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- PCR (12)
- PRRT (12)
- Pharmakologie (12)
- Pilzkörper (12)
- Polytrauma (12)
- Quality of Experience (12)
- Quantenchemie (12)
- Rekonstruktion (12)
- Religion (12)
- Replikation (12)
- Risikofaktor (12)
- Rotatorenmanschette (12)
- Ruthenium (12)
- SMN (12)
- SNP (12)
- Siliciumorganische Verbindungen (12)
- Spracherwerb (12)
- Toll-like-Rezeptoren (12)
- Ultrakurzer Lichtimpuls (12)
- Validierung (12)
- Zelladhäsion (12)
- age (12)
- animal model (12)
- autoantibodies (12)
- biofabrication (12)
- blood–brain barrier (12)
- carbenes (12)
- cartilage (12)
- catalysis (12)
- colorectal carcinoma (12)
- complications (12)
- database (12)
- dementia (12)
- drug delivery (12)
- dynamics (12)
- emotions (12)
- endothelium (12)
- enzyme replacement therapy (12)
- fear conditioning (12)
- genome (12)
- head and neck cancer (12)
- interaction (12)
- lymphocytes (12)
- malignant hyperthermia (12)
- measles (12)
- microarray (12)
- molecular beam epitaxy (12)
- monoclonal antibodies (12)
- neurology (12)
- neuropathy (12)
- optimization (12)
- pollen (12)
- polymers (12)
- proteomics (12)
- rats (12)
- recombination (12)
- screening (12)
- super-resolution microscopy (12)
- synaptic plasticity (12)
- systematic review (12)
- tinnitus (12)
- total knee arthroplasty (12)
- trabeculectomy (12)
- translation (12)
- ubiquitin (12)
- ultrasound (12)
- vitamin D (12)
- vorsprachliche Entwicklung (12)
- zebrafish (12)
- ++ (11)
- 3D (11)
- Alzheimer’s disease (11)
- Anorexia nervosa (11)
- Antigen CD8 (11)
- Arabidopsis (11)
- B-Zelle (11)
- Bioisosterie (11)
- Biosynthese (11)
- Bioverfügbarkeit (11)
- Bruchpilot (11)
- Candida (11)
- Chromatin (11)
- Click-Chemie (11)
- Computertomografie (11)
- Durchflusscytometrie (11)
- Dynamik (11)
- EGFR (11)
- Elektronentransfer (11)
- Enzym (11)
- Epidemiologie (11)
- Epidermaler Wachstumsfaktor-Rezeptor (11)
- Flavonoide (11)
- Fließverhalten (11)
- Fotovoltaik (11)
- Genom (11)
- Geschlecht (11)
- Hypoxie (11)
- Immuncytochemie (11)
- Japankärpfling (11)
- Knochen (11)
- Knochenersatz (11)
- Kolorektales Karzinom (11)
- LPS (11)
- Laser (11)
- Längsschnittuntersuchung (11)
- MS (11)
- Mais (11)
- Mathematik (11)
- Megakaryozyt (11)
- Mensch-Maschine-Kommunikation (11)
- Mesenchymale Stammzellen (11)
- Mesenchymzelle (11)
- Model (11)
- Monitoring (11)
- NIRS (11)
- Nanodiamant (11)
- Neuropathie (11)
- Niereninsuffizienz (11)
- Operation (11)
- Osteoinduktion (11)
- Parathormon (11)
- Perylenbisimid (11)
- Phylogenie (11)
- Proteaseinhibitor (11)
- Proteasen (11)
- Psychiatrie (11)
- Pulmonale Hypertonie (11)
- Quality of life (11)
- Quanten-Hall-Effekt (11)
- Reperfusion (11)
- Risikofaktoren (11)
- Salmonella (11)
- Schizophrenia (11)
- Schlafapnoe (11)
- Schließzelle (11)
- Schule (11)
- Schultergelenk (11)
- Schädel-Hirn-Trauma (11)
- Silicate (11)
- Skala (11)
- Small RNA (11)
- Sprache (11)
- Squark (11)
- Stammzellen (11)
- Sterblichkeit (11)
- Supraleitung (11)
- Symbiose (11)
- T cell (11)
- Training (11)
- Tuberkelbakterium (11)
- Tumor-Nekrose-Faktor <alpha> (11)
- USA (11)
- Ubiquitin (11)
- Vasodilatator-stimuliertes Phosphoprotein (11)
- Wahrnehmung (11)
- Westafrika (11)
- Zelltod (11)
- adhesion (11)
- allergy (11)
- amygdala (11)
- antibody (11)
- atrial fibrillation (11)
- biocompatibility (11)
- biofilm (11)
- cancer treatment (11)
- cell adhesion (11)
- cochlear implant (11)
- communication (11)
- coping (11)
- dosimetry (11)
- fluorescence microscopy (11)
- glioblastoma multiforme (11)
- heart rate (11)
- hypoxia (11)
- kinetics (11)
- lung (11)
- mechanism (11)
- meiosis (11)
- membrane proteins (11)
- microglia (11)
- molecular dynamics (11)
- molecular imaging (11)
- nervous system (11)
- neural networks (11)
- neuroendocrine tumor (11)
- next generation sequencing (11)
- nuclear envelope (11)
- oncolytic virus (11)
- periodontitis (11)
- plasticity (11)
- pollination (11)
- randomized controlled trial (11)
- reactive oxygen species (11)
- relapse (11)
- review (11)
- safety (11)
- topological insulator (11)
- transport (11)
- tumor microenvironment (11)
- university (11)
- Alkohol (10)
- Alzheimer's disease (10)
- Antigen CD28 (10)
- Arzneimittelüberwachung (10)
- Atherosclerosis (10)
- BERA (10)
- BMP-2 (10)
- Bacteria (10)
- Bakterielle Infektion (10)
- Beschichtung (10)
- Bildverarbeitung (10)
- Bioinformatics (10)
- Biokompatibilität (10)
- Blazar (10)
- Borole (10)
- CRISPR/Cas-Methode (10)
- CRISPR/Cas9 (10)
- Cadherine (10)
- Calciumphosphate (10)
- Carbene (10)
- Children (10)
- Chronische Niereninsuffizienz (10)
- Churritisch (10)
- Cochlear-Implantat (10)
- Coronaviren (10)
- Covid-19 (10)
- Cyclo-GMP (10)
- Depressivität (10)
- Diamant (10)
- Digital Humanities (10)
- Dimerisierung (10)
- Dotierung (10)
- Echokardiographie (10)
- Eierstockkrebs (10)
- Elektrochemie (10)
- Elektronenkorrelation (10)
- Englisch (10)
- Enzyminhibitor (10)
- Erbkrankheit (10)
- Ereigniskorreliertes Potenzial (10)
- Erwachsener (10)
- Franken (10)
- Frau (10)
- Funktionalisierung <Chemie> (10)
- Funktionelle Kernspintomografie (10)
- Förderung (10)
- Geldpolitik (10)
- Glatter Krallenfrosch (10)
- Grenzfläche (10)
- HSM-Satztest (10)
- Herzmuskelzelle (10)
- Honigbiene (10)
- Hypophosphatasie (10)
- Immunology (10)
- Impfstoff (10)
- Induzierte pluripotente Stammzelle (10)
- Interleukin 4 (10)
- JNK (10)
- Klassifikation (10)
- Kniegelenk (10)
- Kohlenstoff (10)
- Komplikation (10)
- Kooperation (10)
- Kultur (10)
- LASP1 (10)
- LC-MS (10)
- Ladungstransfer (10)
- Ligand (10)
- Lokalisation (10)
- Magnesiumphosphate (10)
- Mathematikunterricht (10)
- Mathematisches Modell (10)
- Medulloblastom (10)
- Metakognition (10)
- Metallocene (10)
- Methylphenidat (10)
- Mikrokerne (10)
- Multiple Myeloma (10)
- Musik (10)
- Mutagenität (10)
- Nahrungserwerb (10)
- Nebennierenrindenkarzinom (10)
- Neolithikum (10)
- Neuropathischer Schmerz (10)
- Niger (10)
- Osteosynthese (10)
- Pain (10)
- Panikstörung (10)
- Parasit (10)
- Parodontitis (10)
- Pathogenität (10)
- Platelets (10)
- Plattenepithelkarzinom (10)
- Prevalence (10)
- Prostaglandine (10)
- Präfrontaler Cortex (10)
- Psychotherapie (10)
- Pädagogik (10)
- Qualitätskontrolle (10)
- RNA interference (10)
- RNA-seq (10)
- RNS-Spleißen (10)
- Radiotherapy (10)
- Remote Sensing (10)
- Rhodium (10)
- Rituximab (10)
- SAR (10)
- Schilddrüse (10)
- Silaanaloga (10)
- Silber (10)
- Silicon (10)
- South Africa (10)
- Sphingolipide (10)
- Sprachverstehen (10)
- Starke Kopplung (10)
- Stickstoffmonoxid-Synthase (10)
- Stressreaktion (10)
- Stroke (10)
- Struktur (10)
- T-Lymphozyten (10)
- T-Lymphozyten-Rezeptor (10)
- TWEAK (10)
- Tagesrhythmus (10)
- Totalsynthese (10)
- Toxizität (10)
- Transplantat-Wirt-Reaktion (10)
- Transthorakale Echokardiographie (10)
- Treg (10)
- Trypanosomen (10)
- Verwaltungsrecht (10)
- Vitamin D (10)
- Vor- und Frühgeschichte (10)
- Vorschulkind (10)
- Wachstum (10)
- Zebrabärbling (10)
- amino acids (10)
- antimicrobial resistance (10)
- bariatric surgery (10)
- biosynthesis (10)
- boranes (10)
- chemokines (10)
- circadian rhythms (10)
- clinical trial (10)
- comparison (10)
- complex (10)
- coronary artery disease (10)
- decision-making (10)
- density functional calculations (10)
- eNOS (10)
- education (10)
- emotion regulation (10)
- fatigue (10)
- fear (10)
- genome-wide association (10)
- genomics (10)
- global change (10)
- hydrogels (10)
- immunology (10)
- immunomodulation (10)
- induced pluripotent stem cells (10)
- injury (10)
- insect (10)
- knockout (10)
- leaf-cutting ants (10)
- leukemia (10)
- lymph nodes (10)
- mapping (10)
- membrane potential (10)
- microbiome (10)
- motivation (10)
- oncology (10)
- oncolytic virotherapy (10)
- oxidativer Stress (10)
- phenotype (10)
- quality assurance (10)
- regulatorische T-Zellen (10)
- remodeling (10)
- senescence (10)
- silicon (10)
- social interaction (10)
- stem cell transplantation (10)
- tDCS (10)
- thrombosis (10)
- tight junctions (10)
- tumors (10)
- vaccination (10)
- vertigo (10)
- water oxidation (10)
- Östrogene (10)
- 3 (9)
- Adenosin (9)
- Adenosine receptors (9)
- Affekt (9)
- Afrika (9)
- Alps (9)
- Analyse (9)
- Angeregter Zustand (9)
- Anxiety (9)
- Aorta (9)
- Aortenstenose (9)
- Bauchspeicheldrüsenkrebs (9)
- Beyond Standard Model (9)
- Biotransformation (9)
- Bordetella pertussis (9)
- Borylierung (9)
- Boğazkale (9)
- Butyrat (9)
- Carcinogenese (9)
- Catalysis (9)
- Chiralität <Chemie> (9)
- Cloud Computing (9)
- Computational chemistry (9)
- Deep learning (9)
- Dendritic cells (9)
- Diagnose (9)
- Diborane (9)
- Diskursanalyse (9)
- Dünndarm (9)
- Einzelphotonenemission (9)
- Elektroencephalographie (9)
- Elektronenmikroskopie (9)
- Elektronenstruktur (9)
- Elementarteilchenphysik (9)
- Epithel (9)
- Ernährung (9)
- Experimentelle Psychologie (9)
- Extremwertstatistik (9)
- Familie (9)
- Fanconi Anämie (9)
- Fettgewebe (9)
- Fibroblastenwachstumsfaktor (9)
- Fibromyalgie (9)
- Frühgeborene (9)
- GIS (9)
- Geistigbehindertenpädagogik (9)
- Gentherapie (9)
- Geoinformationssystem (9)
- Geruchswahrnehmung (9)
- Glioblastoma (9)
- Google Earth Engine (9)
- Grammatik (9)
- Handlungsorientierung (9)
- Haut (9)
- Herzmuskelkrankheit (9)
- Hethiter (9)
- Hyaluronsäure (9)
- IL-4 (9)
- Immunfluoreszenz (9)
- Immunisierung (9)
- Innovation (9)
- Instrumentelle Analytik (9)
- Integrine (9)
- Interview (9)
- Iran (9)
- Isolierung <Chemie> (9)
- Jugendliche (9)
- Kapillarelektrophorese (9)
- Knorpel (9)
- Kommunikation (9)
- Konflikt (9)
- Koordinationslehre (9)
- Korpus <Linguistik> (9)
- Landsat (9)
- Leber (9)
- Linguistik (9)
- Löslichkeit (9)
- MAPK (9)
- Macrophage (9)
- Magnetische Resonanz (9)
- Magnetismus (9)
- Mehrfachbindung (9)
- Mehrsprachigkeit (9)
- Messenger-RNS (9)
- Mice (9)
- Molekulare Erkennung (9)
- Monozyt (9)
- Morphologie (9)
- Mukoviszidose (9)
- Myokardprotektion (9)
- NAFLD (9)
- NO (9)
- Nebennierenrindenkrebs (9)
- Neuroinflammation (9)
- Nierentransplantation (9)
- Oberfläche (9)
- Oberflächenphysik (9)
- Optoelektronik (9)
- PD-1 (9)
- PD-L1 (9)
- Pathogenese (9)
- Persönlichkeit (9)
- Pharmakotherapie (9)
- Photolumineszenzspektroskopie (9)
- Physiologie (9)
- Plasmamembran (9)
- Protein (9)
- Pseudomonas syringae (9)
- Psychoonkologie (9)
- Quantenmechanik (9)
- Rechenzentrum (9)
- Rechtsvergleich (9)
- Regeneration (9)
- Regionalentwicklung (9)
- Revision (9)
- Sarkoidose (9)
- Satellit (9)
- Schmalwand <Arabidopsis> (9)
- Schwindel (9)
- Schüttgut (9)
- Sentinel-1 (9)
- Spin-Bahn-Wechselwirkung (9)
- Squaraine (9)
- Staphylococcus (9)
- Stathmin (9)
- Stereoselektive Synthese (9)
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- Textverstehen (9)
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- Transplantat (9)
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- Trypanosoma (9)
- Tumorantigen (9)
- Vakuole (9)
- Vergleich (9)
- Visuelle Aufmerksamkeit (9)
- Wurzel (9)
- X-ray crystallography (9)
- Zellkern (9)
- Zentralnervensystem (9)
- Zinkselenid (9)
- aggregation (9)
- agriculture (9)
- aldosterone (9)
- antennal lobe (9)
- anxiety disorders (9)
- aromaticity (9)
- biomechanics (9)
- blood brain barrier (9)
- body size (9)
- bone cement (9)
- cancer therapy (9)
- cardiac surgery (9)
- cell culture (9)
- cell migration (9)
- cell wall (9)
- central nervous system (9)
- chromatin (9)
- chronic heart failure (9)
- collagen (9)
- coronary heart disease (9)
- cuticular hydrocarbons (9)
- cystic fibrosis (9)
- decision making (9)
- dendritische Zellen (9)
- dialysis (9)
- dispersal (9)
- earth observation (9)
- electron microscopy (9)
- electronic properties and materials (9)
- electrophysiology (9)
- energy (9)
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- family (9)
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- gene therapy (9)
- glioma (9)
- glucose (9)
- high energy physics (9)
- hip (9)
- hyaluronic acid (9)
- hydrogel (9)
- impact (9)
- incidence (9)
- inhibitor (9)
- interferon (9)
- mechanotransduction (9)
- mesenchymale Stammzellen (9)
- metapopulation (9)
- methylation (9)
- mitosis (9)
- molecular biology (9)
- monitoring (9)
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- pathway (9)
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- permeability (9)
- personality (9)
- platelet activation (9)
- platelet aggregation (9)
- prognostic factors (9)
- quantification (9)
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- reveals (9)
- serum (9)
- signaling (9)
- spinal muscular atrophy (9)
- synapse (9)
- systematic uncertainty (9)
- temperature (9)
- tolerance (9)
- transcription factor (9)
- transient absorption (9)
- transmission (9)
- type 2 diabetes (9)
- vaccine (9)
- walking (9)
- water (9)
- wound healing (9)
- Übersetzung (9)
- ATLAS (8)
- Adhärenz (8)
- Aggregat <Chemie> (8)
- Akt (8)
- Aktiver galaktischer Kern (8)
- Algorithmus (8)
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- Ancistrocladaceae (8)
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- Aortenklappenersatz (8)
- Arthrose (8)
- Arthroskopie (8)
- Arzneimittelforschung (8)
- Asymmetrie (8)
- Asymmetrische Synthese (8)
- Auge (8)
- Autoaggressionskrankheit (8)
- Autonomer Roboter (8)
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- Biradikal (8)
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- Blutdruck (8)
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- CD28 (8)
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- Caenorhabditis elegans (8)
- Camponotus floridanus (8)
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- Cross-Section (8)
- Cysteinproteasen (8)
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- DLBCL (8)
- Darm (8)
- Data Mining (8)
- Datenbank (8)
- Degradation (8)
- Demenz (8)
- Deutschunterricht (8)
- Diborene (8)
- ERK (8)
- Elektronenspin (8)
- Elektronenspinresonanz (8)
- Emotionsregulation (8)
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- Engagement (8)
- Erbrechen (8)
- Europa (8)
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- Finite-Elemente-Methode (8)
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- Fluoreszenzspektroskopie (8)
- Forschung (8)
- Fußball (8)
- GABA (8)
- Gammastrahlung (8)
- Gedächtnisleistung (8)
- Geschlechtsunterschied (8)
- Gewebe (8)
- Gliom (8)
- Graphen (8)
- HPLC-MS (8)
- Habichtskraut (8)
- Haemophilus influenzae (8)
- Harnwegsinfektion (8)
- Hernie (8)
- Hochbegabung (8)
- Hubbard-Modell (8)
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- Hüftgelenk (8)
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- Immunantwort (8)
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- In vivo (8)
- India (8)
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- Inklusion (8)
- Juvenile chronische Arthritis (8)
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- Kleinsatellit (8)
- Knockout (8)
- Komposit <Zahnmedizin> (8)
- Kondo-Effekt (8)
- Korrelation (8)
- Kreuzband (8)
- Kristallstruktur (8)
- LC-MS/MS (8)
- Landwirtschaft (8)
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- Multiple myeloma (8)
- N-heterocyclic carbenes (8)
- NSCLC (8)
- Nachsorge (8)
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- PONV (8)
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- Parton distributions (8)
- Pemphigus (8)
- Peptide (8)
- Periphere arterielle Verschlusskrankheit (8)
- Permeabilität (8)
- Pharmakodynamik (8)
- Photodissoziation (8)
- Photovoltaik (8)
- Platin (8)
- Pollen (8)
- Polycyclische Aromaten (8)
- Protein p53 (8)
- Protein-Tyrosin-Kinasen (8)
- Proteinbindung (8)
- Protonen-NMR-Spektroskopie (8)
- Präkonditionierung (8)
- Psychische Störung (8)
- Pump-Probe-Technik (8)
- Quantendynamik (8)
- Quelle (8)
- Quran (8)
- Radikal <Chemie> (8)
- Raf <Biochemie> (8)
- Raf-Kinasen (8)
- Raman spectroscopy (8)
- Rastertunnelmikroskop (8)
- Rechenzentrum Universität Würzburg (8)
- Regenerative Medizin (8)
- Rekombination (8)
- Retroviren (8)
- Ringöffnungspolymerisation (8)
- Roman (8)
- Röntgen-Photoelektronenspektroskopie (8)
- Salmonella typhimurium (8)
- Schmerzforschung (8)
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- Statistik (8)
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- Synthesis (8)
- T cell activation (8)
- T lymphocytes (8)
- T-Zelle (8)
- TDM (8)
- Tabak (8)
- Tagung (8)
- Text Mining (8)
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- Titan (8)
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- UAV (8)
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- Vulnerabilität (8)
- Wirkstofffreisetzung (8)
- Zahnmedizin (8)
- Zeitreihenanalyse (8)
- actin cytoskeleton (8)
- acute kidney injury (8)
- adherence (8)
- adolescence (8)
- amyotrophic lateral sclerosis (8)
- analysis of variance (8)
- animal models (8)
- antigen (8)
- astrocytes (8)
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- --- (4)
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- Neurochirurgie (4)
- Neuromelanin (4)
- Neurons (4)
- Neuropeptide (4)
- Neurospora crassa (4)
- Neurotrophic factors (4)
- Neutrophiler Granulozyt (4)
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- Nickelverbindungen (4)
- Nicotiana tabacum (4)
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- Nitratreduktase (4)
- Nonlinear Dynamics (4)
- Numerisches Modell (4)
- Oberflächenzustand (4)
- Oligomere (4)
- Oligomerisation (4)
- Omarthrose (4)
- Online-Handel (4)
- Onlinehandel (4)
- OpenSpaceAlps (4)
- Operationstechnik (4)
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- Organic Chemistry (4)
- Organischer Feldeffekttransistor (4)
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- Overlay-Netz (4)
- Oxidative Stress (4)
- Oxidative stress (4)
- PAK (4)
- PBMC (4)
- PEG (4)
- PER (4)
- PI3K (4)
- PSA (4)
- PSMA-RADS (4)
- PTCA (4)
- PTCDA (4)
- PTEN (4)
- PTH (4)
- Paläoklima (4)
- Palökologie (4)
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- Pe (4)
- Perception (4)
- Performance (4)
- Periphere Stammzellentransplantation (4)
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- Phenomenology (4)
- Pheromone (4)
- Philosophie (4)
- Phobie (4)
- Phosphatidylinositolkinase <Phosphatidylinositol-3-Kinase> (4)
- Phosphoglykolatphosphatase (4)
- Phospholipide (4)
- Phosphor (4)
- Photorezeptor (4)
- Photostrom (4)
- Phthalocyanin (4)
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- Pontryagin maximum principle (4)
- Prehistory (4)
- Prescriptive Analytics (4)
- Priming (4)
- Prion (4)
- Private Altersversorgung (4)
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- Prostaglandin E2 (4)
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- RCT (4)
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- Score (4)
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Multiorgan recovery in a cadaver body using mild hypothermic ECMO treatment in a murine model
(2023)
Background
Transplant candidates on the waiting list are increasingly challenged by the lack of organs. Most of the organs can only be kept viable within very limited timeframes (e.g., mere 4–6 h for heart and lungs exposed to refrigeration temperatures ex vivo). Donation after circulatory death (DCD) using extracorporeal membrane oxygenation (ECMO) can significantly enlarge the donor pool, organ yield per donor, and shelf life. Nevertheless, clinical attempts to recover organs for transplantation after uncontrolled DCD are extremely complex and hardly reproducible. Therefore, as a preliminary strategy to fulfill this task, experimental protocols using feasible animal models are highly warranted. The primary aim of the study was to develop a model of ECMO-based cadaver organ recovery in mice. Our model mimics uncontrolled organ donation after an “out-of-hospital” sudden unexpected death with subsequent “in-hospital” cadaver management post-mortem. The secondary aim was to assess blood gas parameters, cardiac activity as well as overall organ state. The study protocol included post-mortem heparin–streptokinase administration 10 min after confirmed death induced by cervical dislocation under full anesthesia. After cannulation, veno-arterial ECMO (V–A ECMO) was started 1 h after death and continued for 2 h under mild hypothermic conditions followed by organ harvest. Pressure- and flow-controlled oxygenated blood-based reperfusion of a cadaver body was accompanied by blood gas analysis (BGA), electrocardiography, and histological evaluation of ischemia–reperfusion injury. For the first time, we designed and implemented, a not yet reported, miniaturized murine hemodialysis circuit for the treatment of severe hyperkalemia and metabolic acidosis post-mortem.
Results
BGA parameters confirmed profound ischemia typical for cadavers and incompatible with normal physiology, including extremely low blood pH, profound negative base excess, and enormously high levels of lactate. Two hours after ECMO implantation, blood pH values of a cadaver body restored from < 6.5 to 7.3 ± 0.05, pCO2 was lowered from > 130 to 41.7 ± 10.5 mmHg, sO2, base excess, and HCO3 were all elevated from below detection thresholds to 99.5 ± 0.6%, − 4 ± 6.2 and 22.0 ± 6.0 mmol/L, respectively (Student T test, p < 0.05). A substantial decrease in hyperlactatemia (from > 20 to 10.5 ± 1.7 mmol/L) and hyperkalemia (from > 9 to 6.9 ± 1.0 mmol/L) was observed when hemodialysis was implemented. On balance, the first signs of regained heart activity appeared on average 10 min after ECMO initiation without cardioplegia or any inotropic and vasopressor support. This was followed by restoration of myocardial contractility with a heart rate of up to 200 beats per minute (bpm) as detected by an electrocardiogram (ECG). Histological examinations revealed no evidence of heart injury 3 h post-mortem, whereas shock-specific morphological changes relevant to acute death and consequent cardiac/circulatory arrest were observed in the lungs, liver, and kidney of both control and ECMO-treated cadaver mice.
Conclusions
Thus, our model represents a promising approach to facilitate studying perspectives of cadaveric multiorgan recovery for transplantation. Moreover, it opens new possibilities for cadaver organ treatment to extend and potentiate donation and, hence, contribute to solving the organ shortage dilemma.
Purpose
Hypertrophic cartilage is an important characteristic of osteoarthritis and can often be found in patients suffering from osteoarthritis. Although the exact pathomechanism remains poorly understood, hypertrophic de-differentiation of chondrocytes also poses a major challenge in the cell-based repair of hyaline cartilage using mesenchymal stromal cells (MSCs). While different members of the transforming growth factor beta (TGF-β) family have been shown to promote chondrogenesis in MSCs, the transition into a hypertrophic phenotype remains a problem. To further examine this topic we compared the effects of the transcription growth and differentiation factor 5 (GDF-5) and the mutant R57A on in vitro chondrogenesis in MSCs.
Methods
Bone marrow-derived MSCs (BMSCs) were placed in pellet culture and in-cubated in chondrogenic differentiation medium containing R57A, GDF-5 and TGF-ß1 for 21 days. Chondrogenesis was examined histologically, immunohistochemically, through biochemical assays and by RT-qPCR regarding the expression of chondrogenic marker genes.
Results
Treatment of BMSCs with R57A led to a dose dependent induction of chondrogenesis in BMSCs. Biochemical assays also showed an elevated glycosaminoglycan (GAG) content and expression of chondrogenic marker genes in corresponding pellets. While treatment with R57A led to superior chondrogenic differentiation compared to treatment with the GDF-5 wild type and similar levels compared to incubation with TGF-ß1, levels of chondrogenic hypertrophy were lower after induction with R57A and the GDF-5 wild type.
Conclusions
R57A is a stronger inducer of chondrogenesis in BMSCs than the GDF-5 wild type while leading to lower levels of chondrogenic hypertrophy in comparison with TGF-ß1.
The AMADEUS score is not a sufficient predictor for functional outcome after high tibial osteotomy
(2023)
Purpose
The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)-based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open-wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system.
Methods
This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre-osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS-ADL, KOOS-QOL, KOOS-Sports, KOOS-Pain, KOOS-Symptoms) was obtained preoperatively and at a mean follow-up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre- and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system.
Results
There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre- and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02).
Conclusions
The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit.
Background
Iron deficiency (ID) is the leading cause of anemia worldwide. The prevalence of preoperative ID ranges from 23 to 33%. Preoperative anemia is associated with worse outcomes, making it important to diagnose and treat ID before elective surgery. Several studies indicated the effectiveness of intravenous iron supplementation in iron deficiency with or without anemia (ID(A)). However, it remains challenging to establish reliable evidence due to heterogeneity in utilized study outcomes. The development of a core outcome set (COS) can help to reduce this heterogeneity by proposing a minimal set of meaningful and standardized outcomes. The aim of our systematic review was to identify and assess outcomes reported in randomized controlled trials (RCTs) and observational studies investigating iron supplementation in iron-deficient patients with or without anemia.
Methods
We searched MEDLINE, CENTRAL, and ClinicalTrials.gov systematically from 2000 to April 1, 2022. RCTs and observational studies investigating iron supplementation in patients with a preoperative diagnosis of ID(A), were included. Study characteristics and reported outcomes were extracted. Outcomes were categorized according to an established outcome taxonomy. Quality of outcome reporting was assessed with a pre-specified tool. Reported clinically relevant differences for sample size calculation were extracted.
Results
Out of 2898 records, 346 underwent full-text screening and 13 studies (five RCTs, eight observational studies) with sufficient diagnostic inclusion criteria for iron deficiency with or without anemia (ID(A)) were eligible. It is noteworthy to mention that 49 studies were excluded due to no confirmed diagnosis of ID(A). Overall, 111 outcomes were structured into five core areas including nine domains. Most studies (92%) reported outcomes within the ‘blood and lymphatic system’ domain, followed by “adverse event” (77%) and “need for further resources” (77%). All of the latter reported on the need for blood transfusion. Reported outcomes were heterogeneous in measures and timing. Merely, two (33%) of six prospective studies were registered prospectively of which one (17%) showed no signs of selective outcome reporting.
Conclusion
This systematic review comprehensively depicts the heterogeneity of reported outcomes in studies investigating iron supplementation in ID(A) patients regarding exact definitions and timing. Our analysis provides a systematic base for consenting to a minimal COS.
Systematic review registration
PROSPERO CRD42020214247
Background
Severe acute respiratory syndrome coronavirus 2 is a virus affecting different organs and causing a wide variety and severity of symptoms. Headache as well as loss of smell and taste are the most frequently reported neurological manifestations of coronavirus disease 2019 induced by severe acute respiratory syndrome coronavirus 2. Here we report on a patient with chronic migraine and medication overuse headache, who experienced remarkable mitigation of migraine following coronavirus disease 2019.
Case presentation
For many years prior to the severe acute respiratory syndrome coronavirus 2 infection, a 57-year-old Caucasian male suffered from very frequent migraine attacks and for control of headaches he had been taking triptans almost daily. In the 16-month period before the outbreak of coronavirus disease 2019, triptan was taken 98% of the days with only a 21-day prednisolone-supported triptan holiday, which, however, had no longer-lasting consequences on migraine frequency. Upon severe acute respiratory syndrome coronavirus 2 infection, the patient developed only mild symptoms including fever, fatigue, and headache. Directly following recovery from coronavirus disease 2019, the patient surprisingly experienced a period with largely reduced frequency and severity of migraine attacks. Indeed, during 80 days following coronavirus disease 2019, migraine as well as triptan usage were restricted to only 25% of the days, no longer fulfilling criteria of a chronic migraine and medication overuse headache.
Conclusion
Severe acute respiratory syndrome coronavirus 2 infection might be capable of triggering mitigation of migraine.
Objectives
Open-access cancer imaging datasets have become integral for evaluating novel AI approaches in radiology. However, their use in quantitative analysis with radiomics features presents unique challenges, such as incomplete documentation, low visibility, non-uniform data formats, data inhomogeneity, and complex preprocessing. These issues may cause problems with reproducibility and standardization in radiomics studies.
Methods
We systematically reviewed imaging datasets with public copyright licenses, published up to March 2023 across four large online cancer imaging archives. We included only datasets with tomographic images (CT, MRI, or PET), segmentations, and clinical annotations, specifically identifying those suitable for radiomics research. Reproducible preprocessing and feature extraction were performed for each dataset to enable their easy reuse.
Results
We discovered 29 datasets with corresponding segmentations and labels in the form of health outcomes, tumor pathology, staging, imaging-based scores, genetic markers, or repeated imaging. We compiled a repository encompassing 10,354 patients and 49,515 scans. Of the 29 datasets, 15 were licensed under Creative Commons licenses, allowing both non-commercial and commercial usage and redistribution, while others featured custom or restricted licenses. Studies spanned from the early 1990s to 2021, with the majority concluding after 2013. Seven different formats were used for the imaging data. Preprocessing and feature extraction were successfully performed for each dataset.
Conclusion
RadiomicsHub is a comprehensive public repository with radiomics features derived from a systematic review of public cancer imaging datasets. By converting all datasets to a standardized format and ensuring reproducible and traceable processing, RadiomicsHub addresses key reproducibility and standardization challenges in radiomics.
Critical relevance statement
This study critically addresses the challenges associated with locating, preprocessing, and extracting quantitative features from open-access datasets, to facilitate more robust and reliable evaluations of radiomics models.
Key points
- Through a systematic review, we identified 29 cancer imaging datasets suitable for radiomics research.
- A public repository with collection overview and radiomics features, encompassing 10,354 patients and 49,515 scans, was compiled.
- Most datasets can be shared, used, and built upon freely under a Creative Commons license.
- All 29 identified datasets have been converted into a common format to enable reproducible radiomics feature extraction.
In tumor therapy anti-angiogenic approaches have the potential to increase the efficacy of a wide variety of subsequently or co-administered agents, possibly by improving or normalizing the defective tumor vasculature. Successful implementation of the concept of vascular normalization under anti-angiogenic therapy, however, mandates a detailed understanding of key characteristics and a respective scoring metric that defines an improved vasculature and thus a successful attempt. Here, we show that beyond commonly used parameters such as vessel patency and maturation, anti-angiogenic approaches largely benefit if the complex vascular network with its vessel interconnections is both qualitatively and quantitatively assessed. To gain such deeper insight the organization of vascular networks, we introduce a multi-parametric evaluation of high-resolution angiographic images based on light-sheet fluorescence microscopy images of tumors. We first could pinpoint key correlations between vessel length, straightness and diameter to describe the regular, functional and organized structure observed under physiological conditions. We found that vascular networks from experimental tumors diverted from those in healthy organs, demonstrating the dysfunctionality of the tumor vasculature not only on the level of the individual vessel but also in terms of inadequate organization into larger structures. These parameters proofed effective in scoring the degree of disorganization in different tumor entities, and more importantly in grading a potential reversal under treatment with therapeutic agents. The presented vascular network analysis will support vascular normalization assessment and future optimization of anti-angiogenic therapy.
Variability of gene expression due to stochasticity of transcription or variation of extrinsic signals, termed biological noise, is a potential driving force of cellular differentiation. Utilizing single-cell RNA-sequencing, we develop VarID2 for the quantification of biological noise at single-cell resolution. VarID2 reveals enhanced nuclear versus cytoplasmic noise, and distinct regulatory modes stratified by correlation between noise, expression, and chromatin accessibility. Noise levels are minimal in murine hematopoietic stem cells (HSCs) and increase during differentiation and ageing. Differential noise identifies myeloid-biased Dlk1+ long-term HSCs in aged mice with enhanced quiescence and self-renewal capacity. VarID2 reveals noise dynamics invisible to conventional single-cell transcriptome analysis.
Background
Based on low-quality evidence, current nutrition guidelines recommend the delivery of high-dose protein in critically ill patients. The EFFORT Protein trial showed that higher protein dose is not associated with improved outcomes, whereas the effects in critically ill patients who developed acute kidney injury (AKI) need further evaluation. The overall aim is to evaluate the effects of high-dose protein in critically ill patients who developed different stages of AKI.
Methods
In this post hoc analysis of the EFFORT Protein trial, we investigated the effect of high versus usual protein dose (≥ 2.2 vs. ≤ 1.2 g/kg body weight/day) on time-to-discharge alive from the hospital (TTDA) and 60-day mortality and in different subgroups in critically ill patients with AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria within 7 days of ICU admission. The associations of protein dose with incidence and duration of kidney replacement therapy (KRT) were also investigated.
Results
Of the 1329 randomized patients, 312 developed AKI and were included in this analysis (163 in the high and 149 in the usual protein dose group). High protein was associated with a slower time-to-discharge alive from the hospital (TTDA) (hazard ratio 0.5, 95% CI 0.4–0.8) and higher 60-day mortality (relative risk 1.4 (95% CI 1.1–1.8). Effect modification was not statistically significant for any subgroup, and no subgroups suggested a beneficial effect of higher protein, although the harmful effect of higher protein target appeared to disappear in patients who received kidney replacement therapy (KRT). Protein dose was not significantly associated with the incidence of AKI and KRT or duration of KRT.
Conclusions
In critically ill patients with AKI, high protein may be associated with worse outcomes in all AKI stages. Recommendation of higher protein dosing in AKI patients should be carefully re-evaluated to avoid potential harmful effects especially in patients who were not treated with KRT.
Trial registration: This study is registered at ClinicalTrials.gov (NCT03160547) on May 17th 2017.
A novel USP11-TCEAL1-mediated mechanism protects transcriptional elongation by RNA Polymerase II
(2024)
Deregulated expression of MYC oncoproteins is a driving event in many human cancers. Therefore, understanding and targeting MYC protein-driven mechanisms in tumor biology remain a major challenge.
Oncogenic transcription in MYCN-amplified neuroblastoma leads to the formation of the MYCN-BRCA1-USP11 complex that terminates transcription by evicting stalling RNAPII from chromatin. This reduces cellular stress and allows reinitiation of new rounds of transcription. Basically, tumors with amplified MYC genes have a high demand on well orchestration of transcriptional processes-dependent and independent from MYC proteins functions in gene regulation. To date, the cooperation between promoter-proximal termination and transcriptional elongation in cancer cells remains still incomplete in its understanding.
In this study the putative role of the dubiquitinase Ubiquitin Specific Protease 11 (USP11) in transcription regulation was further investigated. First, several USP11 interaction partners involved in transcriptional regulation in neuroblastoma cancer cells were identified. In particular, the transcription elongation factor A like 1 (TCEAL1) protein, which assists USP11 to engage protein-protein interactions in a MYCN-dependent manner, was characterized. The data clearly show that TCEAL1 acts as a pro-transcriptional factor for RNA polymerase II (RNAPII)-medi- ated transcription. In detail, TCEAL1 controls the transcription factor S-II (TFIIS), a factor that assists RNAPII to escape from paused sites. The findings claim that TCEAL1 outcompetes the transcription elongation factor TFIIS in a non-catalytic manner on chromatin of highly expressed genes. This is reasoned by the need regulating TFIIS function in transcription. TCEAL1 equili- brates excessive backtracking and premature termination of transcription caused by TFIIS.
Collectively, the work shed light on the stoichiometric control of TFIIS demand in transcriptional regulation via the USP11-TCEAL1-USP7 complex. This complex protects RNAPII from TFIIS-mediated termination helping to regulate productive transcription of highly active genes in neuroblastoma.
In this study, we developed an innovative nanoparticle formulation to facilitate the delivery of antitumor antibodies to tumor sites. The study commenced with the utilization of 13 bispecific antibody fusion proteins, which targeted the Fn14 receptor, thereby validating the pivotal role of crosslinking in Fn14 receptor activation. Subsequently, gold nanoparticles were activated using COOH-PEG-SH in combination with EDC/NHS, and subsequently conjugated with two Fn14-targeting antibodies, PDL192 and 5B6. Following this, a pH-sensitive shell was generated on the outer layer of the antibody-coupled gold nanoparticles through the application of chemically modified polylysine. The resultant complexes, termed MPL-antibody-AuNP, demonstrated a release profile reminiscent of the tumor microenvironment (TME). Notably, these complexes released antibody-AuNPs only in slightly acidic conditions while remaining intact in neutral or basic environments. Functionality analysis further affirmed the pH-sensitive property of MPL-antibody-AuNPs, demonstrating that the antibodies only initiated potent Fn14 activation in slightly acidic environments. This formulation holds potential for applicability to antibodies or ligands targeting the 80 TNFRSF family, given that gold nanoparticles successfully served as platforms for antibody crosslinking, thereby transforming these antibodies into potent agonists. Moreover, the TME disintegration profile of MPL mitigates the potential cytotoxic effects of antibodies, thereby circumventing associated adverse side effects. This study not only showcases the potential of nanoparticle formulations in targeted therapy, but also provides a solid foundation for further investigations on their clinical application in the context of targeting category II TNFRSF receptors with antibodies or ligands.
Structure and dynamics of the plasma membrane: a single-molecule study in \(Trypanosoma\) \(brucei\)
(2024)
The unicellular, flagellated parasite Trypanosoma brucei is the causative agent of human African sleeping sickness and nagana in livestock. In the last decades, it has become an established eukaryotic model organism in the field of biology, as well as in the interdisciplinary field of biophysics. For instance, the dense variant surface glycoprotein (VSG) coat offers the possibility to study the dynamics of GPI-anchored proteins in the plasma membrane of living cells. The fluidity of the VSG coat is not only an interesting object of study for its own sake, but is critically important for the survival of the parasite in the mammalian host. In order to maintain the integrity of the coat, the entire VSG coat is recycled within a few minutes. This is surprisingly fast for a purely diffusive process with the flagellar pocket (FP) as the sole site for endo- and exocytosis. Previous studies characterising VSG dynamics using FRAP reported diffusion coefficients that were not sufficient to to enable fast turnover based on passive VSG randomisation on the trypanosome surface.
In this thesis, live-cell single-molecule fluorescence microscopy (SMFM) was employed to elucidate whether VSG diffusion coefficients were priorly underestimated or whether directed forces could be involved to bias VSGs towards the entrance of the FP. Embedding the highly motile trypanosomes in thermo-stable hydrogels facilitated the investigation of VSG dynamics on living trypanosomes at the mammalian host's temperature of 37°C. To allow for a spatial correlation of the VSG dynamics to the FP entrance, a cell line was employed harbouring a fluorescently labelled structure as a reference. Sequential two-colour SMFM was then established to allow for recording and registration of the dynamic and static single-molecule information.
In order to characterise VSG dynamics, an algorithm to obtain reliable information from short trajectories was adapted (shortTrAn). It allowed for the quantification of the local dynamics in two distinct scenarios: diffusion and directed motion. The adaptation of the algorithm to the VSG data sets required the introduction of an additional projection filter. The algorithm was further extended to take into account the localisation errors inherent to single-particle tracking. The results of the quantification of diffusion and directed motion were presented in maps of the trypanosome surface, including an outline generated from a super-resolved static structure as a reference. Information on diffusion was displayed in one map, an ellipse plot. The colour code represented the local diffusion coefficient, while the shape of the ellipses provided an indication of the diffusion behaviour (aniso- or isotropic diffusion). The eccentricity of the ellipses was used to quantify deviations from isotropic diffusion. Information on directed motion was shown in three maps: A velocity map, representing the amplitude of the local velocities in a colour code. A quiver plot, illustrating the orientation of directed motion, and a third map which indicated the relative standard error of the local velocities colour-coded. Finally, a guideline based on random walk simulations was used to identify which of the two motion scenarios dominated locally. Application of the guideline to the VSG dynamics analysed by shortTrAn yielded supermaps that showed the locally dominant motion mode colour-coded.
I found that VSG dynamics are dominated by diffusion, but several times faster than previously determined. The diffusion behaviour was additionally characterised by spatial heterogeneity. Moreover, isolated regions exhibiting the characteristics of round and elongated traps were observed on the cell surface. Additionally, VSG dynamics were studied with respect to the entrance of the FP. VSG dynamics in this region displayed similar characteristics compared to the remainder of the cell surface and forces biasing VSGs into the FP were not found.
Furthermore, I investigated a potential interference of the attachment of the cytoskeleton to the plasma membrane with the dynamics of VSGs which are anchored to the outer leaflet of the membrane. Preliminary experiments were conducted on osmotically swollen trypanosomes and trypanosomes depleted for a microtubule-associated protein anchoring the subpellicular microtubule cytoskeleton to the plasma membrane. The measurements revealed a trend that detachment of the cytoskeleton could be associated with a reduction in the VSG diffusion coefficient and a loss of elongated traps. The latter could be an indication that these isolated regions were caused by underlying structures associated with the cytoskeleton.
The measurements on cells with an intact cytoskeleton were complemented by random walk simulations of VSG dynamics with the newly determined diffusion coefficient on long time scales not accessible in experiments. Simulations showed that passive VSG randomisation is fast enough to allow for a turnover of the full VSG coat within a few minutes. According to an estimate based on the known rate of endocytosis and the newly determined VSG diffusion coefficient, the majority of exocytosed VSGs could escape from the FP to the cell surface without being immediately re-endocytosed.
Die vorliegende Arbeit befasst sich mit der Synthese und Reaktivitat niedervalenter borhaltiger Verbindungen der Oxidationsstufe +I, sowie der Darstellung eines neuen zweizähnigen Carbens. Von zentraler Bedeutung waren dabei Verbindungen aus der Substanzklasse der cAACs, die sowohl als stabilisierende Lewis-Basen der Diborene und Borylene zum Einsatz kamen, als auch das Grundgerüst des neuen Carbens bilden.
Zunächst stand die Synthese eines neuen Diborens im Fokus, wobei Cyclohexylsubstituenten am Pyrrolidingerust des cAACs verwendet wurden. Die Reaktivitätsstudien wurden anschließend am Diboren mit dem methylsubstituierten cAAC-Derivat durchgeführt. Dabei konnte neben der 1,2-Addition von Wasser die Insertion von Acetylen in die BB-Bindung, sowie die Spaltung durch die Reaktion mit diversen Aziden beobachtet werden. Darüber hinaus gelingt die vollständige Separierung beider Boratome in zwei getrennte Moleküle bei der Umsetzung mit Kohlenstoffdioxid in einer Reaktionssequenz aus [2+2]-Cycloaddition und -reversion.
Das dabei erhaltene Hydroborylen wurde im zweiten Teil der Arbeit hinsichtlich seiner Reaktivität untersucht. Gerade die Carbonylfunktionalität erlaubte hierbei den Zugang zu vielfältigen Reaktionsprodukten. Unter anderen kann der Carbonylsubstituent in ein Alkin oder ein Nitril überführt werden. Zudem kann die, aus der Übergangsmetall-Carbonylchemie bekannte, Fischer-Carben Synthese am Borylen reproduziert werden und stellt somit ein metallomimetisches Verhalten der Borylene zur Schau.
Der letzte Teil befasst sich mit der Darstellung eines zweizähnigen Carbenliganden, wobei der Nachweis des freien Carbens indirekt mittels Abfangreaktionen gelang.
Bone Morphogenetic Proteins (BMPs) sind potente Differenzierungs- und Wachstumsfaktoren, die strukturell der Transforming Growth Factor-β (TGF-β) - Superfamilie zugeordnet werden. Sie spielen eine Schlüsselrolle in einer Vielzahl an zellulären Prozessen ab den frühen Stadien der Embryogenese. Dadurch sind BMPs nicht nur für die korrekte Festlegung der embryonalen Körperachse verantwortlich, sondern regulieren als multifunktionale Mediatoren neben der Morphogenese auch Proliferation, Differenzierung und Apoptose unterschiedlicher Zelltypen. Bone Morphogenetic Proteins sind somit für die Aufrechthaltung der Homöostase im adulten Körper mitverantwortlich. Ihre Funktionalität vermitteln die BMPs über eine Signalkaskade, indem sie als dimeres Protein spezifische transmembrane Serin/Threonin-Kinaserezeptoren von Typ I und Typ II in einem heteromeren Komplex assemblieren. Die intrazelluläre Signalweiterleitung verläuft über verschiedene Signalkaskaden (Smad-Proteine oder MAPKs), wodurch final im Zellkern Änderungen auf der Ebene der Gentranskription ausgelöst werden. Laut der namensgebenden Eigenschaft fungieren einige Wachstumsfaktoren als aktive Induktoren der Knochenbiosynthese. Ihre Anwesenheit ist essentiell für die vielen zellulären Prozesse, die während einer Frakturheilung auftreten, wobei eine Knochenneubildung ebenso stark abhängig ist vom Zusammenspiel verschiedener Stimulatoren und Inhibitoren, die die BMPs in ihrer Aktivität regulieren. Bedingt durch ihr großes Potential fanden die erstmals durch Marshal Urist 1965 aus Knochenmaterial isolierten BMP-Proteine ihren Einsatz in der regenerativen Medizin. Kommerziell erhältlich und bereits seit vielen Jahren in der klinischen Anwendung befindet sich derzeit das rhBMP-2 und rhBMP-7. Diese beiden Wachstumsfaktoren werden u.a. verwendet, um die Heilungsprozesse von langwierigen Schienbeinfrakturen zu verbessern, aber auch bei degenerativen Wirbelsäulenerkrankungen und in der Kieferchirurgie. Jedoch führt die schlechte Löslichkeit des BMPs aufgrund der ausgeprägten Aggregationstendenz zu gravierenden Problemen, nicht nur während der biotechnologischen Herstellung, sondern auch bei der klinischen Anwendung.
Der Schwerpunkt des Optimierungsbedarfs der BMP-2 Herstellung im Rahmen dieser Doktorarbeit lag daher auf der Etablierung eines prokaryotischen Expressionssystems für die lösliche Produktion von BMP-2. Dafür wurde zunächst der Fokus auf die ungünstigen Löslichkeitseigenschaften des Wachstumsfaktors gelegt. Um die hohe Aggregationsneigung des BMP-2 während der Produktion in Escherichia coli zu minimieren, wurden anhand einer Algorithmus-basierten Analyse BMP-2-Varianten entworfen, in denen Aminosäuren mit stark hydrophoben Eigenschaften gegen solche mit hydrophilem Charakter ausgetauscht wurden. Hierdurch konnten die zur Aggregation neigenden Bereiche des BMP-2 weitestgehend eliminiert werden. Es wurden für die bezüglich ihrer Löslichkeit optimierten Proteinvarianten unterschiedliche Expressionsstrategien etabliert, wodurch dimere BMP-2-Muteine in angepassten chromatographischen Profilen mit einem Aufreinigungsschritt und ohne jegliche Renaturierungsmaßnahmen gewonnen wurden. Allerdings verbleiben hierbei Restmengen an bakteriellen Kontaminationen, die vorwiegend aus endogenen ribosomalen E. coli-Proteinen stammen und nicht vollständig entfernt werden konnten. Während der umfassenden in vitro Charakterisierung der BMP-2-Varianten konnte durch massenspektroskopische Analysen die Gesamtmasse beider Zielproteine bestätigt werden, wobei sequenzspezifische Fragmente eine eindeutige Identifikation der eingebrachten Mutationen ermöglichten. CD-spektroskopische Analysen erweitert um Auswertealgorithmen konnten die wesentlichen Wt-BMP-2-typischen Sekundärstrukturelemente identifizieren. Die neu generierten BMP-2-Varianten zeigen in der dynamischen Lichtstreuungsanalyse stark verminderte Aggregationstendenz im Vergleich zum Wildtyp-BMP-2. Dessen Aggregationsverhalten wurde durch die kombinierte Analytik seiner mikrofluidischen Diffusion und der dynamischen Lichtstreuung zum ersten Mal über den Konzentrationsbereich von 0.5 µM bis 100 mM genau charakterisiert. Erste zellbiologische Versuche verliefen ohne Erfolg, wodurch die biologische Aktivität der BMP-Varianten nicht abschließend geklärt werden konnte.
Die simple Methode zur Expression und Aufreinigung der hydrophilisierte BMP-2-Muteine aus dieser Dissertation kann leicht in einen größeren Produktionsmaßstab überführt werden. BMP 2 kann dadurch schneller und kostengünstiger hergestellt werden. Final bleibt es jedoch erforderlich, die biologische Aktivität der neuen löslichen BMP-2-Varianten vollständig zu charakterisieren, um deren ganzes Funktionsspektrum zu entdecken. Der Fokus weiterer Forschung sollte zudem auf die verbleibende Oligomerisierungstendenz und die bestehende Kontamination mit Fremdproteinen gelegt werden, da diese beiden Faktoren letztendlich die Ausbeute an dimeren BMP-2 Varianten aus diesem System derzeit minimieren.
Ziel dieser Studie war es, zu eruieren, ob die DSE zur Unterscheidung einer TS- von einer PSAS beitragen kann. Ebenfalls untersuchten wir, ob es bestimmte echokardiographische Prädiktoren für eine TS- und eine PSAS gibt und ob die LVEF bei Patienten mit einer LGAS eine entscheidende Rolle spielt. Methoden: Es wurde bei 130 Patienten mit einer asymptomatischen AS im Uniklinikum Würzburg zwischen Januar 2011 und Dezember 2016 sowohl eine TTE als auch eine DSE durchgeführt. Mittels TTE wurden verschiedene echokardiographische Daten erhoben und falls die Patienten eine AVAi 0,6 cm2/m2 und eine PGmean < 40 mmHg aufwiesen, wurden sie in die Studie eingeschlossen. Sie wurden in zwei Gruppen aufgeteilt, je nachdem ob sie eine LGAS mit einer LVEF 50% oder < 50% aufwiesen. Bei allen Patienten wurde in der DSE die AVAproj berechnet und sie wurden daraufhin in zwei Untergruppen aufgeteilt, Patienten mit einer AVAproj 1 cm2 wurden der Gruppe mit einer hochgradigen LGAS (TS-LGAS) und Patienten mit einer AVAproj > 1cm2 der Gruppe mit einer pseudo-hochgradigen LGAS (PS-LGAS) zugeteilt. Alle Patientendaten wurden manuell ausgewertet. Das klinische Follow Up fand frühestens ein Jahr nach der DSE statt und bestand aus einem Telefoninterview oder einer klinischen Untersuchung. Ergebnisse: Die DSE ist zur Diagnose einer TS-LGAS bei Patienten mit einer erhaltenen LVEF von großem Nutzen. Die in der TTE gemessene AVA ist ein unabhängiger Prädiktor für eine TS-LGAS bei Patienten mit erhaltener und reduzierter LVEF. Eine verringerte MAPSE und eine reduzierte TDI-s´ sprechen bei Patienten mit erhaltener LVEF für eine TS-LGAS. Bei Patienten mit reduzierter LVEF weisen ein erhöhter sPAP und eine verringerte AV Geschwindigkeits Ratio auf eine TS-LGAS hin. Bei Zweifeln können weitere bildgebende Verfahren zur Diagnosefindung hinzugezogen werden.
Herz-Kreislauf-Erkrankungen zählen zu den häufigsten Todesursachen weltweit. Ein ihr zugrundeliegender pathologischer Prozess ist die Atherosklerose. Die Ruptur eines atheroskelrotischen Plaques kann lebensbedrohlich sein. Derzeit existieren weder ein evaluierter Biomarker noch eine Bildgebungstechnik, die das Risiko einer solchen Plaqueruptur und eines nachfolgenden akuten kardiovaskulären Ereignisses vorhersagen können. Um die bildgebenden Verfahren zur Detektion der Atherosklerose zu optimieren, wurde in dieser Dissertationsarbeit untersucht, ob der PET/CT-Tracer 68Ga-Pentixafor im Vergleich zu 18F-FDG bessere Ergebnisse in der Diagnostik der Atherosklerose erzielen kann.
Insgesamt wurden 144 onkologische Patienten in die Studie einbezogen, bei denen die 18F-FDG-PET/CT sowie 68Ga-Pentifaxor-PET/CT aus klinischen Gründen indiziert waren. Befunde, bei denen eine gegenüber dem Hintergrund vermehrte Speicherung ohne physiologische Erklärung nachgewiesen werden konnte, wurden als positiv bewertet. Um Unterschiede zwischen den Patienten außer Acht lassen zu können, wurde die target-to-background-ratio (TBR) berechnet. Zur Beschreibung der Speicherintensität einer Läsion wurde der standardized uptake value (SUV) bestimmt.
Nach Auswertung der Daten zeigte sich eine mäßige Korrelation der Anzahl von 68Ga-Pentixafor-positiven Läsionen mit der Anzahl der 18F-FDG positiven Läsionen. Die CXCR4-gerichtete Bildgebung mit 68Ga-Pentixafor identifizierte mehr Läsionen als die 18F-FDG-PET/CT. Bezüglich ihres Verteilungsmusters wiesen die beiden Tracer eine geringe Korrelation auf. Die Aufnahmeintensität beider Tracer korrelierte umgekehrt mit dem Ausmaß der Verkalkung. Stark verkalkte Plaques zeigten die niedrigste Traceraufnahme für beide PET-Tracer.
Weitere Studien zur Aufklärung der zugrunde liegenden biologischen Mechanismen und Quellen der CXCR4-Positivität sind in hohem Maße gerechtfertigt.
Das Vestibularisschwannom ist ein Tumor, dessen Entstehung noch nicht vollständig geklärt ist. Jeder kann von dieser seltenen Erkrankung betroffen sein. Darum ist es wichtig, die Ergebnisse der verschiedenen Therapieoptionen regelmäßig aufzuarbeiten und die Möglichkeiten einer Hörrehabilitation mit konventionellen oder implantierbaren Hörsystemen sowie Ansätze zur Schwindelrehabilitation oder einer möglichen Prähabilitation zu evaluieren. Mit der transtemporalen mikrochirurgischen Tumorexstirpation kann eine Heilung und bei einem großen Teil der Patienten auch ein Hörerhalt erzielt werden. Je jünger die Patienten sind, aber vor allem auch je besser sie vor der Operation hören, desto höher sind auch die Chancen auf einen Hörerhalt. Es zeigte sich jedoch auch, dass bei Patienten mit initial schlechterem Hören, welche dann operiert wurden, dieses zum Teil wieder verbessert werden konnte. Daher sind Ansätze, mehr Patienten eine transtemporale Tumorresektion anzubieten durchaus sinnvoll, auch um die Chancen auf eine Hörverbesserung zu ermöglichen. Des Weiteren sollte auch bei Patienten mit Schwindelbeschwerden eine Operation als Behandlungsoption erwogen werden. Die Prähabilitation mit Gentamicin-Injektionen in das Mittelohr scheint eine neue Möglichkeit zu sein, das zentrale Nervensystem schon auf den Ausfall des Vestibularorgans vorzubereiten. Durch die ototoxische Wirkung des Gentamicins und den potenziellen Hörverlust, wäre jedoch eine Kombination dieser Prähabilitation mit einem hörerhaltenden Eingriff über den transtemporalen Zugang risikobehaftet. Eine zentrale Kompensation der Schwindelbeschwerden sollte nach dem Eingriff mit einer gezielten Schwindelrehabilitation unterstützt werden. Während bei dieser vor allem physiotherapeutische Übungen angewandt werden, gibt es im Hinblick auf eine Hörrehabilitation schon verschiedene medizintechnische Optionen. Aktuell gibt es vor allem Studien zu den implantierbaren Hörhilfen und neue Daten zu den konservativen Möglichkeiten einer Hörrehabilitation sind eher die Ausnahme. Die Nutzung einer konservativen Hörhilfe sollte jedoch vor dem Entscheid zu einer operativen Lösung über implantierbare Systeme konsequent angewandt werden. Die in dieser Arbeit aufgezeigten positiven Momente bei der Versorgung von VS-Patienten prä- und posttherapeutisch mit herkömmlichen Hörgeräten sollten weiteren Eingang in die klinische Routine finden.
Repeatedly encountering a stimulus biases the observer’s affective response and evaluation of the stimuli. Here we provide evidence for a causal link between mere exposure to fictitious news reports and subsequent voting behavior. In four pre-registered online experiments, participants browsed through newspaper webpages and were tacitly exposed to names of fictitious politicians. Exposure predicted voting behavior in a subsequent mock election, with a consistent preference for frequent over infrequent names, except when news items were decidedly negative. Follow-up analyses indicated that mere media presence fuels implicit personality theories regarding a candidate’s vigor in political contexts. News outlets should therefore be mindful to cover political candidates as evenly as possible.
Loss of intestinal epithelial barrier function is a hallmark in digestive tract inflammation. The detailed mechanisms remain unclear due to the lack of suitable cell-based models in barrier research. Here we performed a detailed functional characterization of human intestinal organoid cultures under different conditions with the aim to suggest an optimized ex-vivo model to further analyse inflammation-induced intestinal epithelial barrier dysfunction. Differentiated Caco2 cells as a traditional model for intestinal epithelial barrier research displayed mature barrier functions which were reduced after challenge with cytomix (TNFα, IFN-γ, IL-1ß) to mimic inflammatory conditions. Human intestinal organoids grown in culture medium were highly proliferative, displayed high levels of LGR5 with overall low rates of intercellular adhesion and immature barrier function resembling conditions usually found in intestinal crypts. WNT-depletion resulted in the differentiation of intestinal organoids with reduced LGR5 levels and upregulation of markers representing the presence of all cell types present along the crypt-villus axis. This was paralleled by barrier maturation with junctional proteins regularly distributed at the cell borders. Application of cytomix in immature human intestinal organoid cultures resulted in reduced barrier function that was accompanied with cell fragmentation, cell death and overall loss of junctional proteins, demonstrating a high susceptibility of the organoid culture to inflammatory stimuli. In differentiated organoid cultures, cytomix induced a hierarchical sequence of changes beginning with loss of cell adhesion, redistribution of junctional proteins from the cell border, protein degradation which was accompanied by loss of epithelial barrier function. Cell viability was observed to decrease with time but was preserved when initial barrier changes were evident. In summary, differentiated intestinal organoid cultures represent an optimized human ex-vivo model which allows a comprehensive reflection to the situation observed in patients with intestinal inflammation. Our data suggest a hierarchical sequence of inflammation-induced intestinal barrier dysfunction starting with loss of intercellular adhesion, followed by redistribution and loss of junctional proteins resulting in reduced barrier function with consecutive epithelial death.
Pointing gestures can take on different shapes. For example, people often point with a bent wrist at a referent that is occluded by another object. We hypothesized that while the extrapolation of the index finger is the most important visual cue in such bent pointing gestures, arm orientation is affecting interpretations as well. We tested two competing hypotheses. First, the arm could be processed as a less reliable but additional direction cue also indicating the referent. Consequently, the index finger extrapolation would be biased towards the arm direction (assimilation effect). Second, the arm could be perceived as visual context of the index finger, leading to an interpretation that is repulsed from the arm direction (contrast effect). To differentiate between both, we conducted two experiments in which arm and finger orientation of a virtual pointer were independently manipulated. Participants were asked to determine the pointed-at location. As expected, participants based their interpretations on the extrapolation of the index finger. In line with the second hypothesis, the more the arm was oriented upwards, the lower the point was interpreted and vice versa. Thus, interpretation pattern indicated a contrast effect. Unexpectedly, gestures with aligned arm and index finger deviated from the general contrast effect and were interpreted linearly compared to bent gestures. In sum, the experiments show that interpretations of bent pointing gestures are not only based on the direction of the index finger but also depend on the arm orientation and its relationship to the index finger orientation.