens der Blutgefäße.
Analog hat auch die Messung der cIMT gewisse Einschränkungen. So wäre eine weitere Standardisierung der Messorte (A. carotis communis vs Bulbus vs A. carotis interna), zwischen denen sich die durchschnittliche cIMT erheblich unterscheidet, sowie der Messparameter (Minimal- vs Maximal- vs Mittelwert) wünschenswert. Die universelle Anwendung eines cIMT-Grenzwerts zur Diagnose eines Endorganschadens der Blutgefäße ist daher kritisch zu sehen. Dies zeigt sich auch darin, dass in den neuesten Leitlinien der bislang geltende Grenzwert angezweifelt und kein aktuell gültiger Grenzwert mehr genannt wird.
Wir interpretieren unsere Ergebnisse dahingehend, dass unsere Messung der cIMT die zu erwartende pathologische Gefäßalterung bei Patienten mit koronarer Herzkrankheit besser widerspiegelt als die Messung der Pulswelle mit dem Vascular Explorer. Welche der beiden Untersuchungen hinsichtlich der prognostischen Wertigkeit überlegen ist, muss im Rahmen von Längsschnittstudien geklärt werden.
Purpose
To achieve a highly balanced comparison of trabecular bypass stenting (IS2, iStent inject) with ab interno trabeculectomy (T, Trabectome) by exact matching.
Methods
Fifty-three IS2 eyes were matched to 3446 T eyes. Patients were matched using exact matching by baseline intraocular pressure (IOP), the number of glaucoma medications, and glaucoma type, and using nearest neighbor matching by age. Individuals without a close match were excluded. All surgeries were combined with phacoemulsification.
Results
A total of 78 eyes (39 in each group) could be matched as exact pairs with a baseline IOP of 18.3 ± 5.1 mmHg and glaucoma medications of 2.7 ± 1.2 in each. IOP in IS2 was reduced to 14.6 ± 4.2 mmHg at 3 months and in T to a minimum of 13.1 ± 3.2 mmHg at 1 month. In IS2, IOP began to rise again at 6 months, eventually exceeding baseline. At 24 months, IOP in IS2 was 18.8 ± 9.0 mmHg and in T 14.2 ± 3.5 mmHg. IS2 had a higher average IOP than T at all postoperative visits (p < 0.05 at 1, 12, 18 months). Glaucoma medications decreased to 2.0 ± 1.5 in IS2 and to 1.5 ± 1.4 in T.
Conclusion
T resulted in a larger and sustained IOP reduction compared with IS2 where a rebound occurred after 6 months to slightly above preoperative values.
In der vorliegenden Studie wurde untersucht, ob laryngeale Konstriktionsphänomene regelhaft bei gesunden Säuglingen mit deutscher Umgebungssprache auftreten, ob es eine altersabhängige oder geschlechtsabhängige Entwicklung in der Auftrittshäufigkeit der Phänomene gibt und ob diese zusätzlich durch den Vokalisationstyp beeinflusst wird. Dazu wurden hier vier typische Vokalisationstypen im vorsprachlichen Alter definiert: spontanes Säuglingsweinen vor einer Mahlzeit in zwei Ausprägungsformen (Typ C und UC, letzterer als Typ weniger intensiven Säuglingsweinens) sowie Nichtschreivokalisationen in zwei Ausprägungsformen (UB: Übergangslaut zwischen UC und silbenartigem Vokalisieren (BB)).
In der vorliegenden Arbeit wurden solche Konstriktionsphänomene untersucht, die in der medizinischen Fachliteratur häufig mit pathologischen Zuständen der respiratorischen Regelung sowie Vokaltraktmalformationen bei Säuglingen mit Lippen-Kiefer-Gaumen-Segelspalten beschrieben werden. Es wurde hier untersucht, ob ähnliche Phänomene auch bei gesunden Säuglingen regelhaft auftreten.
Dazu wurde in einem kombinierten Längs- und Querschnittsdesign eine deskriptive Analyse von 20.406 Einzelvokalisationen von 20 Säuglingen in den ersten sieben Lebensmonaten vorgenommen. Die Vokalisationen lagen anonymisiert im Zentrum für vorsprachliche Entwicklung & Entwicklungsstörungen an der Poliklinik für Kieferorthopädie des Universitätsklinikums Würzburg vor. Es handelt sich um eine explorative, retrospektive Analyse.
Unter Verwendung von Frequenzspektren und Audiofiles wurden alle Einzelvokalisationen audio-visuell analysiert und drei Stufen mit unterschiedlicher Ausprägung der Konstriktionen einsortiert (Kategorie 1 – 3; Kategorie 0 = keine Konstriktionen in der Vokalisation). Die Kategoriendefinition wurde vom Autor der vorliegenden Arbeit in einer Voruntersuchung erarbeitet und durch weitere Kodierer getestet und als geeignet befunden.
Im Ergebnis der Arbeit konnte gezeigt werden, dass die hier untersuchten Konstriktionsphänomene regelhaft bei allen gesunden Säuglingen im Untersuchungszeitraum vorkommen. Die Auftrittshäufigkeit war dabei teilweise vom Geschlecht, vom Alter und vom Vokalisationstyp abhängig. Eine vergleichbare systematische Analyse lag bisher in der Literatur nicht vor. Die Ergebnisse werden aus physiologischer und linguistisch-phonetischer Perspektive interpretiert. Es konnte gezeigt werden, dass die im spontanen Weinen beobachteten Konstriktionsphänomene auch bei den Komfortvokalisationen (Nichtschreivokalisationen) vorkamen.
Dies stützt die Kontinuitätshypothese in der vorsprachlichen Entwicklung.
Die Arbeit hat auch widerlegt, dass alle Konstriktionsphänomene im Säuglingsweinen ein Pathologiemarker sind. Die Differenzierung zwischen physiologischen und pathologischen Konstriktionsphänomenen, die z.B. durch respiratorische Dysfunktion entstehen können (Stridor), ist eine Aufgabe für nachfolgende Arbeiten.
Für weiterführende Arbeiten mit dem Ziel der Anwendung von Stimmregisterphänomenen in der Vorsprachlichen Diagnostik sind methodisch erweiterte Ansätze bei gleichzeitig größerer Stichprobe erforderlich.
Folliculin Controls the Intracellular Survival and Trans-Epithelial Passage of Neisseria gonorrhoeae
(2020)
Neisseria gonorrhoeae, a Gram-negative obligate human pathogenic bacterium, infects human epithelial cells and causes sexually transmitted diseases. Emerging multi-antibiotic resistant gonococci and increasing numbers of infections complicate the treatment of infected patients. Here, we used an shRNA library screen and next-generation sequencing to identify factors involved in epithelial cell infection. Folliculin (FLCN), a 64 kDa protein with a tumor repressor function was identified as a novel host factor important for N. gonorrhoeae survival after uptake. We further determined that FLCN did not affect N. gonorrhoeae adherence and invasion but was essential for its survival in the cells by modulating autophagy. In addition, FLCN was also required to maintain cell to cell contacts in the epithelial layer. In an infection model with polarized cells, FLCN inhibited the polarized localization of E-cadherin and the transcytosis of gonococci across polarized epithelial cells. In conclusion, we demonstrate here the connection between FLCN and bacterial infection and in particular the role of FLCN in the intracellular survival and transcytosis of gonococci across polarized epithelial cell layers.
Chlamydia trachomatis (Ct) is an obligate intracellular human pathogen. It causes blinding trachoma and sexually transmitted disease such as chlamydia, pelvic inflammatory disease and lymphogranuloma venereum. Ct has a unique biphasic development cycle and replicates in an intracellular vacuole called inclusion. Normally it has two forms: the infectious form, elementary body (EB); and the non-infectious form, reticulate body (RB). Ct is not easily amenable to genetic manipulation. Hence, to understand the infection process, it is crucial to study how the metabolic activity of Ct exactly evolves in the host cell and what roles of EB and RB play differentially in Ct metabolism during infection. In addition, Ct was found regularly coinfected with other pathogens in patients who got sexually transmitted diseases (STDs). A lack of powerful methods to culture Ct outside of the host cell makes the detailed molecular mechanisms of coinfection difficult to study.
In this work, a genome-scale metabolic model with 321 metabolites and 277 reactions was first reconstructed by me to study Ct metabolic adaptation in the host cell during infection. This model was calculated to yield 84 extreme pathways, and metabolic flux strength was then modelled regarding 20hpi, 40hpi and later based on a published proteomics dataset. Activities of key enzymes involved in target pathways were further validated by RT-qPCR in both HeLa229 and HUVEC cell lines. This study suggests that Ct's major active pathways involve glycolysis, gluconeogenesis, glycerolphospholipid biosynthesis and pentose phosphate pathway, while Ct's incomplete tricarboxylic acid cycle and fatty acid biosynthesis are less active. EB is more activated in almost all these carbohydrate pathways than RB. Result suggests the survival of Ct generally requires a lot of acetyl-CoA from the host. Besides, both EB and RB can utilize folate biosynthesis to generate NAD(P)H but may use different pathways depending on the demands of ATP. When more ATP is available from both host cell and Ct itself, RB is more activated by utilizing energy providing chemicals generated by enzymes associated in the nucleic acid metabolism. The forming of folate also suggests large glutamate consumption, which is supposed to be converted from glutamine by the glutamine-fructose-6-phosphate transaminase (glmS) and CTP synthase (pyrG).
Then, RNA sequencing (RNA-seq) data analysis was performed by me in a coinfection study. Metatranscriptome from patient RNA-seq data provides a realistic overview. Thirteen patient samples were collected and sequenced by our collaborators. Six male samples were obtained by urethral swab, and seven female samples were collected by cervicovaginal lavage. All the samples were Neisseria gonorrhoeae (GC) positive, and half of them had coinfection with Ct. HISAT2 and Stringtie were used for transcriptomic mapping and assembly respectively, and differential expression analysis by DESeq2, Ballgown and Cuffdiff2 are parallelly processed for comparison. Although the measured transcripts were not sufficient to assemble Ct's transcriptome, the differential expression of genes in both the host and GC were analyzed by comparing Ct positive group (Ct+) against Ct-uninfected group. The results show that in the Ct+ group, the host MHC class II immune response was highly induced. Ct infection is associated with the regulation of DNA methylation, DNA double-strand damage and ubiquitination. The analysis also shows Ct infection enhances host fatty acid beta oxidation, thereby inducing mROS, and the host responds to reduce ceramide production and glycolysis. The coinfection upregulates GC's own ion transporters and amino acid uptake, while it downregulates GC's restriction and modification systems. Meanwhile, GC has the nitrosative and oxidative stress response and also increases the ability for ferric uptake especially in the Ct+ group compared to Ct-uninfected group.
In conclusion, methods in bioinformatics were used here in analyzing the metabolism of Ct itself, and the responses of the host and GC respectively in a coinfection study with and without Ct. These methods provide metabolic and metatranscriptomic details to study Ct metabolism during infection and Ct associated coinfection in the human microbiota.
3D cell culture models which closely resemble real human tissues are of high interest for disease modelling, drug screening as well as a deeper understanding of human developmental biology. Such structures are termed organoids. Within the last years, several human organoid models were described. These are usually stem cell derived, arise by self-organization, mimic mechanisms of normal tissue development, show typical organ morphogenesis and recapitulate at least some organ specific functions. Many tissues have been reproduced in vitro such as gut, liver, lung, kidney and brain. The resulting entities can be either derived from an adult stem cell population, or generated from pluripotent stem cells using a specific differentiation protocol. However, many organoid models only recapitulate the organs parenchyma but are devoid of stromal components such as blood vessels, connective tissue and inflammatory cells. Recent studies show that the incorporation of endothelial and mesenchymal cells into organoids improved their maturation and might be required to create fully functional micro-tissues, which will allow deeper insights into human embryogenesis as well as disease development and progression. In this review article, we will summarize and discuss recent works trying to incorporate stromal components into organoids, with a special focus on neural organoid models.
Aims
Chronic heart failure (CHF) can be caused by autoantibodies stimulating the heart via binding to first and/or second extracellular loops of cardiac β1-adrenoceptors. Allosteric receptor activation depends on conformational features of the autoantibody binding site. Elucidating these features will pave the way for the development of specific diagnostics and therapeutics. Our aim was (i) to fine-map the conformational epitope within the second extracellular loop of the human β\(_1\)-adrenoceptor (β1ECII) that is targeted by stimulating β\(_1\)-receptor (auto)antibodies and (ii) to generate competitive cyclopeptide inhibitors of allosteric receptor activation, which faithfully conserve the conformational auto-epitope.
Methods and results
Non-conserved amino acids within the β\(_1\)EC\(_{II}\) loop (compared with the amino acids constituting the ECII loop of the β\(_2\)-adrenoceptor) were one by one replaced with alanine; potential intra-loop disulfide bridges were probed by cysteine–serine exchanges. Effects on antibody binding and allosteric receptor activation were assessed (i) by (auto)antibody neutralization using cyclopeptides mimicking β1ECII ± the above replacements, and (ii) by (auto)antibody stimulation of human β\(_1\)-adrenoceptors bearing corresponding point mutations. With the use of stimulating β\(_1\)-receptor (auto)antibodies raised in mice, rats, or rabbits and isolated from exemplary dilated cardiomyopathy patients, our series of experiments unmasked two features of the β\(_1\)EC\(_{II}\) loop essential for (auto)antibody binding and allosteric receptor activation: (i) the NDPK\(^{211–214}\) motif and (ii) the intra-loop disulfide bond C\(^{209}\)↔C\(^{215}\). Of note, aberrant intra-loop disulfide bond C\(^{209}\)↔C\(^{216}\) almost fully disrupted the functional auto-epitope in cyclopeptides.
Conclusions
The conformational auto-epitope targeted by cardio-pathogenic β\(_1\)-receptor autoantibodies is faithfully conserved in cyclopeptide homologues of the β\(_1\)EC\(_{II}\) loop bearing the NDPK\(^{211–214}\) motif and the C\(^{209}\)↔C\(^{215}\) bridge while lacking cysteine C216. Such molecules provide promising tools for novel diagnostic and therapeutic approaches in β\(_1\)-autoantibodypositive CHF.
Die Entwicklung hochauflösender Fluoreszenzmikroskopiemethoden hat die Lichtmikroskopie revolutioniert. Einerseits ermöglicht die höhere erzielte räumliche Auflösung die Abbildung von Strukturen, die deutlich unterhalb der beugungsbedingten Auflösungsgrenze liegen. Andererseits erhält man durch Einzelmoleküllokalisationsmikroskopiemethoden
wie dSTORM (Direct Stochastic Optical Reconstruction Microscopy) Informationen, welche man für quantitative Analysen heranziehen kann. Aufgrund der sich dadurch bietenden neuen Möglichkeiten, hat sich die hochauflösende Fluoreszenzmikroskopie rasant entwickelt und kommt mittlerweile zur Untersuchung einer Vielzahl biologischer und medizinischer Fragestellungen zum Einsatz. Trotz dieses Erfolgs ist jedoch nicht zu verleugnen, dass auch diese neuen Methoden ihre Nachteile haben. Dazu zählt die Notwendigkeit relativ hoher Laserleistungen, welche Voraussetzung für hohe Auflösung ist und bei lebenden Proben zur Photoschädigung führen kann.
Diese Arbeit widmet sich sowohl dem Thema der Photoschädigung durch Einzelmoleküllokalisationsmikroskopie,
als auch der Anwendung von dSTORM und SIM (Structured Illumination Microscopy) zur Untersuchung neurobiologischer Fragestellungen auf Proteinebene.
Zur Ermittlung der Photoschädigung wurden lebende Zellen unter typischen Bedingungen bestrahlt und anschließend für 20−24 h beobachtet. Als quantitatives Maß für den Grad der Photoschädigung wurde der Anteil sterbender Zellen bestimmt. Neben der zu erwartenden Intensitäts- und Wellenlängenabhängigkeit, zeigte sich, dass die Schwere der Photoschädigung auch von vielen weiteren Faktoren abhängt und dass sich Einzelmoleküllokalisationsmikroskopie bei Berücksichtigung der gewonnenen Erkenntnisse durchaus mit Lebendzellexperimenten vereinbaren lässt.
Ein weiteres Projekt diente der Untersuchung der A- und B-Typ-Glutamatrezeptoren an der neuromuskulären Synapse von Drosophila melanogaster mittels dSTORM. Dabei konnte eine veränderte Anordnung beider Rezeptortypen infolge synaptischer Plastizität beobachtet, sowie eine absolute Quantifizierung des A-Typ-Rezeptors durchgeführt werden.
Im Mittelpunkt eines dritten Projekts standen Cadherin-13 (CDH13) sowie der Glucosetransporter Typ 3 (GluT3), welche beide mit der Aufmerksamkeitsdefizit-Hyperaktivitätsstörung in Verbindung gebracht werden. CDH13 konnte mittels SIM in serotonergen Neuronen, sowie radiären Gliazellen der dorsalen Raphekerne des embryonalen Mausgehirns nachgewiesen werden. Die Rolle von GluT3 wurde in aus induzierten pluripotenten Stammzellen differenzierten Neuronen analysiert, welche verschiedene Kopienzahlvariation des für GluT3-codierenden SLC2A3-Gens aufwiesen. Die Proteine GluT3, Bassoon und Homer wurden mittels dSTORM relativ quantifiziert. Während die Deletion des Gens zu einer erwartenden Verminderung von GluT3 auf Proteinebene führte, hatte die Duplikation keinen Effekt auf die GluT3-Menge. Für Bassoon und Homer zeigte sich weder durch die Deletion noch die Duplikation eine signifikante Veränderung.
Single molecule localization microscopy has seen a remarkable growth since its first
experimental implementations about a decade ago. Despite its technical challenges,
it is already widely used in medicine and biology and is valued as a unique tool
to gain molecular information with high specificity. However, common illumination techniques do not allow the use of single molecule sensitive super-resolution
microscopy techniques such as direct stochastic optical reconstruction microscopy
(dSTORM) for whole cell imaging. In addition, they can potentially alter the
quantitative information.
In this thesis, I combine dSTORM imaging in three dimensions with lattice lightsheet illumination to gain quantitative molecular information from cells unperturbed by the illumination and cover slip effects. Lattice light-sheet illumination
uses optical lattices for beam shaping to restrict the illumination to the detectable
volume. I describe the theoretical background needed for both techniques and detail
the experimental realization of the system as well as the software that I developed
to efficiently evaluate the data.
Eventually, I will present key datasets that demonstrate the capabilities of the
developed microscope system with and without dSTORM. My main goal here was
to use these techniques for imaging the neural cell adhesion molecule (NCAM, also
known as CD56) in whole cells. NCAM is a plasma membrane receptor known to
play a key role in biological processes such as memory and learning. Combining
dSTORM and lattice light-sheet illumination enables the collection of quantitative
data of the distribution of molecules across the whole plasma membrane, and shows
an accumulation of NCAM at cell-cell interfaces. The low phototoxicity of lattice
light-sheet illumination further allows for tracking individual NCAM dimers in living cells, showing a significant dependence of its mobility on the actin skeleton of
the cell.
Mass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.
Purpose
Rescue missions during terrorist attacks are extremely challenging for all rescue forces (police as well as non-police forces) involved. To improve the quality and safety of the rescue missions during an active killing event, it is obligatory to adapt common rescue mission goals and strategies.
Methods
After the recent attacks in Europe, the Federal Office of Civil Protection and Disaster Assistance started an evaluation process on behalf of the Federal Ministry of the Interior and the Federal Ministry of Health. This was done to identify weaknesses, lessons learned and to formulate new adapted guidelines.
Results
The presented bullet point recommendations summarise the basic and most important results of the ongoing evaluation process for the Federal Republic of Germany. The safety of all the rescue forces and survival of the greatest possible number of casualties are the priority goals. Furthermore, the preservation and re-establishment of the socio-political integrity are the overarching goals of the management of active killing events. Strategic incident priorities are to stop the killing and to save as much lives as possible. The early identification and prioritised transportation of casualties with life-threatening non-controllable bleeding are major tasks and the shortest possible on-scene time is an important requirement with respect to safety issues.
Conclusion
With respect to hazard prevention tactics within Germany, we attributed the highest priority impact to the bullet points. The focus of the process has now shifted to intense work about possible solutions for the identified deficits and implementation strategies of such solutions during mass killing incidents.
Multifunctional calcium phosphate based coatings on titanium implants with integrated trace elements
(2020)
For decades, the main focus of titanium implants developed to restore bone functionality was on improved osseointegration. Additional antimicrobial properties have now become desirable, due to the risk that rising antibiotic resistance poses for implant-associated infections. To this end, the trace elements of copper and zinc were integrated into calcium phosphate based coatings by electrochemically assisted deposition. In addition to their antimicrobial activity, zinc is reported to attract bone progenitor cells through chemotaxis and thus increase osteogenic differentiation, and copper to stimulate angiogenesis. Quantities of up to 68.9 ± 0.1 μg cm\(^{-2}\) of copper and 56.6 ± 0.4 μg cm\(^{-2}\) of zinc were deposited; co-deposition of both ions did not influence the amount of zinc but slightly increased the amount of copper in the coatings. The release of deposited copper and zinc species was negligible in serum-free simulated body fluid. In protein-containing solutions, a burst release of up to 10 μg ml\(^{-1}\) was observed for copper, while zinc was released continuously for up to 14 days. The presence of zinc was beneficial for adhesion and growth of human mesenchymal stromal cells in a concentration-dependent manner, but cytotoxic effects were already visible for coatings with an intermediate copper content. However, co-deposited zinc could somewhat alleviate the adverse effects of copper. Antimicrobial tests with E. coli revealed a decrease in adherent bacteria on brushite without copper or zinc of 60%, but if the coating contained both ions there was almost no bacterial adhesion after 12 h. Coatings with high zinc content and intermediate copper content had the overall best multifunctional properties.
Bei Sportlern aber auch bei Nichtsportlern mit Bandläsionen im Bereich des Sprunggelenks ist die Bestimmung des Zeitpunktes der Wiederaufnahme sportlicher Aktivität von entscheidender Bedeutung – insbesondere um möglichen Folgeverletzungen in der Zukunft vorzubeugen.
Zur Beurteilung des richtigen Zeitpunkts zählt die Beurteilung der sportlichen Leistungsfähigkeit zu den wichtigsten Faktoren. Um diese Beurteilung vorzunehmen, ist das Vorhandensein von Referenzwerten für eine geeignete Testbatterie nötig.
Mit Hilfe der Ergebnisse dieser Arbeit sowie der gewählten Art der Darstellung kann so die Leistungsfähigkeit eines Probanden, welcher sich nicht im akuten Stadium einer Verletzung oder der direkt daran anschließenden Rekonvaleszens befindet, nach einer vorangegangenen Verletzung im Bereich des Sprunggelenks beurteilt werden. Ein adäquater Zeitpunkt zum Übergang von der Phase „Return to sports“ zu „Return to play“ beziehungsweise „Return to competition“ ohne das Risiko einer erneuten Verletzung kann so besser abgeschätzt werden.
Excitation energy transport in DNA modelled by multi-chromophoric field-induced surface hopping
(2020)
Absorption of ultraviolet light is known as a major source of carcinogenic mutations of DNA. The underlying processes of excitation energy dissipation are yet not fully understood. In this work we provide a new and generally applicable route for studying the excitation energy transport in multi-chromophoric complexes at an atomistic level. The surface-hopping approach in the frame of the extended Frenkel exciton model combined with QM/MM techniques allowed us to simulate the photodynamics of the alternating (dAdT)10 : (dAdT)10 double-stranded DNA. In accordance with recent experiments, we find that the excited state decay is multiexponential, involving a long and a short component which are due to two distinct mechanisms: formation of long-lived delocalized excitonic and charge transfer states vs. ultrafast decaying localized states resembling those of the bare nucleobases. Our simulations explain all stages of the ultrafast photodynamics including initial photoexcitation, dynamical evolution out of the Franck-Condon region, excimer formation and nonradiative relaxation to the ground state.
Die Phosphatase PDXP (auch bekannt als Chronophin) gehört zur Familie der HAD Phosphatasen, einer ubiquitär exprimierten Enzymklasse mit wichtigen physiologischen Funktionen. PDXP zeigt Phosphatase-Aktivität gegenüber seinem Substrat Pyridoxal 5´-Phosphat (PLP), der aktivierten Form von Vitamin B6. PDXP-defiziente Mäuse (Knockout-Mäuse) weisen im Vergleich zu Wildtypen verdoppelte PLP-Konzentrationen in Erythrozyten sowie im Gesamthirn auf. Vermutlich kommt PDXP daher eine wichtige Funktion in Erythrozyten und im Hirn zu. Ziel dieser Arbeit war es, erste Einblicke in diese Funktion(en) von PDXP zu erlangen.
Hierzu wurden HPLC-basierte Analysen der erythrozytären PLP-Konzentrationen in Wildtyp- sowie PDXP-defizienten Mäusen durchgeführt. Dabei ließen sich die rund doppelt so hohen erythrozytären PLP-Level in den KO-Mäusen bestätigen. Zudem ist es gelungen, eine Methode zur Messung der endogenen Phosphatase-Aktivität von PDXP in Erythrozytenlysaten zu etablieren. So konnte im Wildtyp anhand der Verringerung der PLP-Konzentrationen pro Zeiteinheit eine erythrozytäre PDXP-Aktivität nachgewiesen werden. Dazu waren die Inkubation mit Pyridoxin, sowie die Anwendung eines Inhibitors der PDXK notwendig. Eine bis dato vermutete Funktion der PDXP, zur Mobilisation von erythrozytärem PLP während Fastenzeiten, konnte ausgeschlossen werden. So zeigte der Vergleich der erythrozytären PLP-Konzentrationen aus gefasteten mit normal gefütterten Tieren in beiden Genotypen exakt dieselbe prozentuale PLP-Verringerung. Während Nahrungszufuhr ließ sich jedoch eine Funktion der Phosphatase PDXP als „Converter“ von Pyridoxin zu Pyridoxal erkennen. Ausgehend von PN konnte im Wildtyp (über die Zwischenprodukte PNP und PLP) eine PDXP-abhängige Dephosphorylierung von PLP zu PL erfolgen. So wies der Wildtyp eine rund vierfach höhere PL-Produktion auf, verglichen mit der PDXP-defizienten Maus. Die Phosphatase PDXP erwies sich als essenziell für die erythrozytäre Konversion von Pyridoxin zu Pyridoxal. Dadurch erreicht der Organismus eine metabolische Flexibilität, die ihn bis zu einem gewissen Grad unabhängig von der Nahrungsauswahl macht. Zudem können Zellen oder Organe, denen durch das Fehlen der PNPO, die Konversion zu PLP nicht möglich ist, mit PL versorgt werden.
Aus der hohen Reaktivität von PLP mit umliegenden Nucleophilen ergibt sich eine gewisse Problematik für die Zelle im Umgang mit freiem PLP. So liegt der Großteil des erythrozytären PLPs gebunden an Proteine (vor allem Hämoglobin) vor. Anhand von Filtern (MWCO, 3000) ließ sich zwischen der hier definiert als „freien“ und der „gebundenen“ Form von PLP differenzieren. So konnten erste Erkenntnisse zur Rolle von PDXP als Determinator freier PLP-Konzentrationen in Erythrozyten und insbesondere im Hippocampus erlangt werden. Im Hippocampus ergaben sich insgesamt deutlich höhere Konzentrationen an freiem PLP als in den Erythrozyten und es bestand zudem ein Unterschied zwischen den Genotypen. So wiesen die KO-Mäuse ~1/3 höhere freie PLP-Konzentrationen im Vergleich zu den Wildtypen auf. Schließlich konnte ein Effekt des Tieralters auf den PLP-Metabolismus festgestellt werden. Sowohl in den Erythrozyten als auch im Hippocampus ergaben sich alterskorrelierte Änderungen ihrer PLP-Konzentrationen. Zudem zeigten Western Blot Analysen altersbedingte Unterschiede ihrer Vitamin B6-Enzymexpressionen. So wiesen ältere Wildtypen im Hippocampus eine fünffach erhöhte PDXP-Expression verglichen mit jüngeren Tieren auf. In den Erythrozytenlysaten hingegen zeigten ältere Tiere beider Genotypen eine rund vierfach geringere PNPO-Expression gegenüber jüngeren Tieren. Die mit dem Alter eintretende physiologische Verringerung der erythrozytären PNPO-Expression würde somit für den Organismus einen Verlust seiner metabolischen Flexibilität bedeuten, die mit der Konversion von PN zu PL einhergeht.
Ziel der 6-monatigen Intervention Breakdance im Schulsport im Rahmen von "Sport nach 1" war es, Veränderungen bei physischen und psychosozialen Parametern zu betrachten. In einem Kontrollgruppendesign mit drei Messzeitpunkten wurden quantitative Methoden (motorische Tests, schriftliche Befragung) im Längsschnitt und qualitative Verfahren (mündliche Befragung) im Querschnitt am Ende des Untersuchungszeitraums eingesetzt. Mittels standardisierter Fragebögen wurden die Merkmale sportartspezifische- und allgemeine Selbstwirksamkeit sowie Kooperationsfähigkeit untersucht. Darüber hinaus wurde der Deutsche Motoriktest (DMT 6-18) durchgeführt, um die Entwicklung der Merkmale Kraftausdauer im Rumpf und den oberen Extremitäten, Schnellkraft in den Beinen, Koordination unter Präzisionsdruck sowie Koordination unter Zeitdruck zu betrachten.
This cumulative dissertation is organized as follows:
After the introduction, the second chapter, based on “Asymptotic independence of bivariate order statistics” (2017) by Falk and Wisheckel, is an investigation of the asymptotic dependence behavior of the components of bivariate order statistics. We find that the two components of the order statistics become asymptotically independent for certain combinations of (sequences of) indices that are selected, and it turns out that no further assumptions on the dependence of the two components in the underlying sample are necessary. To establish this, an explicit representation of the conditional distribution of bivariate order statistics is derived.
Chapter 3 is from “Conditional tail independence in archimedean copula models” (2019) by Falk, Padoan and Wisheckel and deals with the conditional distribution of an Archimedean copula, conditioned on one of its components. We show that its tails are independent under minor conditions on the generator function, even if the unconditional tails were dependent. The theoretical findings are underlined by a simulation study and can be generalized to Archimax copulas.
“Generalized pareto copulas: A key to multivariate extremes” (2019) by Falk, Padoan and Wisheckel lead to Chapter 4 where we introduce a nonparametric approach to estimate the probability that a random vector exceeds a fixed threshold if it follows a Generalized Pareto copula. To this end, some theory underlying the concept of Generalized Pareto distributions is presented first, the estimation procedure is tested using a simulation and finally applied to a dataset of air pollution parameters in Milan, Italy, from 2002 until 2017.
The fifth chapter collects some additional results on derivatives of D-norms, in particular a condition for the existence of directional derivatives, and multivariate spacings, specifically an explicit formula for the second-to-last bivariate spacing.
Design choices: Empirical recommendations for designing two-dimensional finger-tracking experiments
(2020)
The continuous tracking of mouse or finger movements has become an increasingly popular research method for investigating cognitive and motivational processes such as decision-making, action-planning, and executive functions. In the present paper, we evaluate and discuss how apparently trivial design choices of researchers may impact participants’ behavior and, consequently, a study’s results. We first provide a thorough comparison of mouse- and finger-tracking setups on the basis of a Simon task. We then vary a comprehensive set of design factors, including spatial layout, movement extent, time of stimulus onset, size of the target areas, and hit detection in a finger-tracking variant of this task. We explore the impact of these variations on a broad spectrum of movement parameters that are typically used to describe movement trajectories. Based on our findings, we suggest several recommendations for best practice that avoid some of the pitfalls of the methodology. Keeping these recommendations in mind will allow for informed decisions when planning and conducting future tracking experiments.
Comprehensive investigation in motor neuron disease is vital not to miss a treatable differential diagnosis. Neuroborreliosis should be considered during an ALS work‐up. However, false‐positive CSF results do occur, and thus, results should be interpreted carefully in context of all clinical test results.
Process model comprehension is essential in order to understand the five Ws (i.e., who, what, where, when, and why) pertaining to the processes of organizations. However, research in this context showed that a proper comprehension of process models often poses a challenge in practice. For this reason, a vast body of research exists studying the factors having an influence on process model comprehension. In order to point research towards a neuro-centric perspective in this context, the paper at hand evaluates the appropriateness of measuring the electrodermal activity (EDA) during the comprehension of process models. Therefore, a preliminary test run and a feasibility study were conducted relying on an EDA and physical activity sensor to record the EDA during process model comprehension. The insights obtained from the feasibility study demonstrated that process model comprehension leads to an increased activity in the EDA. Furthermore, EDA-related results indicated significantly that participants were confronted with a higher cognitive load during the comprehension of complex process models. In addition, the experiences and limitations we learned in measuring the EDA during the comprehension of process models are discussed in this paper. In conclusion, the feasibility study demonstrated that the measurement of the EDA could be an appropriate method to obtain new insights into process model comprehension.
The subject of this thesis is the fabrication and characterization of magnetic topological
insulator layers of (V,Bi,Sb)\(_2\)Te\(_3\) exhibiting the quantum anomalous Hall
effect. A major task was the experimental realization of the quantum anomalous
Hall effect, which is only observed in layers with very specific structural,
electronic and magnetic properties. These properties and their influence on the
quantum anomalous Hall effect are analyzed in detail.
First, the optimal conditions for the growth of pure Bi\(_2\)Te\(_3\) and Sb\(_2\)Te\(_3\) crystal
layers and the resulting structural quality are studied. The crystalline quality of
Bi\(_2\)Te\(_3\) improves significantly at higher growth temperatures resulting in a small
mosaicity-tilt and reduced twinning defects. The optimal growth temperature is
determined as 260\(^{\circ}\)C, low enough to avoid desorption while maintaining a high
crystalline quality.
The crystalline quality of Sb\(_2\)Te\(_3\) is less dependent on the growth temperature.
Temperatures below 230\(^{\circ}\)C are necessary to avoid significant material desorption,
though. Especially for the nucleation on Si(111)-H, a low sticking coefficient is
observed preventing the coalescence of islands into a homogeneous layer.
The influence of the substrate type, miscut and annealing sequence on the growth
of Bi\(_2\)Te\(_3\) layers is investigated. The alignment of the layer changes depending on
the miscut angle and annealing sequence: Typically, layer planes align parallel to
the Si(111) planes. This can enhance the twin suppression due to transfer of the
stacking order from the substrate to the layer at step edges, but results in a step
bunched layer morphology. For specific substrate preparations, however, the layer
planes are observed to align parallel to the surface plane. This alignment avoids
displacement at the step edges, which would cause anti-phase domains. This results
in narrow Bragg peaks in XRD rocking curve scans due to long-range order in
the absence of anti-phase domains. Furthermore, the use of rough Fe:InP(111):B
substrates leads to a strong reduction of twinning defects and a significantly reduced
mosaicity-twist due to the smaller lattice mismatch.
Next, the magnetically doped mixed compound V\(_z\)(Bi\(_{1−x}\)Sb\(_x\))\(_{2−z}\)Te\(_3\) is studied in
order to realize the quantum anomalous Hall effect. The addition of V and Bi to
Sb\(_2\)Te\(_3\) leads to efficient nucleation on the Si(111)-H surface and a closed, homogeneous
layer. Magneto-transport measurements of layers reveal a finite anomalous
Hall resistivity significantly below the von Klitzing constant. The observation of
the quantum anomalous Hall effect requires the complete suppression of parasitic
bulklike conduction due to defect induced carriers. This can be achieved by optimizing
the thickness, composition and growth conditions of the layers.
The growth temperature is observed to strongly influence the structural quality.
Elevated temperatures result in bigger islands, improved crystallographic orientation
and reduced twinning. On the other hand, desorption of primarily Sb is
observed, affecting the thickness, composition and reproducibility of the layers.
At 190\(^{\circ}\)C, desorption is avoided enabling precise control of layer thickness and
composition of the quaternary compound while maintaining a high structural
quality.
It is especially important to optimize the Bi/Sb ratio in the (V,Bi,Sb)\(_2\)Te\(_3\) layers,
since by alloying n-type Bi\(_2\)Te\(_3\) and p-type Sb\(_2\)Te\(_3\) charge neutrality is achieved at
a specific mixing ratio. This is necessary to shift the Fermi level into the magnetic
exchange gap and fully suppress the bulk conduction. The Sb content x furthermore
influences the in-plane lattice constant a significantly. This is utilized to
accurately determine x even for thin films below 10 nm thickness required for the
quantum anomalous Hall effect. Furthermore, x strongly influences the surface
morphology: with increasing x the island size decreases and the RMS roughness
increases by up to a factor of 4 between x = 0 and x = 1.
A series of samples with x varied between 0.56-0.95 is grown, while carefully
maintaining a constant thickness of 9 nm and a doping concentration of 2 at.% V.
Magneto-transport measurements reveal the charge neutral point around x = 0.86
at 4.2 K. The maximum of the anomalous Hall resistivity of 0.44 h/e\(^2\) is observed
at x = 0.77 close to charge neutrality. Reducing the measurement temperature
to 50 mK significantly increases the anomalous Hall resistivity. Several samples
in a narrow range of x between 0.76-0.79 show the quantum anomalous Hall effect
with the Hall resistivity reaching the von Klitzing constant and a vanishing
longitudinal resistivity. Having realized the quantum anomalous Hall effect as the
first group in Europe, this breakthrough enabled us to study the electronic and
magnetic properties of the samples in close collaborations with other groups.
In collaboration with the Physikalisch-Technische Bundesanstalt high-precision
measurements were conducted with detailed error analysis yielding a relative de-
viation from the von Klitzing constant of (0.17 \(\pm\) 0.25) * 10\(^{−6}\). This is published
as the smallest, most precise value at that time, proving the high quality of the
provided samples. This result paves the way for the application of magnetic topological
insulators as zero-field resistance standards.
Non-local magneto-transport measurements were conducted at 15 mK in close
collaboration with the transport group in EP3. The results prove that transport
happens through chiral edge channels. The detailed analysis of small anomalies in
transport measurements reveals instabilities in the magnetic phase even at 15 mK.
Their time dependent nature indicates the presence of superparamagnetic contributions
in the nominally ferromagnetic phase.
Next, the influence of the capping layer and the substrate type on structural properties
and the impact on the quantum anomalous Hall effect is investigated. To
this end, a layer was grown on a semi-insulating Fe:InP(111)B substrate using the
previously optimized growth conditions. The crystalline quality is improved significantly
with the mosaicity twist reduced from 5.4\(^{\circ}\) to 1.0\(^{\circ}\). Furthermore, a layer
without protective capping layer was grown on Si and studied after providing sufficient
time for degradation. The uncapped layer on Si shows perfect quantization,
while the layer on InP deviates by about 5%. This may be caused by the higher
crystalline quality, but variations in e.g. Sb content cannot be ruled out as the
cause. Overall, the quantum anomalous Hall effect seems robust against changes
in substrate and capping layer with only little deviations.
Furthermore, the dependence of the quantum anomalous Hall effect on the thickness
of the layers is investigated. Between 5-8 nm thickness the material typically
transitions from a 2D topological insulator with hybridized top and bottom surface
states to a 3D topological insulator. A set of samples with 6 nm, 8 nm, and
9 nm thickness exhibits the quantum anomalous Hall effect, while 5 nm and 15 nm
thick layers show significant bulk contributions. The analysis of the longitudinal
and Hall conductivity during the reversal of magnetization reveals distinct differences
between different thicknesses. The 6 nm thick layer shows scaling consistent
with the integer quantum Hall effect, while the 9 nm thick layer shows scaling expected
for the topological surface states of a 3D topological insulator. The unique
scaling of the 9 nm thick layer is of particular interest as it may be a result of
axion electrodynamics in a 3D topological insulator.
Subsequently, the influence of V doping on the structural and magnetic properties
of the host material is studied systematically. Similarly to Bi alloying, increased
V doping seems to flatten the layer surface significantly. With increasing V content,
Te bonding partners are observed to increase simultaneously in a 2:3 ratio
as expected for V incorporation on group-V sites. The linear contraction of the
in-plane and out-of-plane lattice constants with increasing V doping is quantitatively
consistent with the incorporation of V\(^{3+}\) ions, possibly mixed with V\(^{4+}\)
ions, at the group-V sites. This is consistent with SQUID measurements showing
a magnetization of 1.3 \(\mu_B\) per V ion.
Finally, magnetically doped topological insulator heterostructures are fabricated
and studied in magneto-transport. Trilayer heterostructures with a non-magnetic
(Bi,Sb)\(_2\)Te\(_3\) layer sandwiched between two magnetically doped layers are predicted
to host the axion insulator state if the two magnetic layers are decoupled and in
antiparallel configuration. Magneto-transport measurements of such a trilayer heterostructure
with 7 nm undoped (Bi,Sb)\(_2\)Te\(_3\) between 2 nm thick layers doped with
1.5 at.% V exhibit a zero Hall plateau representing an insulating state. Similar results
in the literature were interpreted as axion insulator state, but in the absence
of a measurement showing the antiparallel magnetic orientation other explanations
for the insulating state cannot be ruled out.
Furthermore, heterostructures including a 2 nm thin, highly V doped layer region
show an anomalous Hall effect of opposite sign compared to previous samples. A
dependency on the thickness and position of the doped layer region is observed,
which indicates that scattering at the interfaces causes contributions to the anomalous
Hall effect of opposite sign compared to bulk scattering effects.
Many interesting phenomena in quantum anomalous Hall insulators as well as axion
insulators are still not unambiguously observed. This includes Majorana bound
states in quantum anomalous Hall insulator/superconductor hybrid systems and
the topological magneto-electric effect in axion insulators. The limited observation
temperature of the quantum anomalous Hall effect of below 1 K could be increased
in 3D topological insulator/magnetic insulator heterostructures which utilize the
magnetic proximity effect.
The main achievement of this thesis is the reproducible growth and characterization
of (V,Bi,Sb)2Te3 layers exhibiting the quantum anomalous Hall effect. The
detailed study of the structural requirements of the quantum anomalous Hall effect
and the observation of the unique axionic scaling behavior in 3D magnetic
topological insulator layers leads to a better understanding of the nature of this
new quantum state. The high-precision measurements of the quantum anomalous
Hall effect reporting the smallest deviation from the von Klitzing constant
are an important step towards the realization of a zero-field quantum resistance
standard.
This thesis contributes to the understanding of the labor market effects of international trade, with a focus on the effects on wage and earnings inequality. The thesis draws on high-quality micro data and applies modern econometric techniques and theoretical concepts to improve our understanding of the distributional effects of international trade. The thesis focuses on the effects in Germany and the USA.
Investigation of processes that contribute to the maintenance of genomic stability is one crucial factor in the attempt to understand mechanisms that facilitate ageing. The DNA damage response (DDR) and DNA repair mechanisms are crucial to safeguard the integrity of DNA and to prevent accumulation of persistent DNA damage. Among them, base excision repair (BER) plays a decisive role. BER is the major repair pathway for small oxidative base modifications and apurinic/apyrimidinic (AP) sites. We established a highly sensitive non-radioactive assay to measure BER incision activity in murine liver samples. Incision activity can be assessed towards the three DNA lesions 8-oxo-2'-deoxyguanosine (8-oxodG), 5-hydroxy-2'-deoxyuracil (5-OHdU), and an AP site analogue. We applied the established assay to murine livers of adult and old mice of both sexes. Furthermore, poly(ADP-ribosyl)ation (PARylation) was assessed, which is an important determinant in DDR and BER. Additionally, DNA damage levels were measured to examine the overall damage levels. No impact of ageing on the investigated endpoints in liver tissue were found. However, animal sex seems to be a significant impact factor, as evident by sex-dependent alterations in all endpoints investigated. Moreover, our results revealed interrelationships between the investigated endpoints indicative for the synergetic mode of action of the cellular DNA integrity maintaining machinery.
Zeitliche Diskrimination somatosensorischer und kinästhetischer Stimuli wurde als neurophysiologisches Korrelat für propriozeptive Präzision postuliert und bei verschiedenen Bewegungsstörungen als pathologisch beschrieben. Ziel der Untersuchung war es, den Einfluss von Alter und Polyneuropathie auf die kinästhetische (TDMT) und taktile (STDT) zeitliche Wahrnehmungsschwelle sowie die propriozeptive Genauigkeit bei Zeigeversuchen systematisch zu untersuchen.
Hierfür wurden 54 gesunde Probanden und 25 Polyneuropathie-Patienten im Alter zwischen 30 und 76 Jahren untersucht. Die STDT-Messung erfolgte mit Oberflächenelektroden, die an der Zeigefingerspitze bzw. am Großzehengrundgelenk angebracht wurden. Die TDMT-Werte wurden mit Hilfe einer sterilen Nadelelektrode erfasst, welche in den Musculus flexor carpi radialis bzw. Musculus tibialis anterior inseriert wurde.
Die Daten zur Propriozeption wurden mit Hilfe eines Goniometers erhoben und beinhalteten dabei aktive Zeigeaufgaben (Zeigen auf eine LED, Nachahmung einer Bewegung anhand einer auf einem Computerbildschirm dargebotenen PFEIL-Darstellung unterschiedlicher Länge) und die Einschätzung der Position der jeweiligen Extremität nach passiver Bewegung (PASSIV). Die Messungen erfolgten jeweils ohne visuelle Rückmeldung. Die Zeigefehler (Abweichung von der Zielposition) bzw. Schätzfehler (Abweichung der geschätzten von der tatsächlichen Position nach passiver Auslenkung) wurden als Maß der propriozeptiven Präzision verwendet.
Die Ergebnisse der gesunden Probandengruppe zeigten, dass höheres Alter mit höheren STDT- und TDMT-Werten korrelierte. Die Polyneuropathie-Patienten erzielten in allen Bereichen (Diskriminationsschwellen und Propriozeptionsaufgaben) signifikant schlechtere Ergebnisse als die gesunde Kontrollgruppe.
Zusätzlich konnte eine statistisch signifikante positive Korrelation zwischen der propriozeptiven Präzision bei den aktiven Zeige-Aufgaben (LED und PFEIL) und den zeitlichen Diskriminationsschwellen (STDT und TDMT) gezeigt werden.
In Anbetracht dieser Ergebnisse sollten das Patienten-Alter und mögliche Störungen der peripheren Nervenleitung berücksichtigt werden, wenn STDT-und TDMT-Bestimmungen bei Patienten mit Bewegungsstörungen angewendet werden. Die Korrelation zwischen den Diskriminationsschwellen und der Performance bei aktiven Zeigeversuchen (PFEIL- und LED-Aufgabe) legt nahe, dass STDT und TDMT Indikatoren der propriozeptiven Funktion sein könnten. Es ist weitere Forschungsarbeit notwendig, um diese Beziehung exakt zu beleuchten. Im Falle einer Bestätigung der Befunde auch bei Patienten mit Bewegungsstörungen erscheint denkbar, dass sich STDT und TDMT als vergleichsweise leicht messbare und gut quantifizierbare Parameter der Propriozeption herausstellen mit Potenzial zur differenzialdiagnostischen Anwendung, möglicherweise aber auch als Surrogatparameter einer gezielten rehabilitativen Behandlung.
Die E-Zigarette gewinnt in den letzten Jahren immer mehr an Popularität. Die Frage der Toxizität ist jedoch noch nicht abschließend geklärt, und es besteht weltweite Unsicherheit bei der Verwendung der E-Zigarette.
Die vorliegende Arbeit untersucht menschliche Nasenschleimhautzellen nach Dampfexposition mit Propylenglykol, einem Hauptbestandteil der Liquide, auf mögliche akute Entzündungsreaktionen, zytotoxische und genotoxische Wirkungen.
Die Nasenschleimhautzellen von 10 Probanden wurden im Air-Liquid-Interface kultiviert und anschließend verschiedenen Konzentrationen von Propylenglykol ausgesetzt. Die Analyse erfolgte unter Verwendung eines Trypanblau-Tests, eines Comet-Assays, eines Mikrokern-Tests und eines IL-6- und IL-8-Sandwich-ELISAs.
Der Trypanblau-Test zeigte keine Reduktion der Vitalität. Im Sandwich-ELISA konnte kein Anstieg der IL-6- und IL-8-Konzentrationen festgestellt werden. Im Comet-Assay zeigte das Olive Tail Moment in allen untersuchten Konzentrationen eine Schädigung im Vergleich zur Negativkontrolle. Es zeigte sich auch eine dosisabhängige Schädigung. Ein Unterschied zwischen der Reinsubstanz und der Negativkontrolle konnte im Mikrokern-Test festgestellt werden.
Es wurden reparierbare Schäden im Comet-Assay gefunden. Im Mikrokern-Test konnten diese nur in der Reinsubstanzkonzentration bestätigt werden. Die E-Zigarette sollte restriktiv verwendet werden, bis Langzeitstudien vorliegen. Darüber hinaus sollten die Hersteller die Inhaltsstoffe der Flüssigkeiten eindeutig angeben.
In reconstructive and plastic surgery, there exists a growing demand of adequate tissue implants, since currently available strategies for autologous transplantation are limited by complications including transplant failure and donor site morbidity. By developing in vitro and in vivo autologous substitutes for defective tissue sites, adipose tissue engineering can address these challenges, although there are several obstacles to overcome. One of the major limitations is the sufficient vascularization of in vitro engineered large constructs that remains crucial and demanding for functional tissues. Decellularized jejunal segments may represent a suitable scaffolding system with preexisting capillary structures that can be repopulated with human microvascular endothelial cells (hMVECs), and a luminal matrix applicable for the adipogenic differentiation of human adipose-derived stem cells (hASCs). Hence, co-culture of these cells in jejunal segments, utilizing a custom-made bioreactor system, was characterized in terms of vascularization and adipose tissue development. Substantial adipogenesis of hASCs was demonstrated within the jejunal lumen in contrast to non-induced controls, and the increase of key adipogenic markers was verified over time upon induction. The development of major extracellular matrix components of mature adipose tissue, such as laminin and collagen IV, was shown within the scaffold in induced samples. Successful reseeding of the vascular network with hMVECs was demonstrated in long-term culture and co-localization of vascular structures and adipogenically differentiated hASCs was observed. Therefore, these results represent a novel approach for in vitro engineering of vascularized adipose tissue constructs that warrants further investigations in preclinical studies.
Another still existing obstacle in adipose tissue engineering is the insufficient knowledge about the applied cells, for instance the understanding of how cells can be optimally expanded and differentiated for successful engineering of tissue transplants. Even though hASCs can be easily isolated from liposuction of abdominal fat depots, yielding low donor site morbidity, huge numbers of cells are required to entirely seed complex and large 3D matrices or scaffolds. Thus, cells need to be large-scale expanded in vitro on the premise of not losing their differentiation capacity caused by replicative aging. Accordingly, an improved differentiation of hASCs in adipose tissue engineering approaches remains still desirable since most engineered constructs exhibit an inhomogeneous differentiation pattern. For mesenchymal stem cells (MSCs), it has been shown that growth factor application can lead to a significant improvement of both proliferation and differentiation capacity. Especially basic fibroblast growth factor (bFGF) represents a potent mitogen for MSCs, while maintaining or even promoting their osteogenic, chondrogenic and adipogenic differentiation potential. As there are currently different contradictory information present in literature about the applied bFGF concentration and the explicit effect of bFGF on ASC differentiation, here, the effect of bFGF on hASC proliferation and differentiation capacity was investigated at different concentrations and time points in 2D culture. Preculture of hASCs with bFGF prior to adipogenic induction showed a remarkable effect, whereas administration of bFGF during culture did not improve adipogenic differentiation capacity. Furthermore, the observations indicated as mode of action an impact of this preculture on cell proliferation capacity, resulting in increased cellular density at the time of adipogenic induction. The difference in cell density at this time point appeared to be pivotal for increased adipogenic capacity of the cells, which was confirmed in a further experiment employing different seeding densities. Interestingly, furthermore, the obtained results suggested a cell-cell contact-mediated mechanism positively influencing adipogenic differentiation. As a consequence, subsequently, studies were conducted focusing on intercellular communication of these cells, which has hardly been investigated to date.
Despite the multitude of literature on the differentiation capacity of ASCs, little is reported about the physiological properties contributing to and controlling the process of lineage differentiation. Direct intercellular communication between adjacent cells via gap junctions has been shown to modulate differentiation processes in other cell types, with connexin 43 (Cx43) being the most abundant isoform of the gap junction-forming connexins. Thus, in the present study we focused on the expression of Cx43 and gap junctional intercellular communication (GJIC) in hASCs, and its significance for adipogenic differentiation of these cells. Cx43 expression in hASCs was demonstrated histologically and on the gene and protein expression level and was shown to be greatly positively influenced by cell seeding density. Functionality of gap junctions was proven by dye transfer analysis in growth medium. Adipogenic differentiation of hASCs was shown to be also distinctly elevated at higher cell seeding densities. Inhibition of GJIC by 18α-glycyrrhetinic acid significantly compromised adipogenic differentiation, as demonstrated by histology, triglyceride quantification, and adipogenic marker gene expression. Flow cytometry analysis showed a lower proportion of cells undergoing adipogenesis when GJIC was inhibited, further indicating the importance of GJIC in the differentiation process. Altogether, these results demonstrate the impact of direct cell-cell communication via gap junctions on the adipogenic differentiation process of hASCs and may contribute to further integrate direct intercellular crosstalk in rationales for tissue engineering approaches.
Die Studie befasste sich mit den Veränderungen des oralen Mikrobioms bei Patienten, die mit einer herausnehmbaren oder festsitzenden kieferorthopädischen Apparatur behandelt wurden. Während des sechsmonatigen Studienzeitraums wurden 25 Probanden hinsichtlich Streptococcus mutans und Lactobacillus mit dem CRT bacteria Test der Firma Ivoclar Vivadent untersucht. Abgesehen davon wurde ihre gingivale Gesundheit mittels Approximalraum-Plaque Index nach Saxer und Mühlemann und Papillenblutungsindex nach Lange et. al. ermittelt.
Fahrzeughersteller haben die Verfügbarkeit sogenannter hochautomatisierter Fahrfunktionen (SAE Level 3; SAE, 2018) in ihren Modellen angekündigt. Hierdurch wird der Fahrer in der Lage sein, sich permanent von der Fahraufgabe abzuwenden und fahrfremden Tätigkeiten nachzugehen. Allerdings muss er immer noch als Rückfallebene zur Verfügung stehen, um im Fall von Systemgrenzen oder -fehlern (siehe Gold, Naujoks, Radlmayr, Bellem & Jarosch, 2017), die Fahrzeugkontrolle zu übernehmen. Das Übernahmeerfordernis wird dem Fahrer durch die Ausgabe einer Übernameaufforderung vermittelt. Die Übernahme der manuellen Fahrzeugführung aus dem hochautomatisierten Fahren stellt aus psychologischer Sicht einen Aufgabenwechsel dar. Bei der Untersuchung von Aufgabenwechseln im Bereich der kognitiven und angewandten Psychologie zeigte sich vielfach, dass Aufgabenwechsel mit verlängerten Reaktionszeiten und erhöhten Fehlerraten assoziiert sind. Für den Anwendungsfall des automatisierten Fahrens liegen ebenfalls eine Reihe empirischer Studien vor, die darauf hinweisen, dass der Wechsel zum manuellen Fahren mit einer Verschlechterung der Fahrleistung gegenüber dem manuellen Fahren verbunden ist. Da Erkenntnisse vorliegen, dass eine Vorbereitung auf den Aufgabenwechsel die zu erwartenden Kosten verringern kann, ist das Ziel dieser Arbeit die Konzeption und empirische Evaluation einer Mensch-Maschine-Schnittstelle, die Nutzer hochautomatisierter Fahrzeuge durch frühzeitige Vorinformationen über Systemgrenzen auf die Kontrollübernahme vorbereitet.
Drei Experimente im Fahrsimulator mit Bewegungssystem betrachteten jeweils unterschiedliche Aspekte frühzeitiger Vorinformationen über bevorstehende Übernahmen. Das erste Experiment untersuchte, ob Fahrer überhaupt von frühzeitigen Situationsankündigungen, beispielsweise im Sinne einer verbesserten Übernahmeleistung, profitieren. Das zweite Experiment befasste sich mit der Frage, wie solche Ankündigungen zeitlich und inhaltlich zu gestalten sind (d. h. wann sie präsentiert werden und welche Informationen sie enthalten sollten), und welchen Einfluss deren Gestaltung auf die Aufgabenbearbeitung (insbesondere deren Unterbrechung und spätere Wiederaufnahme) während der automatisierten Fahrt hat. Um herauszufinden, wie ein Anzeigekonzept zur längerfristigen Planung von fahrfremden Tätigkeiten während des automatisierten Fahrens beitragen könnte, fand im dritten Experiment ein Vergleich von Situationsankündigungen, die vor dem Erreichen einer Übernahmesituation ausgegeben wurden, mit kontinuierlich präsentierten Informationen über die verbleibende Distanz zur nächsten Systemgrenze statt. In allen Studien wurde neben den Auswirkungen frühzeitiger Vorinformationen auf die Übernahmeleistung und Bearbeitung von fahrfremden Tätigkeiten auch untersucht, welche Auswirkungen ein erweitertes Übernahmekonzept auf die Fahrerreaktion in Grenz- und Fehlerfällen, in denen Vorinformationen entweder nicht oder fehlerhaft angezeigt wurden, hat.
Für die Gestaltung zukünftiger Übernahmekonzepte für hochautomatisierte Fahrzeuge kann basierend auf den Ergebnissen empfohlen werden, frühzeitige Anzeigen von Systemgrenzen zur Ermöglichung eines sicheren und komfortablen Wechsels zwischen dem manuellen und dem automatisierten Fahren in die Mensch-Maschine-Schnittstelle zu integrieren. Basierend auf den Ergebnissen dieser Arbeit liegt der empfohlene Zeitpunkt für diskrete Ankündigungen bei einer Reisegeschwindigkeit von 120 km/h bei etwa 1000 Meter (d. h. ca. 30 Sekunden) vor der Ausgabe der Übernahmeaufforderung. Zudem wird empfohlen zur Abschätzung der verbleibenden Zeit im automatisierten Modus eine Anzeige der Entfernung zur nächsten Systemgrenze in das Konzept zu integrieren, die dem Fahrer eine längerfristige Aufgabenplanung ermöglicht. Neben der reinen Anzeige des Übernahmeerfordernisses sollten dem Fahrer auch Informationen über das erforderliche Fahrmanöver nach der Kontrollübernahme übermittelt werden.
In recent years, great progress has been made in the area of Artificial Intelligence (AI) due to the possibilities of Deep Learning which steadily yielded new state-of-the-art results especially in many image recognition tasks.
Currently, in some areas, human performance is achieved or already exceeded.
This great development already had an impact on the area of Optical Music Recognition (OMR) as several novel methods relying on Deep Learning succeeded in specific tasks.
Musicologists are interested in large-scale musical analysis and in publishing digital transcriptions in a collection enabling to develop tools for searching and data retrieving.
The application of OMR promises to simplify and thus speed-up the transcription process by either providing fully-automatic or semi-automatic approaches.
This thesis focuses on the automatic transcription of Medieval music with a focus on square notation which poses a challenging task due to complex layouts, highly varying handwritten notations, and degradation.
However, since handwritten music notations are quite complex to read, even for an experienced musicologist, it is to be expected that even with new techniques of OMR manual corrections are required to obtain the transcriptions.
This thesis presents several new approaches and open source software solutions for layout analysis and Automatic Text Recognition (ATR) for early documents and for OMR of Medieval manuscripts providing state-of-the-art technology.
Fully Convolutional Networks (FCN) are applied for the segmentation of historical manuscripts and early printed books, to detect staff lines, and to recognize neume notations.
The ATR engine Calamari is presented which allows for ATR of early prints and also the recognition of lyrics.
Configurable CNN/LSTM-network architectures which are trained with the segmentation-free CTC-loss are applied to the sequential recognition of text but also monophonic music.
Finally, a syllable-to-neume assignment algorithm is presented which represents the final step to obtain a complete transcription of the music.
The evaluations show that the performances of any algorithm is highly depending on the material at hand and the number of training instances.
The presented staff line detection correctly identifies staff lines and staves with an $F_1$-score of above $99.5\%$.
The symbol recognition yields a diplomatic Symbol Accuracy Rate (dSAR) of above $90\%$ by counting the number of correct predictions in the symbols sequence normalized by its length.
The ATR of lyrics achieved a Character Error Rate (CAR) (equivalently the number of correct predictions normalized by the sentence length) of above $93\%$ trained on 771 lyric lines of Medieval manuscripts and of 99.89\% when training on around 3.5 million lines of contemporary printed fonts.
The assignment of syllables and their corresponding neumes reached $F_1$-scores of up to $99.2\%$.
A direct comparison to previously published performances is difficult due to different materials and metrics.
However, estimations show that the reported values of this thesis exceed the state-of-the-art in the area of square notation.
A further goal of this thesis is to enable musicologists without technical background to apply the developed algorithms in a complete workflow by providing a user-friendly and comfortable Graphical User Interface (GUI) encapsulating the technical details.
For this purpose, this thesis presents the web-application OMMR4all.
Its fully-functional workflow includes the proposed state-of-the-art machine-learning algorithms and optionally allows for a manual intervention at any stage to correct the output preventing error propagation.
To simplify the manual (post-) correction, OMMR4all provides an overlay-editor that superimposes the annotations with a scan of the original manuscripts so that errors can easily be spotted.
The workflow is designed to be iteratively improvable by training better models as soon as new Ground Truth (GT) is available.
The predicted 80 open reading frames (ORFs) of herpes simplex virus 1 (HSV-1) have been intensively studied for decades. Here, we unravel the complete viral transcriptome and translatome during lytic infection with base-pair resolution by computational integration of multi-omics data. We identify a total of 201 transcripts and 284 ORFs including all known and 46 novel large ORFs. This includes a so far unknown ORF in the locus deleted in the FDA-approved oncolytic virus Imlygic. Multiple transcript isoforms expressed from individual gene loci explain translation of the vast majority of ORFs as well as N-terminal extensions (NTEs) and truncations. We show that NTEs with non-canonical start codons govern the subcellular protein localization and packaging of key viral regulators and structural proteins. We extend the current nomenclature to include all viral gene products and provide a genome browser that visualizes all the obtained data from whole genome to single-nucleotide resolution. Here, using computational integration of multi-omics data, the authors provide a detailed transcriptome and translatome of herpes simplex virus 1 (HSV-1), including previously unidentified ORFs and N-terminal extensions. The study also provides a HSV-1 genome browser and should be a valuable resource for further research.
Diese monozentrische, retrospektive Studie beschäftigt sich mit einem Patientenkollektiv, das bei abdominellen Wundheilungsstörungen nach allgemein- und viszeralchirurgischen Eingriffen, die im Zeitraum von Januar 2013 bis März 2016 am UKW durchgeführt wurden, einer Vakuumtherapie zugeführt wurde. Im Anschluss an die Vakuumtherapie erfolgte entweder eine Sekundärnaht oder die Wunde wurde der offenen Wundheilung zugeführt. Beim Vergleich der prä-, peri- und postoperativen Charakteristika dieser beiden Patientengruppen ergaben sich nahezu keine signifikanten Unterschiede. Lediglich in den präoperativ ermittelten ASA-Stadien schnitten die Patienten ohne Sekundärnaht signifikant schlechter ab als diejenigen mit Sekundärnaht. Dies weist auf deren schon von vorne herein reduzierten Allgemeinzustand hin, was eine spätere Sekundärnaht im Rahmen einer erneuten Operation erschwert. Die Datenanalyse des Follow-ups nach Entlassung lieferte letztlich signifikante Unterschiede zwischen sekundär verschlossenen und offen zugranulierenden Wunden zugunsten der Patienten, die eine Sekundärnaht erhielten mit mehr als "verheilt" dokumentierten Wunden. Somit bestätigte sich die ursprüngliche Befürchtung, dass im Milieu sekundär verschlossener Wunden eine erneute Wundheilungsstörung provoziert und die Wundheilung so im Gegensatz zu offen belassenen Wunden verhindert oder verzögert werden könnte, nicht. Bei der genaueren Betrachtung von Peritonitispatienten im Vergleich mit dem Gesamtkollektiv wurden hingegen bis auf den Einsatz von Antikoagulantien, die Anzahl der abdominellen Voroperationen und die Liegedauern auf Intensivstation keine signifikanten Unterschiede ermittelt, weshalb davon ausgegangen werden kann, dass der Vakuumtherapie unmittelbar vorangegangene Peritonitiden keinen merklichen Einfluss auf diese ausüben.
Es erfolgte eine elektrochemische Abscheidung von Bruschitschichten auf Titan in Gegenwart von Kristallisationsinhibitoren. Dabei wurden die Kristallisationsinhibitoren Zitronensäure, treta-Natriumdiphosphat-Decahydrat und Phytinsäure verwendet und die entstandenen Schichten mit denen ohne Inhibitorzugabe verglichen. Um das Ausmaß der Inhibierung zu verifizieren, wurde die Masse aller Schichten gemessen, welche für die Inhibition mit Zitronensäure und Phytinsäure abnahm und für Natriumdiphosphat zunahm. Die kristallographische Zusammensetzung der mit und ohne Inhibierung abgeschiedenen Schichten wurde mit Hilfe der Röntgendiffraktometrie bestimmt und zeigte, dass sich reine Bruschitschichten mit unterschiedlichem amorphem Anteil abschieden. Die daraus entstandenen Werte lieferten zugleich die Informationen über die einzelnen Kristallitgrößen innerhalb der Schichten. Über den Einfluss der Inhibitoren auf die Schichtmorphologie gaben rasterelektronenmikroskopische Aufnahmen weiteren Aufschluss. Die Inhibition verursachte teils mit Rissen durchzogene Schichten, deren Kristallformationen sich von Standardelektrolyt unterschieden. Ausgewählte Proben wurden unter verschiedenen Bedingungen desinfiziert bzw. sterilisiert und nachfolgend erneut gewogen und mittels Röntgendiffraktogrammetrie und Rasterelektronenmikroskopie analysiert. Nach der Desinfektion entstanden reine Bruschitschichten, die an Masse verloren aber trotzdem die typischen Kristallformationen zeigten. Die Sterilisation führte zur Umwandlung von Bruschit in Monetit und Hydroxylapatit. Des Weiteren wurde die biologische Reaktion der Schichten auf humane fötale Osteoblasten-Zelllinien zur Überprüfung der Zellverträglichkeit ermittelt. Die entstandenen Ergebnisse waren nicht verwertbar und enthielt sehr hohe Standardabweichungen.
Influenza-assoziierte Atemwegserkrankungen führen jedes Jahr zu zahlreichen Hospitalisierungen und Todesfällen. Der während der Pandemie 2009 zirkulierende Erreger Influenza A(H1N1)pdm09 führte zu zahlreichen, zum Teil schweren Komplikationen, insbesondere auch bei jüngeren Erwachsenen. In der vorliegenden Studie wurden Influenza-assoziierte Hospitalisierungen (IAH) hinsichtlich Krankheitsverlauf in den verschiedenen Altersgruppen sowie bei verschiedenen Erregern untersucht. Zudem erfolgte eine Analyse der direkten Krankheitskosten.
Einen besonders schweren Verlauf zeigten Erwachsene mit Grunderkrankung zwischen 18-60 Jahren, die überwiegend mit dem Erreger Influenza A(H1N1)pdm09 infiziert waren. Ebenso waren schwangeren Patientinnen mit IAH mit dem Erreger A(H1N1)pdm09 selten, aber schwer betroffen.
Bei Patienten von 18-60 Jahren mit dem Erreger Influenza A(H1N1)pdm09 entstanden die höchsten direkten Kosten im Vergleich zu den anderen Altersgruppen.
The limited proliferative capacity of neuroprogenitor cells (NPCs) within the periventricular germinal niches (PGNs) located caudal of the subventricular zone (SVZ) of the lateral ventricles together with their high proliferation capacity after isolation strongly implicates cell‐extrinsic humoral factors restricting NPC proliferation in the hypothalamic and midbrain PGNs. We comparatively examined the effects of norepinephrine (NE) as an endogenous candidate regulator of PGN neurogenesis in the SVZ as well as the periventricular hypothalamus and the periaqueductal midbrain. Histological and neurochemical analyses revealed that the pattern of NE innervation of the adult PGNs is inversely associated with their in vivo NPC proliferation capacity with low NE levels coupled to high NPC proliferation in the SVZ but high NE levels coupled to low NPC proliferation in hypothalamic and midbrain PGNs. Intraventricular infusion of NE decreased NPC proliferation and neurogenesis in the SVZ‐olfactory bulb system, while pharmacological NE inhibition increased NPC proliferation and early neurogenesis events in the caudal PGNs. Neurotoxic ablation of NE neurons using the Dsp4‐fluoxetine protocol confirmed its inhibitory effects on NPC proliferation. Contrarily, NE depletion largely impairs NPC proliferation within the hippocampus in the same animals. Our data indicate that norepinephrine has opposite effects on the two fundamental neurogenic niches of the adult brain with norepinephrine being a negative regulator of adult periventricular neurogenesis. This knowledge might ultimately lead to new therapeutic approaches to influence neurogenesis in hypothalamus‐related metabolic diseases or to stimulate endogenous regenerative potential in neurodegenerative processes such as Parkinson's disease.
Validation of text information as a general mechanism for detecting inconsistent or false information is an integral part of text comprehension. This study examined how the credibility of the information source affects validation processes. Two experiments investigated combined effects of source credibility and plausibility of information during validation with explicit (ratings) and implicit (reading times) measurements. Participants read short stories with a high-credible versus low-credible person that stated a consistent or inconsistent assertion with general world knowledge. Ratings of plausibility and ratings of source credibility were lower when a credible source stated a world-knowledge inconsistent assertion compared with a low-credible source. Reading times on target sentences and on spillover sentences were slower when a credible source stated an assertion inconsistent with world knowledge compared with a low-credible source, suggesting that source information modulated the validation of implausible information. These results show that source credibility modulates validation and suggest a bidirectional relationship of perceived plausibility and source credibility in the reading process.
Prostate-specific membrane antigen (PSMA)-targeted PET imaging for prostate cancer with \(^{68}\)Ga-labeled compounds has rapidly become adopted as part of routine clinical care in many parts of the world. However, recent years have witnessed the start of a shift from \(^{68}\)Ga- to \(^{18}\)F-labeled PSMA-targeted compounds. The latter imaging agents have several key advantages, which may lay the groundwork for an even more widespread adoption into the clinic. First, facilitated delivery from distant suppliers expands the availability of PET radiopharmaceuticals in smaller hospitals operating a PET center but lacking the patient volume to justify an onsite \(^{68}\)Ge/\(^{68}\)Ga generator. Thus, such an approach meets the increasing demand for PSMA-targeted PET imaging in areas with lower population density and may even lead to cost-savings compared to in-house production. Moreover, \(^{18}\)F-labeled radiotracers have a higher positron yield and lower positron energy, which in turn decreases image noise, improves contrast resolution, and maximizes the likelihood of detecting subtle lesions. In addition, the longer half-life of 110 min allows for improved delayed imaging protocols and flexibility in study design, which may further increase diagnostic accuracy. Moreover, such compounds can be distributed to sites which are not allowed to produce radiotracers on-site due to regulatory issues or to centers without access to a cyclotron. In light of these advantageous characteristics, \(^{18}\)F-labeled PSMA-targeted PET radiotracers may play an important role in both optimizing this transformative imaging modality and making it widely available. We have aimed to provide a concise overview of emerging \(^{18}\)F-labeled PSMA-targeted radiotracers undergoing active clinical development. Given the wide array of available radiotracers, comparative studies are needed to firmly establish the role of the available \(^{18}\)F-labeled compounds in the field of molecular PCa imaging, preferably in different clinical scenarios.
Exon-4 Mutations in KRAS Affect MEK/ERK and PI3K/AKT Signaling in Human Multiple Myeloma Cell Lines
(2020)
Approximately 20% of multiple myeloma (MM) cases harbor a point mutation in KRAS. However, there is still no final consent on whether KRAS-mutations are associated with disease outcome. Specifically, no data exist on whether KRAS-mutations have an impact on survival of MM patients at diagnosis in the era of novel agents. Direct blockade of KRAS for therapeutic purposes is mostly impossible, but recently a mutation-specific covalent inhibitor targeting KRAS\(^{p.G12C}\) entered into clinical trials. However, other KRAS hotspot-mutations exist in MM patients, including the less common exon-4 mutations. For the current study, the coding regions of KRAS were deep-sequenced in 80 newly diagnosed MM patients, uniformely treated with three cycles of bortezomib plus dexamethasone and cyclophosphamide (VCD)-induction, followed by high-dose chemotherapy and autologous stem cell transplantation. Moreover, the functional impact of KRAS\(^{p.G12A}\) and the exon-4 mutations p.A146T and p.A146V on different survival pathways was investigated. Specifically, KRAS\(^{WT}\), KRAS\(^{p.G12A}\), KRAS\(^{p.A146T}\), and KRAS\(^{p.A146V}\) were overexpressed in HEK293 cells and the KRAS\(^{WT}\) MM cell lines JJN3 and OPM2 using lentiviral transduction and the Sleeping Beauty vector system. Even though KRAS-mutations were not correlated with survival, all KRAS-mutants were found capable of potentially activating MEK/ERK- and sustaining PI3K/AKT-signaling in MM cells.
We investigated the influence of social status on behavior in a modified dictator game (DG). Since the DG contains an inherent dominance gradient, we examined the relationship between dictator decisions and recipient status, which was operationalized by three social identities and an artificial intelligence (AI). Additionally, we examined the predictive value of social dominance orientation (SDO) on the behavior of dictators toward the different social and non-social hierarchical recipients. A multilevel model analysis showed that recipients with the same status as the dictator benefited the most and the artificial intelligence the least. Furthermore, SDO, regardless of social status, predicted behavior toward recipients in such a way that higher dominance was associated with lower dictator offers. In summary, participants treated other persons of higher and lower status equally, those of equal status better and, above all, an algorithm worst. The large proportion of female participants and the limited variance of SDO should be taken into account with regard to the results of individual differences in SDO.
The present dissertation aims to shed light on different mechanisms of socio-emotional feedback in social decision-making situations. The objective is to evaluate emotional facial expressions as feedback stimuli, i.e., responses of interaction partners to certain social decisions. In addition to human faces, artificial emojis are also examined due to their relevance for modern digital communication. Previous research on the influence of emotional feedback suggests that a person's behavior can be effectively reinforced by rewarding stimuli. In the context of this dissertation, the differences in the feedback processing of human photographs and emojis, but also the evaluation of socially expected versus socially unexpected feedback were examined in detail in four studies. In addition to behavioral data, we used the electroencephalogram (EEG) in all studies to investigate neural correlates of social decision-making and emotional feedback.
As the central paradigm, all studies were based on a modified ultimatum game. The game is structured as follows: there is a so-called proposer who holds a specific amount of money (e.g., 10 cents) and offers the responder a certain amount (e.g., 3 cents). The responder then decides whether to accept or reject the offer. In the version of the ultimatum game presented here, different types of proposers are introduced. After the participants have accepted or rejected in the role of the responder, the different proposers react to the participant’s decision with specific emotional facial expressions. Different feedback patterns are used for the individual experiments conducted in the course of this dissertation.
In the first study, we investigated the influence of emotional feedback on decision-making in the modified version of the ultimatum game. We were able to show that a proposer who responds to the acceptance of an offer with a smiling face achieves more accepted offers overall than a control proposer who responds to both accepted and rejected offers with a neutral facial expression. Consequently, the smile served as a positive reinforcement. Similarly, a sad expression in response to a rejected offer also resulted in higher acceptance rates as compared to the control identity, which could be considered an expression of compassion for that proposer. On a neuronal level, we could show that there are differences between simply looking at negative emotional stimuli (i.e., sad and angry faces) and their appearance as feedback stimuli after rejected offers in the modified ultimatum game. The so-called feedback-related negativity was reduced (i.e., more positive) when negative emotions appeared as feedback from the proposers. We argued that these findings might show that the participants wanted to punish the proposers by rejecting an offer for its unfairness and therefore the negative feedback met their expectations. The altered processing of negative emotional facial expressions in the ultimatum game could therefore indicate that the punishment is interpreted as successful. This includes the expectation that the interaction partner will change his behavior in the future and eventually make fairer offers.
In the second study we wanted to show that smiling and sad emojis as feedback stimuli in the modified ultimatum game can also lead to increased acceptance rates. Contrary to our assumptions, this effect could not be observed. At the neural level as well, the findings did not correspond to our assumptions and differed strongly from those of the first study. One finding, however, was that the neural P3 component showed how the use of emojis as feedback stimuli particularly characterizes certain types of proposers. This is supported by the fact that the P3 is increased for the proposer who rewards an acceptance with a smile as well as for the proposer who reacts to rejection with a sad emoji compared to the neutral control proposer.
The third study examined the discrepancy between the findings of the first and second study. Accordingly, both humans and emojis representing the different proposers were presented in the ultimatum game. In addition, emojis were selected that showed a higher similarity to known emojis from common messenger services compared to the second study. We were able to replicate that the proposers in the ultimatum game, who reward an acceptance of the offer with a smile, led to an increased acceptance rate compared to the neutral control proposers. This difference is independent of whether the proposers are represented by emojis or human faces. With regard to the neural correlates, we were able to demonstrate that emojis and human faces differ strongly in their neural processing. Emojis showed stronger activation than human faces in the face-processing N170 component, the feedback-related negativity and the P3 component. We concluded that the results of the N170 and feedback-related negativity could indicate a signal for missing social information of emojis compared to faces. The increased P3 amplitude for emojis might imply that emojis appear unexpectedly as reward stimuli in a social decision task compared to human faces.
The last study of this project dealt with socially unexpected feedback. In comparison to the first three studies, new proposer identities were implemented. In particular, the focus was on a proposer who reacted to the rejection of an offer unexpectedly with a smile and to the acceptance with a neutral facial expression. According to the results, participants approach this unexpected smile through increased rejection, although it is accompanied by financial loss. In addition, as reported in studies one and three, we were able to show that proposers who respond to the acceptance of an offer with a smiling face and thus meet the expectations of the participants have higher offer acceptance rates than the control proposer. At the neuronal level, especially the feedback from the socially unexpected proposer led to an increased P3 amplitude, which indicates that smiling after rejection is attributed a special subjective importance.
The experiments provide new insights into the social influence through emotional feedback and the processing of relevant social cues. Due to the conceptual similarity of the studies, it was possible to differentiate between stable findings and potentially stimulus-dependent deviations, thus creating a well-founded contribution to the current research. Therefore, the novel paradigm presented here, and the knowledge gained from it could also play an important role in the future for clinical questions dealing with limited social competencies.
Objective
As native cartilage consists of different phenotypical zones, this study aims to fabricate different types of neocartilage constructs from collagen hydrogels and human mesenchymal stromal cells (MSCs) genetically modified to express different chondrogenic factors.
Design
Human MSCs derived from bone-marrow of osteoarthritis (OA) hips were genetically modified using adenoviral vectors encoding sex-determining region Y-type high-mobility-group-box (SOX)9,transforming growth factor beta (TGFB) 1or bone morphogenetic protein (BMP) 2cDNA, placed in type I collagen hydrogels and maintained in serum-free chondrogenic media for three weeks. Control constructs contained unmodified MSCs or MSCs expressing GFP. The respective constructs were analyzed histologically, immunohistochemically, biochemically, and by qRT-PCR for chondrogenesis and hypertrophy.
Results
Chondrogenesis in MSCs was consistently and strongly induced in collagen I hydrogels by the transgenesSOX9,TGFB1andBMP2as evidenced by positive staining for proteoglycans, chondroitin-4-sulfate (CS4) and collagen (COL) type II, increased levels of glycosaminoglycan (GAG) synthesis, and expression of mRNAs associated with chondrogenesis. The control groups were entirely non-chondrogenic. The levels of hypertrophy, as judged by expression of alkaline phosphatase (ALP) and COL X on both the protein and mRNA levels revealed different stages of hypertrophy within the chondrogenic groups (BMP2>TGFB1>SOX9).
Conclusions
Different types of neocartilage with varying levels of hypertrophy could be generated from human MSCs in collagen hydrogels by transfer of genes encoding the chondrogenic factorsSOX9,TGFB1andBMP2. This technology may be harnessed for regeneration of specific zones of native cartilage upon damage.
Background
Surgical reattachment of the tendon is still the gold standard for ruptures of the distal biceps brachii tendon. Several fixation techniques have been described in the literature, with suture anchors being one of the most common fixation techniques. Currently, there is no data available on how many anchors are required for a safe and stable refixation. In this case report clinical data of a patient with non-simultaneous bilateral distal biceps tendon ruptures treated with a different number of suture anchors for each side (one vs. two) are demonstrated.
Case presentation
A 47-year-old factory worker suffered a rupture of the distal biceps tendon on both arms following two different occasions. The left side was fixed using a single suture anchor, while refixation on the right side was performed with two anchors. The patient was prospectively followed for one year. Functional outcome was assessed using the Andrews Carson Score (ACS), the Oxford Elbow Score (OES), and the Disabilities of Arm, Shoulder and Hand (DASH) Score after six, twelve, 24 and 48 weeks. Furthermore, an isokinetic strength measurement for flexion strength was performed after 24 and 48 weeks. After 48 weeks the patient presented with excellent functional outcome scores and no follow-up complications. During the follow-up period, no differences in the functional scores nor in the isokinetic flexion strength measurement could be detected. Furthermore, no radiological complications (like heterotopic ossifications) could be detected in the postoperative radiographs after one year.
Conclusions
Anatomic reattachment of the distal biceps tendon is a successful operative treatment option for distal biceps tendon ruptures. Suture anchor fixation remains one of the most common techniques, as it allows fast surgery and provides good results with respect to range of motion (ROM) and functional scoring according to the current literature. However, the number of anchors required for a stable fixation remains unclear. As indicated by our presented case, we hypothesize, that there are no significant differences between a one-point or a two-point fixation. In the presented case report, no intraindividual differences between the usage of one versus two suture anchors were evident in the short-term follow-up.
Background
Mesenchymal stem cell (MSC) based-treatments of cartilage injury are promising but impaired by high levels of hypertrophy after chondrogenic induction with several bone morphogenetic protein superfamily members (BMPs). As an alternative, this study investigates the chondrogenic induction of MSCs via adenoviral gene-delivery of the transcription factor SOX9 alone or in combination with other inducers, and comparatively explores the levels of hypertrophy and end stage differentiation in a pellet culture system in vitro.
Methods
First generation adenoviral vectors encoding SOX9, TGFB1 or IGF1 were used alone or in combination to transduce human bone marrow-derived MSCs at 5 x 10\(^2\) infectious particles/cell. Thereafter cells were placed in aggregates and maintained for three weeks in chondrogenic medium. Transgene expression was determined at the protein level (ELISA/Western blot), and aggregates were analysed histologically, immunohistochemically, biochemically and by RT-PCR for chondrogenesis and hypertrophy.
Results
SOX9 cDNA was superior to that encoding TGFB1, the typical gold standard, as an inducer of chondrogenesis in primary MSCs as evidenced by improved lacuna formation, proteoglycan and collagen type II staining, increased levels of GAG synthesis, and expression of mRNAs associated with chondrogenesis. Moreover, SOX9 modified aggregates showed a markedly lower tendency to progress towards hypertrophy, as judged by expression of the hypertrophy markers alkaline phosphatase, and collagen type X at the mRNA and protein levels.
Conclusion
Adenoviral SOX9 gene transfer induces chondrogenic differentiation of human primary MSCs in pellet culture more effectively than TGFB1 gene transfer with lower levels of chondrocyte hypertrophy after 3 weeks of in vitro culture. Such technology might enable the formation of more stable hyaline cartilage repair tissues in vivo.
Delayed natural killer (NK) cell reconstitution after allogeneic stem cell transplantation (alloSCT) is associated with a higher risk of developing invasive aspergillosis. The interaction of NK cells with the human pathogen Aspergillus (A.) fumigatus is mediated by the fungal recognition receptor CD56, which is relocated to the fungal interface after contact. Blocking of CD56 signaling inhibits the fungal mediated chemokine secretion of MIP-1α, MIP-1β, and RANTES and reduces cell activation, indicating a functional role of CD56 in fungal recognition. We collected peripheral blood from recipients of an allograft at defined time points after alloSCT (day 60, 90, 120, 180). NK cells were isolated, directly challenged with live A. fumigatus germ tubes, and cell function was analyzed and compared to healthy age and gender-matched individuals. After alloSCT, NK cells displayed a higher percentage of CD56\(^{bright}\)CD16\(^{dim}\) cells throughout the time of blood collection. However, CD56 binding and relocalization to the fungal contact side were decreased. We were able to correlate this deficiency to the administration of corticosteroid therapy that further negatively influenced the secretion of MIP-1α, MIP-1β, and RANTES. As a consequence, the treatment of healthy NK cells ex vivo with corticosteroids abrogated chemokine secretion measured by multiplex immunoassay. Furthermore, we analyzed NK cells regarding their actin cytoskeleton by Structured Illumination Microscopy (SIM) and flow cytometry and demonstrate an actin dysfunction of NK cells shown by reduced F-actin content after fungal co-cultivation early after alloSCT. This dysfunction remains until 180 days post-alloSCT, concluding that further actin-dependent cellular processes may be negatively influenced after alloSCT. To investigate the molecular pathomechansism, we compared CD56 receptor mobility on the plasma membrane of healthy and alloSCT primary NK cells by single-molecule tracking. The results were very robust and reproducible between tested conditions which point to a different molecular mechanism and emphasize the importance of proper CD56 mobility.
Chemie - all inclusive
(2020)
Dieses Kompendium von Methodenwerkzeugen für die Entwicklung inklusiv angelegter naturwissenschaftlicher Experimentier-Stationen ist hilfreich zur pädagogischen Gestaltung von inklusiven experimentellen Settings, um einen Zugewinn an Fachlichkeit für alle Schülerinnen und Schüler zu sichern. Es werden Planungsschritte und Methodenwerkzeuge vorgestellt, damit der Zugang zu Experimenten für alle Kinder auf allen Ebenen geschaffen werden kann.
Als die häufigste tödliche Tumorerkrankung weltweit ist das Lungenkarzinom mit einer sehr schlechten Prognose verbunden. Eine Behandlungsoption für Lungenadenokarzinome, die eine aktivierende EGFR-Mutation aufweisen, ist der orale EGFR-TKI Gefitinib (Iressa®, ZD1839). Die Resistenzentwicklung von Tumoren gegen diese Therapie stellt ein großes klinisches Problem dar.
Das Ziel dieser Arbeit war es, die Dosis-Wirkungs-Beziehung von Gefitinib, sowie die Entwicklung von Resistenzen in einem etablierten humanen 3D Lungentumormodell zu untersuchen und dieses Testsystem für eben diese Fragestellungen zu validieren.
Vorliegende Arbeit bestätigt, dass pharmakologische Untersuchungen in Zellkulturen häufig zu einer Überschätzung des Behandlungserfolges führen. Das verwendete Modell entspricht mehr den in vivo Bedingungen. In dieser Arbeit wurden zwei ATP-Zellvitalitätsassays für die statischen 3D Lungentumormodelle etabliert und erfolgreich angewendet. Dabei zeigte sich eine konzentrationsabhängige Wirkung von Gefitinib auf das Wachstum, die Proliferation, die Apoptose, die Markerexpression sowie die Signalwegsaktivierungen. Im statischen 3D Lungentumormodell lag der IC50-Wert zwischen 0,05-0,1 µM Gefitinib welches den Werten aus klinischen Beobachtungen entspricht. Auch der in der Klinik bereits nach wenigen Stunden eintretende zeitliche Effekt von Gefitinib konnte in unserem Modell bestätigt werden. Eine dynamische Kultivierung der Lungentumorzellen, mit von Scherkräften verursachtem schnellerem Zellwachstum, führte zu einer weiteren Annährung an die klinischen Gegebenheiten. Das Netzwerk der Gefitinib-Wirkung auf die EGFR-Signalkaskade wurde in unserem Modell charakterisiert.
Die Betrachtung einer resistenten Zell-Subpopulation zeigte einen Resistenzmechanismus über eine Epitheliale-Mesenchymale-Transition. Zusätzlich wurde versucht, eine neue medikamenten-resistente Zell-Subpopulation zu generieren.
Das beschriebene 3D Lungentumormodell ermöglicht richtungsweisende Untersuchungen zu Dosis-Wirkungs-Beziehung von Gefitinib. Ansätze für eine weitere Optimierung des Modells wurden herausgearbeitet.
Fatigue als ein „überwältigendes Gefühl von Müdigkeit, Energielosigkeit und Erschöpfung” stellt bei Patienten mit MS ein häufig auftretendes und oft im Alltag beeinträchtigendes Symptom dar, das sowohl mit körperlichen als auch mit kognitiven Erschöpfungssymptomen einhergeht. Die objektive Erfassung des Schweregrades der Fatigue beim einzelnen Patienten stellt ein Problem dar, da bisher keine objektiven Messverfahren zur Erfassung der Fatigue existieren. Im klinischen Alltag kommen meist Fragebögen zum Einsatz, die das Ausmaß der subjektiven Beeinträchtigung durch Fatigue im Alltag quantifizieren sollen.
Ziel dieser Arbeit war es, zu untersuchen, inwieweit bestimmte im klinischen Alltag erhobene Parameter Rückschlüsse auf die subjektive Fatigue bei Patienten mit MS erlauben, auch im Hinblick darauf, ob sich einzelne Parameter besonders zur Einschätzung der körperlichen bzw. kognitiven Fatigue eignen. Zudem sollte untersucht werden, ob die untersuchten klinischen Parameter bei bestimmten Patientengruppen besser als bei anderen Rückschlüsse auf die subjektive Fatigue erlauben. Erfasst wurde die subjektive Fatigue durch das Würzburger Erschöpfungsinventar bei Multipler Sklerose (WEIMuS), einer Serie von Fragen, die zwischen körperlicher und kognitiver Fatigue unterscheiden.
Dazu wurden Korrelationsanalysen zwischen der WEIMuS-Gesamtskala bzw. deren Subskalen für körperliche und kognitive Fatigue und EDSS-Wert, MSFC Z-Score einschließlich dessen Subscores und der Zeit des 50-Meter-Gehversuchs durchgeführt. Bezüglich der körperlichen Fatigue ergaben sich zwischen der WEIMuS-Subskala für körperliche Fatigue und dem EDSS sowie der Zeit des 50-Meter-Gehversuchs im Vergleich die stärksten, absolut gesehen als mittelstark zu wertende, Korrelationen. Bezüglich der kognitiven Fatigue ergab sich die stärkste Korrelation zwischen der WEIMuS-Subskala für kognitive Fatigue und dem PASAT3, die allerdings trotzdem als gering zu werten ist. Mit EDSS und 50-Meter-Gehversuch scheinen also zwei objektive klinische Parameter zu existieren, die in einem gewissen Maß auf die subjektive Fatigue rückschließen lassen. Ziel weiterer Untersuchungen wird es sein müssen, einen geeigneten klinischen Parameter zu finden, der bessere Rückschlüsse auf die subjektive kognitive Fatigue erlaubt als der PASAT3.
Zwischen der WEIMuS-Gesamtskala bzw. deren Subskalen für körperliche und kognitive Fatigue und Alter, Geschlecht und Erkrankungsdauer fanden sich bestenfalls geringe Korrelationen, weshalb diese Parameter ungeeignet erscheinen, Aussagen über die subjektive Fatigue zu machen.
Durch die Einteilung der Patienten nach Alter und Geschlecht konnte untersucht werden, inwieweit diese Parameter Einfluss auf die untersuchten Zusammenhänge zwischen klinischen Parametern und subjektiver Fatigue haben. Die Korrelationen zwischen den WEIMuS-Subskalen für körperliche und kognitive Fatigue mit den untersuchten klinischen Parametern waren für junge Patienten überwiegend stärker als für ältere Patienten, insbesondere ältere Männer. Somit scheinen die untersuchten klinischen Parameter bei jüngeren Patienten besser geeignet, Aussagen über die subjektive Fatigue zu machen als bei älteren.
Insgesamt ist festzuhalten, dass EDSS und 50-Meter-Gehversuch insbesondere bei jungen Patienten zu einer besseren objektiven Beurteilbarkeit vor allem der körperlichen Fatigue im klinischen Alltag beitragen können.
Background
To increase the image quality of end-expiratory and end-inspiratory phases of retrospective respiratory self-gated 4D MRI data sets using non-rigid image registration for improved target delineation of moving tumors.
Methods
End-expiratory and end-inspiratory phases of volunteer and patient 4D MRI data sets are used as targets for non-rigid image registration of all other phases using two different registration schemes: In the first, all phases are registered directly (dir-Reg) while next neighbors are successively registered until the target is reached in the second (nn-Reg). Resulting data sets are quantitatively compared using diaphragm and tumor sharpness and the coefficient of variation of regions of interest in the lung, liver, and heart. Qualitative assessment of the patient data regarding noise level, tumor delineation, and overall image quality was performed by blinded reading based on a 4 point Likert scale.
Results
The median coefficient of variation was lower for both registration schemes compared to the target. Median dir-Reg coefficient of variation of all ROIs was 5.6% lower for expiration and 7.0% lower for inspiration compared with nn-Reg. Statistical significant differences between the two schemes were found in all comparisons. Median sharpness in inspiration is lower compared to expiration sharpness in all cases. Registered data sets were rated better compared to the targets in all categories. Over all categories, mean expiration scores were 2.92 +/- 0.18 for the target, 3.19 +/- 0.22 for nn-Reg and 3.56 +/- 0.14 for dir-Reg and mean inspiration scores 2.25 +/- 0.12 for the target, 2.72 +/- 215 0.04 for nn-Reg and 3.78 +/- 0.04 for dir-Reg.
Conclusions
In this work, end-expiratory and inspiratory phases of a 4D MRI data sets are used as targets for non-rigid image registration of all other phases. It is qualitatively and quantitatively shown that image quality of the targets can be significantly enhanced leading to improved target delineation of moving tumors.
Homo- and heterochiral aggregation during crystallization of organic molecules has significance both for fundamental questions related to the origin of life as well as for the separation of homochiral compounds from their racemates in industrial processes. Herein, we analyse these phenomena at the lowest level of hierarchy - that is the self-assembly of a racemic mixture of (R,R)- and (S,S)-PBI into 1D supramolecular polymers. By a combination of UV/vis and NMR spectroscopy as well as atomic force microscopy, we demonstrate that homochiral aggregation of the racemic mixture leads to the formation of two types of supramolecular conglomerates under kinetic control, while under thermodynamic control heterochiral aggregation is preferred, affording a racemic supramolecular polymer. FT-IR spectroscopy and quantum-chemical calculations reveal unique packing arrangements and hydrogen-bonding patterns within these supramolecular polymers. Time-, concentration- and temperature-dependent UV/vis experiments provide further insights into the kinetic and thermodynamic control of the conglomerate and racemic supramolecular polymer formation. Homo- and heterochiral aggregation is a process of interest to prebiotic and chiral separation chemistry. Here, the authors analyze the self-assembly of a racemic mixture into 1D supramolecular polymers and find homochiral aggregation into conglomerates under kinetic control, while under thermodynamic control a racemic polymer is formed.
Purpose:
The model used to calculate dose distributions in a radiotherapy treatment plan relies on the data entered during beam commissioning. The quality of these data heavily depends on the detector choice made, especially in small fields and in the buildup region. Therefore, it is necessary to identify suitable detectors for measurements in the buildup region of small fields. To aid the understanding of a detector's limitations, several factors that influence the detector signal are to be analyzed, for example, the volume effect due to the detector size, the response to electron contamination, the signal dependence on the polarity used, and the effective point of measurement chosen.
Methods:
We tested the suitability of different small field detectors for measurements of depth dose curves with a special focus on the surface‐near area of dose buildup for fields sized between 10 × 10 and 0.6 × 0.6 cm\(^{2}\). Depth dose curves were measured with 14 different detectors including plane‐parallel chambers, thimble chambers of different types and sizes, shielded and unshielded diodes as well as a diamond detector. Those curves were compared with depth dose curves acquired on Gafchromic film. Additionally, the magnitude of geometric volume corrections was estimated from film profiles in different depths. Furthermore, a lead foil was inserted into the beam to reduce contaminating electrons and to study the resulting changes of the detector response. The role of the effective point of measurement was investigated by quantifying the changes occurring when shifting depth dose curves. Last, measurements for the small ionization chambers taken at opposing biasing voltages were compared to study polarity effects.
Results:
Depth‐dependent correction factors for relative depth dose curves with different detectors were derived. Film, the Farmer chamber FC23, a 0.13 cm\(^{3}\) scanning chamber CC13 and a plane‐parallel chamber PPC05 agree very well in fields sized 4 × 4 and 10 × 10 cm\(^{2}\). For most detectors and in smaller fields, depth dose curves differ from the film. In general, shielded diodes require larger corrections than unshielded diodes. Neither the geometric volume effect nor the electron contamination can account for the detector differences. The biggest uncertainty arises from the positioning of a detector with respect to the water surface and from the choice of the detector's effective point of measurement. Depth dose curves acquired with small ionization chambers differ by over 15% in the buildup region depending on sign of the biasing voltage used.
Conclusions:
A scanning chamber or a PPC40 chamber is suitable for fields larger than 4 × 4 cm\(^{2}\). Below that field size, the microDiamond or small ionization chambers perform best requiring the smallest corrections at depth as well as in the buildup region. Diode response changes considerably between the different types of detectors. The position of the effective point of measurement has a huge effect on the resulting curves, therefore detector specific rather than general shifts of half the inner radius of cylindrical ionization chambers for the effective point of measurement should be used. For small ionization chambers, averaging between both polarities is necessary for data obtained near the surface.
Die Resistenz von Tumorzellen gegenüber Apoptose stellt einen zentralen Baustein in der Pathogenese von Tumorerkrankungen dar. cFLIP inhibiert rezeptornah die Todesrezeptor-vermittelte Apoptose und spielt somit eine bedeutende Rolle als Regulator der Apoptose. Eine verstärkte Expression von cFLIP kann folglich hinweisend auf eine Fehlregulation der Apoptose bei der Entstehung und Progression von Tumoren sein. In der vorliegenden Arbeit wurde die Expression von cFLIP in kutanen epithelialen und melanozytären Tumoren mit formalinfixierten und paraffinierten Gewebeproben untersucht. Bei der zunächst durchgeführten Charakterisierung der käuflich erhältlichen monoklonalen cFLIP-Antikörper mittels cFLIP-überexprimierenden HaCaT-Keratinozyten wurde überraschenderweise die fehlende Spezifität eines Antikörpers (KlonEPR8438(2)) nachgewiesen, was zur Folge hatte, dass der Hersteller die Produktion nach Mitteilung der Befunde eingestellt hat. Daher wurden die weiteren Untersuchungen unter Verwendung des Antikörper-Klons G11, der sowohl im Western Blot als auch immunhistochemisch die beiden cFLIP-Splicevarianten cFLIPL und cFLIPS spezifisch nachweist, durchgeführt. Hierbei konnte gezeigt werden, dass cFLIP in epithelialen Hauttumoren in erheblichem Maß exprimiert wird. In jeweils 40% der untersuchten aktinischen Keratosen und Morbi Bowen konnte cFLIP nachgewiesen werden. Im Vergleich dazu zeigte sich in den fortgeschrittenen Formen epithelialer Hauttumoren eine deutlich höhere Expressionsrate. Eine Expression wiesen zudem 100% der untersuchten Keratoakanthome und 95% der Plattenepithelkarzinome (mit überwiegend gutem Differenzierungsgrad) auf. Dementsprechend war es nicht verwunderlich, dass alle untersuchten Metastasen von Plattenepithelkarzinomen cFLIP überexprimierten. Die Analyse melanozytärer Läsionen ergab, dass cFLIP in melanozytären Nävi wie auch superfiziell spreitenden Melanomen, Lentigo-maligna-Melanomen und akral lentiginösen Melanomen nur in einer sehr geringen Anzahl der untersuchten Präparate überexprimiert wurde. Erstaunlicherweise konnte jedoch in 65% der nodulären Melanome sowie in 60% der Melanommetastasen cFLIP nachgewiesen werden. Bezüglich der Expression von cFLIP im Primärtumor sowie der Metastase desselben Patienten konnte kein eindeutiger Trend festgestellt werden. Die Ergebnisse dieser Arbeit deuten darauf hin, dass die frühe Hemmung des extrinsischen Apoptoseweges durch das antiapoptotische Protein cFLIP an der Entstehung, dem Wachstum und möglicherweise der Metastasierung epithelialer Hauttumore beteiligt sein dürfte. Die auffallend hohe Expressionsrate im nodulären Melanom sowie den untersuchten Melanommetastasen könnte einen zukünftigen therapeutischen Angriffspunkt darstellen.
The introduction of new therapeutic agents has revolutionized the treatment of metastatic melanoma. The approval of adjuvant anti‐programmed death‐1 monotherapy with nivolumab or pembrolizumab, and dabrafenib plus trametinib has recently set a new landmark in the treatment of stage III melanoma. Now, clinical trials have shown that immune checkpoint blockade can be performed in a neoadjuvant setting, an approach established as a standard therapeutic approach for other tumour entities such as breast cancer. Recent studies suggest that a pathological response achieved by neoadjuvant immunotherapy is associated with long‐term tumour control and that short neoadjuvant application of checkpoint inhibitors may be superior to adjuvant therapy. Most recently, neoadjuvant ipilimumab plus nivolumab in stage III melanoma was reported. With two courses of dose‐optimized ipilimumab (1 mg kg−1) combined with nivolumab (3 mg kg−1), pathological responses were observed in 77% of patients, while only 20% of patients experienced grade 3 or 4 adverse events. However, the neoadjuvant trials employing combined immune checkpoint blockade conducted so far have excluded patients with in transit metastases, a common finding in stage III melanoma. Here we report four patients with in transit metastases or an advanced primary tumour who have been treated with neoadjuvant ipilimumab plus nivolumab according to the OpACIN‐neo trial scheme (arm B). All patients achieved radiological disease control and a pathological response. None of the patients has relapsed so far.
Eine fundierte Ausbildung ist in der interventionellen Kardiologie essentiell, um die teilweise komplexen Prozeduren erfolgreich und sicher durchführen zu können. Bei der perkutanen Koronarintervention (PCI) können u.a. Fehler beim Handling des Führungsdrahtes auftreten. So kann es einerseits zum Drahtverlust, andererseits zur distalen Koronargefäßperforation kommen. Daher ist es sinnvoll, die Technik des Katheterwechsels ohne inadäquate Drahtbewegung vor der ersten Intervention im Herzkatheterlabor am Modell zu trainieren. Für diesen Zweck wurde der DACH-BOSS-Simulator entwickelt, an dem der Katheterwechsel trainiert werden kann.
Die Validität des Modells wurde im Rahmen einer Studie bei 10 Medizinstudenten (S) sowie 10 angehenden interventionellen Kardiologen (F) untersucht. Jeder Teilnehmer führte eine Trainingsreihe bestehend aus 25 Prozeduren durch. Um den Trainingseffekt zu ermitteln, wurden die mittleren Punktzahlen der ersten 3 und der letzten 3 Prozeduren jedes Probanden in der Studenten- und Fortgeschrittenengruppe verglichen. Zur Bestimmung der Konstruktvalidität führte eine dritte Gruppe von 5 Experten (E, > 1000 PCIs) jeweils 3 Prozeduren durch. Ausmaß der Drahtbewegung und benötigte Zeit wurden mit Punkten bewertet und als Skills score dargestellt.
Bei den ersten 3 Prozeduren erzielten die Experten signifikant höhere Werte als die Studenten oder die Fortgeschrittenengruppe (E: 12,9±1,0; S: 7,1±2,6, p = 0,001;
F: 8,3±2,0; p = 0,001; Mann-Whitney-U). Anfänger und Fortgeschrittene durchliefen während der 25 Trainingsprozeduren eine Lernkurve; im Mittel verbesserte sich die Studentengruppe von 7,1±2,6 auf 12,2±2 (p=0,007, Wilcoxon) und die Fortgeschrittenengruppe von 8,3±2,0 auf 13,2±1,0 (p = 0,005, Wilcoxon).
Der DACH-BOSS-Simulator stellt somit ein valides Modell zum Training des Katheterwechsels ohne inadäquate Drahtbewegung dar. Angehende interventionelle Kardiologen können diesen wichtigen Schritt der Prozedur am Modell trainieren und erlernen. Ob die am Simulator erworbenen Fähigkeiten auf die klinische Prozedur übertragbar sind, muss in weiteren Studien untersucht werden.
Metabolic Alterations Caused by Defective Cardiolipin Remodeling in Inherited Cardiomyopathies
(2020)
The heart is the most energy-consuming organ in the human body. In heart failure, the homeostasis of energy supply and demand is endangered by an increase in cardiomyocyte workload, or by an insufficiency in energy-providing processes. Energy metabolism is directly associated with mitochondrial redox homeostasis. The production of toxic reactive oxygen species (ROS) may overwhelm mitochondrial and cellular ROS defense mechanisms in case of heart failure. Mitochondria are essential cell organelles and provide 95% of the required energy in the heart. Metabolic remodeling, changes in mitochondrial structure or function, and alterations in mitochondrial calcium signaling diminish mitochondrial energy provision in many forms of cardiomyopathy. The mitochondrial respiratory chain creates a proton gradient across the inner mitochondrial membrane, which couples respiration with oxidative phosphorylation and the preservation of energy in the chemical bonds of ATP. Akin to other mitochondrial enzymes, the respiratory chain is integrated into the inner mitochondrial membrane. The tight association with the mitochondrial phospholipid cardiolipin (CL) ensures its structural integrity and coordinates enzymatic activity. This review focuses on how changes in mitochondrial CL may be associated with heart failure. Dysfunctional CL has been found in diabetic cardiomyopathy, ischemia reperfusion injury and the aging heart. Barth syndrome (BTHS) is caused by an inherited defect in the biosynthesis of cardiolipin. Moreover, a dysfunctional CL pool causes other types of rare inherited cardiomyopathies, such as Sengers syndrome and Dilated Cardiomyopathy with Ataxia (DCMA). Here we review the impact of cardiolipin deficiency on mitochondrial functions in cellular and animal models. We describe the molecular mechanisms concerning mitochondrial dysfunction as an incitement of cardiomyopathy and discuss potential therapeutic strategies.
Long-term treatment effect studies in large female Fabry patient groups are challenging to design because of phenotype heterogeneity and lack of appropriate comparison groups, and have not been reported. We compared long-term cardiomyopathy and kidney function outcomes after agalsidase beta treatment with preceding treatment-naive outcomes.
Methods and results Self-controlled pretreatment and post-treatment comparison (piecewise mixed linear modelling) included Fabry female patients ≥18 years at treatment initiation who received agalsidase beta (0.9–1.1 mg/kg every other week) for ≥2 years, with ≥2 pretreatment and ≥2 post-treatment outcome measurements during 10-year follow-up. Left ventricular posterior wall thickness (LVPWT)/interventricular septal thickness (IVST) and estimated glomerular filtration rate (eGFR, Chronic Kidney Disease Epidemiology Collaboration creatinine equation) analyses included 42 and 86 patients, respectively, aged 50.0 and 46.3 years at treatment initiation, respectively. LVPWT and IVST increased pretreatment (follow-up 3.5 years) but stabilized during 3.6 years of treatment (LVPWT: n = 38, slope difference [95% confidence interval (CI)] = - 0.41 [ - 0.68, - 0.15] mm/year, P\(_{pre–post difference}\)<0.01; IVST: n = 38, slope difference =-0.32 [-0.67, 0.02] mm/year, P\(_{pre–post difference}\) = 0.07). These findings were not modified by renal involvement or antiproteinuric agent use. Compared with the treatment-naive period (follow-up 3.6 years), eGFR decline remained modest and stabilized within normal ranges during 4.1 years of treatment (slope difference, 95% CI: -0.13 [-1.15, 0.89] mL/min/1.73m\(^2\)/year, P\(_{pre–post difference}\) = 0.80).
Conclusions Cardiac hypertrophy, progressing during pretreatment follow-up, appeared to stabilize during sustained agalsidase beta treatment. eGFR decline remained within normal ranges. This suggests that treatment may prevent further Fabry-related progression of cardiomyopathy in female patients and maintain normal kidney function.
A method is reported for making hollow channels within hydrogels decorated with cell‐adhesion peptides exclusively at the channel surface. Sacrificial fibers of different diameters are used to introduce channels within poly(ethylene glycol) hydrogels crosslinked with maleimide‐thiol chemistry, which are backfilled with a cysteine‐containing peptide solution which is conjugated to the lumen with good spatial efficiency. This allows for peptide patterning in only the areas of the hydrogel where they are needed when used as cell‐guides, reducing the amount of required peptide 20‐fold when compared to bulk functionalization. The power of this approach is highlighted by successfully using these patterned hydrogels without active perfusion to guide fibroblasts and olfactory ensheathing cells—the latter having unique potential in neural repair therapies.
Background and Aims: Colonoscopy as standard procedure in endoscopy is often perceived as uncomfortable for patients. Patient's anxiety is therefore a significant issue, which often lead to avoidance of participation of relevant examinations as CRC-screening. Non-pharmacological anxiety management interventions such as music might contribute to relaxation in the phase prior and during endoscopy. Although music's anxiolytic effects have been reported previously, no objective measurement of stress level reduction has been reported yet. Focus of this study was to evaluate the objective measurement of the state of relaxation in patients undergoing colonoscopy.
Methods: Prospective study (n = 196) performed at one endoscopic high-volume center. Standard colonoscopy was performed in control group. Interventional group received additionally self-chosen music over earphones. Facial Electromyography (fEMG) activity was obtained. Clinician Satisfaction with Sedation Instrument (CSSI) and Patients Satisfaction with Sedation Instrument (PSSI) was answered by colonoscopists and patients, respectively. Overall satisfaction with music accompanied colonoscopy was obtained if applicable.
Results: Mean difference measured by fEMG via musculus zygomaticus major indicated a significantly lower stress level in the music group [7.700(±5.560) μV vs. 4.820(±3.330) μV; p = 0.001]. Clinician satisfaction was significantly higher with patients listening to music [82.69(±15.04) vs. 87.3(±15.02) pts.; p = 0.001]. Patient's satisfaction was higher but did not differ significantly.
Conclusions: We conclude that self-chosen music contributes objectively to a reduced stress level for patients and therefore subjectively perceived satisfaction for endoscopists. Therefore, music should be considered as a non-pharmacological treatment method of distress reduction especially in the beginning of endoscopic procedures.
Oxylipine werden in der Pflanze unter Stressbedingungen gebildet. Die dafür notwendige Oxidation von Fettsäuren wird entweder nicht-enzymatisch über Radikale wie reaktive Sauerstoffspezies (ROS) oder enzymatisch über Lipoxygenasen katalysiert. Abhängig von der Position der Oxidation in der Fettsäure entstehen dabei C13- oder C9-Oxylipine. Sehr gut erforscht sind C13-Oxylipine wie Jasmonsäure (JA), die bei biotischem Stress und Verwundung gebildet werden und bei exogener Gabe das Wurzelwachstum von Arabidopsis thaliana hemmen. Die C9-Oxylipine wie 9-Hydroxyoktadekatriensäure (9-HOT) sind erst wenig erforscht. Ziel dieser Arbeit war die Charakterisierung von Transkriptionsfaktoren, mit dem Fokus auf 9-HOT-vermittelte Signalwegen in Arabidopsis thaliana. Da bekannt ist, dass auch sie zu einer Hemmung des Wurzelwachstums führen, wurde dazu die Untersuchung des Wurzelwachstums von 10 Tage alten Keimlingen etabliert. Funktionsgewinn-Mutanten des Transkriptionsfaktors TGA5 sowie des TGA5-Zielgens CYTOCHROM P450 MONOOXYGENASE CYP81D11 zeigten auf 9-HOT ein verglichen mit Col-0 deutlich besseres Wurzelwachstum. Die AtTORF-Ex-Kollektion, eine große Sammlung an Überexpressions-Linien verschiedener Transkriptionsfaktoren, wurde hinsichtlich Wurzelwachstums auf dem Oxylipin 9-HOT analysiert. Die Gesamtheit der untersuchten Pflanzen enthielt 263 unabhängige TF-Expressions-Konstrukte. Von 6087 untersuchten Pflanzen zeigten 201 Pflanzen keine Hemmung des Wurzelwachstums auf 9-HOT. Dabei konnten 80 verschiedene Transkriptionsfaktoren identifiziert werden, deren Überexpression die Wurzelwachstums-hemmende Wirkung von 9-HOT kompensiert. Es zeigte sich eine Häufung von Transkriptionsfaktoren der ERF- (ethylene responsive factor) Familie. Die verstärkte Expression der nahe verwandten Transkriptionsfaktoren ERF106 und ERF107 ermöglichte sowohl auf 9-HOT als auch auf 9-KOT ein längeres Wurzelwachstum im Vergleich zum Wildtyp. Die Genexpression von ERF106 und ERF107 wird durch Überflutung aktiviert. Durch Überflutung wird im Wildtyp die Expression von Hypoxia-Antwort-Genen wie HRE1, SUS4 oder PDC1 induziert. In den Funktionsverlust-Mutanten sind diese Gene in der Expression aber nicht beeinflusst. Auch ist nach Überflutung im normalen Tag / Nacht-Rhythmus kein signifikanter Unterschied im Überleben zwischen Col-0 und den Mutanten erf106, erf107 und erf106xerf107 nachweisbar. Zur Identifikation möglicher Ziel-Gene von ERF106 und ERF107 wurden Transkriptom-Analysen durchgeführt. Die Funktionsverlust-Mutanten erf106, erf107 und erf106xerf107 zeigten weder im Grundzustand noch nach 4 Stunden Überflutung Veränderungen in den bekannten Hypoxia-Antwort-Genen. Die Funktionsgewinn-Mutanten von ERF106 und ERF107 zeigten in der Transkriptom-Analyse eine deutliche Aktivierung von Genen, die wichtig für Entgiftung und Stressabwehr sind. Ebenso wurden wichtige Biosynthese-Gene aus der Camalexin- und Glukosinolat-Synthese in den Funktionsgewinn-Mutanten verstärkt exprimiert. Des Weiteren konnte eine verringerte Expression von Genen beobachtet werden, die wichtig für die Regulation der Eisen-Aufnahme sind, darunter bHLH-Transkriptionsfaktoren, der Eisen-Transporter IRON REGULATED TRANSPORTER 1 (IRT1) und die Eisen-Reduktase FERRIC REDUCTION OXIDASE 2 (FRO2). Zusammenfassend wurden in dieser Arbeit durch die Untersuchung der AtTORF-Ex-Kollektion mehrere TF identifiziert, die wichtige Abwehr-Gene gegen Stress- und Vergiftung sowie bedeutende Gene im Bereich der Biosynthese und Eisenaufnahme regulieren können, um so die Antwort auf C9-Oxylipine zu beeinflussen.
Due to the rapidly increasing development and use of cellular products, there is a rising demand for non-animal-based test platforms to predict, study and treat undesired immunity. Here, we generated human organotypic skin models from human biopsies by isolating and expanding keratinocytes, fibroblasts and microvascular endothelial cells and seeding these components on a collagen matrix or a biological vascularized scaffold matrix in a bioreactor. We then were able to induce inflammation-mediated tissue damage by adding pre-stimulated, mismatched allogeneic lymphocytes and/or inflammatory cytokine-containing supernatants histomorphologically mimicking severe graft versus host disease (GvHD) of the skin. This could be prevented by the addition of immunosuppressants to the models. Consequently, these models harbor a promising potential to serve as a test platform for the prediction, prevention and treatment of GvHD. They also allow functional studies of immune effectors and suppressors including but not limited to allodepleted lymphocytes, gamma-delta T cells, regulatory T cells and mesenchymal stromal cells, which would otherwise be limited to animal models. Thus, the current test platform, developed with the limitation that no professional antigen presenting cells are in place, could greatly reduce animal testing for investigation of novel immune therapies.
Graft-versus-Host Disease (GvHD) stellt einen häufigen, den Gesamterfolg einer allogenen hämatopoetischen Stammzelltransplantation limitierenden Faktor dar. Bei dieser Komplikation attackieren vor allem alloreaktive T-Lymphozyten des Stammzellspenders gesunde Körperzellen des Patienten. Infolgedessen kommt es zu Gewebeschäden in den Zielorganen Haut, Leber und Darm. Die Behandlung der GvHD erfordert eine effektive Immunsuppression, was wiederum Graft-versusTumor-Effekte kompromittiert und den Rückfall der malignen Grunderkrankung bedingen kann. Viele Patienten sprechen aus bisher ungeklärten Gründen nicht auf die klassische immunsuppressive Therapie mit Steroiden oder second-line Therapien an. Neue zelluläre Therapien zur Behandlung der refraktären GvHD sind auf dem Vormarsch, bedürfen aber einer weiterführenden klinischen Testung, auch um die exakten Wirkungsmechanismen zu verstehen. Idealerweise könnten neue Testsysteme das GvHD-Potential von allogenen Stammzellpräparaten oder aber das immunsuppressive Potential von neuen GvHD-Therapien vorhersagen, bevor diese in klinischen Studien eingesetzt werden. Ziel der vorliegenden Arbeit war es, ein erstes, in multiplen Replikaten einsetzbares, humanes organotypisches Gewebemodell zur Simulation einer GvHD-Reaktion am Beispiel der Haut zu etablieren.
Zu diesem Zweck wurden artifizielle humane Hautmodelle unter statischen (KollagenHautmodelle) und dynamischen Kulturbedingungen (vaskularisierte Hautmodelle) generiert. Die Injektion unstimulierter PBMCs (engl. peripheral blood mononuclear cells) führte zu keinen histomorphologischen Veränderungen in den KollagenHautmodellen. Im Gegensatz dazu hatte die Injektion vorstimulierter allogener PBMCs eine Zerstörung der epidermalen Strukturen der Kollagen-Hautmodelle zur Folge, welche vergleichbar waren mit Gewebeschäden bei einer akuten GvHD der Haut. Dieselben Schädigungen der Epidermis wurden durch die Injektion von Mediumüberständen vorstimulierter PBMCs in die Kollagen-Hautmodelle erreicht. Im Kulturmedium der Kollagen-Hautmodelle wurden hohe Konzentrationen von Interleukin 2 und 17, Interferon gamma sowie Tumornekrosefaktor alpha gemessen, wodurch auf die Beteiligung von Zytokinen an der inflammatorischen Reaktion geschlossen werden konnte. Auch im komplexeren vaskularisierten Hautmodell verursachte die Injektion vorstimulierter PBMCs histomorphologische Veränderungen entsprechend einer akuten Haut-GvHD sowie einen zeitabhängigen Anstieg proinflammatorischer Zytokine.
Zusammenfassend zeigen die Resultate dieser Arbeit, dass die Induktion einer starken Inflammations- und Immunreaktion in artifiziellen humanen Hautmodellen, welche histomorphologisch eine GvHD imitiert, möglich ist. Dieses Modell könnte als Grundlage für die Entwicklung eines klinisch relevanten Testsystems zur Bestimmung des GvHD-Restpotentials oder zur Festlegung der immunsuppressiven Kapazität innovativer Zellpräparate dienen. Somit könnten humane artifizielle GvHDModelle in klinischen Studien eingesetzt werden und die Erfahrungen aus Tiermodellen ergänzen sowie erste in vitro Ergebnisse im humanen System liefern, welche dann mit dem tatsächlichen klinischen Resultat verglichen werden könnten.
Die koronare Herzkrankheit ist weltweit die häufigste Todesursache und belastet die Gesellschaft durch Therapien und Arbeitsausfälle mit hohen Kosten. Die Europäischen Gesellschaft für Kardiologie empfiehlt in den Leitlinien zur Sekundärprävention der koronaren Herzkrankheit verschiedene Lebensstiländerungen. In der vorliegenden Arbeit wurde untersucht, wie häufig diese Empfehlungen tatsächlich gegeben werden, ob diese von den Patienten umgesetzt werden und welche Faktoren den Erhalt der Empfehlung bzw. die Umsetzung beeinflussen. Hierzu wurden 536 Probanden mit bekannter KHK aus dem Raum Würzburg im Rahmen der multizentrischen Querschnittsstudie EUROASPIRE IV befragt und untersucht.
Es konnte gezeigt werden, dass die Empfehlungen insgesamt viel zu selten gegeben werden. Als positiver Einflussfaktor für den Erhalt einer Empfehlung konnte die Teilnahme an einem Rehabilitationsprogramm identifiziert werden. Die Wahrscheinlichkeit, die Empfehlungen zu erhalten, sank zudem mit zunehmendem Alter bei Erstdiagnose der KHK. Diese Erkenntnisse können in Zukunft dabei helfen, die Aufklärung über die Risikofaktoren insgesamt und besonders bei älteren Menschen zu intensivieren. Sie untermauern zudem die große Bedeutung eines Rehabilitationsprogrammes bei der Informationsvermittlung.
Auch die Umsetzung der empfohlenen Lebensstilveränderungen erfolgte nicht in zufriedenstellender Häufigkeit. Für die Beendigung des Rauchens konnte die Teilnahme an einem Rehabilitationsprogramm als größter Einflussfaktor ermittelt werden. Die Wahrscheinlichkeit, dass die verschiedenen Maßnahmen zu Lebensstilveränderungen umgesetzt werden, war beim weiblichen Geschlecht deutlich höher als beim männlichen. Die Umsetzung wurde zudem dadurch beeinflusst, ob der Patient vorher die entsprechende Empfehlung erhalten hatte. Die Daten zeigen somit auch bei der Umsetzung der Maßnahmen die Bedeutung von Rehabilitationsprogrammen, besonders für Raucher, und verdeutlichen, dass vor allem bei Männern weitere Anreize geschaffen werden müssen, damit diese die Empfehlungen zur Lebensstiländerung auch umsetzen. Dass viel mehr Probanden die Maßnahmen umgesetzt haben, wenn sie vorher die entsprechende Empfehlung erhalten haben, unterstreicht die außerordentliche Wichtigkeit der umfassenden Aufklärung des Patienten über die existentiellen Chancen eines Lebensstilwandels.
In heart failure, a functional block of complex I of the respiratory chain provokes superoxide generation, which is transformed to H\(_2\)O\(_2\) by dismutation. The Krebs cycle produces NADH, which delivers electrons to complex I, and NADPH for H\(_2\)O\(_2\) elimination via isocitrate dehydrogenase and nicotinamide nucleotide transhydrogenase (NNT). At high NADH levels, α-ketoglutarate dehydrogenase (α-KGDH) is a major source of superoxide in skeletal muscle mitochondria with low NNT activity. Here, we analyzed how α-KGDH and NNT control H\(_2\)O\(_2\) emission in cardiac mitochondria. In cardiac mitochondria from NNT-competent BL/6N mice, H\(_2\)O\(_2\) emission is equally low with pyruvate/malate (P/M) or α-ketoglutarate (α-KG) as substrates. Complex I inhibition with rotenone increases H2O2 emission from P/M, but not α-KG respiring mitochondria, which is potentiated by depleting H\(_2\)O\(_2\)-eliminating capacity. Conversely, in NNT-deficient BL/6J mitochondria, H2O2 emission is higher with α-KG than with P/M as substrate, and further potentiated by complex I blockade. Prior depletion of H\(_2\)O\(_2\)-eliminating capacity increases H\(_2\)O\(_2\) emission from P/M, but not α-KG respiring mitochondria. In cardiac myocytes, downregulation of α-KGDH activity impaired dynamic mitochondrial redox adaptation during workload transitions, without increasing H\(_2\)O\(_2\) emission. In conclusion, NADH from α-KGDH selectively shuttles to NNT for NADPH formation rather than to complex I of the respiratory chain for ATP production. Therefore, α-KGDH plays a key role for H\(_2\)O\(_2\) elimination, but is not a relevant source of superoxide in heart. In heart failure, α-KGDH/NNT-dependent NADPH formation ameliorates oxidative stress imposed by complex I blockade. Downregulation of α-KGDH may, therefore, predispose to oxidative stress in heart failure.
Zinc is an essential trace element for all living organisms. In mammals, including humans and mice, it is required for normal growth, development, hematopoiesis and immune defense. This thesis investigates the influence of zinc on the development of megakaryocytes (MKs), the cells responsible for bone marrow-derived platelet production. Furthermore, a detailed analysis of the expression of zinc import and export transporters (Slc39a/Slc30a genes) is carried out, firstly over the course of MK differentiation and secondly dependent on extracellular zinc.
Background
While multiple in vitro studies examined mesenchymal stromal cells (MSCs) derived from bone marrow or hyaline cartilage, there is little to no data about the presence of MSCs in the joint capsule or the ligamentum capitis femoris (LCF) of the hip joint. Therefore, this in vitro study examined the presence and differentiation potential of MSCs isolated from the bone marrow, arthritic hyaline cartilage, the LCF and full-thickness samples of the anterior joint capsule of the hip joint.
Methods
MSCs were isolated and multiplied in adherent monolayer cell cultures. Osteogenesis and adipogenesis were induced in monolayer cell cultures for 21 days using a differentiation medium containing specific growth factors, while chondrogenesis in the presence of TGF-ss1 was performed using pellet-culture for 27 days. Control cultures were maintained for comparison over the same duration of time. The differentiation process was analyzed using histological and immunohistochemical stainings as well as semiquantitative RT-PCR for measuring the mean expression levels of tissue-specific genes.
Results
This in vitro research showed that the isolated cells from all four donor tissues grew plastic-adherent and showed similar adipogenic and osteogenic differentiation capacity as proven by the histological detection of lipid droplets or deposits of extracellular calcium and collagen type I. After 27 days of chondrogenesis proteoglycans accumulated in the differentiated MSC-pellets from all donor tissues. Immunohistochemical staining revealed vast amounts of collagen type II in all differentiated MSC-pellets, except for those from the LCF. Interestingly, all differentiated MSCs still showed a clear increase in mean expression of adipogenic, osteogenic and chondrogenic marker genes. In addition, the examination of an exemplary selected donor sample revealed that cells from all four donor tissues were clearly positive for the surface markers CD44, CD73, CD90 and CD105 by flow cytometric analysis.
Conclusions
This study proved the presence of MSC-like cells in all four examined donor tissues of the hip joint. No significant differences were observed during osteogenic or adipogenic differentiation depending on the source of MSCs used. Further research is necessary to fully determine the tripotent differentiation potential of cells isolated from the LCF and capsule tissue of the hip joint.
The topical application of tranexamic acid (TXA) helps to prevent post-operative blood loss in total joint replacements. Despite these findings, the effects on articular and periarticular tissues remain unclear. Therefore, this in vitro study examined the effects of varying exposure times and concentrations of TXA on proliferation rates, gene expression and differentiation capacity of chondrocytes and human mesenchymal stromal cells (hMSCs), which underwent osteogenic differentiation. Chondrocytes and hMSCs were isolated and multiplied in monolayer cell cultures. Osteogenic differentiation of hMSCs was induced for 21 days using a differentiation medium containing specific growth factors. Cell proliferation was analyzed using ATP assays. Effects of TXA on cell morphology were examined via light microscopy and histological staining, while expression levels of tissue-specific genes were measured using semiquantitative RT-PCR. After treatment with 50 mg/mL of TXA, a decrease in cell proliferation rates was observed. Furthermore, treatment with concentrations of 20 mg/mL of TXA for at least 48 h led to a visible detachment of chondrocytes. TXA treatment with 50 mg/mL for at least 24 h led to a decrease in the expression of specific marker genes in chondrocytes and osteogenically differentiated hMSCs. No significant effects were observed for concentrations beyond 20 mg/mL of TXA combined with exposure times of less than 24 h. This might therefore represent a safe limit for topical application in vivo. Further research regarding in vivo conditions and effects on hMSC functionality are necessary to fully determine the effects of TXA on articular and periarticular tissues.
Purpose
To assess the impact of isocenter shifts due to linac gantry and table rotation during cranial stereotactic radiosurgery on D\(_{98}\), target volume coverage (TVC), conformity (CI), and gradient index (GI).
Methods
Winston‐Lutz (WL) checks were performed on two Elekta Synergy linacs. A stereotactic quality assurance (QA) plan was applied to the ArcCHECK phantom to assess the impact of isocenter shift corrections on Gamma pass rates. These corrections included gantry sag, distance of collimator and couch axes to the gantry axis, and distance between cone‐beam computed tomography (CBCT) isocenter and treatment beam (MV) isocenter. We applied the shifts via script to the treatment plan in Pinnacle 16.2. In a planning study, isocenter and mechanical rotation axis shifts of 0.25 to 2 mm were applied to stereotactic plans of spherical planning target volumes (PTVs) of various volumes. The shifts determined via WL measurements were applied to 16 patient plans with PTV sizes between 0.22 and 10.4 cm3.
Results
ArcCHECK measurements of a stereotactic treatment showed significant increases in Gamma pass rate for all three measurements (up to 3.8 percentage points) after correction of measured isocenter deviations. For spherical targets of 1 cm3, CI was most severely affected by increasing the distance of the CBCT isocenter (1.22 to 1.62). Gradient index increased with an isocenter‐collimator axis distance of 1.5 mm (3.84 vs 4.62). D98 (normalized to reference) dropped to 0.85 (CBCT), 0.92 (table axis), 0.95 (collimator axis), and 0.98 (gantry sag), with similar but smaller changes for larger targets. Applying measured shifts to patient plans lead to relevant drops in D\(_{98}\) and TVC (7%) for targets below 2 cm\(^3\) treated on linac 1.
Conclusion
Mechanical deviations during gantry, collimator, and table rotation may adversely affect the treatment of small stereotactic lesions. Adjustments of beam isocenters in the treatment planning system (TPS) can be used to both quantify their impact and for prospective correction of treatment plans.
In dieser Arbeit ist die Synthese von funktionalisiertem Nanodiamant mit bioaktiven Substanzen, welche vor allem als Wirkstofftransporter eingesetzt werden sollen, beschrieben. Dazu werden zum einen bereits bekannte Anbindungsmöglichkeiten an Nanodiamant, wie zum Beispiel die Klick-Reaktion, sowie die Ausbildung von Amidbrücken verwendet. Zum anderen werden neuartige Funktionalisierungsmöglichkeiten wie Protein Ligation und Thioharnstoffbrücken verwendet und somit das Repertoire an bekannten Anbindungsreaktion erweitert.
Des weiteren wurde ein multifunktionales Nanodiamantsystem synthetisiert. Dieses ist in der Lage, zwei verschiedene Moleküle auf einem Partikel zu immobilisieren. Die verwendeten Methoden ermöglichen die Anbindung verschiedener Substanzen aus unterschiedlichen Molekülgruppen an Nanodiamanten und sind somit universell einsetzbar.
Solitary bees are subject to a variety of pressures that cause severe population declines. Currently, habitat loss, temperature shifts, agrochemical exposure, and new parasites are identified as major threats. However, knowledge about detrimental bacteria is scarce, although they may disturb natural microbiomes, disturb nest environments, or harm the larvae directly. To address this gap, we investigated 12 Osmia bicornis nests with deceased larvae and 31 nests with healthy larvae from the same localities in a 16S ribosomal RNA (rRNA) gene metabarcoding study. We sampled larvae, pollen provisions, and nest material and then contrasted bacterial community composition and diversity in healthy and deceased nests. Microbiomes of pollen provisions and larvae showed similarities for healthy larvae, whilst this was not the case for deceased individuals. We identified three bacterial taxa assigned to Paenibacillus sp. (closely related to P. pabuli/amylolyticus/xylanexedens), Sporosarcina sp., and Bacillus sp. as indicative for bacterial communities of deceased larvae, as well as Lactobacillus for corresponding pollen provisions. Furthermore, we performed a provisioning experiment, where we fed larvae with untreated and sterilized pollens, as well as sterilized pollens inoculated with a Bacillus sp. isolate from a deceased larva. Untreated larval microbiomes were consistent with that of the pollen provided. Sterilized pollen alone did not lead to acute mortality, while no microbiome was recoverable from the larvae. In the inoculation treatment, we observed that larval microbiomes were dominated by the seeded bacterium, which resulted in enhanced mortality. These results support that larval microbiomes are strongly determined by the pollen provisions. Further, they underline the need for further investigation of the impact of detrimental bacterial acquired via pollens and potential buffering by a diverse pollen provision microbiome in solitary bees.
Insect microbiota plays an essential role on the hosts’ health and fitness, regulating their development, nutrition and immunity. The natural microbiota of bees, in particular, has been given much attention, largely because of the globally reported bee population declines. However, although the worker honey bee has been associated with distinctive and specialized microbiota, the microbiota of solitary bees has not been examined in detail, despite their enormous ecological importance. The main objectives of the present thesis were a) the bacterial community description for various solitary bee species, b) the association of the solitary bee microbiota with ecological factors such as landscape type, c) the relation of the bee foraging preferences with their nest bacterial microbiota, d) the examination of the nest building material contribution to the nest microbiota, e) the isolation of bacterial strains with beneficial or harmful properties for the solitary bee larvae and f) the pathological investigation of bacteria found in deceased solitary bee larvae.
The findings of the present study revealed a high bacterial biodiversity in the solitary bee nests. At the same time, the bacterial communities were different for each bee host species. Furthermore, it was shown that the pollen bacterial communities underwent compositional shifts reflecting a reduction in floral bacteria with progressing larval development, while a clear landscape effect was absent. The examination of the nest pollen provisions showed different foraging preferences for each included bee species. Both the pollen composition and the host species identity had a strong effect on the pollen bacteria, indicating that the pollen bacterial communities are the result of a combinatory process. The introduced environmental material also contributed to the nest natural microbiome. However, although the larval microbiota was significantly influenced by the pollen microbiota, it was not much associated with that of the nest material.
Two Paenibacillus strains isolated from O. bicornis nests showed strong antifungal activities, while several isolated strains were able to metabolize various oligosaccharides which are common in pollen and nectar. Screening for potential pathogenic bacteria in the nests of O. bicornis unveiled bacterial taxa, which dominated the bacterial community in deceased larvae, while at the same time they were undetectable in the healthy individuals.
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Finally, larvae which were raised in vitro developed distinct bacterial microbiomes according to their diet, while their life span was affected.
The present thesis described aspects of the microbiota dynamics in the nests of seven megachilid solitary bee nests, by suggesting which transmission pathways shape the established bacterial communities and how these are altered with larval development. Furthermore, specific bacterial taxa were associated with possible services they might provide to the larvae, while others were related with possible harmful effects. Future studies should integrate microbiota examination of different bee generations and parallel investigation of the microbiota of the nests and their surrounding environment (plant community, soil) to elucidate the bacterial transmission paths which establish the nest microbiota of solitary bees. Functional assays will also allow future studies to characterize specific nest bacteria as beneficial or harmful and describe how they assist the development of healthy bees and the fitness of bee populations.
This paper analyzes the mental development of the main character Salvador in the Spanish movie Los girasoles ciegos (2008) by José Luis Cuerda, based on the camera perspective and focalization, as well as the three-instance model according to Sigmund Freud. For this purpose, screen captures from the movie are examined to see how Salvador’s loss of control is pictured. This is applied to Freud’s three-instance model to prove the takeover of the Id. Throughout the whole movie, the inner conflict between his Ego and Id, i.e. his life as a deacon versus his life as a soldier, is present. The whole process of the breakdown of his mental state is revealed through the camera perspective and visual focalization.
Maintenance of tumor vasculature integrity is indispensable for tumor growth and thus affects tumor progression. Previous studies have identified platelets as major regulators of tumor vascular integrity, as their depletion selectively renders tumor vessels highly permeable, causing massive intratumoral hemorrhage. While these results establish platelets as potential targets for anti-tumor therapy, depletion is not a treatment option due to the essential role of platelets for hemostasis. This thesis demonstrates for the first time that functional inhibition of glycoprotein (GP) VI on the platelet surface rapidly induces tumor hemorrhage and diminishes tumor growth similar to complete platelet depletion but without inducing systemic bleeding complications. Both, the intratumoral bleeding and tumor growth arrest could be reverted by depletion of Ly6G+ cells confirming them to be responsible for the induction of bleeding and necrosis within the tumor. In addition, GPVI inhibition increased intra-tumoral accumulation of co-administered chemotherapeutic agents, thereby resulting in a profound anti-tumor effect. In summary, this thesis manifests platelet GPVI as a key regulator of vascular integrity specifically in growing tumors, serving as a potential basis for the development of anti-tumor strategies.
In the second part of this thesis, light is shed on the modulating role of bridging integrator 2 (BIN2) in platelet Ca2+ signaling. Stromal interaction molecule 1 (STIM1) mediated store-operated calcium entry (SOCE) is the major route of Ca2+ influx in platelets, triggered by inositol trisphosphate receptor (IP3R)-dependent Ca2+ store release. In this thesis, the BAR domain superfamily member BIN2 was identified as the first Ca2+ signaling modulator, interacting with both, STIM1 and IP3R in platelets. Deletion of BIN2 resulted in reduced Ca2+ store release and Ca2+ influx in response to all tested platelet agonists. These defects were a consequence of impaired IP3R function in combination with defective STIM1-mediated SOC channel activation, while Ca2+ store content and agonist-induced IP3 production were unaltered. These results establish BIN2 as a central regulator of platelet Ca2+ signaling.
The third part of this thesis focuses on the effect of the soluble neuronal guidance protein Sema7A on platelet function. Rosenberger et al. discovered that Sema7A cleavage from red blood cells increases the formation of platelet-neutrophil complexes, thereby reinforcing thrombo-inflammation in myocardial ischemia-reperfusion injury (MIRI). This thesis establishes soluble Sema7A as a stimulator of platelet thrombus formation via its interaction with platelet GPIbα, thereby reinforcing PNC formation. Thus, interfering with the GPIb-Sema7A interaction during MIRI represents a potential strategy to reduce cardiac damage and improve clinical outcome following MI.
Ellagitannins are signature constituents of oak wood and their consumption has been associated with various health benefits. In vivo, they undergo metabolic degradation including gut microbial metabolism yielding urolithins. Only limited data is available about compounds being present in blood after intake of an extract from French oak wood, Robuvit®. In the course of a randomized, double-blind, controlled clinical investigation, 66 patients undergoing hysterectomy received placebo or 300 mg Robuvit® per day before and over 8 weeks after surgery. Serum and blood cell samples were analyzed by liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). The number of urolithin producers and the urolithin levels increased after intake of Robuvit®. In serum samples, the median concentration of urolithin A was 14.0 ng/ml [interquartile range (IQR) 57.4] after 8 weeks. Urolithin B was determined at 22.3 ng/ml (IQR 12.6), urolithin C at 2.66 ng/ml (IQR 2.08). In blood cells, lower concentrations and only urolithins A and B were detected. A statistically significant association of lower post-surgical pain scores with metabotype A was detected (p < 0.05). To conclude, supplementation with French oak wood extract raised urolithin generation in patients and suggested health advantages for urolithin-producers.
The muscarinic M\(_1\) acetylcholine receptor is an important drug target for the treatment of various neurological disorders. Designing M\(_1\) receptor-selective drugs has proven challenging, mainly due to the high conservation of the acetylcholine binding site among muscarinic receptor subtypes. Therefore, less conserved and topographically distinct allosteric binding sites have been explored to increase M\(_1\) receptor selectivity. In this line, bitopic ligands, which target orthosteric and allosteric binding sites simultaneously, may provide a promising strategy. Here, we explore the allosteric, M1-selective BQCAd scaffold derived from BQCA as a starting point for the design, synthesis, and pharmacological evaluation of a series of novel bitopic ligands in which the orthosteric moieties and linker lengths are systematically varied. Since β-arrestin recruitment seems to be favorable to therapeutic implication, all the compounds were investigated by G protein and β-arrestin assays. Some bitopic ligands are partial to full agonists for G protein activation, some activate β-arrestin recruitment, and the degree of β-arrestin recruitment varies according to the respective modification. The allosteric BQCAd scaffold controls the positioning of the orthosteric ammonium group of all ligands, suggesting that this interaction is essential for stimulating G protein activation. However, β-arrestin recruitment is not affected. The novel set of bitopic ligands may constitute a toolbox to study the requirements of β-arrestin recruitment during ligand design for therapeutic usage.
Im Rahmen dieser Arbeit wurden die elektronischen Eigenschaften von Graphen auf Metalloberflächen mittels Rastertunnelmikroskopie und Quasiteilcheninterferenz (englisch quasiparticle interference, QPI)-Messungen untersucht. Durch das Verwenden schwerer Substrate sollte die Spin-Bahn-Wechselwirkung des Graphen verstärkt werden und damit eine Bandlücke am K-Punkt der Bandstruktur mittels QPI beobachtet werden. Um das Messen von QPI auf Graphen zu testen, wurde auf der Oberfläche eines SiC(0001)-Kristalls durch Erhitzen Graphen erzeugt und mit dem Rastertunnelmikroskop untersucht. Dieses System wurde schon ausführlich in der Literatur beschrieben und bereits bekannte QPI-Messungen von Streuringen, die auf den Dirac-Kegeln des Graphen am K-Punkt basieren, konnte ich auf gr/SiC(0001) in guter Qualität erfolgreich reproduzieren. Anschließend wurde Graphen nach einem wohlbekannten Verfahren durch Aufbringen von Ethylen auf ein erhitztes Ir(111)-Substrat erzeugt. Dieses gr/Ir(111)-System diente auch als Grundlage für Interkalationsversuche von Bismut (gr/Bi/Ir(111)) und Gadolinium (gr/Gd/Ir(111)) zwischen das Graphen und das Substrat. Auf gr/Bi/Ir(111) wurde ein schon aus der Literatur bekanntes Netzwerk aus Versetzungslinien beobachtet, dem zusätzlich eine Temperaturabhängigkeit nachgewiesen werden konnte. Beim Versuch, Gadolinium zu interkalieren, wurden zwei verschieden Oberflächenstrukturen beobachtet, die auf eine unterschiedlich Anordnung bzw. Menge des interkalierten Gadoliniums zurückzuführen sein könnten. Auf keinem dieser drei Systeme konnten allerdings Streuringe mittels QPI beobachtet werden. Als Vorbereitung der Interkalation von Gadolinium wurden dessen Wachstum und magnetische Eigenschaften auf einem W(110)-Kristall untersucht. Dabei konnte eine aus der Literatur bekannte temperaturabhängige Austauschaufspaltung reproduziert werden. Darüber hinaus konnten sechs verschieden magnetische Domänen beobachtet werden. Zusätzlich sind auf der Oberfläche magnetische Streifen auszumachen, die möglicherweise auf einer Spinspirale basieren. Als Grundlage für die mögliche zukünftige Erzeugung Graphen-artiger Molekülgitter wurde das Wachstum von H-TBTQ und Me-TBTQ auf Ag(111) untersucht. Die Moleküle richten sich dabei nach der Oberflächenstruktur des Silber aus und bilden längliche Inseln, deren Kanten in drei Vorzugsrichtungen verlaufen. Auf H-TBTQ wurde zudem eine zweite, Windmühlen-artige Ausrichtung der Moleküle auf der Oberfläche beobachtet. Auf den mit den Molekülen bedeckten Stellen der Oberfläche wurde eine Verschiebung des Ag-Oberflächenzustands beobachtet, die mit einem Ladungstransfer vom Ag(111)-Substrat auf die TBTQ-Moleküle zu erklären sein könnte.
Die Hypophosphatasie (HPP) ist eine seltene, angeborene Knochen- und Systemerkrankung, welche Patienten allen Alters betrifft. Verursacht wird die Erkrankung durch Mutationen im ALPL-Gen, welches für die gewebeunspezifische Alkalische Phosphatase codiert und mit einem Funktionsverlust des Enzyms einhergeht. Die Ausprägung der klinischen Symptomatik ist sehr heterogen und reicht von milden und unspezifischen bis hin zu potenziell lebensbedrohlichen Symptomen, was die korrekte Diagnose zusätzlich erschwert und verzögert. Um das Verständnis der pädiatrischen HPP zu verbessern und die Dauer von Symptombeginn bis zur korrekten Diagnose zu verkürzen, haben wir den Verlauf der Erkrankung anhand einer retrospektiven Aufarbeitung der Daten von 50 pädiatrischen HPP Patienten, die in den letzten 25 Jahren an der Universitäts-Kinderklinik in Würzburg vorstellig waren, untersucht.
Diese Ergebnisse bestätigen den klinischen Eindruck der HPP als chronische Systemerkrankung, welche aufgrund ihrer unspezifischen klinischen Präsentation oftmals nur mit zeitlicher Verzögerung diagnostiziert wird. Dieser Verzögerung kommt insbesondere im Hinblick auf die 2015 zur Behandlung der pädiatrischen HPP zugelassenen Enzymersatztherapie mit dem Wirkstoff Asfotase alfa eine besondere Bedeutung zu, da die Patienten von einer frühzeitigen Diagnose und einem damit einhergehenden frühzeitigen Beginn der Behandlung profitieren können.
Diese Ergebnisse tragen einen Teil dazu bei, das Bewusstsein und die Kenntnis der Erkrankung zu verbessern, um so die die Zeitspanne zwischen Symptombeginn und Diagnosestellung zu verkürzen und die medizinische Versorgung der Patienten zu verbessern.
Background
Hypophosphatasia (HPP) is a rare, inherited metabolic disorder caused by loss-of-function mutations in the ALPL gene that encodes the tissue-nonspecific alkaline phosphatase TNAP (ORPHA 436). Its clinical presentation is highly heterogeneous with a remarkably wide-ranging severity. HPP affects patients of all ages. In children HPP-related musculoskeletal symptoms may mimic rheumatologic conditions and diagnosis is often difficult and delayed. To improve the understanding of HPP in children and in order to shorten the diagnostic time span in the future we studied the natural history of the disease in our large cohort of pediatric patients. This single centre retrospective chart review included longitudinal data from 50 patients with HPP diagnosed and followed at the University Children's Hospital Wuerzburg, Germany over the last 25 years.
Results
The cohort comprises 4 (8%) perinatal, 17 (34%) infantile and 29 (58%) childhood onset HPP patients. Two patients were deceased at the time of data collection. Diagnosis was based on available characteristic clinical symptoms (in 88%), low alkaline phosphatase (AP) activity (in 96%), accumulating substrates of AP (in 58%) and X-ray findings (in 48%). Genetic analysis was performed in 48 patients (31 compound heterozygous, 15 heterozygous, 2 homozygous mutations per patient), allowing investigations on genotype-phenotype correlations. Based on anamnestic data, median age at first clinical symptoms was 3.5 months (min. 0, max. 107), while median time to diagnosis was 13 months (min. 0, max. 103). Common symptoms included: impairment of motor skills (78%), impairment of mineralization (72%), premature loss of teeth (64%), musculoskeletal pain and craniosynostosis (each 64%) and failure to thrive (62%). Up to now 20 patients started medical treatment with Asfotase alfa.
Conclusions
Reported findings support the clinical perception of HPP being a chronic multi-systemic disease with often delayed diagnosis. Our natural history information provides detailed insights into the prevalence of different symptoms, which can help to improve and shorten diagnostics and thereby lead to an optimised medical care, especially with promising therapeutic options such as enzyme-replacement-therapy with Asfotase alfa in mind.
The enrichment of deadwood is essential for the conservation of saproxylic biodiversity in managed forests. However, existing strategies focus on a cost‐intensive increase of deadwood amount, while largely neglecting increasing deadwood diversity.
Deadwood objects, that is logs and branches, from six tree species were experimentally sun exposed, canopy shaded and artificially shaded for 4 years, after which the alpha‐, beta‐ and gamma‐diversity of saproxylic beetles, wood‐inhabiting fungi and spiders were analysed. Analyses of beta‐diversity included the spatial distance between exposed deadwood objects. A random‐drawing procedure was used to identify the combination of tree species and sun exposure that yielded the highest gamma‐diversity at a minimum of exposed deadwood amount.
In sun‐exposed plots, species numbers in logs were higher than in shaded plots for all taxa, while in branches we observed the opposite for saproxylic beetles. Tree species affected the species numbers only of saproxylic beetles and wood‐inhabiting fungi. The beta‐diversity of saproxylic beetles and wood‐inhabiting fungi among logs was influenced by sun exposure and tree species, but beta‐diversity of spiders by sun exposure only. For all saproxylic taxa recorded in logs, differences between communities increased with increasing spatial distance.
A combination of canopy‐shaded Carpinus logs and sun‐exposed Populus logs resulted in the highest species numbers of all investigated saproxylic taxa among all possible combinations of tree species and sun‐exposure treatments.
Synthesis and applications. We recommend incorporating the enrichment of different tree species and particularly the variation in sun exposure into existing strategies of deadwood enrichment. Based on the results of our study, we suggest to combine the logs of softwood broadleaf tree species (e.g. Carpinus, Populus), hardwood broadleaf tree species (e.g. Quercus) and coniferous tree species (e.g. Pinus) under different conditions of sun exposure and distribute them spatially in a landscape to maximize the beneficial effects on overall diversity.
Our body is colonized by a vast array of bacteria the sum of which forms our microbiota. The gut alone harbors >1,000 bacterial species. An understanding of their individual or synergistic contributions to human health and disease demands means to interfere with their functions on the species level. Most of the currently available antibiotics are broad‐spectrum, thus too unspecific for a selective depletion of a single species of interest from the microbiota. Programmable RNA antibiotics in the form of short antisense oligonucleotides (ASOs) promise to achieve precision manipulation of bacterial communities. These ASOs are coupled to small peptides that carry them inside the bacteria to silence mRNAs of essential genes, for example, to target antibiotic‐resistant pathogens as an alternative to standard antibiotics. There is already proof‐of‐principle with diverse bacteria, but many open questions remain with respect to true species specificity, potential off‐targeting, choice of peptides for delivery, bacterial resistance mechanisms and the host response. While there is unlikely a one‐fits‐all solution for all microbiome species, I will discuss how recent progress in bacterial RNA biology may help to accelerate the development of programmable RNA antibiotics for microbiome editing and other applications.