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Temporale Vokalisationseigenschaften von Neugeborenen mit intrauteriner Wachstumsretardierung
(2024)
Die Zielstellung der vorliegenden Arbeit bestand in der Reflektion möglicher Einflüsse intrauteriner Wachstumsretardierungen auf die temporalen Vokalisationseigenschaften von Neugeborenen in den ersten fünf Lebenstagen. Unter der Annahme, dass das Gehirn des Neugeborenen das Schreiverhalten steuert, können die spezifischen Merkmale des Schreiens Aufschluss über die zugrunde liegende neuronale Integrität des Säuglings und eine eventuelle Prädisposition für Sprachanomalien geben. Zusätzlich wurden mögliche Einflüsse des Geburtsmodus, des Geschlechts und des Probanden- und Gestationsalters auf die temporalen Vokalisationseigenschaften untersucht. Dazu wurden spontane Lautäußerungen von 55 reifgeborenen, gesunden, neurologisch unbeeinträchtigten Neugeborenen mit einem Gestationsalter von 36-41 Wochen untersucht. Der Atemzyklus wurde gesamt und spezifisch für jedes Intervall betrachtet. 1605 Lautaufnahmen wurden vermessen und analysiert. Anhand standardisierter Wachstumskurven des Geburtsgewichtes erfolgte die somatische Klassifikation in SGA und AGA. Die Analysen ergaben signifikant verlängerte Zeitwerte der SGA-Neugeborenen für die Inspirationslänge, die Exspirationslänge und das Messintervall. Die hier berichteten Ergebnisse zeigen, dass signifikante Unterschiede bezüglich der Dauer einzelner zeitlicher Intervalle spontaner Vokalisationen zwischen SGA- und AGA-Neugeborenen bestehen. Das Verhältnis zwischen Inspirationslänge und Exspirationslänge hingegen erweist sich als robuste Größe, die sich nicht signifikant unterschied. Ein signifikanter Einfluss des Geburtsmodus auf die zeitliche Organisation von spontanen Lauten konnte in den Analysen nicht festgestellt werden. Jedoch waren die Zeitwerte der Messgrößen bei per Sectionem entbundenen Neugeborenen im Vergleich zu Spontangeburten tendenziell erhöht. Auch ein Einfluss des Geschlechts, des Probanden- oder Gestationsalters wurde für die temporalen Charakteristika nicht beobachtet.
The focus of this thesis is on analysing a linear stochastic partial differential equation (SPDE) with a bounded domain. The first part of the thesis commences with an examination of a one-dimensional SPDE. In this context, we construct estimators for the parameters of a parabolic SPDE based on discrete observations of a solution in time and space on a bounded domain. We establish central limit theorems for a high-frequency asymptotic regime, showing substantially smaller asymptotic variances compared to existing estimation methods. Moreover, asymptotic confidence intervals are directly feasible. Our approach builds upon realized volatilities and their asymptotic illustration as the response of a log-linear model with a spatial explanatory variable. This yields efficient estimators based on realized volatilities with optimal rates of convergence and minimal variances. We demonstrate our results by Monte Carlo simulations.
Extending this framework, we analyse a second-order SPDE model in multiple space dimensions in the second part of this thesis and develop estimators for the parameters of this model based on discrete observations in time and space on a bounded domain. While parameter estimation for one and two spatial dimensions was established in recent literature, this is the first work that generalizes the theory to a general, multi-dimensional framework. Our methodology enables the construction of an oracle estimator for volatility within the underlying model. For proving central limit theorems, we use a high-frequency observation scheme. To showcase our results, we conduct a Monte Carlo simulation, highlighting the advantages of our novel approach in a multi-dimensional context.
Hintergrund: Depressionen zählen zu den häufigsten psychischen Erkrankungen. Depressive Symptome umfassen beeinträchtigte kognitive Funktionen, vegetative Beschwerden und ein verändertes emotionales Erleben. Die defizitäre Wahrnehmung interner körperlicher Signale wird sowohl mit der Pathogenese der Depression als auch mit Angststörungen in Verbindung gebracht. Interozeptive Genauigkeit (IAc) beschreibt dabei die Fähigkeit, körperliche Empfindungen wie den eigenen Herzschlag akkurat wahrzunehmen und wird mit einer Herzwahrnehmungsaufgabe erfasst. In bildgebenden Verfahren wie der funktionellen Magnetresonanztomografie (fMRT) war eine niedrigere IAc mit einer verringerten Inselaktivität assoziiert. Während der Ruhezustandsmessung des Gehirns (resting-state fMRT) kann in Abwesenheit einer Aufgabe die intrinsische Aktivität des Gehirns gemessen werden. Dies ermöglicht die Identifizierung von kortikalen Netzwerken. Depressive Patienten weisen eine veränderte funktionelle Konnektivität innerhalb und zwischen einzelnen Netzwerken wie dem Salience Network (SN), welchem die Insel zugerechnet wird, und dem Default Mode Network (DMN) auf. Bisherige Studien, in denen überwiegend jüngere depressive Patienten untersucht wurden, kamen jedoch hinsichtlich der IAc und den kortikalen Netzwerken zu inkonsistenten Ergebnissen. Insbesondere ist unklar, inwieweit sich die IAc nach einem Therapieansprechen verändert, von der Herzratenvariabilität (HRV) moduliert wird und welche Auswirkungen dies auf die funktionelle Konnektivität kortikaler Netzwerke hat.
Ziele: Eine veränderte IAc und HRV wie auch funktionelle Konnektivitätsunterschiede im DMN und SN könnten Biomarker der Depression darstellen. Im Rahmen einer Längsschnittuntersuchung wurde getestet, ob ältere depressive Patienten über eine verringerte IAc, eine geringere HRV und über eine veränderte funktionelle Konnektivität im SN sowie DMN verfügen. Darüber hinaus sollte erforscht werden, in welchem Ausmaß sich Patienten, die auf die Behandlung ansprachen (Responder), von sogenannten Non-Respondern in Bezug auf die IAc, die HRV, das SN und das DMN unterschieden.
Methoden: In Studie 1 (Baseline) wurden 30 größtenteils medizierte, schwer depressive Patienten (> 50 Jahre) und 30 gesunde Kontrollprobanden untersucht. Die IAc wurde in einer Herzwahrnehmungsaufgabe ermittelt und die HRV bestimmt. Zusätzlich wurde eine resting-state fMRT durchgeführt. Eine funktionelle Konnektivitätsanalyse für Saatregionen im SN und DMN wurde mit einem saatbasierten Ansatz (seed-to-voxel) durchgeführt. Für eine Subgruppenanalyse wurde die Patientengruppe in ängstlich-depressive und nicht-ängstlich depressive Patienten unterteilt.
In Studie 2 (sechs Monate Follow-up) wurde die Studienkohorte nochmals untersucht. Es nahmen 21 Personen der Patientengruppe und 28 Probanden der Kontrollgruppe teil. Wiederum wurden die IAc und die HRV bestimmt. Außerdem fand eine resting-state fMRT-Messung statt. Die Patientengruppe wurde unterteilt in depressive Responder und Non-Responder.
Ergebnisse: In Studie 1 zeigten depressive Patienten eine funktionelle Hypokonnektivität zwischen einzelnen Saatregionen der Insel (SN) und Teilen des superioren frontalen Gyrus, des supplementärmotorischen Cortex, des lateralen okzipitalen Cortex sowie des Okzipitalpols. Zudem wiesen depressive Patienten zwischen der Saatregion im anterioren Teil des DMN und der Insel sowie dem Operculum eine erhöhte funktionelle Konnektivität auf. Die Gruppen unterschieden sich nicht in der IAc und der HRV. Ängstlich-depressive Patienten zeigten eine höhere funktionelle Konnektivität innerhalb der Insel als nicht-ängstlich depressive Patienten, jedoch zeigten sich keine Unterschiede in der IAc und der HRV.
In Studie 2 wiesen depressive Non-Responder im Vergleich zu Respondern eine Hyperkonnektivität zwischen dem posterioren DMN und dem Frontalpol sowie zwischen dem posterioren DMN und temporalen Arealen im SN auf. Keine funktionellen Konnektivitätsunterschiede zeigten sich für die Saatregionen im SN. Depressive Responder, Non-Responder und die Kontrollprobanden unterschieden sich in ihrer IAc und HRV nicht.
Schlussfolgerungen: Die Ergebnisse der Studien unterstreichen, dass bei depressiven Patienten, Respondern und Non-Respondern Unterschiede in der intrinsischen Gehirnaktivität funktioneller Netzwerke bestehen, jedoch nicht in der akkuraten Wahrnehmung des eigenen Herzschlages und der HRV. Therapeutische Interventionen, die auf eine Verbesserung der IAc abzielen, könnten insbesondere für Non-Responder dennoch eine zusätzliche Behandlungsmöglichkeit darstellen. Für eine personalisierte Medizin könnte die weitere Erforschung von kortikalen Netzwerken einen wesentlichen Beitrag leisten, um ein individuelles Therapieansprechen zu prädizieren.
mRNA is co- or post-transcriptionally processed from a precursor mRNA to a mature mRNA. In addition to 5'capping and splicing, these modifications also include polyadenylation, the addition of a polyA tail to the 3'end of the mRNA. In recent years, alternative polyadenylation in particular has increasingly been taken into account as a mechanism for regulating gene expression. It is assumed that approximately 70-75 % of human protein coding genes contain alternative polyadenylation signals, which are often located within intronic sequences of protein-coding genes. The use of such polyadenylation signals leads to shortened mRNA transcripts and thus to the generation of C-terminal shortened protein isoforms.
Interestingly, the majority of microRNAs, small non-coding RNAs that play an essential role in post-transcriptional gene regulation, are also encoded in intronic sequences of protein-coding genes and are co-transcriptionally expressed with their host genes. The biogenesis of microRNA has been well studied and is well known, but mechanisms that may influence the expression regulation of mature microRNAs are just poorly understood.
In the presented work, I aimed to investigate the influence of alternative intronic polyadenylation on the biogenesis of microRNAs. The human ion channel TRPM1 could already be associated with melanoma pathogenesis and truncated isoforms of this protein have already been described in literature. In addition, TRPM1 harbors a microRNA, miR211, in its sixth intron, which is assumed to act as a tumor suppressor. Since both, TRPM1 and miR211 have already been associated with melanoma pathogenesis, the shift towards truncated transcripts during the development of various cancers is already known and it has been shown that certain microRNAs play a crucial role in the development and progression of melanoma, melanoma cell lines were used as an in vitro model for these investigations.
Physical regimes characterized by low Mach numbers and steep stratifications pose severe challenges to standard finite volume methods. We present three new methods specifically designed to navigate these challenges by being both low Mach compliant and well-balanced. These properties are crucial for numerical methods to efficiently and accurately compute solutions in the regimes considered.
First, we concentrate on the construction of an approximate Riemann solver within Godunov-type finite volume methods. A new relaxation system gives rise to a two-speed relaxation solver for the Euler equations with gravity. Derived from fundamental mathematical principles, this solver reduces the artificial dissipation in the subsonic regime and preserves hydrostatic equilibria. The solver is particularly stable as it satisfies a discrete entropy inequality, preserves positivity of density and internal energy, and suppresses checkerboard modes.
The second scheme is designed to solve the equations of ideal MHD and combines different approaches. In order to deal with low Mach numbers, it makes use of a low-dissipation version of the HLLD solver and a partially implicit time discretization to relax the CFL time step constraint. A Deviation Well-Balancing method is employed to preserve a priori known magnetohydrostatic equilibria and thereby reduces the magnitude of spatial discretization errors in strongly stratified setups.
The third scheme relies on an IMEX approach based on a splitting of the MHD equations. The slow scale part of the system is discretized by a time-explicit Godunov-type method, whereas the fast scale part is discretized implicitly by central finite differences. Numerical dissipation terms and CFL time step restriction of the method depend solely on the slow waves of the explicit part, making the method particularly suited for subsonic regimes. Deviation Well-Balancing ensures the preservation of a priori known magnetohydrostatic equilibria.
The three schemes are applied to various numerical experiments for the compressible Euler and ideal MHD equations, demonstrating their ability to accurately simulate flows in regimes with low Mach numbers and strong stratification even on coarse grids.
The goal of this thesis is to study the topological and algebraic properties of the quasiconformal automorphism groups of simply and multiply connected domains in the complex plain, in which the quasiconformal automorphism groups are endowed with the supremum metric on the underlying domain. More precisely, questions concerning central topological properties such as (local) compactness, (path)-connectedness and separability and their dependence on the boundary of the corresponding domains are studied, as well as completeness with respect to the supremum metric. Moreover, special subsets of the quasiconformal automorphism group of the unit disk are investigated, and concrete quasiconformal automorphisms are constructed. Finally, a possible application of quasiconformal unit disk automorphisms to symmetric cryptography is presented, in which a quasiconformal cryptosystem is defined and studied.
Different effects of conditional Knock-Out of Stat3 on the sensory epithelium of the Organ of Corti
(2024)
The mammalian cochlea detects sound in response to vibration at frequency-dependent positions along the cochlea duct. The sensory outer hair cells, which are surrounded by supporting cells, act as a signal amplifier by changing their cell length. This is called electromotility. To ensure correct electrical transmission during mechanical forces, a certain resistance of the sensory epithelium is a prerequisite for correct transduction of auditory information. This resistance is managed by microtubules and its posttranslational modification in the supporting cells of the sensory epithelium of the cochlea. Stat3 is a transcription factor, with its different phosphorylation sites, is involved in many cellular processes like differentiation, inflammation, cell survival and microtubule dynamics, depending on cell type and activated pathway. While Stat3 has a wide range of intracellular roles, the question arose, how and if Stat3 is involved in cells of the organ of Corti to ensure a correct hearing.
To test this, Cre/loxp system were used to perform conditional Knock-Out (cKO) of Stat3 in outer hair cells or supporting cells either before hearing onset or after hearing onset. Hearing performances included DPOAE and ABR measurements, while molecular were performed by sequencing. Additionally, morphological examination was used by immunohistochemistry and electron microscopy.
A cKO of Stat3 before and after hearing onset in outer hair cells leads to hearing impairments, whereas synapses, nerve fibers and mitochondria were not affected. Bulk sequencing analyzation of outer hair cells out of cKO mice before hearing onset resulted in a disturbance of cellular homeostasis and extracellular signals. A cKO of Stat3 in the outer hair cells after hearing onset resulted in inflammatory signaling pathway with increased cytokine production and upregulation of NF-kb pathway. In supporting cells, cKO of Stat3 only after hearing onset resulted in a hearing impairment. However, synapses, nerve soma and fibers were not affected of a cKO of Stat3 in supporting cells. Nevertheless, detyronisated modification of microtubules were altered, which can lead to an instability of supporting cells during hearing.
In conclusion, Stat3 likely interact in a cell-specific and function-specific manner in cells of the organ of Corti. While a cKO in outer hair cells resulted in increased cytokine production, supporting cells altered its stability due to decreased detyronisated modification of microtubules. Together the results indicated that Stat3 is an important protein for hearing performances. However, additional investigations of the molecular mechanism are needed to understand the role of Stat3 in the cells of the organ of Corti.
Zusammenfassend kann davon ausgegangen werden, dass die späte Rezeption Landstei-ners und seiner Entdeckung der Blutgruppen sowie die langsame Entwicklung der flä-chendeckenden Anwendung der Bluttransfusion als lebensrettende medizinische Maß-nahme auf mehreren Problematiken beruhte. Diese sollen hier nochmal einzeln kurz be-leuchtet werden.
Einer der Gründe für die verspätete Rezeption kann sicherlich in Karl Landsteiners zu-rückhaltenden und etwas sperrigen Persönlichkeit gesehen werden, aufgrund derer die Gruppe seiner Anhänger in Österreich eher klein blieb. Nur wenige kamen mit seiner Ar-beitsweise und dem Klima, das in seinem Laboratorium vorherrschte, zurecht. Es dauerte eine Weile, bis der Großteil der Wissenschaftler über Landsteiners komplexe Persönlich-keitsstruktur, mit der er vielfach aneckte, hinwegsahen und ihn für den genialen Forscher-geist feierten, den er besaß. Seine Scheu vor Aufmerksamkeit führte dazu, dass er seine Entdeckung der Blutgruppen nicht aktiv und nachdrücklich publik zu machen versuchte. Er war zwar ein herausragender Wissenschaftler, strebte aber nicht nach einem Leben im Rampenlicht. Hätte er das gewollt, wäre seine Entdeckung mutmaßlich nicht nur in einem einzigen Artikel von ihm publiziert worden, sondern Landsteiner hätte daraufhin weiter nachgeforscht und seine Ergebnisse noch mehr mit der Entwicklung der Transfusionsme-dizin in Verbindung gestellt. Stattdessen wechselte er das Forschungsgebiet und beauf-tragte seine Assistenten, das Thema weiterzuverfolgen. Dies führte erst dazu, dass er mit der Entdeckung der vierten Blutgruppe schon gar nicht mehr in Verbindung gebracht wurde und öffnete schließlich in den Folgejahren anderen Medizinern das Tor zu weiterer Forschung auf diesem Gebiet. Es gab neue Blutgruppen-Nomenklaturen von verschiede-nen Wissenschaftlern und die Errungenschaften bei der Entwicklung der Bluttransfusion standen letztendlich scheinbar in keiner Verbindung mehr mit Karl Landsteiner.
Mit Sicherheit spielte jedoch Landsteiners Wahl bei der Entscheidung für sein Institut in Wien eine Rolle, durch die er in einen alten wissenschaftlichen Streit hineingezogen wur-de. Die Ursprünge des Konflikts zwischen Max Gruber und Paul Ehrlich hatten die Sci-entific Community in zwei Lager entzweit. Durch Landsteiners Tätigkeit am Hygiene-Institut und die Unterstützung Grubers, hatte er sich in Bezug auf die Aussicht auf wis-senschaftlichen Erfolg für die falsche Seite entschieden. Da es in Landsteiners Natur lag, nur wissenschaftlichen Tatsachen zu vertrauen und er sich nicht von Opportunitätsdenken abhalten ließ, die Wahrheit ans Licht zu bringen, stellte er durch seine Handlungen die gegenüberstehende Konfliktpartei bloß. Dass dies ausgerechnet die Gruppe um Paul Ehr-lich war, der den Rückhalt des Großteils der Wissenschaftsgesellschaft genoss und zudem das Gebiet der Immunologie, das Landsteiner erforschte, bis dahin beherrschte, machte es dem Blutgruppenentdecker fast unmöglich, in der österreichischen Universitätslandschaft Erfolge zu feiern.
Auch der Verdacht, Karl Landsteiners Erfolg sei von antisemitischen Vorurteilen beein-trächtigt worden, darf nicht vernachlässigt werden. Landsteiner fühlte sich sein Leben lang von seinen jüdischen Wurzeln regelrecht verfolgt, wie an dem Gerichtsprozess gegen die jüdische Enzyklopädie zu erkennen ist. Er schien sich geradezu dafür zu schämen, sonst hätte er wohl seinen Sohn in diesen Teil der Familiengeschichte eingeweiht. Ob es sich dabei eher um ein Selbstbewusstseinsproblem Landsteiners handelte, oder ob es hier-für triftige Gründe in Form von antisemitischen Anfeindungen während seiner Zeit in Wien gab, konnte aufgrund der mangelhaften Quellenlage nicht abschließend geklärt wer-den. Deutlich wird aber, dass der zunehmende Antisemitismus und der Mangel an Auf-stiegschancen in Wien ihn aus seiner Heimat vertrieben.
Der am stärksten zu gewichtende Grund für die verspätete Rezeption der Entdeckung der Blutgruppen und deren Bedeutung waren die Hemmungen vor der Anwendung aufgrund von etlichen ungelösten technischen Problemen. Hinzu kamen die Berichte über schwer-wiegenden Folgereaktionen auf Bluttransfusionen, die in der Zeit vor Entdeckung der Blutgruppen verzeichnet wurden, weshalb die breite Masse der Ärzteschaft sich von die-ser Technik abgewandt hatte. Es brauchte eine gewisse Zeit und eine Reihe vertrauens-würdiger Studien, aus denen hervorging, dass diese schweren Reaktionen eben genau auf dem fehlenden Wissen über die Blutgruppen beruhten, bis sich die breite Masse wieder an diese therapeutische Maßnahme herantraute. Da, wie heute bekannt ist, die Einteilung nach dem AB0-System noch nicht alle Gefahren der Bluttransfusion aus dem Weg ge-räumt hat, sondern weitere Faktoren wie der Rhesusfaktor und eventuelle unregelmäßige Blutgruppen eine Rolle spielten, kam es trotz Landsteiners bahnbrechender Entdeckung doch weiterhin zu Zwischenfällen, mit teilweise tödlichem Ausgang nach Bluttransfusio-nen nach dem AB0–System. Des Weiteren spielte das Fehlen einer einfachen, für den Arzt in der Praxis geeigneten Technik eine Rolle. Außer der, aufgrund von Landois Be-obachtungen, unpopulären Möglichkeit der Transfusion von defibriniertem Blut gab es mehr als ein Jahrzehnt nach Landsteiners Entdeckung nur die Möglichkeit der direkten Transfusion. Hierfür mussten sich nicht nur Spender und Empfänger im selben Raum befinden, sondern es bedurfte auch ausgezeichneter chirurgischer Fähigkeiten für eine Gefäßnaht oder benötigte später, nach Erfindung zahlreicher Apparaturen, zumindest viel Personal und Zeit für das aufwändige Verfahren. Diese Voraussetzungen waren aus-schließlich in großen Kliniken gegeben und auch hier nicht als Standardverfahren. Als 1914 die gerinnungshemmende Wirkung von Natriumcitrat entdeckt wurde, verhalf dies der Bluttransfusion in vielen Ländern zum Durchbruch. Die neu entdeckte Möglichkeit der Konservierung von Blut kam rechtzeitig zum Beginn des Ersten Weltkrieges, der, mit der Vielzahl an Verwundeten und der Notwendigkeit der Kompensation großer Blutver-luste, den medizinischen Fortschritt auf diesem Gebiet deutlich vorantrieb. Jedoch gab es auch hier noch viele Gegner, vor allem in Deutschland und Landsteiners Heimat Öster-reich, die vermuteten, dass der gerinnungshemmende Zusatz das Blut krankhaft verändern würde und eine Transfusion dieses Blutes gesundheitsschädlich sei. Sie zogen weiterhin die direkte Bluttransfusion vor oder suchten vergeblich weiter nach einer unkomplizierten Methode der Bluttransfusion, die sich flächendeckend anwenden ließ.
Während der Durchführung dieser Studie wurde offenbar, dass keiner der soeben ange-führten Aspekte als alleiniger Grund für die verspätete Rezeption der landsteinerschen Blutgruppen angesehen werden kann. Vielmehr war es ein Zusammenspiel der politischen Situation in Europa, der Rivalitäten unter Kollegen, die den Universitätsalltag beherrschten und nicht zuletzt die dargelegten Charakterzüge Landsteiners, die es ihm erschwerten, ein wissenschaftlich-soziales Netzwerk aufzubauen, das notwendig gewesen wäre, um seine Kollegen von der Bedeutung seiner Entdeckung zu überzeugen.
Articular cartilage defects represent one of the most challenging clinical problem for orthopedic surgeons and cartilage damage after trauma can result in debilitating joint pain, functional impairment and in the long-term development of osteoarthritis. The lateral cartilage-cartilage integration is crucial for the long-term success and to prevent further tissue degeneration. Tissue adhesives and sealants are becoming increasingly more popular and can be a beneficial approach in fostering tissue integration, particularly in tissues like cartilage where alternative techniques, such as suturing, would instead introduce further damage. However, adhesive materials still require optimization regarding the maximization of adhesion strength on the one hand and long-term tissue integration on the other hand. In vitro models can be a valuable support in the investigation of potential candidates and their functional mechanisms. For the conducted experiments within this work, an in vitro disc/ring model obtained from porcine articular cartilage tissue was established. In addition to qualitative evaluation of regeneration, this model facilitates the implementation of biomechanical tests to quantify cartilage integration strength. Construct harvesting for histology and other evaluation methods could be standardized and is ethically less questionable compared to in vivo testing. The opportunity of cell culture technique application for the in vitro model allowed a better understanding of cartilage integration processes.
Tissue bonding requires chemical or physical interaction of the adhesive material and the substrate. Adhesive hydrogels can bind to the defect interface and simultaneously fill the gap of irregularly shaped defect voids. Fibrin gels are derived from the physiological blood-clot formation and are clinically applied for wound closure. Within this work, comparisons of different fibrin glue formulations with the commercial BioGlue® were assessed, which highlighted the need for good biocompatibility when applied on cartilage tissue in order to achieve satisfying long-term integration. Fibrin gel formulations can be adapted with regard to their long-term stability and when applied on cartilage disc/ring constructs improved integrative repair is observable. The kinetic of repairing processes was investigated in fibrin-treated cartilage composites as part of this work. After three days in vitro cultivation, deposited extracellular matrix (ECM) was obvious at the glued interface that increased further over time. Interfacial cell invasion from the surrounding native cartilage was detected from day ten of tissue culture. The ECM formation relies on molecular factors, e.g., as was shown representatively for ascorbic acid, and contributes to increasing integration strengths over time. The experiments performed with fibrin revealed that the treatment with a biocompatible adhesive that allows cartilage neosynthesis favors lateral cartilage integration in the long term. However, fibrin has limited immediate bonding strength, which is disadvantageous for use on articular cartilage that is subject to high mechanical stress. The continuing aim of this thesis was to further develop adhesive mechanisms and new adhesive hydrogels that retain the positive properties of fibrin but have an increased immediate bonding strength.
Two different photochemical approaches with the advantage of on-demand bonding were tested. Such treatment potentially eases the application for the professional user. First, an UV light induced crosslinking mechanism was transferred to fibrin glue to provide additional bonding strength. For this, the cartilage surface was functionalized with highly reactive light-sensitive diazirine groups, which allowed additional covalent bonds to the fibrin matrix and thus increased the adhesive strength. However, the disadvantages of this approach were the multi-step bonding reactions, the need for enzymatic pretreatment of the cartilage, expensive reagents, potential UV-light damage, and potential toxicity hazards. Due to the mentioned disadvantages, no further experiments, including long-term culture, were carried out. A second photosensitive approach focused on blue light induced crosslinking of fibrinogen (RuFib) via a photoinitiator molecule instead of using thrombin as a crosslinking mediator like in normal fibrin glue. The used ruthenium complex allowed inter- and intramolecular dityrosine binding of fibrinogen molecules. The advantage of this method is a one-step curing of fibrinogen via visible light that further achieved higher adhesive strengths than fibrin. In contrast to diazirine functionalization of cartilage, the ruthenium complex is of less toxicological concern. However, after in vitro cultivation of the disc/ring constructs, there was a decrease in integration strength. Compared to fibrin, a reduced cartilage synthesis was observed at the defect. It is also disadvantageous that a direct adjustment of the adhesive can only be made via protein concentration, since fibrinogen is a natural protein that has a fixed number of tyrosine binding sites without chemical modification.
An additional cartilage adhesive was developed that is based on a mussel-inspired adhesive mechanism in which reactivity to a variety of substrates is enabled via free DOPA amino acids. DOPA-based adhesion is known to function in moist environments, a major advantage for application on water-rich cartilage tissue surrounded by synovial liquid. Reactive DOPA groups were synthetically attached to a polymer, here POx, to allow easy chemical modifiability, e.g. insertion of hydrolyzable ester motifs for tunable degradation. The possibility of preparing an adhesive hybrid hydrogel of POx in combination with fibrinogen led to good cell compatibility as was similarly observed with fibrin, but with increased immediate adhesive strength. Degradation could be adjusted by the amount of ester linkages on the POx and a direct influence of degradation rates on the development of integration in the in vitro model could be shown.
Hydrogels are well suited to fill defect gaps and immediate integration can be achieved via adhesive properties. The results obtained show that for the success of long-term integration, a good ability of the adhesive to take up synthesized ECM components and cells to enable regeneration is required. The degradation kinetics of the adhesive must match the remodeling process to avoid intermediate loss of integration power and to allow long-term firm adhesion to the native tissue.
Hydrogels are not only important as adhesives for smaller lesions, but also for filling large defect volumes and populating them with cells to produce tissue engineered cartilage. Many different hydrogel types suitable for cartilage synthesis are reported in the literature. A long-term stable fibrin formulation was tested in this work not only as an adhesive but also as a bulk hydrogel construct. Agarose is also a material widely used in cartilage tissue engineering that has shown good cartilage neosynthesis and was included in integration assessment. In addition, a synthetic hyaluronic acid-based hydrogel (HA SH/P(AGE/G)) was used. The disc/ring construct was adapted for such experiments and the inner lumen of the cartilage ring was filled with the respective hydrogel. In contrast to agarose, fibrin and HA-SH/P(AGE/G) gels have a crosslink mechanism that led to immediate bonding upon contact with cartilage during curing. The enhanced cartilage neosynthesis in agarose compared to the other hydrogel types resulted in improved integration during in vitro culture. This shows that for the long-term success of a treatment, remodeling of the hydrogel into functional cartilage tissue is a very high priority. In order to successfully treat larger cartilage defects with hydrogels, new materials with these properties in combination with chemical modifiability and a direct adhesion mechanism are one of the most promising approaches.
Spielfilme gelten im Sinne einer „Visual History“ als wertvolle medizinhistorische Quellen. Dass die Arztfilme der DDR-Zeit ebenfalls als solche zu betrachten sind, da sie realhistorische Parallelen aufweisen, soll dieses Projekt zeigen. Anhand dreier Spielfilme aus den verschiedenen Jahrzehnten, in denen die DDR Bestand hatte, werden für die damalige Zeit typische Konflikte und Themen des Arztseins in der DDR näher beleuchtet. Die drei Hauptfilme dieses Projekts – „Ärzte“ (1960), „Dr. med. Sommer II“ (1970) und „Ärztinnen“ (1983/84) – wurden hinsichtlich ihrer Hauptfiguren, Filmtechnik und -musik analysiert und mittels Filmkritiken, Werbematerial und Aufsätzen aus der damaligen Zeit in einen realhistorischen Kontext gesetzt. Außerdem wurden zur besseren filmgeschichtlichen Einordnung weitere Arztfilme aus der DDR in die Arbeit miteinbezogen. Das Medium Film spielte in Zeiten der DDR auch zur allgemeinen gesellschaftlichen Beeinflussung eine wichtige Rolle. Durch die Analyse der Filme unter Einbeziehung von historischen Zeitungsartikeln und Werbematerial wird das Bild eines sozialistischen Idealmenschen und -arztes, wie von der SED propagiert, dargestellt und untersucht.
Development Of A Human iPSC-Derived Cortical Neuron Model Of Adaptor- Protein-Complex-4-Deficiency
(2024)
Adaptor-protein-4-deficiency (AP-4-deficiency) is an autosomal-recessive childhood- onset form of complicated hereditary spastic paraplegia (HSP) caused by bi-allelic loss- of-function mutations in one of the four subunits of the AP-4-complex. These four conditions are named SPG47 (AP4B1, OMIM #614066), SPG50 (AP4M1, OMIM #612936), SPG51 (AP4E1, OMIM #613744) and SPG52 (AP4S1, OMIM #614067), respectively and all present with global developmental delay, progressive spasticity and seizures. Imaging features include a thinning of the corpus callosum, ventriculomegaly and white matter changes. AP-4 is a highly conserved heterotetrameric complex, which is responsible for polarized sorting of transmembrane cargo including the autophagy- related protein 9 A (ATG9A). Loss of any of the four subunits leads to an instable complex and defective sorting of AP-4-cargo. ATG9A is implicated in autophagosome formation and neurite outgrowth. It is missorted in AP-4-deficient cells and CNS-specific knockout of Atg9a in mice results in a phenotype reminiscent of AP-4-deficiency. However, the AP-4-related cellular phenotypes including ATG9A missorting have not been investigated in human neurons.
Thus, the aim of this study is to provide the first human induced pluripotent stem cell- derived (iPSC) cortical neuron model of AP-4-deficiency to explore AP-4-related phenotypes in preparation for a high-content screening. Under the hypothesis that AP-4- deficiency leads to ATG9A missorting, elevated ATG9A levels, impaired autophagy and neurite outgrowth in human iPSC-derived cortical neurons, in vitro biochemical and imaging assays including automated high-content imaging and analysis were applied. First, these phenotypes were investigated in fibroblasts from three patients with compound heterozygous mutations in the AP4B1 gene and their sex-matched parental controls. The same cell lines were used to generate iPSCs and differentiate them into human excitatory cortical neurons.
This work shows that ATG9A is accumulating in the trans-Golgi-network in AP-4- deficient human fibroblasts and that ATG9A levels are increased compared to parental controls and wild type cells suggesting a compensatory mechanism. Protein levels of the AP4E1-subunit were used as a surrogate marker for the AP-4-complex and were decreased in AP-4-deficient fibroblasts with co-immunoprecipitation confirming the instability of the complex. Lentiviral re-expression of the AP4B1-subunit rescues this corroborating the fact that a stable AP-4-complex is needed for ATG9A trafficking. Surprisingly, autophagic flux was present in AP-4-deficient fibroblasts under nutrient- rich and starvation conditions. These phenotypic markers were evaluated in iPSC-derived cortical neurons and here, a robust accumulation of ATG9A in the juxtanuclear area was seen together with elevated ATG9A protein levels. Strikingly, assessment of autophagy markers under nutrient-rich conditions showed alterations in AP-4-deficient iPSC- derived cortical neurons indicating dysfunctional autophagosome formation. These findings point towards a neuron-specific impairment of autophagy and need further investigation. Adding to the range of AP-4-related phenotypes, neurite outgrowth and branching are impaired in AP-4-deficient iPSC-derived cortical neurons as early as 24h after plating and together with recent studies point towards a distinct role of ATG9A in neurodevelopment independent of autophagy.
Together, this work provides the first patient-derived neuron model of AP-4-deficiency and shows that ATG9A is sorted in an AP-4-dependent manner. It establishes ATG9A- related phenotypes and impaired neurite outgrowth as robust markers for a high-content screening. This disease model holds the promise of providing a platform to further study AP-4-deficiency and to search for novel therapeutic targets.
This doctoral thesis investigates magneto-optical properties of mercury telluride layers grown tensile strained on cadmium telluride substrates. Here, layer thicknesses start above the usual quantum well thickness of about 20 nm and have a upper boundary around 100 nm due to lattice relaxation effects. This kind of layer system has been attributed to the material class of three-dimensional topological insulators in numerous publications. This class stands out due to intrinsic boundary states which cross the energetic band gap of the layer's bulk.
In order to investigate the band structure properties in a narrow region around the Fermi edge, including possible boundary states, the method of highly precise time-domain Terahertz polarimetry is used. In the beginning, the state of the art of Teraherz technology at the start of this project is discussed, moving on to a detailed description and characterization of the self-built measurement setup. Typical standard deviation of a polarization rotation or ellipticity measurement are on the order of 10 to 100 millidegrees, according to the transmission strength through investigated samples. A range of polarization spectra, depending on external magnetic fields up to 10 Tesla, can be extracted from the time-domain signal via Fourier transformation.
The identification of the actual band structure is done by modeling possible band structures by means of the envelope function approximation within the framework of the k·p method. First the bands are calculated based on well-established model parameters and from them the possible optical transitions and expected ellipticity spectra, all depending on external magnetic fields and the layer's charge carrier concentration. By comparing expected with measured spectra, the validity of k·p models with varying depths of detail is analyzed throughout this thesis. The rich information encoded in the ellipitcity spectra delivers key information for the attribution of single optical transitions, which are not part of pure absorption spectroscopy. For example, the sign of the ellipticity signals is linked to the mix of Landau levels which contribute to an optical transition, which shows direct evidence for bulk inversion asymmetry effects in the measured spectra.
Throughout the thesis, the results are compared repeatedly with existing publications on the topic. It is shown that the models used there are often insufficient or, in worst case, plainly incorrect. Wherever meaningful and possible without greater detours, the differences to the conclusions that can be drawn from the k·p model are discussed.
The analysis ends with a detailed look on remaining differences between model and measurement. It contains the quality of model parameters as well as different approaches to integrate electrostatic potentials that exist in the structures into the model.
An outlook on possible future developments of the mercury cadmium telluride layer systems, as well as the application of the methods shown here onto further research questions concludes the thesis.
Postoperative pulmonale Komplikationen (PPC) stellen den Hauptgrund für erhöhte Morbidität und Mortalität sowie eine längere stationäre Liegedauer nach chirurgischen Eingriffen dar. Die Elektrische Impedanztomographie (EIT) ermöglicht als strahlungsfreie Methode die bettseitige Visualisierung der regionalen pulmonalen Ventilation in einem thorakalen Querschnittsbereich über den zeitlichen Verlauf.
Die Hauptfragestellung dieser Studie war die perioperativen Veränderungen der regionalen pulmonalen Ventilation bei spontanatmenden Patienten nach abdominalchirurgischen Eingriffen in Allgemeinnarkose bis in die späte postoperative Phase zu untersuchen. Zusätzlich untersuchten wir die Lungenfunktion mittels Spirometrie. Wir nahmen eine Verschiebung der pulmonalen Ventilation in dorso-ventraler Richtung an, sowie eine postoperativ reduzierte Vitalkapazität, z.B. durch Atelektasen oder Pleuraergüsse.
In die prospektive Observationsstudie wurden 36 erwachsene Patienten eingeschlossen, die sich einem elektiven abdominalchirurgischen Eingriff unter Allgemeinanästhesie unterzogen und ein mittleres Risiko gemäß ARISCAT Score für die Entwicklung von PPC aufwiesen. Präoperativ, sowie am 1. und 3. postoperativen Tag erfolgte die Untersuchung der pulmonalen Ventilation mittels EIT in Spontanatmung, Errechnung des Center of Ventilation (COV), sowie eine Lungenfunktionsprüfung mittels Spirometrie.
Nach abdominalchirurgischen Operationen kam es zu einer statistisch signifikanten und bis zum 3. postoperativen Tag anhaltenden Verschiebung der pulmonalen Ventilation nach ventral (COVy präop. 16,5; 1. Tag postop. 17,8; 3. Tag postop. 17,4). Zudem zeigte sich eine anhaltend reduzierte Forcierten Vitalkapazität in % vom Sollwert (FVC%Soll): präop. 93%; 1. Tag postop. 58%; 3. Tag postop. 64%. Am 3. postoperativen Tag bestand unter forcierter Atmung eine negative Assoziation zwischen der Änderung des COVy und der Änderung der FVC%Soll. PPC traten bei 10 Patienten in Form von respiratorischer Insuffizienz, Atelektase und Pleuraerguss auf. Bei diesen Patienten zeigte die EIT keine komplikationsspezifischen Bilder.
Abdominalchirurgische Operationen hatten hat einen relevanten Einfluss auf die postoperative regionale Lungenventilation und somit auf die Entstehung von PPC. Die EIT hilft die Entstehung von PPC besser zu verstehen und Strategien zur Vermeidung solcher im klinischen Alltag zu implementieren.
Auswirkungen der Genpolymorphismen ASIC1, BDNF und NPSR1 auf die Antizipationsphase aversiver Reize
(2024)
In dieser Arbeit wurden einerseits die Antizipationsphasen von aversiven gegenüber neutralen Reizen anhand von Messungen der Hautleitfähigkeit und der Startle-Reaktion untersucht. Andererseits wurde die Hautleitfähigkeit auch während der Präsentation aversiver und neutraler Reize mit dem Ziel gemessen, signifikante Unterschiede festzustellen. Insbesondere wurden die Auswirkungen der Allele der Gene ASIC1 und der Interaktion der Genallele BDNF und NPSR1 betrachtet.
Ziel der vorliegenden Arbeit war es, den Einfluss der Risikogene auf die physiologische Angstreaktion und die subjektive Angstwahrnehmung zu untersuchen. Hierzu wurden den genotypisierten Probanden aversive und neutrale Videos präsentiert. Vor jedem Video erfolgte die Ankündigung, ob es sich um ein neutrales oder aversives Video handelt, wodurch bei Letzterem im Allgemeinen antizipatorische Angst – Erwartungsangst – hervorgerufen wird.
Im Vergleich der Antizipationsphase vor Darbietung aversiver Videos mit der Antizipationsphase vor neutralen Videos konnte eine erhöhte Startle-Amplitude gemessen werden. Jedoch konnte weder anhand der Veränderung der Hautleitfähigkeit noch anhand der Startle-Amplitude ein signifikanter Unterschied bei Trägern und Nicht- Trägern der Risikogenallelen in der Antizipationsphase festgestellt werden. Während der Präsentation der Videos konnte für die aversiven Videos im Vergleich zu den neutralen eine erhöhte Hautleitfähigkeit gemessen werden. Ebenfalls konnte bei der Darbietung von aversiven Videos bei den Trägern der Genallel-Interaktion NPSR1 AT/TT * BDNF GG und den Trägern des Risikogenallels ASIC1TT eine erhöhte Hautleitfähigkeit gemessen werden. So konnte mit den Ergebnissen dieser Arbeit belegt werden, dass Antizipationsangst auslösbar und anhand der Startle-Amplitude messbar ist.
Um Antizipationsangst festzustellen oder diese bei Risikogenallel-Träger zu untersuchen, waren die Ergebnisse bezüglich der Hautleitfähigkeit jedoch weniger aussagekräftig als erwartet.
Allgemein konnte die Interaktion NPSR1 AT/TT * BDNF GG und ASIC1 TT als Risikogenallele bezüglich einer verstärken Reaktion auf aversive Reize bestätigt werden. Weitere Studien sind notwendig, um die genetische Komponente von Angst und damit auch von Angsterkrankungen näher zu beleuchten, damit zukünftige Diagnostik- und Therapieansätze präzise entwickelt werden können.
In vitro models mimic the tissue-specific anatomy and play essential roles in personalized medicine and disease treatments. As a sophisticated manufacturing technology, 3D printing overcomes the limitations of traditional technologies and provides an excellent potential for developing in vitro models to mimic native tissue. This thesis aims to investigate the potential of a high-resolution 3D printing technology, melt electrowriting (MEW), for fabricating in vitro models. MEW has a distinct capacity for depositing micron size fibers with a defined design. In this thesis, three approaches were used, including 1) extending the MEW polymer library for different biomedical applications, 2) developing in vitro models for evaluation of cell growth and migration toward the different matrices, and 3) studying the effect of scaffold designs and biochemical cues of microenvironments on cells.
First, we introduce the MEW processability of (AB)n and (ABAC)n segmented copolymers, which have thermally reversible network formulation based on physical crosslinks. Bisurea segments are combined with hydrophobic poly(dimethylsiloxane) (PDMS) or hydrophilic poly(propylene oxide)-poly(ethylene oxide)-poly(propylene oxide) (PPO-PEG-PPO) segments to form the (AB)n segmented copolymers. (ABAC)n segmented copolymers contain all three segments: in addition to bisurea, both hydrophobic and hydrophilic segments are available in the same polymer chain, resulting in tunable mechanical and biological behaviors. MEW copolymers either support cells attachment or dissolve without cytotoxic side effects when in contact with the polymers at lower concentrations, indicating that this copolymer class has potential in biological applications. The unique biological and surface properties, transparency, adjustable hydrophilicity of these copolymers could be beneficial in several in vitro models.
The second manuscript addresses the design and development of a melt electrowritten competitive 3D radial migration device. The approach differs from most of the previous literature, as MEW is not used here to produce cell invasive scaffolds but to fabricate an in vitro device. The device is utilized to systematically determine the matrix which promotes cell migration and growth of glioblastoma cells. The glioblastoma cell migration is tested on four different Matrigel concentrations using a melt electrowritten radial device. The glioblastoma U87 cell growth and migration increase at Matrigel concentrations 6 and 8 mg mL-1 In the development of this radial device, the accuracy, and precision of melt electrowritten circular shapes were investigated. The results show that the printing speed and design diameter are essential parameters for the accuracy of printed constructs. It is the first instance where MEW is used for the production of in vitro devices.
The influence of biochemical cues and scaffold designs on astrocytes and glioblastoma is investigated in the last manuscript. A fiber comprising the box and triangle-shaped pores within MEW scaffolds are modified with biochemical cues, including RGD and IKVAV peptides using a reactive NCO-sP(EO-stat-PO) macromer. The results show that astrocytes and glioblastoma cells exhibit different phenotypes on scaffold designs and peptide-coated scaffolds.
The variant surface glycoprotein (VSG) of African trypanosomes plays an essential role in protecting the parasites from host immune factors. These trypanosomes undergo antigenic variation resulting in the expression of a single VSG isoform out of a repertoire of around 2000 genes. The molecular mechanism central to the expression and regulation of the VSG is however not fully understood.
Gene expression in trypanosomes is unusual due to the absence of typical RNA polymerase II promoters and the polycistronic transcription of genes. The regulation of gene expression is therefore mainly post-transcriptional. Regulatory sequences, mostly present in the 3´ UTRs, often serve as key elements in the modulation of the levels of individual mRNAs. In T. brucei VSG genes, a 100 % conserved 16mer motif within the 3´ UTR has been shown to modulate the stability of VSG transcripts and hence their expression. As a stability-associated sequence element, the absence of nucleotide substitutions in the motif is however unusual. It was therefore hypothesised that the motif is involved in other essential roles/processes besides stability of the VSG transcripts.
In this study, it was demonstrated that the 100 % conservation of the 16mer motif is not essential for cell viability or for the maintenance of functional VSG protein levels. It was further shown that the intact motif in the active VSG 3´ UTR is neither required to promote VSG silencing during switching nor is it needed during differentiation from bloodstream forms to procyclic forms. Crosstalk between the VSG and procyclin genes during differentiation to the insect vector stage is also unaffected in cells with a mutated 16mer motif. Ectopic overexpression of a second VSG however requires the intact motif to trigger silencing and exchange of the active VSG, suggesting a role for the motif in transcriptional VSG switching. The 16mer motif therefore plays a dual role in VSG in situ switching and stability of VSG transcripts. The additional role of the 16mer in the essential process of antigenic variation appears to be the driving force for the 100 % conservation of this RNA motif.
A screen aimed at identifying candidate RNA-binding proteins interacting with the 16mer motif, led to the identification of a DExD/H box protein, Hel66. Although the protein did not appear to have a direct link to the 16mer regulation of VSG expression, the DExD/H family of proteins are important players in the process of ribosome biogenesis. This process is relatively understudied in trypanosomes and so this candidate was singled out for detailed characterisation, given that the 16mer story had reached a natural end point. Ribosome biogenesis is a major cellular process in eukaryotes involving ribosomal RNA, ribosomal proteins and several non-ribosomal trans-acting protein factors. The DExD/H box proteins are the most important trans-acting protein factors involved in the biosynthesis of ribosomes. Several DExD/H box proteins have been directly implicated in this process in yeast. In trypanosomes, very few of this family of proteins have been characterised and therefore little is known about the specific roles they play in RNA metabolism. Here, it was shown that Hel66 is involved in rRNA processing during ribosome biogenesis. Hel66 localises to the nucleolus and depleting the protein led to a severe growth defect. Loss of the protein also resulted in a reduced rate of global translation and accumulation of rRNA processing intermediates of both the small and large ribosomal subunits. Hel66 is therefore an essential nucleolar DExD/H protein involved in rRNA processing during ribosome biogenesis. As very few protein factors involved in the processing of rRNAs have been described in trypanosomes, this finding represents an important platform for future investigation of this topic.
Die vorliegende Arbeit befasst sich mit der Beschreibung des Status quo der Versorgungsrealität von BARMER Patient*innen, welche nach operativem inguinalen- oder femoralen Hernienverschluss an Schmerzen litten und geht in weiterer Folge dessen Hinweisen auf CPIP nach. Es fand die Sekundärdatenanlyse von Routinedaten der BARMER Krankenkasse Anwendung. Die Stichprobe umfasste 11221 Patient*innen, von denen 77.7% unter keinen Leistenschmerzen im prä- oder postoperativen Zusammenhang mit dem Eingriff litten, bezeichnet als Gruppe „Pain 0“. 4.2% litten sowohl innerhalb von 365 Tagen vor- als auch nach dem Krankenhausaufenthalt an Schmerzen, was als chronisch zu bezeichnen war und unter Gruppe „Pain 2“ geführt wurde. 8.5% der Patient*innen litten nur innerhalb von 365 Tagen nach Entlassung an Schmerzen, was nur im erweiterten Sinne auf CPIP hinwies, da der Ausschluss der ersten 90 Tage postoperativ nicht in der Definition der Gruppe enthalten war. Diese Patient*innen gehörten der Gruppe „Pain 1“ an. Die Gruppe „Pain 3“ umfasste diejenigen 9.6% der Patient*innen, welche innerhalb von 365 Tagen präoperativ an Schmerzen litten. Obwohl keine postoperativen Leistenschmerzen für diese Patient*innen codiert worden sind, stellte sich eine bessere Versorgung als die der Gruppe „Pain 0“ dar.
Patient*innen der Gruppe „Pain 2“ mit der längsten Schmerzerfahrung wurden signifikant besser versorgt. Diese Gruppe, welche an chronischen, postoperativen, inguinalen Schmerzen litt, zeichnete sich durch eine signifikant jüngere Patient*innenklientel aus. Der Anteil an Frauen war signifikant höher. Begleitende psychiatrische Komorbiditäten traten signifikant häufiger auf. Die Versorgung dieser Patient*innengruppe war signifikant besser, allerdings vor allem hinsichtlich der psychologischen und psychiatrischen Betreuung nicht ausreichend gut. Die Mehrzahl der Analysen war hochsignifikant, deren Effektstärke fiel klein aus.
Within this thesis, three main approaches for the assessment and investigation of altered hemodynamics like wall shear stress, oscillatory shear index and the arterial pulse wave velocity in atherosclerosis development and progression were conducted:
1. The establishment of a fast method for the simultaneous assessment of 3D WSS and PWV in the complete murine aortic arch via high-resolution 4D-flow MRI
2. The utilization of serial in vivo measurements in atherosclerotic mouse models using high-resolution 4D-flow MRI, which were divided into studies describing altered hemodynamics in late and early atherosclerosis
3. The development of tissue-engineered artery models for the controllable application and variation of hemodynamic and biologic parameters, divided in native artery models and biofabricated artery models, aiming for the investigation of the relationship between atherogenesis and hemodynamics
Chapter 2 describes the establishment of a method for the simultaneous measurement of 3D WSS and PWV in the murine aortic arch at, using ultra high-field MRI at 17.6T [16], based on the previously published method for fast, self-navigated wall shear stress measurements in the murine aortic arch using radial 4D-phase contrast MRI at 17.6 T [4]. This work is based on the collective work of Dr. Patrick Winter, who developed the method and the author of this thesis, Kristina Andelovic, who performed the experiments and statistical analyses. As the method described in this chapter is basis for the following in vivo studies and undividable into the sub-parts of the contributors without losing important information, this chapter was not split into the single parts to provide fundamental information about the measurement and analysis methods and therefore better understandability for the following studies. The main challenge in this chapter was to overcome the issue of the need for a high spatial resolution to determine the velocity gradients at the vascular wall for the WSS quantification and a high temporal resolution for the assessment of the PWV without prolonging the acquisition time due to the need for two separate measurements. Moreover, for a full coverage of the hemodynamics in the murine aortic arch, a 3D measurement is needed, which was achieved by utilization of retrospective navigation and radial trajectories, enabling a highly flexible reconstruction framework to either reconstruct images at lower spatial resolution and higher frame rates for the acquisition of the PWV or higher spatial resolution and lower frame rates for the acquisition of the 3D WSS in a reasonable measurement time of only 35 minutes. This enabled the in vivo assessment of all relevant hemodynamic parameters related to atherosclerosis development and progression in one experimental session. This method was validated in healthy wild type and atherosclerotic Apoe-/- mice, indicating no differences in robustness between pathological and healthy mice.
The heterogeneous distribution of plaque development and arterial stiffening in atherosclerosis [10, 12], however, points out the importance of local PWV measurements. Therefore, future studies should focus on the 3D acquisition of the local PWV in the murine aortic arch based on the presented method, in order to enable spatially resolved correlations of local arterial stiffness with other hemodynamic parameters and plaque composition.
In Chapter 3, the previously established methods were used for the investigation of changing aortic hemodynamics during ageing and atherosclerosis in healthy wild type and atherosclerotic Apoe-/- mice using the previously established methods [4, 16] based on high-resolution 4D-flow MRI. In this work, serial measurements of healthy and atherosclerotic mice were conducted to track all changes in hemodynamics in the complete aortic arch over time. Moreover, spatially resolved 2D projection maps of WSS and OSI of the complete aortic arch were generated. This important feature allowed for the pixel-wise statistical analysis of inter- and intragroup hemodynamic changes over time and most importantly – at a glance. The study revealed converse differences of local hemodynamic profiles in healthy WT and atherosclerotic Apoe−/− mice, with decreasing longWSS and increasing OSI, while showing constant PWV in healthy mice and increasing longWSS and decreasing OSI, while showing increased PWV in diseased mice. Moreover, spatially resolved correlations between WSS, PWV, plaque and vessel wall characteristics were enabled, giving detailed insights into coherences between hemodynamics and plaque composition. Here, the circWSS was identified as a potential marker of plaque size and composition in advanced atherosclerosis. Moreover, correlations with PWV values identified the maximum radStrain could serve as a potential marker for vascular elasticity. This study demonstrated the feasibility and utility of high-resolution 4D flow MRI to spatially resolve, visualize and analyze statistical differences in all relevant hemodynamic parameters over time and between healthy and diseased mice, which could significantly improve our understanding of plaque progression towards vulnerability. In future studies the relation of vascular elasticity and radial strain should be further investigated and validated with local PWV measurements and CFD.
Moreover, the 2D histological datasets were not reflecting the 3D properties and regional characteristics of the atherosclerotic plaques. Therefore, future studies will include 3D plaque volume and composition analysis like morphological measurements with MRI or light-sheet microscopy to further improve the analysis of the relationship between hemodynamics and atherosclerosis.
Chapter 4 aimed at the description and investigation of hemodynamics in early stages of atherosclerosis. Moreover, this study included measurements of hemodynamics at baseline levels in healthy WT and atherosclerotic mouse models. Due to the lack of hemodynamic-related studies in Ldlr-/- mice, which are the most used mouse models in atherosclerosis research together with the Apoe-/- mouse model, this model was included in this study to describe changing hemodynamics in the aortic arch at baseline levels and during early atherosclerosis development and progression for the first time. In this study, distinct differences in aortic geometries of these mouse models at baseline levels were described for the first time, which result in significantly different flow- and WSS profiles in the Ldlr-/- mouse model. Further basal characterization of different parameters revealed only characteristic differences in lipid profiles, proving that the geometry is highly influencing the local WSS in these models. Most interestingly, calculation of the atherogenic index of plasma revealed a significantly higher risk in Ldlr-/- mice with ongoing atherosclerosis development, but significantly greater plaque areas in the aortic arch of Apoe-/- mice. Due to the given basal WSS and OSI profile in these two mouse models – two parameters highly influencing plaque development and progression – there is evidence that the regional plaque development differs between these mouse models during very early atherogenesis.
Therefore, future studies should focus on the spatiotemporal evaluation of plaque development and composition in the three defined aortic regions using morphological measurements with MRI or 3D histological analyses like LSFM. Moreover, this study offers an excellent basis for future studies incorporating CFD simulations, analyzing the different measured parameter combinations (e.g., aortic geometry of the Ldlr-/- mouse with the lipid profile of the Apoe-/- mouse), simulating the resulting plaque development and composition. This could help to understand the complex interplay between altered hemodynamics, serum lipids and atherosclerosis and significantly improve our basic understanding of key factors initiating atherosclerosis development.
Chapter 5 describes the establishment of a tissue-engineered artery model, which is based on native, decellularized porcine carotid artery scaffolds, cultured in a MRI-suitable bioreactor-system [23] for the investigation of hemodynamic-related atherosclerosis development in a controllable manner, using the previously established methods for WSS and PWV assessment [4, 16]. This in vitro artery model aimed for the reduction of animal experiments, while simultaneously offering a simplified, but completely controllable physical and biological environment. For this, a very fast and gentle decellularization protocol was established in a first step, which resulted in porcine carotid artery scaffolds showing complete acellularity while maintaining the extracellular matrix composition, overall ultrastructure and mechanical strength of native arteries. Moreover, a good cellular adhesion and proliferation was achieved, which was evaluated with isolated human blood outgrowth endothelial cells. Most importantly, an MRI-suitable artery chamber was designed for the simultaneous cultivation and assessment of high-resolution 4D hemodynamics in the described artery models. Using high-resolution 4D-flow MRI, the bioreactor system was proven to be suitable to quantify the volume flow, the two components of the WSS and the radStrain as well as the PWV in artery models, with obtained values being comparable to values found in literature for in vivo measurements. Moreover, the identification of first atherosclerotic processes like intimal thickening is achievable by three-dimensional assessment of the vessel wall morphology in the in vitro models. However, one limitation is the lack of a medial smooth muscle cell layer due to the dense ECM. Here, the utilization of the laser-cutting technology for the generation of holes and / or pits on a microscale, eventually enabling seeding of the media with SMCs showed promising results in a first try and should be further investigated in future studies. Therefore, the proposed artery model possesses all relevant components for the extension to an atherosclerosis model which may pave the way towards a significant improvement of our understanding of the key mechanisms in atherogenesis.
Chapter 6 describes the development of an easy-to-prepare, low cost and fully customizable artery model based on biomaterials. Here, thermoresponsive sacrificial scaffolds, processed with the technique of MEW were used for the creation of variable, biomimetic shapes to mimic the geometric properties of the aortic arch, consisting of both, bifurcations and curvatures. After embedding the sacrificial scaffold into a gelatin-hydrogel containing SMCs, it was crosslinked with bacterial transglutaminase before dissolution and flushing of the sacrificial scaffold. The hereby generated channel was subsequently seeded with ECs, resulting in an easy-to-prepare, fast and low-cost artery model. In contrast to the native artery model, this model is therefore more variable in size and shape and offers the possibility to include smooth muscle cells from the beginning. Moreover, a custom-built and highly adaptable perfusion chamber was designed specifically for the scaffold structure, which enabled a one-step creation and simultaneously offering the possibility for dynamic cultivation of the artery models, making it an excellent basis for the development of in vitro disease test systems for e.g., flow-related atherosclerosis research. Due to time constraints, the extension to an atherosclerosis model could not be achieved within the scope of this thesis. Therefore, future studies will focus on the development and validation of an in vitro atherosclerosis model based on the proposed bi- and three-layered artery models.
In conclusion, this thesis paved the way for a fast acquisition and detailed analyses of changing hemodynamics during atherosclerosis development and progression, including spatially resolved analyses of all relevant hemodynamic parameters over time and in between different groups. Moreover, to reduce animal experiments, while gaining control over various parameters influencing atherosclerosis development, promising artery models were established, which have the potential to serve as a new platform for basic atherosclerosis research.
To grow larger, insects must shed their old rigid exoskeleton and replace it with a new one. This process is called molting and the motor behavior that sheds the old cuticle is called ecdysis. Holometabolic insects have pupal stages in between their larval and adult forms, during which they perform metamorphosis. The pupal stage ends with eclosion, i.e., the emergence of the adult from the pupal shell. Insects typically eclose at a specific time during the day, likely when abiotic conditions are at their optimum. A newly eclosed insect is fragile and needs time to harden its exoskeleton. Hence, eclosion is regulated by sophisticated developmental and circadian timing mechanisms.
In Drosophila melanogaster, eclosion is limited to a daily time window in the morning, regarded as the “eclosion gate”. In a population of laboratory flies entrained by light/dark cycles, most of the flies eclose around lights on. This rhythmic eclosion pattern is controlled by the circadian clock and persists even under constant conditions.
Developmental timing is under the control of complex hormonal signaling, including the steroid ecdysone, insulin-like peptides, and prothoracicotropic hormone (PTTH). The interactions of the central circadian clock in the brain and a peripheral clock in the prothoracic gland (PG) that produces ecdysone are important for the circadian timing of eclosion. These two clocks are connected by a bilateral pair of peptidergic PTTH neurons (PTTHn) that project to the PG. Before each molt, the ecdysone level rises and then falls shortly before ecdysis. The falling ecdysone level must fall below a certain threshold value for the eclosion gate to open. The activity of PTTHn is inhibited by short neuropeptide F (sNPF) from the small ventrolateral neurons (sLNvs) and inhibition is thought to lead to a decrease in ecdysone production.
The general aim of this thesis is to further the understanding of how the circadian clock and neuroendocrinal pathways are coordinated to drive eclosion rhythmicity and to identify when these endocrinal signaling pathways are active. In Chapter I, a series of conditional PTTHn silencing-based behavioral assays, combined with neuronal activity imaging techniques such as non-invasive ARG-Luc show that PTTH signaling is active and required shortly before eclosion and may serve to phase-adjust the activity of the PG at the end of pupal development. Trans-synaptic anatomical stainings identified the sLNvs, dorsal neurons 1 (DN1), dorsal neurons 2 (DN2), and lateral posterior neurons (LPNs) clock neurons as directly upstream of the PTTHn.
Eclosion motor behavior is initiated by Ecdysis triggering hormone (ETH) which activates a pair of ventromedial (Vm) neurons to release eclosion hormone (EH) which positively feeds back to the source of ETH, the endocrine Inka cells. In Chapter II trans-synaptic tracing showed that most clock neurons provide input to the Vm and non-canonical EH neurons. Hence, clock can potentially influence the ETH/EH feedback loop. The activity profile of the Inka cells and Vm neurons before eclosion is described. Vm and Inka cells are active around seven hours before eclosion. Interestingly, all EH neurons appear to be exclusively peptidergic.
In Chapter III, using chemoconnectomics, PTTHns were found to express receptors for sNPF, allatostatin A (AstA), allatostatin C (AstC), and myosuppressin (Ms), while EH neurons expressed only Ms and AstA receptors. Eclosion assays of flies with impaired AstA, AstC, or Ms signaling do not show arrhythmicity under constant conditions. However, optogenetic activation of the AstA neurons strongly suppresses eclosion.
Chapter IV focuses on peripheral ventral’ Tracheal dendrite (v’Td) and class IV dendritic arborization (C4da) neurons. The C4da neurons mediate larval light avoidance through endocrine PTTH signaling. The v’Td neurons mainly receive O2/CO2 input from the trachea and are upstream of Vm neurons but are not required for eclosion rhythmicity. Conditional ablation of the C4da neurons or torso (receptor of PTTH) knock-out in the C4da neurons impaired eclosion rhythmicity. Six to seven hours before eclosion, PTTHn, C4da, and Vm neurons are active based on ARG-Luc imaging. Thus, C4da neurons may indirectly connect the PTTHn to the Vm neurons.
In summary, this thesis advances our knowledge of the temporal activity and role of PTTH signaling during pupal development and rhythmic eclosion. It further provides a comprehensive characterization of the synaptic and peptidergic inputs from clock neurons to PTTHn and EH neurons. AstA, AstC, and Ms are identified as potential modulators of eclosion circuits and suggest an indirect effect of PTTH signaling on EH signaling via the peripheral sensory C4da neurons.
Introduction.
Mobile health (mHealth) integrates mobile devices into healthcare, enabling remote monitoring, data collection, and personalized interventions. Machine Learning (ML), a subfield of Artificial Intelligence (AI), can use mHealth data to confirm or extend domain knowledge by finding associations within the data, i.e., with the goal of improving healthcare decisions. In this work, two data collection techniques were used for mHealth data fed into ML systems: Mobile Crowdsensing (MCS), which is a collaborative data gathering approach, and Ecological Momentary Assessments (EMA), which capture real-time individual experiences within the individual’s common environments using questionnaires and sensors. We collected EMA and MCS data on tinnitus and COVID-19. About 15 % of the world’s population suffers from tinnitus.
Materials & Methods.
This thesis investigates the challenges of ML systems when using MCS and EMA data. It asks: How can ML confirm or broad domain knowledge? Domain knowledge refers to expertise and understanding in a specific field, gained through experience and education. Are ML systems always superior to simple heuristics and if yes, how can one reach explainable AI (XAI) in the presence of mHealth data? An XAI method enables a human to understand why a model makes certain predictions. Finally, which guidelines can be beneficial for the use of ML within the mHealth domain? In tinnitus research, ML discerns gender, temperature, and season-related variations among patients. In the realm of COVID-19, we collaboratively designed a COVID-19 check app for public education, incorporating EMA data to offer informative feedback on COVID-19-related matters. This thesis uses seven EMA datasets with more than 250,000 assessments. Our analyses revealed a set of challenges: App user over-representation, time gaps, identity ambiguity, and operating system specific rounding errors, among others. Our systematic review of 450 medical studies assessed prior utilization of XAI methods.
Results.
ML models predict gender and tinnitus perception, validating gender-linked tinnitus disparities. Using season and temperature to predict tinnitus shows the association of these variables with tinnitus. Multiple assessments of one app user can constitute a group. Neglecting these groups in data sets leads to model overfitting. In select instances, heuristics outperform ML models, highlighting the need for domain expert consultation to unveil hidden groups or find simple heuristics.
Conclusion.
This thesis suggests guidelines for mHealth related data analyses and improves estimates for ML performance. Close communication with medical domain experts to identify latent user subsets and incremental benefits of ML is essential.