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Die Situation in Chinas nordwestlicher Region Xinjiang hat in den letzten Jahren zunehmende internationale Aufmerksamkeit erfahren. Berichte über Masseninternierungen von Uiguren und anderen ethnischen Gruppen in Umerziehungslagern, Zwangsarbeit, Zwangssterilisation und weitere Menschenrechtsverletzungen beherrschen die Schlagzeilen und belasten die Beziehungen zwischen China und seinen Kritikern. Die chinesische Regierung rechtfertigt ihr Vorgehen hingegen als Kampf gegen Terrorismus, islamistischen Extremismus und ethnischen Separatismus.
„Xinjiang – China und die Uiguren“ präsentiert erstmalig in deutscher Sprache eine tiefergehende wissenschaftliche Auseinandersetzung mit diesem kontroversen Thema. Prägnant und anschaulich führt der erste Teil des Buchs in die komplexe Geschichte der Region ein. Der zweite Teil stellt die Entwicklungen im 21. Jahrhundert dar. Hierbei zeigt sich ein facettenreiches Bild der sozioökonomischen Entwicklung, der ethnischen Identität sowie der Sprach- und Religionspolitik. Der dritte Teil hinterfragt die gängigen Deutungen des Xinjiang-Konflikts, analysiert Proteste und Terrorismus ebenso wie die staatlichen Repressionsmaßnahmen und die internationale Dimension der Auseinandersetzung. Quellennah, basierend auf den Ergebnissen der neuesten Forschung und in einem unaufgeregten Ton vermittelt „Xinjiang – China und die Uiguren“ ein ausgewogenes Bild der aktuellen Konflikte.
Metabolic glycoengineering enables a directed modification of cell surfaces by introducing target molecules to surface proteins displaying new features. Biochemical pathways involving glycans differ in dependence on the cell type; therefore, this technique should be tailored for the best results. We characterized metabolic glycoengineering in telomerase-immortalized human mesenchymal stromal cells (hMSC-TERT) as a model for primary hMSC, to investigate its applicability in TERT-modified cell lines. The metabolic incorporation of N-azidoacetylmannosamine (Ac\(_4\)ManNAz) and N-alkyneacetylmannosamine (Ac\(_4\)ManNAl) into the glycocalyx as a first step in the glycoengineering process revealed no adverse effects on cell viability or gene expression, and the in vitro multipotency (osteogenic and adipogenic differentiation potential) was maintained under these adapted culture conditions. In the second step, glycoengineered cells were modified with fluorescent dyes using Cu-mediated click chemistry. In these analyses, the two mannose derivatives showed superior incorporation efficiencies compared to glucose and galactose isomers. In time-dependent experiments, the incorporation of Ac\(_4\)ManNAz was detectable for up to six days while Ac\(_4\)ManNAl-derived metabolites were absent after two days. Taken together, these findings demonstrate the successful metabolic glycoengineering of immortalized hMSC resulting in transient cell surface modifications, and thus present a useful model to address different scientific questions regarding glycosylation processes in skeletal precursors.
The superfamily of G protein-coupled receptors (GPCRs) comprises more than 800 members, which are divided into five families based on phylogenetic analyses (GRAFS classification): Glutamate, Rhodopsin, Adhesion, Frizzled/Taste2 and Secretin. The adhesion G protein-coupled receptor (aGPCR) family forms with 33 homologs in Mammalia the second largest and least investigated family of GPCRs. The general architecture of an aGPCR comprises the GPCR characteristics of an extracellular region (ECR), a seven transmembrane (7TM) domain and an intracellular region (ICR). A special feature of aGPCRs is the extraordinary size of the ECR through which they interact with cellular and matricellular ligands via adhesion motif folds. In addition, the ECR contains a so-called GPCR autoproteolysis-inducing (GAIN) domain, which catalyzes autoproteolytic cleavage of the protein during maturation. This cleavage leads to the formation of an N-terminal (NTF) and a C-terminal fragment (CTF), which build a unit by means of hydrophobic interactions and therefore appear as a heterodimeric receptor at the cell surface. In the past, it has been shown that the first few amino acids of the CTF act as a tethered agonist (TA) that mediates the activation of the receptor through the interaction with the 7TM domain. However, the molecular mechanism promoting the TA-7TM domain interaction remains elusive. This work reveals a novel molecular mechanism that does not require the dissociation of the NTF-CTF complex to promote release of the TA and thus activation of the aGPCR. The introduction of bioorthogonal labels into receptorsignaling- relevant regions of the TA of various aGPCRs demonstrated that the TA is freely accessible within the intact GAIN domain. This suggests a structural flexibility of the GAIN domain, which allows a receptor activation independent of the NTF-CTF dissociation, as found in cleavage-deficient aGPCR variants. Furthermore, the present study shows that the cellular localization and the conformation of the 7TM domain depends on the activity state of the aGPCR, which in turn indicates that the TA mediates conformational changes through the interaction with the 7TM domain, which ultimately regulates the receptor activity. In addition, biochemical analyses showed that the GAIN domain-mediated autoproteolysis of the human aGPCR CD97 (ADGRE5/E5) promotes further cleavage events within the receptor. This suggests that aGPCRs undergo cleavage cascades, which are initialized by the autoproteolytic reaction of the GAIN domain. Thus, it can be assumed that aGPCRs are subject to additional proteolytic events. Finally, the constitutive internalization of the NTF and the CTF of E5 was demonstrated by various labeling methods. It was possible to label both fragments independently and to follow their subcellular location in vitro. In summary, these obtained results contribute to a better understanding about the molecular mechanisms of activity and signaling of aGPCRs.
Atherosclerosis is an inflammatory disease of large and medium-sized arteries, characterized by the growth of atherosclerotic lesions (plaques). These plaques often develop at inner curvatures of arteries, branchpoints, and bifurcations, where the endothelial wall shear stress is low and oscillatory. In conjunction with other processes such as lipid deposition, biomechanical factors lead to local vascular inflammation and plaque growth. There is also evidence that low and oscillatory shear stress contribute to arterial remodeling, entailing a loss in arterial elasticity and, therefore, an increased pulse-wave velocity. Although altered shear stress profiles, elasticity and inflammation are closely intertwined and critical for plaque growth, preclinical and clinical investigations for atherosclerosis mostly focus on the investigation of one of these parameters only due to the experimental limitations. However, cardiovascular magnetic resonance imaging (MRI) has been demonstrated to be a potent tool which can be used to provide insights into a large range of biological parameters in one experimental session. It enables the evaluation of the dynamic process of atherosclerotic lesion formation without the need for harmful radiation. Flow-sensitive MRI provides the assessment of hemodynamic parameters such as wall shear stress and pulse wave velocity which may replace invasive and radiation-based techniques for imaging of the vascular
function and the characterization of early plaque development. In combination with inflammation imaging, the analyses and correlations of these parameters could not only significantly advance basic preclinical investigations of atherosclerotic lesion formation and progression, but also the diagnostic clinical evaluation for early identification of high-risk plaques, which are prone to rupture. In this review, we summarize the key applications of magnetic resonance imaging for the evaluation of plaque characteristics through flow sensitive and morphological measurements. The simultaneous measurements of functional and structural parameters will further preclinical research on atherosclerosis and has the potential to fundamentally improve the detection of inflammation and vulnerable plaques in patients.
Growth, ageing and atherosclerotic plaque development alter the biomechanical forces acting on the vessel wall. However, monitoring the detailed local changes in wall shear stress (WSS) at distinct sites of the murine aortic arch over time has been challenging. Here, we studied the temporal and spatial changes in flow, WSS, oscillatory shear index (OSI) and elastic properties of healthy wildtype (WT, n = 5) and atherosclerotic apolipoprotein E-deficient (Apoe\(^{−/−}\), n = 6) mice during ageing and atherosclerosis using high-resolution 4D flow magnetic resonance imaging (MRI). Spatially resolved 2D projection maps of WSS and OSI of the complete aortic arch were generated, allowing the pixel-wise statistical analysis of inter- and intragroup hemodynamic changes over time and local correlations between WSS, pulse wave velocity (PWV), plaque and vessel wall characteristics. The study revealed converse differences of local hemodynamic profiles in healthy WT and atherosclerotic Apoe\(^{−/−}\) mice, and we identified the circumferential WSS as potential marker of plaque size and composition in advanced atherosclerosis and the radial strain as a potential marker for vascular elasticity. Two-dimensional (2D) projection maps of WSS and OSI, including statistical analysis provide a powerful tool to monitor local aortic hemodynamics during ageing and atherosclerosis. The correlation of spatially resolved hemodynamics and plaque characteristics could significantly improve our understanding of the impact of hemodynamics on atherosclerosis, which may be key to understand plaque progression towards vulnerability.
Effects of dopamine on BDNF / TrkB mediated signaling and plasticity on cortico-striatal synapses
(2021)
Progressive loss of voluntary movement control is the central symptom of Parkinson's disease (PD). Even today, we are not yet able to cure PD. This is mainly due to a lack of understanding the mechanisms of movement control, network activity and plasticity in motor circuits, in particular between the cerebral cortex and the striatum. Brain-derived neurotrophic factor (BDNF) has emerged as one of the most important factors for the development and survival of neurons, as well as for synaptic plasticity. It is thus an important target for the development of new therapeutic strategies against neurodegenerative diseases. Together with its receptor, the Tropomyosin receptor kinase B (TrkB), it is critically involved in development and function of the striatum. Nevertheless, little is known about the localization of BDNF within presynaptic terminals in the striatum, as well as the types of neurons that produce BDNF in the cerebral cortex. Furthermore, the influence of midbrain derived dopamine on the control of BDNF / TrkB interaction in striatal medium spiny neurons (MSNs) remains elusive so far. Dopamine, however, appears to play an important role, as its absence leads to drastic changes in striatal synaptic plasticity. This suggests that dopamine could regulate synaptic activity in the striatum via modulation of BDNF / TrkB function. To answer these questions, we have developed a sensitive and reliable protocol for the immunohistochemical detection of endogenous BDNF. We find that the majority of striatal BDNF is provided by glutamatergic, cortex derived afferents and not dopaminergic inputs from the midbrain. In fact, we found BDNF in cell bodies of neurons in layers II-III and V of the primary and secondary motor cortex as well as layer V of the somatosensory cortex. These are the brain areas that send dense projections to the dorsolateral striatum for control of voluntary movement. Furthermore, we could show that these projection neurons significantly downregulate the expression of BDNF during the juvenile development of mice between 3 and 12 weeks.
In parallel, we found a modulatory effect of dopamine on the translocation of TrkB to the cell surface in postsynaptic striatal Medium Spiny Neurons (MSNs). In MSNs of the direct pathway (dMSNs), which express dopamine receptor 1 (DRD1), we observed the formation of TrkB aggregates in the 6-hydroxydopamine (6-OHDA) model of PD. This suggests that DRD1 activity controls TrkB surface expression in these neurons. In contrast, we found that DRD2 activation has opposite effects in MSNs of the indirect pathway (iMSNs). Activation of DRD2 promotes a rapid decrease in TrkB surface expression which was reversible and depended on cAMP. In parallel, stimulation of DRD2 led to induction of phospho-TrkB (pTrkB). This effect was significantly slower than the effect on TrkB surface expression and indicates that TrkB is transactivated by DRD2. Together, our data provide evidence that dopamine triggers dual modes of plasticity on striatal MSNs by acting on TrkB surface expression in DRD1 and DRD2 expressing MSNs. This surface expression of the receptor is crucial for the binding of BDNF, which is released from corticostriatal afferents. This leads to the induction of TrkB-mediated downstream signal transduction cascades and long-term potentiation (LTP). Therefore, the dopamine-mediated translocation of TrkB could be a mediator that modulates the balance between dopaminergic and glutamatergic signaling to allow synaptic plasticity in a spatiotemporal manner. This information and the fact that TrkB is segregated to persistent aggregates in PD could help to improve our understanding of voluntary movement control and to develop new therapeutic strategies beyond those focusing on dopaminergic supply.
Background
International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important.
Methods
Patients’ tumours were retrospectively defined borderline resectable according to ICC. The study cohort was grouped into either BR-A or BR-B and compared with patients considered primarily resectable (R). Differences in postoperative complications, pathological reports, overall (OS), and disease-free survival were assessed.
Results
A total of 345 patients underwent resection for PDAC. By applying ICC in routine preoperative assessment, 30 patients were classified as stage BR-A and 62 patients as stage BR-B. In total, 253 patients were considered R. The cohort did not contain BR-C patients. No differences in postoperative complications were detected. Median OS was significantly shorter in BR-A (15 months) and BR-B (12 months) compared with R (20 months) patients (BR-A vs. R: p = 0.09 and BR-B vs. R: p < 0.001). CA19-9, as the determining factor of BR-B patients, turned out to be an independent prognostic risk factor for OS.
Conclusions
Preoperative staging defining surgical resectability in PDAC according to ICC is crucial for patient survival. Patients with PDAC BR-B should be considered for multimodal neoadjuvant therapy even if considered anatomically resectable.
Sensitivity analysis for interpretation of machine learning based segmentation models in cardiac MRI
(2021)
Background
Image segmentation is a common task in medical imaging e.g., for volumetry analysis in cardiac MRI. Artificial neural networks are used to automate this task with performance similar to manual operators. However, this performance is only achieved in the narrow tasks networks are trained on. Performance drops dramatically when data characteristics differ from the training set properties. Moreover, neural networks are commonly considered black boxes, because it is hard to understand how they make decisions and why they fail. Therefore, it is also hard to predict whether they will generalize and work well with new data. Here we present a generic method for segmentation model interpretation. Sensitivity analysis is an approach where model input is modified in a controlled manner and the effect of these modifications on the model output is evaluated. This method yields insights into the sensitivity of the model to these alterations and therefore to the importance of certain features on segmentation performance.
Results
We present an open-source Python library (misas), that facilitates the use of sensitivity analysis with arbitrary data and models. We show that this method is a suitable approach to answer practical questions regarding use and functionality of segmentation models. We demonstrate this in two case studies on cardiac magnetic resonance imaging. The first case study explores the suitability of a published network for use on a public dataset the network has not been trained on. The second case study demonstrates how sensitivity analysis can be used to evaluate the robustness of a newly trained model.
Conclusions
Sensitivity analysis is a useful tool for deep learning developers as well as users such as clinicians. It extends their toolbox, enabling and improving interpretability of segmentation models. Enhancing our understanding of neural networks through sensitivity analysis also assists in decision making. Although demonstrated only on cardiac magnetic resonance images this approach and software are much more broadly applicable.
Purpose
Artificial neural networks show promising performance in automatic segmentation of cardiac MRI. However, training requires large amounts of annotated data and generalization to different vendors, field strengths, sequence parameters, and pathologies is limited. Transfer learning addresses this challenge, but specific recommendations regarding type and amount of data required is lacking. In this study, we assess data requirements for transfer learning to experimental cardiac MRI at 7T where the segmentation task can be challenging. In addition, we provide guidelines, tools, and annotated data to enable transfer learning approaches by other researchers and clinicians.
Methods
A publicly available segmentation model was used to annotate a publicly available data set. This labeled data set was subsequently used to train a neural network for segmentation of left ventricle and myocardium in cardiac cine MRI. The network is used as starting point for transfer learning to 7T cine data of healthy volunteers (n = 22; 7873 images) by updating the pre-trained weights. Structured and random data subsets of different sizes were used to systematically assess data requirements for successful transfer learning.
Results
Inconsistencies in the publically available data set were corrected, labels created, and a neural network trained. On 7T cardiac cine images the model pre-trained on public imaging data, acquired at 1.5T and 3T, achieved DICE\(_{LV}\) = 0.835 and DICE\(_{MY}\) = 0.670. Transfer learning using 7T cine data and ImageNet weight initialization improved model performance to DICE\(_{LV}\) = 0.900 and DICE\(_{MY}\) = 0.791. Using only end-systolic and end-diastolic images reduced training data by 90%, with no negative impact on segmentation performance (DICE\(_{LV}\) = 0.908, DICE\(_{MY}\) = 0.805).
Conclusions
This work demonstrates and quantifies the benefits of transfer learning for cardiac cine image segmentation. We provide practical guidelines for researchers planning transfer learning projects in cardiac MRI and make data, models, and code publicly available.
Cyclic adenosine monophosphate (cAMP), the ubiquitous second messenger produced upon stimulation of GPCRs which couple to the stimulatory GS protein, orchestrates an array of physiological processes including cardiac function, neuronal plasticity, immune responses, cellular proliferation and apoptosis. By interacting with various effector proteins, among others protein kinase A (PKA) and exchange proteins directly activated by cAMP (Epac), it triggers signaling cascades for the cellular response. Although the functional outcomes of GSPCR-activation are very diverse depending on the extracellular stimulus, they are all mediated exclusively by this single second messenger. Thus, the question arises how specificity in such responses may be attained. A hypothesis to explain signaling specificity is that cellular signaling architecture, and thus precise operation of cAMP in space and time would appear to be essential to achieve signaling specificity. Compartments with elevated cAMP levels would allow specific signal relay from receptors to effectors within a micro- or nanometer range, setting the molecular basis for signaling specificity. Although the paradigm of signaling compartmentation gains continuous recognition and is thoroughly being investigated, the molecular composition of such compartments and how they are maintained remains to be elucidated. In addition, such compartments would require very restricted diffusion of cAMP, but all direct measurements have indicated that it can diffuse in cells almost freely.
In this work, we present the identification and characterize of a cAMP signaling compartment at a GSPCR. We created a Förster resonance energy transfer (FRET)-based receptor-sensor conjugate, allowing us to study cAMP dynamics in direct vicinity of the human glucagone-like peptide 1 receptor (hGLP1R). Additional targeting of analogous sensors to the plasma membrane and the cytosol enables assessment of cAMP dynamics in different subcellular regions. We compare both basal and stimulated cAMP levels and study cAMP crosstalk of different receptors. With the design of novel receptor nanorulers up to 60nm in length, which allow mapping cAMP levels in nanometer distance from the hGLP1R, we identify a cAMP nanodomain surrounding it. Further, we show that phosphodiesterases (PDEs), the only enzymes known to degrade cAMP, are decisive in constraining cAMP diffusion into the cytosol thereby maintaining a cAMP gradient. Following the discovery of this nanodomain, we sought to investigate whether downstream effectors such as PKA are present and active within the domain, additionally studying the role of A-kinase anchoring proteins (AKAPs) in targeting PKA to the receptor compartment. We demonstrate that GLP1-produced cAMP signals translate into local nanodomain-restricted PKA phosphorylation and determine that AKAP-tethering is essential for nanodomain PKA.
Taken together, our results provide evidence for the existence of a dynamic, receptor associated cAMP nanodomain and give prospect for which key proteins are likely to be involved in its formation. These conditions would allow cAMP to exert its function in a spatially and temporally restricted manner, setting the basis for a cell to achieve signaling specificity. Understanding the molecular mechanism of cAMP signaling would allow modulation and thus regulation of GPCR signaling, taking advantage of it for pharmacological treatment.
Olfactory circuits change structurally and physiologically during development and adult life. This allows insects to respond to olfactory cues in an appropriate and adaptive way according to their physiological and behavioral state, and to adapt to their specific abiotic and biotic natural environment. We highlight here findings on olfactory plasticity and modulation in various model and non-model insects with an emphasis on moths and social Hymenoptera. Different categories of plasticity occur in the olfactory systems of insects. One type relates to the reproductive or feeding state, as well as to adult age. Another type of plasticity is context-dependent and includes influences of the immediate sensory and abiotic environment, but also environmental conditions during postembryonic development, periods of adult behavioral maturation, and short- and long-term sensory experience. Finally, plasticity in olfactory circuits is linked to associative learning and memory formation. The vast majority of the available literature summarized here deals with plasticity in primary and secondary olfactory brain centers, but also peripheral modulation is treated. The described molecular, physiological, and structural neuronal changes occur under the influence of neuromodulators such as biogenic amines, neuropeptides, and hormones, but the mechanisms through which they act are only beginning to be analyzed.
The Bateman functions and the allied Havelock functions were introduced as solutions of some problems in hydrodynamics about ninety years ago, but after a period of one or two decades they were practically neglected. In handbooks, the Bateman function is only mentioned as a particular case of the confluent hypergeometric function. In order to revive our knowledge on these functions, their basic properties (recurrence functional and differential relations, series, integrals and the Laplace transforms) are presented. Some new results are also included. Special attention is directed to the Bateman and Havelock functions with integer orders, to generalizations of these functions and to the Bateman-integral function known in the literature.
Strategies in Times of Pandemic Crisis — Retailers and Regional Resilience in Würzburg, Germany
(2021)
Research on the COVID-19 crisis and its implications on regional resilience is still in its infancy. To understand resilience on its aggregate level it is important to identify (non)resilient actions of individual actors who comprise regions. As the retail sector among others represents an important factor in an urban regions recovery, we focus on the resilience of (textile) retailers within the city of Würzburg in Germany to the COVID-19 pandemic. To address the identified research gap, this paper applies the concept of resilience. Firstly, conducting expert interviews, the individual (textile) retailers’ level and their strategies in coping with the crisis is considered. Secondly, conducting a contextual analysis of the German city of Würzburg, we wish to contribute to the discussion of how the resilience of a region is influenced inter alia by actors. Our study finds three main strategies on the individual level, with retailers: (1) intending to “bounce back” to a pre-crisis state, (2) reorganising existing practices, as well as (3) closing stores and winding up business. As at the time of research, no conclusions regarding long-term impacts and resilience are possible, the results are limited. Nevertheless, detailed analysis of retailers’ strategies contributes to a better understanding of regional resilience.
Numerous ephemeral rivers and thousands of natural pans characterize the transboundary Iishana-System of the Cuvelai Basin between Namibia and Angola. After the rainy season, surface water stored in pans is often the only affordable water source for many people in rural areas. High inter- and intra-annual rainfall variations in this semiarid environment provoke years of extreme flood events and long periods of droughts. Thus, the issue of water availability is playing an increasingly important role in one of the most densely populated and fastest growing regions in southwestern Africa. Currently, there is no transnational approach to quantifying the potential storage and supply functions of the Iishana-System. To bridge these knowledge gaps and to increase the resilience of the local people's livelihood, suitable pans for expansion as intermediate storage were identified and their metrics determined. Therefore, a modified Blue Spot Analysis was performed, based on the high-resolution TanDEM-X digital elevation model. Further, surface area–volume ratio calculations were accomplished for finding suitable augmentation sites in a first step. The potential water storage volume of more than 190,000 pans was calculated at 1.9 km\(^3\). Over 2200 pans were identified for potential expansion to facilitate increased water supply and flood protection in the future.
In einer randomisierten und kontrollierten Studie an 57 ambulanten Patienten mit leichter- bis mittelgradiger Depression wurden die Effekte von körperorientierten Therapieverfahren (Affektregulierende Massagetherapie und Progressive Muskelrelaxation) untersucht. Dazu wurden die Teilnehmer in Massagegruppe (MG, n=30) und Kontrollgruppe (KG, n= 27) eingeteilt. Sie erhielten eine Serie von vier wöchentlichen Einzeltherapien in den jeweiligen Verfahren.
Bei jeder Behandlung wurde eine Selbstbeurteilung mittels Visueller Analogskalen durch die Teilnehmer selbst durchgeführt. Außerdem gab es eine zweimalige Fremdbeurteilung mittels standardisierter Fragebögen (HAMD und BRMS), die vor und nach der kompletten Behandlungsserie durchgeführt wurde.
Es wurden zudem Vor- und Abschlussgespräche durchgeführt und schriftlich dokumentiert. In der Selbstbeurteilung mittels VAS zeigten sich signifikante Ergebnisse zugunsten der Affektregulierenden Massagetherapie. Dabei waren die Dimensionen „Innere Unruhe“, „Schmerzen“, „Psychomotorische Hemmung“ und „Negatives Körpergefühl“ besonders beachtenswert. Auch in der Fremdbeurteilung ergaben sich signifikante Veränderungen zugunsten der Affektregulierenden Massagetherapie (HAMD p=0.034, BRMS p=0.041). Die durchgeführten Abschlussgespräche ergänzten und verfestigten diese Beobachtungen. Die statistische Überlegenheit der Affektregulierenden Massagetherapie lässt sich mit neurophysiologischen, psychologischen und humoralen Effekten begründen. Dabei spielen gesteigerte Interozeption, Aktivierung von CT-Afferenzen, sowie eine verbesserte interpersonelle Resonanz und Schwingungsfähigkeit dabei die entscheidende Rolle.
Die Ergebnisse erbringen neue Evidenz, dass Patienten mit leicht- und mittelgradigen Depressionen von der Behandlung mit Affektregulierender Massagetherapie (ARMT) profitieren können.
The parent borylene (CAAC)(Me\(_{3}\)P)BH, 1 (CAAC=cyclic alkyl(amino)carbene), acts both as a Lewis base and one-electron reducing agent towards group 13 trichlorides (ECl\(_{3}\), E=B, Al, Ga, In), yielding the adducts 1-ECl\(_{3}\) and increasing proportions of the radical cation [1]\(^{•+}\) for the heavier group 13 analogues. With boron trihalides (BX\(_{3}\), X=F, Cl, Br, I) 1 undergoes sequential adduct formation and halide abstraction reactions to yield borylboronium cations and shows an increasing tendency towards redox processes for the heavier halides. Calculations confirm that 1 acts as a strong Lewis base towards EX3 and show a marked increase in the B−E bond dissociation energies down both group 13 and the halide group.
Patients operated for infective endocarditis (IE) are at high risk of developing an excessive systemic hyperinflammatory state, resulting in systemic inflammatory response syndrome and septic shock. Hemoadsorption (HA) by cytokine adsorbers has been successfully applied to remove inflammatory mediators. This randomized controlled trial investigates the effect of perioperative HA therapy on inflammatory parameters and hemodynamic status in patients operated for IE. A total of 20 patients were randomly assigned to either HA therapy or the control group. HA therapy was initiated intraoperatively and continued for 24 hours postoperatively. Cytokine levels (IL‐6, IL‐1b, TNF‐α), leukocytes, C‐reactive protein (CRP), and Procalcitonin (PCT) as well as catecholamine support, and volume requirement were compared between both groups. Operative procedures included aortic (n = 7), mitral (n = 6), and multiple valve surgery (n = 7). All patients survived to discharge. No significant differences concerning median cytokine levels (IL‐6 and TNF‐α) were observed between both groups. CRP and PCT baseline levels were significantly higher in the HA group (59.5 vs. 26.3 mg/dL, P = .029 and 0.17 vs. 0.05 µg/L, P = .015) equalizing after surgery. Patients in the HA group required significantly higher doses of vasopressors (0.093 vs. 0.025 µg/kg/min norepinephrine, P = .029) at 12 hours postoperatively as well as significantly more overall volume replacement (7217 vs. 4185 mL at 12 hours, P = .015; 12 021 vs. 4850 mL at 48 hours, P = .015). HA therapy did neither result in a reduction of inflammatory parameters nor result in an improvement of hemodynamic parameters in patients operated for IE. For a more targeted use of HA therapy, appropriate selection criteria are required.
This paper examines situations where two vertically integrated firms consider supplying an input to an independent downstream competitor via privately observed contracts. We identify equilibria where competition in the upstream market emerges—the downstream competitor gets supplied—as well as when the downstream firm does not receive the input and is excluded from the market. The likelihood of the outcome in which the downstream firm does not get supplied depends not only on demand parameters, but also on contractual flexibility and observability. We show that when contracts are unobservable, downstream entry will occur less often. Furthermore, our results suggest that permitting contracts that enable the contracting parties to coordinate their behavior in the downstream market may improve welfare by increasing the likelihood that the downstream firm is supplied.
Die tiefe Hirnstimulation ist eine etablierte und hocheffiziente operative Behandlungsmethode für Patienten mit idiopathischem Parkinson- Syndrom (IPS). Als Zielgebiet dient in den meisten Fällen der Nucleus subthalamicus. Die Indikationen zur Implantation einer tiefen Hirnstimulation (THS) sind medikamentös nicht behandelbare motorische Fluktuationen und Dyskinesien oder ein medikamentös nicht kontrollierbarer Tremor.
Bislang erfolgt eine kontinuierliche Stimulation. Little et al. konnten jedoch bereits in ihrer 2013 veröffentlichen Studie zeigen, dass eine adaptive Stimulation, gemessen am UPDRS, um 27 % effektiver war und entsprechend die Stimulationszeit um 56 % gesenkt werden konnte.
Voraussetzung für die Anwendbarkeit einer adaptiven Stimulation im klinischen Alltag ist der Nachweis eines oder mehrerer Physiomarker, welche als Rückkopplungssignal für den Stimulationsbeginn dienen. Diese Marker müssen verlässlich mit dem Auftreten und der Ausprägung der Bewegungsstörungen korrelieren. Die Systeme müssen die Signale auslesen und entsprechend darauf reagieren können, damit ein sogenanntes Closed- loop- Verfahren entstehen kann. Bei diesen Markern handelt es sich um sogenannte lokale Feldpotenzialaktivitäten, das heißt niederfrequente Potentialänderungen von Zellen in subkortikalen Arealen des Gehirns, welche über Elektroden der THS abgeleitet werden können. Der Stimulator Activa PC+S (Medtronic) ermöglicht es erstmalig Aufzeichnungen von LFP- Daten, außerhalb eines experimentellen Laboraufbaus, mittels dauerhaft implantiertem Gerät vorzunehmen und damit auch Langzeitanalysen durchzuführen.
Erkenntnisse vergangener Studien ergaben, dass die synchronisierte, pathologisch gesteigerte oszillatorische Aktivität im Beta-Frequenzband (13- 35 Hz) eine bedeutende Rolle im Bezug auf die Pathophysiologie des IPS spielt und als krankheitsspezifische Aktivität gilt. Es konnte bereits belegt werden, dass die Verbesserung der motorischen Symptome (Bradykinese und Rigor) mit dem Ausmaß der Suppression der Betaband- Aktivität korreliert. Die Betabandaktivität als lokale Feldpotentialaktivität kann als Physiomarker einer adaptiven Stimulation dienen.
Unser Hauptaugenmerk galt daher der Analyse der Betabandaktivität oder anderer Frequenzbereiche während des Schlafes um hier die THS bedarfsgerecht einzusetzen. Hierfür wurden nächtliche subkortikale LFP- Aufzeichnungen parallel zur Schlaf- Polysomnographie durchgeführt. Zudem erfolgte in der vorliegenden Arbeit sowohl in unserem Vorversuch als auch in unserem Hauptversuch die Anwendung des UPDRS Teil III zur Erfassung der motorischen Symptome, sowie die Durchführung von Fragebögen zur Erfassung der nicht- motorischen Symptome, insbesondere des Schlafes vor und nach Implantation der tiefen Hirnstimulation.
Wir konnten belegen, dass es nach Implantation der THS zu einer Erhöhung der Schlafeffizienz und zu einer Erhöhung des Anteils der Schlafstadien II und III und damit einhergehend zu einer Steigerung der Schlafqualität kommt. Übereinstimmend mit anderen Studien konnten wir zeigen, dass sich die Motorik unter Stimulation deutlich verbessert. Im Vorversuch reduzierte sich der mittlere präoperative MDS- UPDRS III im MedsOFF verglichen mit dem mittleren postoperativ MDS- UPDRS III im MedsOFF/StimON um 37 %. In der PC+S- Studie imponierte eine Reduktion um 67%. Zudem zeigte sich eine Reduktion der nicht- motorischen Symptome durch die THS, insbesondere in der Kategorie Schlaf. Die Ergebnisse der vorliegenden Arbeit ergaben außerdem, dass die Betabandaktivität im Schlafstadium II und vor allem im Schlafstadium III am geringsten ist. Im Schlafstadium I und REM ist die Betabandaktivität höher als im Schlafstadium II und III. Hierbei war entscheidend, dass die Patienten eine klar abgrenzbare Betabandaktivität im Wachstadium aufwiesen und die Elektrodenkontakte im dorsolateralen Kerngebiet des STN lokalisiert waren.
Gegenläufig dazu verhält sich die Deltaaktivität. Sie ist im Schlafstadium II und besonders im Stadium III am höchsten. Stadium I ist mit durchschnittlich um 7,3 % niedriger als im Wachstadium. Am geringsten ist sie jedoch im REM-Schlafstadium.
Indem wir mit der Betabandaktivität und Deltaaktivität in den einzelnen Schlafstadien einen stabilen und reproduzierbaren Physiomarker finden konnten, sind wir unserem Ziel der adaptiven THS ein Stück näher gekommen.
Stapylococcus aureus colonises the nose of healthy individuals but can also cause a wide range of infections. Amino acid (AA) synthesis and their availability is crucial to adapt to conditions encountered in vivo. Most S. aureus genomes comprise all genes required for AA biosynthesis. Nevertheless, different strains require specific sets of AAs for growth. In this study we show that regulation inactivates pathways under certain conditions which result in these observed auxotrophies. We analyzed in vitro and modeled in silico in a Boolean semiquantitative model (195 nodes, 320 edges) the regulatory impact of stringent response (SR) on AA requirement in S. aureus HG001 (wild-type) and in mutant strains lacking the metabolic regulators RSH, CodY and CcpA, respectively. Growth in medium lacking single AAs was analyzed. Results correlated qualitatively to the in silico predictions of the final model in 92% and quantitatively in 81%. Remaining gaps in our knowledge are evaluated and discussed. This in silico model is made fully available and explains how integration of different inputs is achieved in SR and AA metabolism of S. aureus. The in vitro data and in silico modeling stress the role of SR and central regulators such as CodY for AA metabolisms in S. aureus.