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- Center for Interdisciplinary Clinical Research, Würzburg University, Würzburg, Germany (2)
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Scientific surveys provide sufficient evidence that anxiety disorders are one of the most common psy-chiatric disorders in the world. The lifetime prevalence rate of anxiety disorder is 28.8% (Kessler, et al., 2005). The most widely studied anxiety disorders are as follows panic disorder (PD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social phobia (or social anxiety disorder), specific phobias, and generalized anxiety disorder (GAD). (NIMH Article, 2009). Classical conditioning is the stable paradigm used from the last one century to understand the neurobi-ology of fear learning. Neurobiological mechanism of fear learning is well documented with the condi-tioning studies. In the therapy of anxiety disorders, exposure based therapies are known to be the most effective approaches. Flooding is a form of exposure therapy in which a participant is exposed to the fear situation and kept in that situation until their fear dissipates. The exposure therapy is based on the phenomena of extinction; this means that a conditioned response diminishes if the conditioned stimulus (CS) is repeatedly presented without an unconditioned stimulus (UCS). One problem with extinction as well as with exposure-based therapy is the problem of fear return (for e.g. renewal, spontaneous recov-ery and reinstatement) after successful extinction. Therefore, extinction does not delete the fear memory trace. It has been well documented that memory processes can be modulated or disrupted using several sci-entific paradigms such as behavioral (for e.g. exposure therapy), pharmacological (for e.g. drug manipu-lation), non-invasive stimulation (for e.g. non-invasive stimulation such as electroconvulsive shock (ECS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), etc. However, modulation of memory processes after reactivation or via non-invasive stimulation is still not clear, which is the focus of the current study. In addition, study of genetic variant suggests that genetic differences play a vital role in the psychiatric disorder especially in fear learning. Hence, it is also one of the concerns of the current dissertation to investigate the interaction between gene and reconsolidation of memory. With respect to fear-conditioning, there are three findings in the current dissertation, which are as fol-lows: (i) In the first study we investigated that non-invasive weak electrical stimulation interferes with the consolidation process and disrupts the fear consolidation to attain stable form. This might offer an effective treatment in the pathological memories, for e.g. PTSD, PD, etc. (ii) In the second study we demonstrated whether a brief single presentation of the CS will inhibit the fear recovery. Like earlier studies we also found that reactivation followed by reconsolidation douses fear return. Attenuation of fear recovery was observed in the reminder group compared to the no-reminder group. (iii) Finally, in our third study we found a statistically significant role of brain derived neurotrophic factor (BDNF) polymorphism in reconsolidation. Results of the third study affirm the involvement of BDNF variants (Met vs. Val) in the modulation of conditioned fear memory after its reactivation. In summary, we were able to show in the current thesis modulation of associative learning and recon-solidation via transcranial direct current stimulation and genetic polymorphism.
Renewal of fear is one form of relapse that occurs after successful therapy, resulting from an encounter with a feared object in a context different from the context of the exposure therapy. According to Bouton (1994), the return of fear, provoked by context change, indicates that the fear was not erased in the first place. More importantly, the return of fear indicates that during the exposure session a new association was learned that connected the feared object with “no fear”; yet, as Bouton further argues, this association is context dependent. Such dependence could explain effects like renewal. In a new context, the therapeutic association will not be expressed and thus will no longer inhibit the fear. The assumption that an association is context dependent has been tested and showed robust results (Balooch & Neumann, 2011; Siavash Bandarian Balooch, Neumann, & Boschen, 2012; Culver, Stoyanova, & Craske, 2011; Kim & Richardson, 2009; Neumann & Kitlertsirivatana, 2010). Research for the treatment of anxiety disorders, aiming to reduce fear and, more importantly, prevent relapse, is flourishing. There are several exposure protocols currently under investigation: multiple contexts exposure (MCE), which aims at reducing the return of fear due to renewal (e.g., Balooch & Neumann, 2011); prolonged exposure (PE), which aims at strengthening the inhibitory association during the extinction learning (e.g., Thomas, Vurbic, & Novak, 2009); and reconsolidation update (RU), which aims at “updating” the reconsolidation process by briefly exposing the CS+ before the actual extinction takes place (Schiller et al., 2010). So far, however, few clinical studies conducted on humans have investigated these novel treatment protocols, and as far as I know none has investigated the mechanisms of action behind these protocols with a human clinical sample. The present thesis has three main goals. The first is to demonstrate that exposure therapy in multiple contexts reduces the likelihood of renewal. The second is to examine the mechanisms contributing to the effect of MCE and the third is to shed light on the concept of context in the framework of the conditioning and extinction paradigm. To this end, three studies were conducted. The first study investigated the effect of MCE on renewal, the second and third studies examined working mechanisms of MCE. In the first study thirty spider-phobic participants were exposed four times to a virtual spider. The exposure trials were conducted either in one single context or in four different contexts. Finally, all participants completed both a virtual renewal test, with the virtual spider presented in a novel virtual context, and an in vivo behavioral avoidance test with a real spider. This study successfully demonstrated the efficacy of MCE on reducing renewal. Study 2 investigated the working mechanisms behind MCE by utilizing a differential conditioning paradigm and conducting the extinction in multiple contexts, targeting similar renewal attenuation as achieved in study 1. This was followed by two tests that attempted to reveal extinction-relevant associations like ones causing context inhibitory effects. This study had three main hypotheses: (1) The extinction context is associated with the exposure, and thus operates as a safety signal at some point during the extinction; it will therefore compete with the safety learning of the CS, leading to a decreased extinction effect on the CS if the extinction is conducted in only one context. (2) The elements (e.g., room color, furniture) of the extinction context are connected to the therapeutic association and therefore should serve as reminders of the extinction, causing a stronger fear inhibition when presented during a test. (3) Therapy process factors, according to emotional processing theory, determine the renewal effect (e.g., initial fear activation, and within-session and between-session activation are correlated with the strength of renewal). In this study, however, no differences between the groups at the renewal phase were observed, presumably because the extinction was too strong to enable a renewal of fear at the test phase conducted immediately following the extinction. This hence rendered the two inhibitory tests useless. Study 3 aimed at defining the concept of context in the conditioning and exposure framework. Study 3 utilized the phenomenon known as generalization decrement, whereby a conditioned response is reduced due to change in the environment. This allowed context similarity to be quantified. After an acquisition phase in one context, participants were tested in one of three contexts, two of which differed in only one dimension (configuration of objects vs. features). The third group was tested in the same context and served as control group. The goal was to show that both configuration and features play an important role in the definition of context. There was, however, no significant statistical difference between the groups at the test phases, likely because of context novelty effects (participants exposed to a new context following extinction in another context expected a second extinction phase, and thus demonstrated greater fear than expected in all three groups).
Auditory Brainstem Implantation Improves Speech Recognition in Neurofibromatosis Type II Patients
(2013)
This prospective study aimed to determine speech understanding in neurofibromatosis type II (NF2) patients following implantation of a MED-EL COMBI 40+ auditory brainstem implant (ABI). Patients (n = 32) were enrolled postsurgically. Nonauditory side effects were evaluated at fitting and audiological performance was determined using the Sound Effects Recognition Test (SERT), Monosyllable-Trochee-Polysyllable (MTP) test and open-set sentence tests. Subjective benefits were determined by questionnaire. ABI activation was documented in 27 patients, 2 patients were too ill for testing and 3 patients were without any auditory perception. SERT and MTP outcomes under auditory-only conditions improved significantly between first fitting and 12-month follow-up. Open-set sentence recognition improved from 5% at first fitting to 37% after 12 months. The number of active electrodes had no significant effect on performance. All questionnaire respondents were ‘satisfied' to ‘very satisfied' with their ABI. An ABI is an effective treatment option in NF2 patients with the potential to provide open-set speech recognition and subjective benefits. To our knowledge, the data presented herein is exceptional in terms of the open-set speech perception achieved in NF2 patients.
Innate and adaptive immune responses in neurodegenerative diseases have become recently a focus of research and discussions. Parkinson’s disease (PD) is a neurodegenerative disorder without known etiopathogenesis. The past decade has generated evidence for an involvement of the immune system in PD pathogenesis. Both inflammatory and autoimmune mechanisms have been recognized and studies have emphasized the role of activated microglia and T-cell infiltration. In this short review, we focus on dendritic cells, on their role in initiation of autoimmune responses, we discuss aspects of neuroinflammation and autoimmunity in PD, and we report new evidence for the involvement of neuromelanin in these processes.
Sterile bone inflammation is the hallmark of autoinflammatory bone disorders, including chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO). Autoinflammatory osteopathies are the result of a dysregulated innate immune system, resulting in immune cell infiltration of the bone and subsequent osteoclast differentiation and activation. Interestingly, autoinflammatory bone disorders are associated with inflammation of the skin and/or the intestine. In several monogenic autoinflammatory bone disorders mutations in disease-causing genes have been reported. However, regardless of recent developments, the molecular pathogenesis of CNO/CRMO remains unclear. Here, we discuss the clinical presentation and molecular pathophysiology of human autoinflammatory osteopathies and animal models with special focus on CNO/CRMO. Treatment options in monogenic autoinflammatory bone disorders and CRMO will be illustrated.
Sterile bone inflammation is the hallmark of autoinflammatory bone disorders, including chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO). Autoinflammatory osteopathies are the result of a dysregulated innate immune system, resulting in immune cell infiltration of the bone and subsequent osteoclast differentiation and activation. Interestingly, autoinflammatory bone disorders are associated with inflammation of the skin and/or the intestine. In several monogenic autoinflammatory bone disorders mutations in disease-causing genes have been reported. However, regardless of recent developments, the molecular pathogenesis of CNO/CRMO remains unclear.
Here, we discuss the clinical presentation and molecular pathophysiology of human autoinflammatory osteopathies and animal models with special focus on CNO/CRMO. Treatment options in monogenic autoinflammatory bone disorders and CRMO will be illustrated.
The development of ICT infrastructures has facilitated the emergence of new paradigms for looking at society and the environment over the last few years. Participatory environmental sensing, i.e. directly involving citizens in environmental monitoring, is one example, which is hoped to encourage learning and enhance awareness of environmental issues. In this paper, an analysis of the behaviour of individuals involved in noise sensing is presented. Citizens have been involved in noise measuring activities through the WideNoise smartphone application. This application has been designed to record both objective (noise samples) and subjective (opinions, feelings) data. The application has been open to be used freely by anyone and has been widely employed worldwide. In addition, several test cases have been organised in European countries. Based on the information submitted by users, an analysis of emerging awareness and learning is performed. The data show that changes in the way the environment is perceived after repeated usage of the application do appear. Specifically, users learn how to recognise different noise levels they are exposed to. Additionally, the subjective data collected indicate an increased user involvement in time and a categorisation effect between pleasant and less pleasant environments.
b-adrenergic receptors (b-ARs) participate strongly in the development of cardiac hypertrophy and human heart failure. Stimulation of b-adrenergic receptors with catecholamines as well as cardiac overexpression of b1-ARs or of Gas-proteins in transgenic mice induces cardiac hypertrophy. However, direct activation of their downstream targets, such as adenylyl cyclase (AC) or protein kinase A do not promote a significant degree of cardiac hypertrophy. These findings suggest that additional events may occur and that these events require Gas-protein activation. A hypertrophic pathway involving Gaq-protein coupled receptors has recently been described. Upon activation of Gaq-coupled receptors Gbg-subunits are released from Gaq and bind directly to the activated Raf/Mek/Erk cascade. Direct interaction between bg-subunits and activated Erk1/2 leads to an additional autophosphorylation of Erk2 at threonine 188, which mediates cardiac hypertrophy. Murine hearts, as well as isolated cardiomyocytes present an increase in Erk2Thr188-phosphorylation upon b-AR activation. Similarly overexpression of phosphorylation deficient Erk2 mutants (Erk2T188S and Erk2T188A) reduces b-AR mediated cardiomyocyte hypertrophy. Increase in left ventricular wall thickness, fibrosis and up-regulation of natriuretic peptide synthesis, which are physiological features for cardiac hypertrophy, are strongly inhibited in transgenic mice with a cardiac expression of Erk2T188S after two weeks of sustained isoproterenol treatment. It could further be shown in this work that b-AR mediated cardiac hypertrophy requires two distinct pathways initiated by Gs-protein activation: the canonical phosphorylation of Erk1/2 via adenylyl cyclase and the direct interaction of released bg-subunits with activated Erk1/2. Coincidence of both events leads to Erk2Thr188-phosphorylation, which activates then different transcription factors responsible for cardiac hypertrophy. Sequestration of bg-subunits by overexpression of the C-terminus of GRK2 bark-ct and inhibition of adenylyl cyclase efficiently reduced the hypertrophic response to isoproterenol, whereas direct activation of AC by forskolin failed to induce Erk2Thr188-phosphorylation and cardiomyocyte hypertrophy. These findings may help to develop new therapeutic strategies for the prevention of cardiac hypertrophy and maladaptive remodeling of the heart.
Bacteria Regulate Intestinal Epithelial Cell Differentiation Factors Both In Vitro and In Vivo
(2013)
Background: The human colon harbours a plethora of bacteria known to broadly impact on mucosal metabolism and function and thought to be involved in inflammatory bowel disease pathogenesis and colon cancer development. In this report, we investigated the effect of colonic bacteria on epithelial cell differentiation factors in vitro and in vivo. As key transcription factors we focused on Hes1, known to direct towards an absorptive cell fate, Hath1 and KLF4, which govern goblet cell.
Methods: Expression of the transcription factors Hes1, Hath1 and KLF4, the mucins Muc1 and Muc2 and the defensin HBD2 were measured by real-time PCR in LS174T cells following incubation with several heat-inactivated E. coli strains, including the probiotic E. coli Nissle 1917+/- flagellin, Lactobacilli and Bifidobacteria. For protein detection Western blot experiments and chamber-slide immunostaining were performed. Finally, mRNA and protein expression of these factors was evaluated in the colon of germfree vs. specific pathogen free vs. conventionalized mice and colonic goblet cells were counted.
Results: Expression of Hes1 and Hath1, and to a minor degree also of KLF4, was reduced by E. coli K-12 and E. coli Nissle 1917. In contrast, Muc1 and HBD2 expression were significantly enhanced, independent of the Notch signalling pathway. Probiotic E. coli Nissle 1917 regulated Hes1, Hath1, Muc1 and HBD2 through flagellin. In vivo experiments confirmed the observed in vitro effects of bacteria by a diminished colonic expression of Hath1 and KLF4 in specific pathogen free and conventionalized mice as compared to germ free mice whereas the number of goblet cells was unchanged in these mice.
Conclusions: Intestinal bacteria influence the intestinal epithelial differentiation factors Hes1, Hath1 and KLF4, as well as Muc1 and HBD2, in vitro and in vivo. The induction of Muc1 and HBD2 seems to be triggered directly by bacteria and not by Notch.
Abstract
Streptococcus pneumoniae (pneumococcal) meningitis is a common bacterial infection of the brain. The cholesterol-dependent cytolysin pneumolysin represents a key factor, determining the neuropathogenic potential of the pneumococci. Here, we demonstrate selective synaptic loss within the superficial layers of the frontal neocortex of post-mortem brain samples from individuals with pneumococcal meningitis. A similar effect was observed in mice with pneumococcal meningitis only when the bacteria expressed the pore-forming cholesterol-dependent cytolysin pneumolysin. Exposure of acute mouse brain slices to only pore-competent pneumolysin at disease-relevant, non-lytic concentrations caused permanent dendritic swelling, dendritic spine elimination and synaptic loss. The NMDA glutamate receptor antagonists MK801 and D-AP5 reduced this pathology. Pneumolysin increased glutamate levels within the mouse brain slices. In mouse astrocytes, pneumolysin initiated the release of glutamate in a calcium-dependent manner. We propose that pneumolysin plays a significant synapto- and dendritotoxic role in pneumococcal meningitis by initiating glutamate release from astrocytes, leading to subsequent glutamate-dependent synaptic damage. We outline for the first time the occurrence of synaptic pathology in pneumococcal meningitis and demonstrate that a bacterial cytolysin can dysregulate the control of glutamate in the brain, inducing excitotoxic damage.
Author Summary
Bacterial meningitis is one of the most devastating brain diseases. Among the bacteria that cause meningitis, Streptococcus pneumoniae is the most common. Meningitis predominantly affects children, especially in the Third World, and most of them do not survive. Those that do survive often suffer permanent brain damage and hearing problems. The exact morphological substrates of brain damage in Streptococcus pneumoniae meningitis remain largely unknown. In our experiments, we found that the brain cortex of patients with meningitis demonstrated a loss of synapses (the contact points among neurons, responsible for the processes of learning and memory), and we identified the major pneumococcal neurotoxin pneumolysin as a sufficient cause of this loss. The effect was not direct but was mediated by the brain neurotransmitter glutamate, which was released upon toxin binding by one of the non-neuronal cell types of the brain – the astrocytes. Pneumolysin initiated calcium influx in astrocytes and subsequent glutamate release. Glutamate damaged the synapses via NMDA-receptors – a mechanism similar to the damage occurring in brain ischemia. Thus, we show that synaptic loss is present in pneumococcal meningitis, and we identify the toxic bacterial protein pneumolysin as the major factor in this process. These findings alter our understanding of bacterial meningitis and establish new therapeutic strategies for this fatal disease.
All animal and plant species must disperse in order to survive. Although this fact may seem trivial, and the importance of the dispersal process is generally accepted, the eco-evolutionary forces influencing dispersal, and the underlying movement elements, are far from being comprehensively understood. Beginning in the 1950s scientists became aware of the central role of dispersal behaviour and landscape connectivity for population viability and species diversity. Subsequently, dispersal has mainly been studied in the context of metapopulations. This has allowed researchers to take into account the landscape level, e.g. for determining conservation measures. However, a majority of theses studies classically did not include dispersal evolution. Yet, it is well known that dispersal is subject to evolution and that this process may occur (very) rapidly, i.e. over short ecological time-scales. Studies that do take dispersal evolution into account, mostly focus on eco-evolutionary forces arising at the level of populations - intra-specific competition or Allee effects, for example - and at the level of landscapes - e.g. connectivity, patch area and fragmentation. Yet, relevant ecological and evolutionary forces can emerge at all levels of biological complexity, from genes and individuals to populations, communities and landscapes. Here, I focus on eco-evolutionary forces arising at the gene- and especially at the individual level. Combining individual-based modelling and empirical field work, I explicitly analyse the influence of mobility trade-offs and information use for dispersal decisions - i.e. individual level factors - during the three phases of dispersal - emigration, transfer and immigration. I additionally take into account gene level factors such as ploidy, sexual reproduction (recombination) and dominance. Mobility-fertility trade-offs may shape evolutionarily stable dispersal strategies and lead to the coexistence of two or more dispersal strategies, i.e. polymorphisms and polyphenisms. This holds true for both dispersal distances (chapter 3) and emigration rates (chapter 4). In sessile organisms - such as trees or corals - maternal investment, i.e. transgenerational trade-offs between maternal fertility and propagule dispersiveness, can be the cause of bimodal and fat-tailed dispersal kernels. However, the coexistence of two or more dispersal strategies may be critically dependent on gene level factors, such as ploidy or dominance (chapter 4). Passively dispersing individuals may realize such multimodal dispersal kernels by mixing different dispersal vectors. Active choice of these vectors allows to optimize the kernel. As most animals have evolved some kind of memory and sensory apparatus - chemical, acoustic or optical sensors - it is obvious that these capacities should be used for dispersal decisions. Chapter 5 explores the use of chemical cues for vector choice in passively dispersed animals. I find that the neotropical phoretic flower mites Spadiseius calyptrogynae non-randomly mix different dispersal vectors, i.e. one short- and one long-distance disperser, in order to achieve fat-tailed dispersal kernels. Such kernels allow an optimal exploitation of patchily distributed habitats. In addition, this strategy increases the probability of successful immigration as the short-distance dispersal vectors show directed dispersal towards suitable habitats. Results from individual-based simulations support and explain my empirical findings. The use of memory and sensory apparatus in dispersal is also the main topic of chapter 6 which strives to bridge the gap between dispersal and movement ecology. In this part of my thesis I develop a model of non-random, memory-based animal movement strategies. Extending the movement ecology paradigm of Nathan (2008a) I postulate that four elements may be relevant for the emergence of efficient movement strategies: perception, memory, inference and anticipation. Movement strategies including these four elements optimize search efficiency at two scales: within patches and between patches. This leads to a significantly increased search efficiency over a comparable area restricted search strategy. These four chapters are completed by a general analysis of metapopulation dynamics (chapter 2). I find that although the metapopulation concept is very popular in theoretical ecology, classical metapopulations can be predicted to be rare in nature, as suggested by lacking empirical evidence. This is especially the case when gene level factors, such as ploidy and sex, are taken into account. In summary, my work analyses the effects of ecological and evolutionary forces arising at the gene- and individual level on the evolution of dispersal and movement strategies. I highlight the importance of including these limiting factors, mechanisms and processes and show how they impact the evolution of dispersal in spatially structured populations. All chapters demonstrate that these forces may have dramatic effects on resulting ecological and evolutionary dynamics. If we intend to understand animal and plant dispersal or movement, it is crucial to include eco-evolutionary forces emerging at all levels of complexity, from genes to communities and landscapes. This endeavour is certainly not purely academic. Particularly nowadays, with rapidly changing landscape structures and anticipated drastic shifts of climatic zones due to global change, dispersal is a factor that cannot be overestimated.
The novel refrigerant 2,3,3,3‐tetrafluoropropene (HFO‐1234yf) as well as the novel foam blowing and precision cleaning agent trans‐1‐chloro‐3,3,3‐trifluoropropene (trans‐HCFO‐1233zd) are both chlorofluorocarbon replacements with low GWPs and a short atmospheric life time. Whereas the hydrofluoroolefin HFO‐1234yf has no negative effect on stratospheric ozone due to the lack of chlorine in its structure, the hydrochlorofluoroolefine trans‐HCFO‐1233zd exhibits a very low potential for ozone depletion (ODP). This is approximately 100 times lower than the ozone depletion potential of precursor compounds such as 1,1,2‐trichloro‐1,2,2‐trifluoroethane (CFC‐113). Principle aims of this thesis were to investigate the unknown metabolism of the new solvent trans‐HCFO‐1233zd and to further investigate a possible biotransformation based toxicity of HFO‐1234yf observed in rabbits. Therefore study specimens of different in vitro and in vivo studies with trans‐HCFO‐1233zd and HFO‐1234yf were analyzed for metabolites using 19FNMR spectroscopy, LC‐MS/MS spectrometry and GC/MS spectrometry. Metabolites were identified by comparison with purchased or synthesized standard substances. Excretion kinetics of the predominant metabolites were determined by LC‐MS/MS quantification,inorganic fluoride was determined by potentiometry. Moreover cytochrome P‐450 2E1 and 3A4 liver enzyme activities were measured in a multi‐exposure study with HFO‐1234yf. ...
Background: Uro-oncological neoplasms have both a high incidence and mortality rate and are therefore a major public health problem. The aim of this study was to evaluate research activity in uro-oncology over the last decade.
Methods: We searched MEDLINE and ClinicalTrials.gov systematically for studies on prostatic, urinary bladder, kidney, and testicular neoplasms. The increase in newly published reports per year was analyzed using linear regression. The results are presented with 95% confidence intervals, and a p value <0.05 was considered statistically significant.
Results: The number of new publications per year increased significantly for prostatic, kidney and urinary bladder neoplasms (all <0.0001). We identified 1,885 randomized controlled trials (RCTs); also for RCTs, the number of newly published reports increased significantly for prostatic (p = 0.001) and kidney cancer (p = 0.005), but not for bladder (p = 0.09) or testicular (p = 0.44) neoplasms. We identified 3,114 registered uro-oncological studies in ClinicalTrials.gov. However, 85% of these studies are focusing on prostatic (45%) and kidney neoplasms (40%), whereas only 11% were registered for bladder cancers.
Conclusions: While the number of publications on uro-oncologic research rises yearly for prostatic and kidney neoplasms, urothelial carcinomas of the bladder seem to be neglected despite their important clinical role. Clinical research on neoplasms of the urothelial bladder must be explicitly addressed and supported.
Background
Suboccipital craniectomy is a conventional approach for exploring cerebellopontine angle lesions. A variety of techniques have been successfully employed to reconstruct a craniectomy. This is the first report about the histological findings after performing a cranioplasty by using a mixture of autologous bone chips and human allogenic fibrin glue.
Case presentation
A 53-year-old German woman underwent left lateral suboccipital retrosigmoidal craniectomy for treatment of trigeminal neuralgia in 2008. Cranioplasty was perfomed by using a mixture of autologous bone chips and human allogenic fibrin glue. Due to recurrent neuralgia, a second left lateral suboccipital craniectomy was performed in 2012. The intraoperative findings revealed a complete ossification of the former craniotomy including widely mature trabecular bone tissue in the histological examination.
Conclusion
A mixture of autologous bone chips and human allogenic fibrin glue seems to provide sufficient bone-regeneration revealed by histological and neuroradiological examinations.
Functional magnetic resonance imaging (fMRI) has become a powerful and influential method to non-invasively study neuronal brain activity. For this purpose, the blood oxygenation level-dependent (BOLD) effect is most widely used. T2* weighted echo planar imaging (EPI) is BOLD sensitive and the prevailing fMRI acquisition technique. Here, we present an alternative to its standard Cartesian recordings, i.e. k-space density weighted EPI, which is expected to increase the signal-to-noise ratio in fMRI data. Based on in vitro and in vivo pilot measurements, we show that fMRI by k-space density weighted EPI is feasible and that this new acquisition technique in fact boosted spatial and temporal SNR as well as the detection of local fMRI activations. Spatial resolution, spatial response function and echo time were identical for density weighted and conventional Cartesian EPI. The signal-to-noise ratio gain of density weighting can improve activation detection and has the potential to further increase the sensitivity of fMRI investigations.
Objective: Brain Computer Interfaces (BCI) provide a muscle independent interaction channel making them particularly valuable for individuals with severe motor impairment. Thus, different BCI systems and applications have been proposed as assistive technology (AT) solutions for such patients. The most prominent system for communication utilizes event-related potentials (ERP) obtained from the electroencephalogram (EEG) to allow for communication on a character-by-character basis. Yet in their current state of technology, daily life use cases of such systems are rare. In addition to the high EEG preparation effort, one of the main reasons is the low information throughput compared to other existing AT solutions. Furthermore, when testing BCI systems in patients, a performance drop is usually observed compared to healthy users. Patients often display a low signal-to-noise ratio of the recorded EEG and detection of brain responses may be aggravated due to internally (e.g. spasm) or externally induced artifacts (e.g. from ventilation devices). Consequently, practical BCI systems need to cope with mani-fold inter-individual differences. Whilst these high demands lead to increasing complexity of the technology, daily life use of BCI systems requires straightforward setup including an easy-to-use graphical user interface that nonprofessionals can handle without expert support. Research questions of this thesis: This dissertation project aimed at bringing forward BCI technology toward a possible integration into end-users' daily life. Four basic research questions were addressed: (1) Can we identify performance predictors so that we can provide users with individual BCI solutions without the need of multiple, demanding testing sessions? (2) Can we provide complex BCI technology in an automated, user-friendly and easy-to-use manner, so that BCIs can be used without expert support at end-users' homes? (3) How can we account for and improve the low information transfer rates as compared to other existing assistive technology solutions? (4) How can we prevent the performance drop often seen when bringing BCI technology that was tested in healthy users to those with severe motor impairment? Results and discussion: (1) Heart rate variability (HRV) as an index of inhibitory control (i.e. the ability to allocate attention resources and inhibit distracting stimuli) was significantly related to ERP-BCI performance and accounted for almost 26% of variance. HRV is easy to assess from short heartbeat recordings and may thus serve as a performance predictor for ERP-BCIs. Due to missing software solutions for appropriate processing of artifacts in heartbeat data (electrocardiogram and inter-beat interval data), our own tool was developed that is available free of charge. To date, more than 100 researchers worldwide have requested the tool. Recently, a new version was developed and released together with a website (www.artiifact.de). (2) Furthermore, a study of this thesis demonstrated that BCI technology can be incorporated into easy-to-use software, including auto-calibration and predictive text entry. Naïve, healthy nonprofessionals were able to control the software without expert support and successfully spelled words using the auto-calibrated BCI. They reported that software handling was straightforward and that they would be able to explain the system to others. However, future research is required to study transfer of the results to patient samples. (3) The commonly used ERP-BCI paradigm was significantly improved. Instead of simply highlighting visually displayed characters as is usually done, pictures of famous faces were used as stimulus material. As a result, specific brain potentials involved in face recognition and face processing were elicited. The event-related EEG thus displayed an increased signal-to-noise ratio, which facilitated the detection of ERPs extremely well. Consequently, BCI performance was significantly increased. (4) The good results of this new face-flashing paradigm achieved with healthy participants transferred well to users with neurodegenerative disease. Using a face paradigm boosted information throughput. Importantly, two users who were highly inefficient with the commonly used paradigm displayed high accuracy when exposed to the face paradigm. The increased signal-to-noise ratio of the recorded EEG thus helped them to overcome their BCI inefficiency. Significance: The presented work at hand (1) successfully identified a physiological predictor of ERP-BCI performance, (2) proved the technology ready to be operated by naïve nonprofessionals without expert support, (3) significantly improved the commonly used spelling paradigm and (4) thereby displayed a way to effectively prevent BCI inefficiency in patients with neurodegenerative disease. Additionally, missing software solutions for appropriate handling of artifacts in heartbeat data encouraged development of our own software tool that is available to the research community free of charge. In sum, this thesis significantly improved current BCI technology and enhanced our understanding of physiological correlates of BCI performance.
Bone Morphogenetic Proteins (BMPs) are important growth factors that regulate many cellular processes. During embryogenesis they act as morphogens and play a critical role during organ development. They influence cell fates via concentration-gradients in the embryos where cells transduce this extracellular information into gene expression profiles and cell fate decisions. How receiving cells decode and quantify BMP2/4 signals is hardly understood. There is little data on the quantitative relationships between signal input, transducing molecules, their states and location, and ultimately their ability to integrate graded systemic inputs and generate qualitative responses. Understanding this signaling network on a quantitative level should be considered a prerequisite for efficient pathway modulation, as the BMP pathway is a prime target for therapeutic invention. Hence, we quantified the spatial distribution of the main signal transducer of the BMP2/4 pathway in response to different types and levels of stimuli in c2c12 cells. We found that the subcellular localization of Smad1 is independent of ligand concentration. In contrast, Smad1 phosphorylation levels relate proportionally to BMP2 ligand concentrations and they are entirely located in the nucleus. Interestingly, we found that BMP2 stimulates target gene expression in non-linear, wave-like forms. Amplitudes showed a clear concentration-dependency, for sustained and transient stimulation. We found that even burst-stimulation triggers gene-expression wave-like modulations that are detectable for at least 30 h. Finally, we show here that target gene expression oscillations depend on receptor kinase activity, as the kinase drives further expression pulses without receptor reactivation and the target gene expression breaks off after inhibitor treatment in c2c12 cells.
Resection of musculoskeletal sarcoma can result in large bone defects where regeneration is needed in a quantity far beyond the normal potential of self-healing. In many cases, these defects exhibit a limited intrinsic regenerative potential due to an adjuvant therapeutic regimen, seroma, or infection. Therefore, reconstruction of these defects is still one of the most demanding procedures in orthopaedic surgery. The constraints of common treatment strategies have triggered a need for new therapeutic concepts to design and engineer unparalleled structural and functioning bone grafts. To satisfy the need for long-term repair and good clinical outcome, a paradigm shift is needed from methods to replace tissues with inert medical devices to more biological approaches that focus on the repair and reconstruction of tissue structure and function. It is within this context that the field of bone tissue engineering can offer solutions to be implemented into surgical therapy concepts after resection of bone and soft tissue sarcoma. In this paper we will discuss the implementation of tissue engineering concepts into the clinical field of orthopaedic oncology.
Purpose: To determine the effects of progressive resistance training on mobility, muscle strength, and quality of life in nursing-home residents with impaired mobility.
Methods: Nursing-home residents aged 77 years and older with impaired mobility were recruited in Berlin, Germany. The eight-week exercise program consisted of progressive resistance training twice a week. Mobility (primary outcome) was assessed with the Elderly Mobility Scale (zero = worst, 20 = best) at baseline and after 8 weeks. Muscle strength (secondary outcome) was determined by the eight-repetition maximum. The Short Form-36 Health Survey was used to assess quality of life.
Results: Of the 15 participants (mean age 84 years, range 77-97 years), ten completed the 8-week program. Mobility (Elderly Mobility Scale mean +/- standard deviation pre 14.1 +/- 3.2 and post 17.5 +/- 3.6; P = 0.005) as well as muscle strength of upper and lower limbs improved (from 62% at chest press up to 108% at leg extension machine), whereas most quality of life subscales did not show considerable change.
Conclusion: Resistance training twice a week over 2 months seemed to considerably improve mobility and muscle strength in persons aged 77-97 years with impaired mobility.
Background-—Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning.
Methods and Results-—Prospective follow-up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women’s Health Initiative Memory Study (WHIMS). CVD was determined by self-report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini-mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow-up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity.
Conclusions-—CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.
Background Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning.
Methods and Results: Prospective follow‐up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women's Health Initiative Memory Study (WHIMS). CVD was determined by self‐report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini‐mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow‐up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity.
Conclusions: CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.
Targeted cancer therapy concepts often aim at the induction of adjuvant antitumor immunity or stimulation of tumor cell apoptosis. There is further evidence that combined application of immune stimulating and tumor apoptosis-inducing compounds elicits a synergistic antitumor effect. Here, we describe the development and characterization of bifunctional fusion proteins consisting of a single-chain variable fragment (scFv) domain derived from the CD40-specific monoclonal antibody G28-5 that is fused to the N-terminus of stabilized trimeric soluble variants of the death ligand TNF-related apoptosis-inducing ligand (TRAIL). As shown before by us and others for other cell surface antigen-targeted scFv-TRAIL fusion proteins, scFv:G28-TRAIL displayed an enhanced capacity to induce apoptosis upon CD40 binding. Studies with scFv:G28 fusion proteins of TRAIL mutants that discriminate between the two TRAIL death receptors, TRAILR1 and TRAILR2, further revealed that the CD40 binding-dependent mode of apoptosis induction of scFv:G28-TRAIL is operable with each of the two TRAIL death receptors. Binding of scFv:G28-TRAIL fusion proteins to CD40 not only result in enhanced TRAIL death receptor signaling but also in activation of the targeted CD40 molecule. In accordance with the latter, the scFv:G28-TRAIL fusion proteins triggered strong CD40-mediated maturation of dendritic cells. The CD40-targeted TRAIL fusion proteins described in this study therefore represent a novel type of bifunctional fusion proteins that couple stimulation of antigen presenting cells and apoptosis induction.
Cell-autonomous axon growth of young motoneurons is triggered by a voltage-gated sodium channel
(2013)
Spontaneous electrical activity preceding synapse formation contributes to the precise regulation of neuronal development. Examining the origins of spontaneous activity revealed roles for neurotransmitters that depolarize neurons and activate ion channels. Recently, we identified a new molecular mechanism underlying fluctuations in spontaneous neuronal excitability. We found that embryonic motoneurons with a genetic loss of the low-threshold sodium channel Na\(_V\)1.9 show fewer fluctuations in intracellular calcium in axonal compartments and growth cones than wild-type littermates. As a consequence, axon growth of Na\(_V\)1.9-deficient motoneurons in cell culture is drastically reduced while dendritic growth and cell survival are not affected. Interestingly, Na\(_V\)1.9 function is observed under conditions that would hardly allow a ligand- or neurotransmitter-dependent depolarization. Thus, Na\(_V\)1.9 may serve as a cell-autonomous trigger for neuronal excitation. In this addendum, we discuss a model for the interplay between cell-autonomous local neuronal activity and local cytoskeleton dynamics in growth cone function.
Background
Fibrosis poses a substantial setback in regenerative medicine. Histopathologically, fibrosis is an excessive accumulation of collagen affected by myofibroblasts and this can occur in any tissue that is exposed to chronic injury or insult. Transforming growth factor (TGF)-β1, a crucial mediator of fibrosis, drives differentiation of fibroblasts into myofibroblasts. These cells exhibit α-smooth muscle actin (α-SMA) and synthesize high amounts of collagen I, the major extracellular matrix (ECM) component of fibrosis. While hormones stimulate cells in a pulsatile manner, little is known about cellular response kinetics upon growth factor impact. We therefore studied the effects of short TGF-β1 pulses in terms of the induction and maintenance of the myofibroblast phenotype.
Results
Twenty-four hours after a single 30 min TGF-β1 pulse, transcription of fibrogenic genes was upregulated, but subsided 7 days later. In parallel, collagen I secretion rate and α-SMA presence were elevated for 7 days. A second pulse 24 h later extended the duration of effects to 14 days. We could not establish epigenetic changes on fibrogenic target genes to explain the long-lasting effects. However, ECM deposited under singly pulsed TGF-β1 was able to induce myofibroblast features in previously untreated fibroblasts. Dependent on the age of the ECM (1 day versus 7 days’ formation time), this property was diminished. Vice versa, myofibroblasts were cultured on fibroblast ECM and cells observed to express reduced (in comparison with myofibroblasts) levels of collagen I.
Conclusions
We demonstrated that short TGF-β1 pulses can exert long-lasting effects on fibroblasts by changing their microenvironment, thus leaving an imprint and creating a reciprocal feed-back loop. Therefore, the ECM might act as mid-term memory for pathobiochemical events. We would expect this microenvironmental memory to be dependent on matrix turnover and, as such, to be erasable. Our findings contribute to the current understanding of fibroblast induction and maintenance, and have bearing on the development of antifibrotic drugs.
The eminent importance of snow cover for climatic, hydrologic, anthropogenic, and economic reasons has been widely discussed in scientific literature. Up to 50% of the Northern Hemisphere is covered by snow at least temporarily, turning snow to the most prevalent land cover types at all. Depending on regular precipitation and temperatures below freezing point it is obvious that a changing climate effects snow cover characteristics fundamentally. Such changes can have severe impacts on local, national, and even global scale. The region of Central Asia is not an exception from this general rule, but are the consequences accompanying past, present, and possible future changes in snow cover parameters of particular importance. Being characterized by continental climate with hot and dry summers most precipitation accumulates during winter and spring months in the form of snow. The population in this 4,000,000 km² vast area is strongly depending on irrigation to facilitate agriculture. Additionally, electricity is often generated by hydroelectric power stations. A large proportion of the employed water originates from snow melt during spring months, implying that changes in snow cover characteristics will automatically affect both the total amount of obtainable water and the time when this water becomes available. The presented thesis explores the question how the spatial extent of snow covered surface has evolved since the year 1986. This investigation is based on the processing of medium resolution remote sensing data originating from daily MODIS and AVHRR sensors, thus forming a unique approach of snow cover analysis in terms of temporal and spatial resolution. Not only duration but also onset and melt of snow coverage are tracked over time, analyzing for systematic changes within this 26 years lasting time span. AVHRR data are processed from raw Level 1B orbit data to Level 3 thematic snow cover products. Both, AVHRR and MODIS snow maps undergo a further post-processing, producing daily full-area mosaics while completely eliminating inherent cloud cover. Snow cover parameters are derived based on these daily and cloud-free time series, allowing for a detailed analysis of current status and changes. The results confirm the predictions made by coarse resolution predictions from climate models: Central Asian snow cover is changing, posing new challenges for the ecosystem and future water supply. The changes, however, are not aimed at only one direction. Regions with decreasing snow cover exist as well as those where the duration of snow cover increases. A shift towards earlier snow cover start and melt can be observed, posing a serious challenge to water management authorities due to a changed runoff regime.
Human cysticercosis caused by Taenia crassiceps tapeworm larvae involves the muscles and subcutis mostly in immunocompromised patients and the eye in immunocompetent persons. We report a successfully treated cerebellar infection in an immunocompetent woman. We developed serologic tests, and the parasite was identified by histologic examination and 12s rDNA PCR and sequencing.
FADD, caspase-8, and cFLIP regulate the outcome of cell death signaling. Mice that constitutively lack these molecules die at an early embryonic age, whereas tissue-specific constitutive deletion of FADD or caspase-8 results in inflammatory skin disease caused by increased necroptosis. The function of cFLIP in the skin in vivo is unknown. In contrast to tissue-specific caspase-8 knockout, we show that mice constitutively lacking cFLIP in the epidermis die around embryonic days 10 and 11. When cFLIP expression was abrogated in adult skin of cFLIP(fl/fl)-K14CreER(tam) mice, severe inflammation of the skin with concomitant caspase activation and apoptotic, but not necroptotic, cell death developed. Apoptosis was dependent of autocrine tumor necrosis factor production triggered by loss of cFLIP. In addition, epidermal cFLIP protein was lost in patients with severe drug reactions associated with epidermal apoptosis. Our data demonstrate the importance of cFLIP for the integrity of the epidermis and for silencing of spontaneous skin inflammation.
Background: The transmission of the malaria parasite Plasmodium falciparum from the human to the mosquito is mediated by dormant sexual precursor cells, the gametocytes, which become activated in the mosquito midgut. Because gametocytes are the only parasite stages able to establish an infection in the mosquito, they play a crucial role in spreading the tropical disease. The human-to-mosquito transmission triggers important molecular changes in the gametocytes, which initiate gametogenesis and prepare the parasite for life-cycle progression in the insect vector.
Results: To better understand gene regulations during the initial phase of malaria parasite transmission, we focused on the transcriptome changes that occur within the first half hour of parasite development in the mosquito. Comparison of mRNA levels of P. falciparum gametocytes before and 30 min following activation using suppression subtractive hybridization (SSH) identified 126 genes, which changed in expression during gametogenesis. Among these, 17.5% had putative functions in signaling, 14.3% were assigned to cell cycle and gene expression, 8.7% were linked to the cytoskeleton or inner membrane complex, 7.9% were involved in proteostasis and 6.4% in metabolism, 12.7% were cell surface-associated proteins, 11.9% were assigned to other functions, and 20.6% represented genes of unknown function. For 40% of the identified genes there has as yet not been any protein evidence. For a subset of 27 genes, transcript changes during gametogenesis were studied in detail by real-time RT-PCR. Of these, 22 genes were expressed in gametocytes, and for 15 genes transcript expression in gametocytes was increased compared to asexual blood stage parasites. Transcript levels of seven genes were particularly high in activated gametocytes, pointing at functions downstream of gametocyte transmission to the mosquito. For selected genes, a regulated expression during gametogenesis was confirmed on the protein level, using quantitative confocal microscopy.
Conclusions: The obtained transcriptome data demonstrate the regulations of gene expression immediately following malaria parasite transmission to the mosquito. Our findings support the identification of proteins important for sexual reproduction and further development of the mosquito midgut stages and provide insights into the genetic basis of the rapid adaption of Plasmodium to the insect vector.
In this thesis we study various aspects of chaos synchronization of time-delayed coupled chaotic maps. A network of identical nonlinear units interacting by time-delayed couplings can synchronize to a common chaotic trajectory. Even for large delay times the system can completely synchronize without any time shift. In the first part we study chaotic systems with multiple time delays that range over several orders of magnitude. We show that these time scales emerge in the Lyapunov spectrum: Different parts of the spectrum scale with the different delays. We define various types of chaos depending on the scaling of the maximum exponent. The type of chaos determines the synchronization ability of coupled networks. This is, in particular, relevant for the synchronization properties of networks of networks where time delays within a subnetwork are shorter than the corresponding time delays between the different subnetworks. If the maximum Lyapunov exponent scales with the short intra-network delay, only the elements within a subnetwork can synchronize. If, however, the maximum Lyapunov exponent scales with the long inter-network connection, complete synchronization of all elements is possible. The results are illustrated analytically for Bernoulli maps and numerically for tent maps. In the second part the attractor dimension at the transition to complete chaos synchronization is investigated. In particular, we determine the Kaplan-Yorke dimension from the spectrum of Lyapunov exponents for iterated maps. We argue that the Kaplan-Yorke dimension must be discontinuous at the transition and compare it to the correlation dimension. For a system of Bernoulli maps we indeed find a jump in the correlation dimension. The magnitude of the discontinuity in the Kaplan-Yorke dimension is calculated for networks of Bernoulli units as a function of the network size. Furthermore the scaling of the Kaplan-Yorke dimension as well as of the Kolmogorov entropy with system size and time delay is investigated. Finally, we study the change in the attractor dimension for systems with parameter mismatch. In the third and last part the linear response of synchronized chaotic systems to small external perturbations is studied. The distribution of the distances from the synchronization manifold, i.e., the deviations between two synchronized chaotic units due to external perturbations on the transmitted signal, is used as a measure of the linear response. It is calculated numerically and, for some special cases, analytically. Depending on the model parameters this distribution has power law tails in the region of synchronization leading to diverging moments. The linear response is also quantified by means of the bit error rate of a transmitted binary message which perturbs the synchronized system. The bit error rate is given by an integral over the distribution of distances and is studied numerically for Bernoulli, tent and logistic maps. It displays a complex nonmonotonic behavior in the region of synchronization. For special cases the distribution of distances has a fractal structure leading to a devil's staircase for the bit error rate as a function of coupling strength. The response to small harmonic perturbations shows resonances related to coupling and feedback delay times. A bi-directionally coupled chain of three units can completely filter out the perturbation. Thus the second moment and the bit error rate become zero.
The study of magnetic phases in spintronic materials is crucial to both our fundamental understanding of magnetic interactions and for finding new effects for future applications.
In this thesis, we study the basic electrical and magnetic transport properties of both epitaxially-grown MnSi thin films, a helimagnetic metal only starting to be developed within our group, and parabolic-doped ultra-thin (Ga,Mn)As layers for future studies and applications.
Genes involved in sex determination and differentiation have been identified in mice, humans, chickens, reptiles, amphibians and teleost fishes. However, little is known of their functional conservation, and it is unclear whether there is a common set of genes shared by all vertebrates. Coelacanths, basal Sarcopterygians and unique "living fossils", could help establish an inventory of the ancestral genes involved in these important developmental processes and provide insights into their components. In this study 33 genes from the genome of Latimeria chalumnae and from the liver and testis transcriptomes of Latimeria menadoensis, implicated in sex determination and differentiation, were identified and characterized and their expression levels measured. Interesting findings were obtained for GSDF, previously identified only in teleosts and now characterized for the first time in the sarcopterygian lineage; FGF9, which is not found in teleosts; and DMRT1, whose expression in adult gonads has recently been related to maintenance of sexual identity. The gene repertoire and testis-specific gene expression documented in coelacanths demonstrate a greater similarity to modern fishes and point to unexpected changes in the gene regulatory network governing sexual development.
Optical in vivo imaging methods have advanced the fields of stem cell transplantation, graft-versus–host disease and graft-versus-tumor responses. Two well known optical methods, based on the transmission of light through the test animal are bioluminescence imaging (BLI) and fluorescence imaging (FLI). Both methods allow whole body in vivo imaging of the same animal over an extended time span where the cell distribution and proliferation can be visualized. BLI has the advantages of producing almost no unspecific background signals and no necessity for external excitation light. Hence, BLI is a highly sensitive and reliable detection method. Yet, the BLI reporter luciferase is not applicable with common microscopy techniques, therefore abolishing this method for cellular resolution imaging. FLI in turn, presents the appealing possibility to use one fluorescent reporter for whole body imaging as well as cellular resolution applying microscopy techniques. The absorption of light occurs mainly due to melanin and hemoglobin in wavelengths up to 650 nm. Therefore, the wavelength range beyond 650 nm may allow sensitive optical imaging even in deep tissues. For this reason, significant efforts are undertaken to isolate or develop genetically enhanced fluorescent proteins (FP) in this spectral range. “Katushka” also called FP635 has an emission close to this favorable spectrum and is reported as one of the brightest far-red FPs. Our experiments also clearly showed the superiority of BLI for whole body imaging over FLI. Based on these results we applied the superior BLI technique for the establishment of a pre-clinical multiple myeloma (MM) mouse model. MM is a B-cell disease, where malignant plasma cells clonally expand in the bone marrow (BM) of older people, causing significant morbidity and mortality. Chromosomal abnormalities, considered a hallmark of MM, are present in nearly all patients and may accumulate or change during disease progression. The diagnosis of MM is based on clinical symptoms, including the CRAB criteria: increased serum calcium levels, renal insufficiency, anemia, and bone lesions (osteolytic lesions or osteoporosis with compression fractures). Other clinical symptoms include hyperviscosity, amyloidosis, and recurrent bacterial infections. Additionally, patients commonly exhibit more than 30% clonal BM plasma cells and the presence of monoclonal protein is detected in serum and/or urine. With current standard therapies, MM remains incurable and patients diagnosed with MM between 2001 and 2007 had a 5-year relative survival rate of only 41%. Therefore, the development of new drugs or immune cell-based therapies is desirable and necessary. To this end we developed the MOPC-315 cell line based syngeneic MM mouse model. MOPC-315 cells were labeled with luciferase for in vivo detection by BLI. We validated the non-invasively obtained BLI data with histopathology, measurement of idiotype IgA serum levels and flow cytometry. All methods affirmed the reliability of the in vivo BLI data for this model. We found that this orthotopic MM model reflects several key features of the human disease. MOPC-315 cells homed efficiently to the BM compartment including subsequent proliferation. Additionally, cells disseminated to distant skeletal parts, leading to the typical multifocal MM growth. Osteolytic lesions and bone remodeling was also detected. We found evidence that the cell line had retained plasticity seen by dynamic receptor expression regulation in different compartments such as the BM and the spleen.
p53 protects us from cancer by transcriptionally regulating tumor suppressive programs designed to either prevent the development or clonal expansion of malignant cells. How p53 selects target genes in the genome in a context-and tissue-specific manner remains largely obscure. There is growing evidence that the ability of p53 to bind DNA in a cooperative manner prominently influences target gene selection with activation of the apoptosis program being completely dependent on DNA binding cooperativity. Here, we used ChIP-seq to comprehensively profile the cistrome of p53 mutants with reduced or increased cooperativity. The analysis highlighted a particular relevance of cooperativity for extending the p53 cistrome to non-canonical binding sequences characterized by deletions, spacer insertions and base mismatches. Furthermore, it revealed a striking functional separation of the cistrome on the basis of cooperativity; with low cooperativity genes being significantly enriched for cell cycle and high cooperativity genes for apoptotic functions. Importantly, expression of high but not low cooperativity genes was correlated with superior survival in breast cancer patients. Interestingly, in contrast to most p53-activated genes, p53-repressed genes did not commonly contain p53 binding elements. Nevertheless, both the degree of gene activation and repression were cooperativity-dependent, suggesting that p53-mediated gene repression is largely indirect and mediated by cooperativity-dependently transactivated gene products such as CDKN1A, E2F7 and non-coding RNAs. Since both activation of apoptosis genes with non-canonical response elements and repression of pro-survival genes are crucial for p53's apoptotic activity, the cistrome analysis comprehensively explains why p53-induced apoptosis, but not cell cycle arrest, strongly depends on the intermolecular cooperation of p53 molecules as a possible safeguard mechanism protecting from accidental cell killing.
The top quark plays an important role in current particle physics, from a theoretical point of view because of its uniquely large mass, but also experimentally because of the large number of top events recorded by the LHC experiments ATLAS and CMS, which makes it possible to directly measure the properties of this particle, for example its couplings to the other particles of the standard model (SM), with previously unknown precision. In this thesis, an effective field theory approach is employed to introduce a minimal and consistent parametrization of all anomalous top couplings to the SM gauge bosons and fermions which are compatible with the SM symmetries. In addition, several aspects and consequences of the underlying effective operator relations for these couplings are discussed. The resulting set of couplings has been implemented in the parton level Monte Carlo event generator WHIZARD in order to provide a tool for the quantitative assessment of the phenomenological implications at present and future colliders such as the LHC or a planned international linear collider. The phenomenological part of this thesis is focused on the charged current couplings of the top quark, namely anomalous contributions to the trilinear tbW coupling as well as quartic four-fermion contact interactions of the form tbff, both affecting single top production as well as top decays at the LHC. The study includes various aspects of inclusive cross section measurements as well as differential distributions of single tops produced in the t channel, bq → tq', and in the s channel, ud → tb. We discuss the parton level modelling of these processes as well as detector effects, and finally present the prospected LHC reach for setting limits on these couplings with 10 resp. 100 fb−1 of data recorded at √s = 14 TeV.
Whereas interspecific associations receive considerable attention in evolutionary, behavioural and ecological literature, the proximate bases for these associations are usually unknown. This in particular applies to associations between vertebrates with invertebrates. The West-African savanna frog Phrynomantis microps lives in the underground nest of ponerine ants (Paltothyreus tarsatus). The ants usually react highly aggressively when disturbed by fiercely stinging, but the frog is not attacked and lives unharmed among the ants. Herein we examined the proximate mechanisms for this unusual association. Experiments with termites and mealworms covered with the skin secretion of the frog revealed that specific chemical compounds seem to prevent the ants from stinging. By HPLC-fractionation of an aqueous solution of the frogs' skin secretion, two peptides of 1,029 and 1,143 Da were isolated and found to inhibit the aggressive behaviour of the ants. By de novo sequencing using tandem mass spectrometry, the amino acid sequence of both peptides consisting of a chain of 9 and 11 residues, respectively, was elucidated. Both peptides were synthesized and tested, and exhibited the same inhibitory properties as the original frog secretions. These novel peptides most likely act as an appeasement allomone and may serve as models for taming insect aggression.
Human herpesvirus-6 (HHV-6) exists in latent form either as a nuclear episome or integrated into human chromosomes in more than 90% of healthy individuals without causing clinical symptoms. Immunosuppression and stress conditions can reactivate HHV-6 replication, associated with clinical complications and even death. We have previously shown that co-infection of Chlamydia trachomatis and HHV-6 promotes chlamydial persistence and increases viral uptake in an in vitro cell culture model. Here we investigated C. trachomatis-induced HHV-6 activation in cell lines and fresh blood samples from patients having Chromosomally integrated HHV-6 (CiHHV-6). We observed activation of latent HHV-6 DNA replication in CiHHV-6 cell lines and fresh blood cells without formation of viral particles. Interestingly, we detected HHV-6 DNA in blood as well as cervical swabs from C. trachomatis-infected women. Low virus titers correlated with high C. trachomatis load and vice versa, demonstrating a potentially significant interaction of these pathogens in blood cells and in the cervix of infected patients. Our data suggest a thus far underestimated interference of HHV-6 and C. trachomatis with a likely impact on the disease outcome as consequence of co-infection.
The cancerous inhibitor of protein phosphatase 2A (CIP2A) is an oncogenic factor that stabilises the c-Myc protein. CIP2A is overexpressed in several tumours, and expression levels are an independent marker for long-term outcome. To determine whether CIP2A expression is elevated in colon cancer and whether it might serve as a prognostic marker for survival, we analysed CIP2A mRNA expression by real-time PCR in 104 colon cancer samples. CIP2A mRNA was overexpressed in colon cancer samples and CIP2A expression levels correlated significantly with tumour stage. We found that CIP2A serves as an independent prognostic marker for disease-free and overall survival. Further, we investigated CIP2A-dependent effects on levels of c-Myc, Akt and on cell proliferation in three colon cancer cell lines by silencing CIP2A using small interfering (si) and short hairpin (sh) RNAs. Depletion of CIP2A substantially inhibited growth of colon cell lines and reduced c-Myc levels without affecting expression or function of the upstream regulatory kinase, Akt. Expression of CIP2A was found to be dependent on MAPK activity, linking elevated c-Myc expression to deregulated signal transduction in colon cancer.
Climate change has created potential major threats to global biodiversity. The multiple components of climate change are projected to affect all pillars of biodiversity, from genes over species to biome level. Of particular concerns are "tipping points" where the exceedance of ecosystem thresholds will possibly lead to irreversible shifts of ecosystems and their functioning. As biodiversity underlies all goods and services provided by ecosystems that are crucial for human survival and wellbeing, this paper presents potential effects of climate change on biodiversity, its plausible impacts on human society as well as the setting in addressing a global crisis. Species affected by climate change may respond in three ways: change, move or die. Local species extinctions or a rapidly affected ecosystem as a whole respectively might move toward its particular "tipping point", thereby probably depriving its services to human society and ending up in a global crisis. Urgent and appropriate actions within various scenarios of climate change impacts on biodiversity, especially in tropical regions, are needed to be considered. Foremost a multisectoral approach on biodiversity issues with broader policies, stringent strategies and programs at international, national and local levels is essential to meet the challenges of climate change impacts on biodiversity.
The perception of pain can be modulated by a variety of factors such as biological/pharmacological treatments as well as potent cognitive and emotional manipulations. Placebo and nocebo effects are among the most prominent examples for such manipulations. Placebo and nocebo manipulations cause reliable psychological and physiological changes, although the administered agent or treatment is inert. The present dissertation aimed at investigating the role of cognitive and emotional influences in the generation of placebo and nocebo effects on pain perception. In addition, the feasibility of solely psychological placebo manipulations to alter the perception of pain was tested.
Two commonly discussed preconditions for the generation of placebo and nocebo effects are prior experiences (i.e., past encounter of drug effects) and expectations (i.e., positive or negative attitudes towards an intervention). So far, research on placebo and nocebo effects relied on the administration of sham interventions, which resembled medical treatments like inert pills, creams or injections. However, such experimental procedures deal with confounds due to earlier experiences and expectations resulting from the individual’s history with medical interventions. Accordingly, the implementation of a placebo manipulation that is completely new to an individual, seems necessary to disentangle the contribution of experience and expectation for the induction of placebo and nocebo effects.
To this end, in Experiment 1 the level of experience and expectation regarding a placebo-nocebo treatment was stepwise manipulated across three different experimental groups. To avoid any resemblances to earlier experiences and individual expectations, a mere psychological placebo-nocebo treatment was chosen that was new to all participants. They were instructed that visual black and white stripe patterns had been found to reliably alter the perception of pain. One group of participants received only the placebo-nocebo instruction (expectation), a second group experienced a placebo-nocebo treatment within a conditioning phase (experience) but no instruction, and a third group received the combination of both that is a placebo-nocebo instruction and a placebo-nocebo conditioning (experience + expectation).
It was shown that only the experience + expectation group revealed significantly higher pain ratings and physiological responses during nocebo, compared to placebo trials of the succeeding test phase. These findings demonstrate that the induction of a mere psychological placebo-nocebo effect on pain is in principle possible. Most important, results indicate that such effects most likely rely on both, a positive treatment experience, due to the encounter of an effective intervention (placebo conditioning), and a positive expectation about the intervention (placebo instruction).Besides experience and expectation, the current mood state has been shown to modulate pain and to impact the induction of placebo and nocebo effects. In this vein it has been demonstrated that placebo effects come along with positive affect, while nocebo effects often occur together with elevated feelings of anxiety. To clarify the interaction of emotions and placebo-nocebo manipulations on pain perception, in Experiment 2 the paradigm of Experiment 1 was modified. Instead of black and white stripe patterns, positive and negative emotional pictures were presented, which either cued pain increase (nocebo) or pain decrease (placebo). Two experimental groups were compared, which differed with regard to the instructed contingency of positive pictures serving as placebo and negative pictures serving as nocebo cues or vice versa (congruent vs. incongruent). Results indicate that the differentiation of placebo and nocebo trials (behaviorally and physiologically) was more pronounced for the congruent compared to the incongruent group. However, in the incongruent group, affective pain ratings were also significantly higher for nocebo (positive pictures) than placebo (negative pictures) trials, similar to the congruent group. These findings demonstrate that a placebo-nocebo manipulation is capable to dampen and even reverse the originally pain augmenting effect of negative emotions.
The results of Experiment 2 were further corroborated in Experiment 3, when the design was adapted to the fMRI scanner, and again a congruent and an incongruent experimental group were compared. Behavioral, physiological and neurophysiological markers of pain processing revealed a differentiation between nocebo and placebo conditions that was present irrespective of the experimental group. In addition, the fMRI analysis revealed an increased engagement of prefrontal areas for the incongruent group only, supposedly reflecting the reinterpretation or appraisal process when positive pictures were cueing negative outcomes.
Taken together, the results of the present studies showed (a) that it is possible to induce a placebo-nocebo effect on pain solely by a psychological manipulation, (b) that both, prior experiences and positive expectation, are necessary preconditions for this placebo-nocebo effect, (c) that the impact of negative emotion on pain can be dampened and even reversed by placebo-nocebo manipulations, and (d) that most likely a cognitive top-down process is crucial for the induction of (psychological) placebo-nocebo effects.
These results significantly enhance our understanding of psychological mechanisms involved in the induction of placebo-nocebo effects. Further, a fruitful foundation for future studies is provided, which will need to determine the contributions of primarily nocebo or placebo responses mediating the effects as demonstrated in the present studies. In a long-term perspective, the present findings may also help to exploit placebo effects and prevent from nocebo effect in clinical contexts by further elucidating crucial psychological factors that contribute to the placebo and nocebo response.
Interaction between light and matter generates optical nonlinearities, which are particularly pronounced in the quantum strong coupling regime. When a single bosonic mode couples to a single fermionic mode, a Jaynes-Cummings (JC) ladder is formed, which we realize here using cavity photons and quantum dot excitons. We measure and model the coherent anharmonic response of this strongly coupled exciton-cavity system at resonance. Injecting two photons into the cavity, we demonstrate a \(\sqrt 2\) larger polariton splitting with respect to the vacuum Rabi splitting. This is achieved using coherent nonlinear spectroscopy, specifically four-wave mixing, where the coherence between the ground state and the first (second) rung of the JC ladder can be interrogated for positive (negative) delays. With increasing excitation intensity and thus rising average number of injected photons, we observe spectral signatures of the quantum-to-classical crossover of the strong coupling regime.
Three spectroscopic techniques are presented that provide simultaneous spatial and temporal resolution: modified confocal microscopy with heterodyne detection, space-time-resolved spectroscopy using coherent control concepts, and coherent two-dimensional nano-spectroscopy. Latest experimental results are discussed.
Coherent two-dimensional electronic spectroscopy in the Soret band of a chiral porphyrin dimer
(2013)
Using coherent two-dimensional (2D) electronic spectroscopy in fully noncollinear geometry, we observe the excitonic coupling of β,β'-linked bis[tetraphenylporphyrinato-zinc(II)] on an ultrafast timescale in the excited state. The results for two states in the Soret band originating from an excitonic splitting are explained by population transfer with approximately 100 fs from the energetically higher to the lower excitonic state. This interpretation is consistent with exemplary calculations of 2D spectra for a model four-level system with coupling.
Combined effects of climate change and extreme events on plants, arthropods and their interactions
(2013)
I. Global climate change directly and indirectly influences biotic and abiotic components of ecosystems. Changes in abiotic ecosystem components caused by climate change comprise temperature increases, precipitation changes and more frequently occurring extreme events. Mediated by these abiotic changes, biotic ecosystem components including all living organisms will also change. Expected changes of plants and animals are advanced phenologies and range shifts towards higher latitudes and altitudes which presumably induce changes in species interactions and composition. Altitudinal gradients provide an optimal opportunity for climate change studies, because they serve as natural experiments due to fast changing climatic conditions within short distances. In this dissertation two different approaches were conducted to reveal species and community responses to climate change. First, species richness and community trait analyses along an altitudinal gradient in the Bavarian Alps (chapters II, III) and second, climate change manipulation experiments under different climatic contexts (chapters IV, V, IV). II. We performed biodiversity surveys of butterfly and diurnal moth species on 34 grassland sites along an altitudinal gradient in the National Park Berchtesgaden. Additionally, we analysed the dominance structure of life-history traits in butterfly assemblages along altitude. Species richness of butterflies and diurnal moths decreased with increasing altitude. The dominance of certain life-history-traits changed along the altitudinal gradient with a higher proportion of larger-winged species and species with higher egg numbers towards higher altitudes. However, the mean egg maturation time, population density and geographic distribution within butterfly assemblages decreased with increasing altitude. Our results indicate that butterfly assemblages were mainly shaped by environmental filtering. We conclude that butterfly assemblages at higher altitudes will presumably lack adaptive capacity to future climatic conditions, because of specific trait combinations. III. In addition to butterfly and diurnal moth species richness we also studied plant species richness in combination with pollination type analyses along the altitudinal gradient. The management type of the alpine grasslands was also integrated in the analyses to detect combined effects of climate and management on plant diversity and pollination type. Plant species richness was highest at intermediate altitudes, whereby the management type influenced the plant diversity with more plant species at grazed compared to mown or non-managed grasslands. The pollination type was affected by both the changing climate along the gradient and the management type. These results suggest that extensive grazing can maintain high plant diversity along the whole altitudinal gradient. With ongoing climate change the diversity peak of plants may shift upwards, which can cause a decrease in biodiversity due to reduced grassland area but also changes in species composition and adaptive potential of pollination types. IV. We set up manipulation experiments on 15 grassland sites along the altitudinal gradient in order to determine the combined effects of extreme climatic events (extreme drought, advanced and delayed snowmelt) and elevation on the nutritional quality and herbivory rates of alpine plants. The leaf CN (carbon to nitrogen) ratio and the plant damage through herbivores were not significantly affected by the simulated extreme events. However, elevation influenced the CN ratios and herbivory rates of alpine plants with contrasting responses between plant guilds. Furthermore, we found differences in nitrogen concentrations and herbivory rates between grasses, legumes and forbs, whereas legumes had the highest nitrogen concentrations and were damaged most. Additionally, CN ratios and herbivory rates increased during the growing season, indicating a decrease of food plant quality during the growing season. Contrasting altitudinal responses of grasses, legumes and forbs presumably can change the dominance structure among these plant guilds with ongoing climate change. V. In this study we analysed the phenological responses of grassland species to an extreme drought event, advanced and delayed snowmelt along the altitudinal gradient. Advanced snowmelt caused an advanced beginning of flowering, whereas this effect was more pronounced at higher than at lower altitudes. Extreme drought and delayed snowmelt had rather low effects on the flower phenology and the responses did not differ between higher and lower sites. The strongest effect influencing flower phenology was altitude, with a declining effect through the season. The length of flowering duration was not significantly influenced by treatments. Our data suggest that plant species at higher altitudes may be more affected by changes in snowmelt timing in contrast to lowland species, as at higher altitudes more severe changes are expected. However, the risk of extreme drought events on flowering phenology seems to be low. VI. We established soil-emergence traps on the advanced snowmelt and control treatment plots in order to detect possible changes in abundances and emergence phenologies of five arthropod orders due to elevation and treatment. Additionally, we analysed the responses of Coleoptera species richness to elevation and treatment. We found that the abundance and species richness of Coleoptera increased with elevation as well as the abundance of Diptera. However, the abundance of Hemiptera decreased with elevation and the abundances of Araneae and Hymenoptera showed no elevational patterns. The advanced snowmelt treatment increased the abundances of Araneae and Hymenoptera. The emergence of soil-hibernating arthropods was delayed up to seven weeks at higher elevations, whereas advanced snowmelt did not influence the emergence phenology of arthropods immediately after snowmelt. With climate change earlier snowmelt will occur more often, which especially will affect soil-hibernating arthropods in alpine regions and may cause desynchronisations between species interactions. VII. In conclusion, we showed that alpine ecosystems are sensitive towards changing climate conditions and extreme events and that many alpine species in the Bavarian Alps are endangered. Many alpine species could exist under warmer climatic conditions, however they are expected to be outcompeted by more competitive lowland species. Furthermore, host-parasite or predator-prey interactions can be disrupted due to different responses of certain guilds to climate change. Understanding and predicting the complex dynamics and potential risks of future climate change remains a great challenge and therefore further studies analysing species and community responses to climate change are needed.
Using viruses to treat cancer is a novel approach to an age-old disease. Oncolytic viruses are native or recombinant viruses that have the innate or enhanced capability to infect tumour cells, replicate within the tumour microenvironment and subsequently lyse those cells. One representative, the vaccinia virus (VACV), belongs to the orthopoxvirus genus of the Poxviridae family. GLV-1h68, a recombinant and attenuated vaccinia virus devel- oped by the Genelux Corporation, is a member of this family currently being tested in various phase I/II clinical trials under the name GL-ONC1. It has been shown to specif- ically replicate in tumour cells while sparing healthy tissue and to metabolise prodrug at or transport immunological payloads to the site of affliction. Since imaging modalities offer little insight into viral replication deep within the body, and because oncolytic virotherapy is dependent on replication within the target tissue, the need for a monitoring system is evident. Pharmacokinetic analysis of this oncolytic agent was to give insight into the dynamics present in tumours during treatment. This, in turn, would give clinicians the opportunity to monitor the efficacy as early as possible after the onset of treatment, to observe treatment progression and possibly to gauge prognosis, without resorting to invasive procedures, e.g. biopsies. A criteria for viable biomarkers was that it had to be directly dependent on viral replica- tion. Ideally, a marker for treatment efficacy would be specific to the treatment modality, not necessarily the treatment type. Such a marker would be highly detectable (high sen- sitivity), specific for the treatment (high specificity), and present in an easily obtained specimen (blood). Taking this into consideration, the biomarkers were chosen for their potential to be indicators of viral replication. Thus, the biomarkers analysed in this thesis are: the native proteins expressed by the viral genes A27L and B5R, the virally encoded recombinant proteins β-galactosidase, β-glucuronidase, green fluorescent protein (GFP), carboxypeptidase G2 (CPG2) and carcinoembryonic antigen (CEA). Each marker is under the control of one of five different promoters present. All recombinant viruses used in this thesis express A27L, B5R, GFP and β-glucuronidase and all are derived from the parental virus GLV-1h68. In addition to these markers, GLV-1h68 expresses β-galactosidase; GLV-1h181 expresses CPG2. [...]
Background
Cataract and glaucoma are both common comorbidities among older patients. Combining glaucoma surgery with minimal invasive phacoemulsification (phaco) is a considerable option to treat both conditions at the same time, although the combination with filtration surgery can produce a strong inflammatory response. Combined non-penetrating procedures like canaloplasty have shown to reduce intraocular pressure (IOP) comparable to trabeculectomy without the risk of serious bleb-related complications. The purpose of this retrospective study was to compare the outcomes of phacotrabeculectomy and phacocanaloplasty.
Methods
Thirty-nine eyes with concomitant cataract and glaucoma who underwent phacotrabeculectomy (n = 20; 51.3%) or phacocanaloplasty (n = 19; 48.7%) were included into this trial on reduction of IOP, use of medication, success rate, incidence of complications and postsurgical interventions. Complete success was defined as IOP reduction by 30% or more and to 21 mmHg or less (definition 1a) or IOP to less than 18 mmHg (definition 2a) without glaucoma medication.
Results
Over a 12-month follow-up, baseline IOP significantly decreased from 30.0 ± 5.3 mmHg with a mean of 2.5 ± 1.2 glaucoma medications to 11.7 ± 3.5 mmHg with a mean of 0.2 ± 0.4 medications in eyes with phacotrabeculectomy (P < .0001). Eyes with phacocanaloplasty had a preoperative IOP of 28.3 ± 4.1 mmHg and were on 2.8 ± 1.1 IOP-lowering drugs. At 12 months, IOP significantly decreased to 12.6 ± 2.1 mmHg and less glaucoma medications were necessary (mean 1.0 ± 1.5 topical medications; P < .05). 15 patients (78.9%) with phacotrabeculectomy and 9 patients (60.0%) in the phacocanaloplasty group showed complete success according to definition 1 and 2 after 1 year (P = .276). Postsurgical complications were seen in 7 patients (36.8%) of the phacocanaloplasty group which included intraoperative macroperforation of the trabeculo-Descemet membrane (5.3%), hyphema (21.1%) and bleb formation (10.5%). Although more complications were observed in the phacotrabeculectomy group, no statistically significant difference was found.
Conclusions
Phacocanaloplasty offers a new alternative to phacotrabeculectomy for treatment of concomitant glaucoma and cataract, although phacotrabeculectomy yielded in better results in terms of IOP maintained without glaucoma medications.
This paper describes a case study with a patient in the classic locked-in state, who currently has no means of independent communication. Following a user-centered approach, we investigated event-related potentials (ERP) elicited in different modalities for use in brain-computer interface (BCI) systems. Such systems could provide her with an alternative communication channel. To investigate the most viable modality for achieving BCI based communication, classic oddball paradigms (1 rare and 1 frequent stimulus, ratio 1:5) in the visual, auditory and tactile modality were conducted (2 runs per modality). Classifiers were built on one run and tested offline on another run (and vice versa). In these paradigms, the tactile modality was clearly superior to other modalities, displaying high offline accuracy even when classification was performed on single trials only. Consequently, we tested the tactile paradigm online and the patient successfully selected targets without any error. Furthermore, we investigated use of the visual or tactile modality for different BCI systems with more than two selection options. In the visual modality, several BCI paradigms were tested offline. Neither matrix-based nor so-called gaze-independent paradigms constituted a means of control. These results may thus question the gaze-independence of current gaze-independent approaches to BCI. A tactile four-choice BCI resulted in high offline classification accuracies. Yet, online use raised various issues. Although performance was clearly above chance, practical daily life use appeared unlikely when compared to other communication approaches (e.g., partner scanning). Our results emphasize the need for user-centered design in BCI development including identification of the best stimulus modality for a particular user. Finally, the paper discusses feasibility of EEG-based BCI systems for patients in classic locked-in state and compares BCI to other AT solutions that we also tested during the study.
Compensatory base changes (CBCs) in internal transcribed spacer 2 (ITS2) rDNA secondary structures correlate with Ernst Mayr’s biological species concept. This hypothesis also referred to as the CBC species concept recently was subjected to large-scale testing, indicating two distinct probabilities. (1) If there is a CBC then there are two different species with a probability of ~0.93. (2) If there is no CBC then there is the same species with a probability of ~0.76. In ITS2 research, however, the main problem is the multicopy nature of ITS2 sequences. Most recently, 454 pyrosequencing data have been used to characterize more than 5000 intragenomic variations of ITS2 regions from 178 plant species, demonstrating that mutation of ITS2 is frequent, with a mean of 35 variants per species, respectively per individual organism. In this study, using those 454 data, the CBC criterion is reconsidered in the light of intragenomic variability, a proof of concept, a necessary criterion, expecting no intragenomic CBCs in variant ITS2 copies. In accordance with the CBC species concept, we could demonstrate that the probability that there is no intragenomic CBC is ~0.99.