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Usability of a mHealth solution using speech recognition for point-of-care diagnostic management
(2023)
The administrative burden for physicians in the hospital can affect the quality of patient care. The Service Center Medical Informatics (SMI) of the University Hospital Würzburg developed and implemented the smartphone-based mobile application (MA) ukw.mobile1 that uses speech recognition for the point-of-care ordering of radiological examinations. The aim of this study was to examine the usability of the MA workflow for the point-of-care ordering of radiological examinations. All physicians at the Department of Trauma and Plastic Surgery at the University Hospital Würzburg, Germany, were asked to participate in a survey including the short version of the User Experience Questionnaire (UEQ-S) and the Unified Theory of Acceptance and Use of Technology (UTAUT). For the analysis of the different domains of user experience (overall attractiveness, pragmatic quality and hedonic quality), we used a two-sided dependent sample t-test. For the determinants of the acceptance model, we employed regression analysis. Twenty-one of 30 physicians (mean age 34 ± 8 years, 62% male) completed the questionnaire. Compared to the conventional desktop application (DA) workflow, the new MA workflow showed superior overall attractiveness (mean difference 2.15 ± 1.33), pragmatic quality (mean difference 1.90 ± 1.16), and hedonic quality (mean difference 2.41 ± 1.62; all p < .001). The user acceptance measured by the UTAUT (mean 4.49 ± 0.41; min. 1, max. 5) was also high. Performance expectancy (beta = 0.57, p = .02) and effort expectancy (beta = 0.36, p = .04) were identified as predictors of acceptance, the full predictive model explained 65.4% of its variance. Point-of-care mHealth solutions using innovative technology such as speech-recognition seem to address the users’ needs and to offer higher usability in comparison to conventional technology. Implementation of user-centered mHealth innovations might therefore help to facilitate physicians’ daily work.
There has been a steady increase (annual percentage growth rate of 19.2%, average of 18.3 citations per document) in capsule endoscopy (CE) publications from a global, interdisciplinary research community on a growing range of CE applications over the last 20+ years. We here present the status of CE as a field of research, tracing its evolution over time and providing insight into its potential for diagnostics, prevention and treatment of gastrointestinal (GI) tract diseases. To portray the development of the CE research landscape in the 2000–2021 time span, we analyzed 5764 scientific publications. Analyses were performed using the R language and environment for statistical computing and graphics and VOSviewer, a software developed for scientific literature analysis by scientometricians. The aim of this paper is to provide a wide comprehensive analysis of the trends in CE publications. We thus performed subgroup analysis on the selected papers, including indications, annual percentage growth rate, average citations per document, most publications from research areas/interdisciplinary field of the articles, geography, collaboration networks through institutions, specific clinical keywords and device type. The firm increase in CE publications over the last two decades highlights the overall strength of the technology in GI applications. Furthermore, the introduction to the field of artificial intelligence (AI) tools has been promoting a range of technological advances that keep on affecting the diagnostic potential of CE.
Welcome to the inaugural meeting of the International Society for Nutritional Psychiatry Research (ISNPR).
It is a great pleasure to have the opportunity to join with colleagues working in this new and exciting field of research. Although there has long been interest in the links between nutritional deficiencies and psychiatric illness, as well as interest in the role of food allergies in such illnesses, the last five years has seen a significant and notable growth in this nascent field of research, with an accompanying impact on the viewpoints and practices of scientists and clinicians working in mental health.
In my particular field of interest – that of the role of overall dietary quality in the common mental disorders, depression and anxiety - there has been an exponential growth in the literature since the end of 2009. It is exciting and gratifying to see concordant results from across the globe, in young children and adolescents through to older adults, and from countries as diverse as Norway and Taiwan.
The study of the efficacy of nutritional interventions in psychiatric illness is also developing rapidly, with high quality randomised controlled trials now being conducted in multiple settings and with outcomes that include cognition as well as depression, bipolar disorder, schizophrenia and anxiety disorders. Another important development in this field is the rapidly growing recognition that nutrition is of central importance in the risk for cognitive decline and dementia. As this new recognition filters through to clinical researchers, I look forward to seeing new interventions in this area.
Another area of research with significant interest and activity grows from the understanding of the centrality of physical health to mental health and vice versa. There are many nutrition researchers, dietitians and other health practitioners working to address the physical health of patients with mental illness; acting on the recognition that physical and mental health are closely related and mutually reinforcing.
There is no doubt that the formation of an international society is timely; we now have the opportunity to join forces to share knowledge and build important collaborations. Building capacity in this field by sharing our knowledge with students and early career researchers will be another important activity of our society, as will building the credibility of nutritional psychiatry research through a clear understanding and implementation of best practice scientific methodology.
I welcome each of you to extend the invitation to join our new ISNPR to colleagues and students in your networks. I would also encourage you to contribute to the discussions and sharing of knowledge by contributing short pieces to our newsletter, which will be disseminated by the end of this year. For those who are unable to attend this year’s meeting, we hope that 2014 may present a possibility for attendance.
Our aim is conduct our first Annual General Meeting before the end of July 2013 via teleconference and I welcome agenda items from those interested.
With very best wishes
Felice Jacka
President ISNPR
Besides caloric restriction, a diet rich in fruits and vegetables is believed to delay the ageing process thus providing a powerfull tool in preventive medicine. To investigate underlying interactions between food ingredients and genes simple models, such as the red flour beetle Tribolium castaneum, appear especially constructive. Here we show that 1 % of a grape seed extract containing 30 % of procyanidins, significantly increases the survival of T. castaneum at 42 °C when added to flour as a dietary source. The beneficial effects of grape seed extract could not be reproduced by supplementing flour with single catechins of which the oligomeric procyanidins consist. We identified previously stress resistance genes responsible for a survival extension by dietary ingredients and show here by the use of RNA-interference that a knockdown of transcripts encoding homologues of Nrf-2 or Jnk-1 block the effects of grape seed extract on survival. Interestingly, grape seed extract under knockdown of Foxo-1 caused a significant survival reduction, stressing the hormetic response as underlying the survival extension by the dietary interventions.
In conclusion, our studies provide evidence that a procyanidin-rich extract is able to extend the survival of the model organism T. castaneum. Catechin monomers, however, appear not to mediate the effects. The active ingredients, moreover, need the presence of stress resistance factors, and here especially of Foxo-1, in order to promote their preventive activities with regard to degenerations.
Medical history of obesity
(2013)
This paper contains the following sections, in approximate chronological order: Early years, Scientific research on energy metabolism, Clinical teaching, Evidence on health risks, Slow recognition of obesity in diabetes, Depression and war, some Obesity research continued in the 1950s and 1960s, New approaches to management, a Universal standard weight for height, Luxuskonsumption, Calories (incompletely) replaced by Joules, Food intakes of obese people, Genetics, unexpected Surge of obesity from 1980, Diabetes, Scarcity of effective, safe drugs for obesity, Leptin and Ghrelin stimulate basic research, Why has the obesity epidemic happened? What is the best weight-reducing diet? Bariatric surgery
Critical illness like sepsis, shock, and intestinal bowel disease are one of the leading causes of morbidity and mortality in the US and around the world. At present, studies to define new therapeutic interventions that can protect tissues and cells against injury and attenuate inflammation are fields of intense investigation. While research over the past decade has clearly identified GLN as a vital stress substrate facilitating cellular survival following injury, the initiation steps in GLN’s cytoprotective molecular mechanism still remain elusive. Previously published work suggested that stabilization of ECM proteins and activation of ECM receptor osmosignaling may play a central role in the orchestration of many cellular pathways following stress. Thus, I hypothesized that preservation of ECM protein and EGFR levels as well as ECM receptor signaling play key roles in the molecular mechanisms underlying GLN’s protection against thermal injury in the intestine. I was able to confirm via Western blotting and by using silencing RNA against FN, Ntn-1, EGFR, and their negative controls, that GLN-mediated preservation of FN, Ntn-1, and EGFR levels is critical in GLN’s protection against hyperthermia in IEC-6 cells. By using a selective FN-Integrin interaction inhibitor GRGDSP, its negative control peptide GRGESP, and Src-kinase inhibitor PP2, I showed that FN-Integrin signaling and Src-kinase activation are essential in GLN-mediated protection in the intestine. This applied to EGFR signaling as demonstrated using the EGFR tyrosine kinase inhibitor AG1478. In addition to GRGDSP and AG1478, ERK1/2 inhibitors PD98059 and UO126 as well as the p38MAPK inhibitor SB203580 revealed that GLN is protective by activating ERK1/2 and dephosphorylating p38MAPK via FN-Integrin and EGFR signaling. However, GLN-mediated PI3-K/Akt/Hsp70 activation seems to occur independently of FN-Integrin and EGFR signaling as indicated by Western blots as well as experiments using the PI3-K inhibitor LY294002, GRGDSP, and AG1478. The results showed that GLN activates cell survival signaling pathways via integrins as well as EGFRs after hyperthermia. Moreover, I found that GLN-mediated preservation of FN expression after HS is regulated via PI3-K signaling. Whether GLN-mediated PI3-K signaling happens simultaneously to FN-Integrin and EGFR signaling or whether PI3-K signaling coordinates FN-Integrin and EGFR signaling needs to be investigated in future studies. Further, experiments with PD98059 and GRGDSP revealed that ERK1/2 assists in mediating transactivation of HSF-1 following HS. This leads to increases in Hsp70 expression via FN-Integrin signaling, which is known to attenuate apoptosis after thermal injury. Fluorescence microscopy results indicated that HS and GLN regulate cell are size changes and the morphology of F-actin via FN-Integrin signaling. Experiments using GRGDSP and GRGESP showed that GLN enhances cellular survival via FN-Integrin signaling in a manner that does not require increased intracellular GLN concentrations (as quantified using LC-MS/MS). In summary, my thesis work gives new and potentially clinically relevant mechanistic insights into GLN-mediated molecular cell survival pathways. These results warrant clinical translation to assess if clinical outcome of critically ill patients suffering from gastrointestinal diseases can be improved by GLN treatment and/or by targeting the molecular pathways found in my studies.
The nothotaxa of the genus Sedum series Rupestria Berger (Crassulaceae) are reviewed, three new hybrids (S. ×affomarcoi, S. ×henkii and S. ×pascalianum) are described and Sedum brevierei Chass. is typified. The identity of the western (French) populations of S. rupestre L. subsp. erectum ‘t Hart is also clarified, and a table with all known combinations is given.
Small-angle X-ray scattering (SAXS) is a universal low-resolution method to study proteins in solution and to analyze structural changes in response to variations of conditions (pH, temperature, ionic strength etc). SAXS is hardly limited by the particle size, being applicable to the smallest proteins and to huge macromolecular machines like ribosomes and viruses. SAXS experiments are usually fast and require a moderate amount of purified material. Traditionally, SAXS is employed to study the size and shape of globular proteins, but recent developments have made it possible to quantitatively characterize the structure and structural transitions of metastable systems, e.g. partially or completely unfolded proteins. In the absence of complementary information, low-resolution macromolecular shapes can be reconstructed ab initio and overall characteristics of the systems can be extracted. If a high or low-resolution structure or a predicted model is available, it can be validated against the experimental SAXS data. If the measured sample is polydisperse, the oligomeric state and/or oligomeric composition in solution can be determined. One of the most important approaches for macromolecular complexes is a combined ab initio/rigid body modeling, when the structures (either complete or partial) of individual subunits are available and SAXS data is employed to build the entire complex. Moreover, this method can be effectively combined with information from other structural, computational and biochemical methods. All the above approaches are covered in a comprehensive program suite ATSAS for SAXS data analysis, which has been developed at the EMBL-Hamburg. In order to meet the growing demands of the structural biology community, methods for SAXS data analysis must be further developed. This thesis describes the development of two new modules, RANLOGS and EM2DAM, which became part of ATSAS suite. The former program can be employed for constructing libraries of linkers and loops de novo and became a part of a combined ab initio/rigid body modeling program CORAL. EM2DAM can be employed to convert electron microscopy maps to bead models, which can be used for modeling or structure validation. Moreover, the programs CRYSOL and CRYSON, for computing X-ray and neutron scattering patterns from atomic models, respectively, were refurbished to work faster and new options were added to them. Two programs, to be contributed to future releases of the ATSAS package, were also developed. The first program generates a large pool of possible models using rigid body modeling program SASREF, selects and refines models with lowest discrepancy to experimental SAXS data using a docking program HADDOCK. The second program refines binary protein-protein complexes using the SAXS data and the high-resolution models of unbound subunits. Some results and conclusions from this work are presented here. The developed approaches detailed in this thesis, together with existing ATSAS modules were additionally employed in a number of collaborative projects. New insights into the “structural memory” of natively unfolded tau protein were gained and supramodular structure of RhoA-specific guanidine nucleotide exchange factor was reconstructed. Moreover, high resolution structures of several hematopoietic cytokine-receptor complexes were validated and re-modeled using the SAXS data. Important information about the oligomeric state of yeast frataxin in solution was derived from the scattering patterns recorded under different conditions and its flexibility was quantitatively characterized using the Ensemble Optimization Method (EOM).
Spontaneous neural activity has been shown to regulate crucial events in neurite growth including axonal branching and path finding. In animal models of spinal muscular atrophy (SMA) cultured embryonic mouse motoneurons show distinct defect in axon elongation and neural activity. This defect is governed by abnormal clustering of Ca2+ channels in the axonal regions and the protruding growth cone area. The mechanisms that regulate the opening of calcium channels in developing motoneurons are not yet clear. The question was addressed by blocking neural activity in embryonic cultured motoneurons by pharmacological inhibition of voltage-gated sodium channels (VGSC) by saxitoxin (STX) and tetrodotoxin (TTX). Low dosages of STX resulted in significant reduction of axon growth and neural activity in cultured motoneurons. This pharmacological treatment did not affect survival of motoneurons in comparison to control motoneurons that was grown in the presence of survival neurotrophic factors BDNF and CNTF. It was also found that STX was 10 times more potent than TTX a common inhibitor of VGSC with a reduced activity on the TTX-insensitive sodium channels NaV1.5, NaV1.8 and NaV1.9. Reverse Transcriptase-PCR experiments revealed the presence of NaV1.9 as the likely candidate that begins to express from embryonic stage sixteen in the mouse spinal cord. Immunolabelling experiments showed that the channel is expressed in the axonal compartments and axonal growth cones in cultured motoneurons. Suppression of NaV1.9 in cultured motoneurons by lentivirus mediated short hairpin-RNA (shRNA) resulted in shorter axon length in comparison with uninfected and scrambled constructs. Further, embryonic motoneurons cultured from NaV1.9 knockout mice also showed a significant reduction in neural activity and axon growth. The findings of this work highlight the role of NaV1.9 as an important contender in regulating activity dependent axon growth in embryonic cultured motoneurons. NaV1.9 could therefore be considered as a prospective molecule that could play an important role in regulating axon growth in motoneuron disease models like spinal muscular atrophy (SMA).
181 names of Hieracium species going back to original herbarium material of Alexis Jordan or Alexandre Boreau are lectotypified, 27 are neotypified. The study is based on herbarium specimens of the Université Catholique de Lyon (LY) and Ville d’Angers (ANG), Martrin-Donos’s herbarium at the Institut Botanique de Montpellier (MPUTarn) and Arvet-Touvet’s herbarium at the Musée d’Histoire Naturelle de Grenoble (GRM-AT). The type specimens are illustrated by photographs of the entire herbarium sheets with some detail views of flower heads and leaves. Usual nomenclatural synonyms are given for each taxon.