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Winter warming is ecologically more relevant than summer
warming in a cool-temperate grassland
(2019)
Vitamin B6 deficiency during pregnancy translates into a severe vitamin B6 deficiency (plasma levels decreased by 97%) in new-born rats. Further, hallmarks are increased (+89%) concentrations of homocysteine, gross changes in gene methylation and expression, and metabolic alterations including lipid metabolism. This study focuses on determining the effects of vitamin B6-deficiency on cardiolipin composition and oxidative phosphorylation in liver. For this purpose, hepatic cardiolipin composition was analyzed by means of LC/MS/MS, and mitochondrial oxygen consumption was determined by using a Clark-type electrode in a rat model of vitamin B6 deficiency. Liver mitochondria from new-born rats with pre-term vitamin B6 deficiency responded with substantial alterations in cardiolipin composition that include the following changes in the amounts of cardiolipin incorporated fatty acids: increase in C16, decrease in C18, decrease in saturated fatty acid, as well as increase in amount of oxidized cardiolipin species. These changes were accompanied by significantly decreased capacity of oxidative phosphorylation. In conclusion, vitamin B6 deficiency in new born rats induces massive alterations of cardiolipin composition and function of liver mitochondria. These findings support the importance of sufficient periconceptional supply of vitamin B6 to prevent vitamin B6 deficiency.
Impact statement
Vitamin B6 (VitB6) is an active co-enzyme for more than 150 enzymes and is required for a great diversity of biosynthesis and metabolic reactions. There is an increased need for VitB6 during pregnancy and sufficient supply of VitB6 is crucial for the prevention of cleft palate and neural tube defects. We show that liver mitochondria from new-born rats with pre-term VitB6 deficiency respond with substantial alterations in cardiolipin (CL) composition and in the amount of oxidized CL species. These changes are associated with a decrease in the efficiency of oxidative phosphorylation. The results of this study support the significance of sufficient supply of VitB6 during pregnancy (and periconceptional) for diminishing the number of early abortions and minimizing malformation. The established link between VitB6 deficiency, CL composition, and mitochondrial respiration/energy production provides mechanistic insight as to how the VitB6 deficiency translates into the known pathophysiological and clinically relevant conditions.
Background: Intensive speech-language therapy (SLT) can promote recovery from chronic post-stroke aphasia, a major consequence of stroke. However, effect sizes of intensive SLT are moderate, potentially reflecting a physiological limit of training-induced progress. Transcranial direct current stimulation (tDCS) is an easy-to-use, well-tolerated and low-cost approach that may enhance effectiveness of intensive SLT. In a recent phase-II randomized controlled trial, 26 individuals with chronic post-stroke aphasia received intensive SLT combined with anodal-tDCS of the left primary motor cortex (M1), resulting in improved naming and proxy-rated communication ability, with medium-to-large effect sizes.
Aims: The proposed protocol seeks to establish the incremental benefit from anodal-tDCS of M1 in a phase-III randomized controlled trial with adequate power, ecologically valid outcomes, and evidence-based SLT.
Methods: The planned study is a prospective randomized placebo-controlled (using sham-tDCS), parallel-group, double-blind, multi-center, phase-III superiority trial. A sample of 130 individuals with aphasia at least 6 months post-stroke will be recruited in more than 18 in- and outpatient rehabilitation centers.
Outcomes: The primary outcome focuses on communication ability in chronic post-stroke aphasia, as revealed by changes on the Amsterdam-Nijmegen Everyday Language Test (A-scale; primary endpoint: 6-month follow-up; secondary endpoints: immediately after treatment, and 12-month follow-up). Secondary outcomes include measures assessing linguistic-executive skills, attention, memory, emotional well-being, quality of life, health economic costs, and adverse events (endpoints: 6-month follow-up, immediately after treatment, and 12-month follow-up).
Discussion: Positive results will increase the quality of life for persons with aphasia and their families while reducing societal costs. After trial completion, a workshop with relevant stakeholders will ensure transfer into best-practice guidelines and successful integration within clinical routine.
Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03930121.
Abstract
Reactive high power impulse magnetron sputtering (HiPIMS) of a cobalt cathode in pure argon gas and with different oxygen admixtures was investigated by time-resolved optical emission spectroscopy (OES) and time-integrated energy-resolved mass spectrometry. The HiPIMS discharge was operated with a bipolar pulsed power supply capable of providing a large negative voltage with a typical pulse width of 100 μs followed by a long positive pulse with a pulse width of about 350 μs. The HiPIMS plasma in pure argon is dominated by Co+ ions. With the addition of oxygen, O+ ions become the second most prominent positive ion species. OES reveals the presence of Ar I, Co I, O I, and Ar II emission lines. The transition from an Ar+ to a Co+ ion sputtering discharge is inferred from time-resolved OES. The enhanced intensity of excited Ar+* ions is explained by simultaneous excitation and ionisation induced by energetic secondary electrons from the cathode. The intensity of violet Ar I lines is drastically reduced during HiPIMS. Intensity of near-infrared Ar I lines resumes during the positive pulse indicating an additional heating mechanism.
The present work is a cumulative dissertation that covers the research work of the author at the Department of Analytical and Physical Chemistry of Chelyabinsk State University. It contains a short description of the study and a set of attached publications in peer-reviewed journals and conference proceedings.
The phase and chemical equilibria in binary systems Me – Si
(where Me is the 4th-period transition metal) as well as Mo – Si, Mn – Ge and Fe – Ge at low temperatures were considered. The solid solubility of silicon in vanadium, chromium, manganese, iron, nickel, cobalt and copper and that of germanium in manganese and iron was estimated.
The phase equilibria in Me – Si – O, Mo – Si – O, Mn – Ge – O and Fe – Ge – O ternary systems at standard conditions were considered from a thermodynamic viewpoint. The atmospheric corrosion of transition metals silicides and manganese and iron germanides was discussed.
The chemical and electrochemical equilibria in Me – Si – H2O, Mo – Si – H2O, Mn – Ge – H2O and Fe – Ge – H2O systems were considered from a thermodynamic viewpoint. Pourbaix diagrams for some 4th-period transition metals and molybdenum, as well as for silicon, were revised. The potential – pH diagrams for Me – Si – H2O, Mo – Si – H2O, Mn – Ge – H2O and Fe – Ge – H2O systems were plotted in the first time. The corrosion-electrochemical behaviour of transition metals silicides and manganese and iron germanides in aqueous media was discussed.
The potential – pH diagrams for some siliceous brasses and bronzes (which are multicomponent alloys containing both transition metals and silicon) were plotted, and the corrosion of these alloys in aqueous media was discussed.
Method of estimation of corrosion-electrochemical behaviour of multicomponent alloys, which takes into account both thermodynamic and kinetic data and is based on mutual construction of equilibrium and polarisation potential – pH diagrams, was described. Its usage was illustrated in the example of the structural steel 20KT.
Abstract
This article compares the use of calques modelled on anglicisms in different European languages, especially Spanish and German, which do not only show structural differences (e.g. with regard to the use of noun-noun compounds, which are more common in German) but also reflect different attitudes towards English. Aspects covered range from the factors generally favouring the coinage of such replacive forms, to the reasons for the emergence of different types of calques, to variations in their use and challenges concerning their identification. To unravel the main patterns and trends in calquing, this study includes numerous examples from written and oral language, i.e. items of different register affiliation, age, length, and semantic transparency. On a theoretical level, the article incorporates findings from the fields of lexicology, contact linguistics and sociolinguistics.
Abstract
This article compares the use of calques modelled on anglicisms in different European languages, especially Spanish and German, which do not only show structural differences (e.g. with regard to the use of noun-noun compounds, which are more common in German) but also reflect different attitudes towards English. Aspects covered range from the factors generally favouring the coinage of such replacive forms, to the reasons for the emergence of different types of calques, to variations in their use and challenges concerning their identification. To unravel the main patterns and trends in calquing, this study includes numerous examples from written and oral language, i.e. items of different register affiliation, age, length, and semantic transparency. On a theoretical level, the article incorporates findings from the fields of lexicology, contact linguistics and sociolinguistics.
The southern Baltic Sea embodies an incomparable geological archive of the tectonic evolution of the 450 Ma old Trans‐European Suture Zone (TESZ). This WNW to NW trending suture formed during the collision of Baltica and Avalonia and has accommodated the repeatedly changing stress regimes since then, as evidenced by numerous fault zones and systems. The German offshore part in the vicinity of Rügen Island is strongly block‐faulted, with each block showing a specific geological pattern, enabling the reconstruction of the structural evolution of the area.
The work of this thesis is part of the USO working group of the University of Greifswald and the Geological Survey of Mecklenburg‐Western Pomerania, which aims to build a unified three‐dimensional tectonic model of the southern Baltic Sea area. This thesis presents the results of new structural investigations of the Arkona, Wolin and Gryfice blocks north and east of Rügen. Especially, conflicting structural analyses in the previous work are united into a consistent model.
The integrated interpretation of 144 reprocessed seismic vintage lines (original Petrobaltic data) and 23 high resolution academic seismic sections (from the Universities of Hamburg and Bremen), with additional consideration of on‐ and offshore wells, revealed 19 seismostratigraphic horizons that subdivide the succession between the Proterozoic basement and the Upper Cretaceous. Up to 100 faults of superior fault zones and systems control the tectonic situation. Besides NW trending deep faults formed during the Palaeozoic, for instance the Wiek and Nord Jasmund faults, and NNW trending Mesozoic faults and flexures that belong to the Western Pomeranian Fault System, other major faults such as the Adler‐Kamień Fault Zone document the polyphase evolution of this area.
The restoration of selected seismic sections support the evaluation of separately generated faults and their reactivation, leading to a subdivision of the tectonic evolution of the area into six stages:
(1) The Caledonian Orogeny (Ordovician/Silurian) was accompanied by a NE‐SW compression, resulting in the formation of the TESZ and an accretionary wedge within the upper crust. (2) The following S to SW trending extension of the Variscan Foreland (Devonian/Carboniferous) triggered the
evolution of the Middle Devonian Old Red Rügen Basin south of the Wiek Fault. Further WNW to NW trending faults (e.g. Nord Jasmund Fault) subdivided the basin. (3) The advancing Variscan Orogeny (Late Carboniferous) caused an increasing NE‐SW orientated compression and subsequently reactivated faults and tilted blocks (e.g. Lohme Sub‐block). (4) The North German Basin and Mid Polish Trough formed by thermic subsidence in the S to SE of the research area during the Permo‐Carboniferous. Simultaneously, the evolution of the Gryfice Graben as part of the Teisseyre‐Tornquist Zone commenced. (5) Due to the Arctic‐North Atlantic Rifting an E‐W trending extension increased. Consequently, grabens such as the Gryfice Graben continued their subsidence. As the stress system rotated counter‐clockwise, the shear strength increased along the NE trending faults. The Western Pomeranian Fault System developed due to intense transtension during the Keuper and Jurassic, and is characterised by pull‐apart structures. (6) In the Upper Cretaceous, a NE‐SW compression, forced by the Africa‐Iberia‐Europe convergence, triggered the reactivation of faults and flexures as reverse ones, the inversion of grabens (e.g. Gryfice Graben), and the formation of anticlines, for instance at the Wolin Block.
This thesis combines the calculation of gridded time structure maps and a detailed fault pattern analysis, and represents the base for a velocity‐ and subsequently depth‐based 3D modelling.
The Spider Anatomy Ontology (SPD)—A Versatile Tool to Link Anatomy with Cross-Disciplinary Data
(2019)
Periodontitis is one of the most prevalent oral diseases worldwide and is caused by multifactorial interactions between host and oral bacteria. Altered cellular metabolism of host and microbes releases a number of intermediary end products known as metabolites. There is an increasing interest in identifying metabolites from oral fluids such as saliva to widen the understanding of the complex pathogenesis of periodontitis. It is believed that some metabolites might serve as indicators toward early detection and screening of periodontitis and perhaps even for monitoring its prognosis in the future. Because contemporary periodontal screening methods are deficient, there is an urgent need for novel approaches in periodontal screening procedures. To this end, we associated oral parameters (clinical attachment level, periodontal probing depth, supragingival plaque, supragingival calculus, number of missing teeth, and removable denture) with a large set of salivary metabolites (n = 284) obtained by mass spectrometry among a subsample (n = 909) of nondiabetic participants from the Study of Health in Pomerania (SHIP-Trend-0). Linear regression analyses were performed in age-stratified groups and adjusted for potential confounders. A multifaceted image of associated metabolites (n = 107) was revealed with considerable differences according to age groups. In the young (20 to 39 y) and middle-aged (40 to 59 y) groups, metabolites were predominantly associated with periodontal variables, whereas among the older subjects (≥60 y), tooth loss was strongly associated with metabolite levels. Metabolites associated with periodontal variables were clearly linked to tissue destruction, host defense mechanisms, and bacterial metabolism. Across all age groups, the bacterial metabolite phenylacetate was significantly associated with periodontal variables. Our results revealed alterations of the salivary metabolome in association with age and oral health status. Among our comprehensive panel of metabolites, periodontitis was significantly associated with the bacterial metabolite phenylacetate, a promising substance for further biomarker research.
The proteasome is a major part of the ubiquitin-proteasome-system playing an important role in cell homeostasis due to its protein quality control function. Moreover, the proteasome is involved in cell cycle regulation and in the regulation of transcription factors. Upon induction of interferons, or treatment with lipopolysaccharides, an isoform of the standard-proteasome is composed, named immunoproteasome (i-proteasome). The i-proteasome is constitutively expressed in immune cells and deficiency of proteolytic subunits of this multiprotein complex has been associated with a poor outcome during infectious diseases. I-proteasome-deficiency has been shown to result in reduced MHC class I presentation. Using mice which are deficient for all three proteolytic active subunits LMP2, MECL-1 and LMP7, we could demonstrate that i-proteasome-deficiency lead to an altered recruitment of immune cells to the CNS when challenged with the intracellular parasite Toxoplasma gondii, resulting in increased frequencies of neutrophils and other cells of myeloid origin. The shift to reduced frequencies of CD45highCD11blow lymphocytes can be further explained by a decreased migratory capacity of i-proteasome-deficient CD8+ T cells. In contrast to previous studies using other pathogens, effector function of CD8+ as well as CD4+ T cells, measured by frequencies of IFNγ, TNF, IL-2 and granzyme B producing cells, were not impaired in these mice, whereas induction of CD4+ Tregs was strongly reduced. In addition, we found that parasite control was comparable to control mice and that i-proteasome deletion caused an overall pro-inflammatory cytokine milieu within the brain. Our results indicate that i-proteasome-deficiency lead to prolonged tissue inflammation during T. gondii infection which could be an explanation for the more severe course of disease observed in these mice.
The Src homology domain containing phosphatase 2 (SHP2) is a tyrosine phosphatase modulating several signaling pathways and therefore has an influence in cell cycle, differentiation, proliferation and cell activation. However, SHP2 is assumed to play a negative role during T-cell activation as the phosphatase has been shown to inhibit T-cell receptor-induced signaling cascades. Although, various gain-of-function mutations in the SH2 or PTP domain of this phosphatase, such as D61Y, have been associated with myeloproliferative diseases such as juvenile myelomonocytic leukemia (JMML), effects of such mutations on T cells have not been addressed in scientific literature so far. Therefore, in the second part of this thesis we could demonstrate that D61Y mutation in the SH2 domain of SHP2 did not cause JMML pathology when only introduced into T cells. Especially in aged mice, T cells of SHP2 mutant mice showed an increased expression of cell adhesion molecule CD44. In accordance with these findings, we observed increased influenza A virus-specific T cells in the bone marrow of SHP2 D61Y mutant mice, indicating a role of the phosphatase in memory formation or maintenance of CD8+ Tem. Although SHP2D61Y mice revealed a comparable viral clearance, IFNγ production of virus experienced CD4+ and CD8+ T cells was diminished compared to control mice, underlining a negative involvement of the phosphatase in the JAK/STAT1 signaling axis as suggested before by studies using mice with SHP2-/- T cells.
Background: Sedentary behavior (SB) is a modifiable behavior with increasing prevalence worldwide. There is emerging evidence that time spend in SB and the manner in which SB is accumulated over time is associated with cardiovascular and cardiometabolic health. The requirement for SB data to be accurately measured is minimization, or at least accurate quantification of human-related sources of measurement errors such as accelerometer measurement reactivity (AMR). The present thesis was to examine SB and their associations with cardiovascular and cardiometabolic health, and to focus on challenges related to the assessment of SB. The first aim of the thesis was to identify patterns of SB describing how individuals accumulate their time spend in SB day-by-day over one week, and to examine how these patterns are associated with cardiorespiratory fitness as a marker for cardiovascular health (paper 1). The second aim of the thesis was to examine the multiple types of SB, and how this is associated with a clustered cardiometabolic risk score (CMRS; paper 2). The third aim of the thesis was to examine AMR and the reproducibility in SB and physical activity (PA) in two measurement periods, and to quantify AMR as a confounder for the estimation of the reproducibility of SB and PA data (paper 3).
Methods: The three papers were based on data of two different studies. For study 1, 1165 individuals aged 40 to 75 years were recruited in three different settings. Among these, 582 participated in a cardiovascular risk factor screening program including cardiopulmonary exercise testing. For the analyses of paper 1, 170 participants were eligible, agreed to wear an accelerometer, fulfilled the wearing regime, and completed the study period by wearing the accelerometer for seven consecutive days. Patterns in accelerometer data were classified based on time spent in SB per day applying growth mixture modeling. Model‐implied class‐specific peak oxygen uptake (VO2peak) means were compared using adjusted equality test of means (paper 1). The underlying study of paper 2 and 3 were based on data of a pilot study aiming to investigate the feasibility of a brief tailored letter intervention to increase PA and to reduce SB during leisure time. Among the individuals who agreed to be contacted again in study 1, a random sample of those aged between 40 and 65 years was drawn. Of those, 175 attended in a cardiovascular examination program. Assessment included giving blood sample, standardized measurement of blood pressure, waist circumference, body weight, and height at baseline, and after twelve months. Further, they agreed to complete a paper-pencil questionnaire on SB (Last 7-d Sedentary Behavior Questionnaire, SIT-Q-7d) and PA (International Physical Activity Questionnaire, IPAQ), and to receive seven-day accelerometery at baseline, and after 12 months. In addition, self-administered assessments were conducted at months one, three, four, and six after baseline. Only individuals of a random subsample (= intervention group) received up to three letters tailored to their self-reported SB and PA at months one, three, and four. For paper 2, associations between SBs and a clustered cardiometabolic risk score (CMRS) were analyzed using linear as well as quantile regression. To account for missing values at baseline, multiple imputations using chained equations were performed resulting in a total sample of 173 participants. Paper 3 comprised data of 136 individuals who participated at the baseline and twelve months assessments, and fulfilled the wearing regime. AMR was examined using latent growth modeling in each measurement period. Intraclass correlations (ICC) were calculated to examine the reproducibility of SB and PA data using two-level mixed-effects linear regression analyses.
Results: Results of paper 1 revealed four patterns of SB: 'High, stable', 'Low, increase', 'Low, decrease', and 'High, decrease'. Persons in the class 'High, stable' had significantly lower VO2peak values (M = 25.0 mL/kg/min, SD = 0.6) compared to persons in the class 'Low, increase' (M = 30.5 mL/kg/min, SD = 3.6; p = 0.001), in the class 'Low, decrease' (M = 30.1 mL/kg/min, SD = 5.0; p = 0.009), and in the class High, decrease' (M = 29.6 mL/kg/min, SD = 5.9; p = 0.032), respectively. No differences among the other classes were found. In paper 2, results revealed that the only factor positively associated with a CMRS in all regression models was watching television. Depending on the regression analysis approach used, other leisure-time SBs showed inconsistent (using a computer), or no associations (reading and socializing) with a CMRS. In paper 3, results revealed that time spent in SB increased (baseline: b = 2.3 min/d; after 12 months: b = 3.8 min/d), and time spent in light PA decreased (b = 2.0 min/day; b = 3.3 min/d). However, moderate-to-vigorous PA remained unchanged. Accelerometer wear time was reduced (b = 4.6 min/d) only at baseline. The ICC coefficients ranged from 0.42 (95% CI = 0.29 - 0.57) for accelerometer wear time to 0.70 (95% CI = 0.61 - 0.78) for moderate-to-vigorous PA. None of the regression models identified a reactivity indicator as a confounder for the reproducibility of SB and PA data.
Conclusions: The present thesis highlights SB in the field of cardiovascular and cardiometabolic research that have implications for future research. Individuals sit for different purposes and durations in multiple life domains, and the time spent in SB is accumulated in different patterns over time. Therefore, research should consider the fact that SB is embedded in an individual's daily life routine, hence might have differential effects on cardiovascular and cardiometabolic health. Further, methodological aspects have to be considered when dealing with SB. In order to detect how SB is 'independently' associated to an individual's health, an accurate measurement of SB is fundamental. Therefore, human-related sources of bias such as AMR should be taken into account when either planning studies or when interpreting data drawn from analysis of SB data.
The Role of Evidence-Based Practice in German Special Education—State of Research and Discussion
(2019)
The Müritzeum is a nature discovery centre and a museum in the heart of the Mecklenburg Lake District. It is the first natural history museum in Mecklenburg-Vorpommern, with natural history collections that are over 150 years old, and are still growing today. The collections contain about 290 000 specimens from the fields of botany, zoology and geology. An extensive library and an archive are also
part of the museum. Collecting, preserving and researching natural history are our main spheres of activity. The exhibition in the Müritzeum offers the visitor a comprehensive insight into the development of the nature and landscape of northeastern Germany and of Mecklenburg-Vorpommern and the Lake Müritz region in particular. The largest aquarium for indigenous freshwater species in Germany enables visitors to imagine themselves in the underwater world of the Mecklenburg Lake District.
The first part of my work comprises empirical findings and theoretical foundations on stress in its historical development and socio-emotional and behavioural factors.
The first study of my dissertation focuses on the relationship between perceived stress in adolescence, the context variables of perceived helpfulness and competition and socio-emotional and behavioural strengths and difficulties (i.e., emotional problems, symptoms of hyperactivity, problems with peers, prosocial behaviour and conduct problems) from early to middle adolescence. I postulated a moderation or mediation of the effect of perceived stress on socio-emotional and behavioural strengths and difficulties through the two context variables. My hypotheses were tested using a latent moderating structural equation model (moderation analysis) and a multi-group structural equation model taking into account the gender and age of the students (mediation analysis). The theoretical basis of my first study is the transactional stress model by Lazarus and Folkman (1984).
The second study of my dissertation is dedicated to the question whether perceived stress is a moderator in the relationship between depressive symptoms in early adolescence and socio-emotional and behavioural strengths and difficulties in middle adolescence. Based on the cognitive vulnerability-transactional stress theory of Hankin and Abramson (2001), which assumes reciprocal and dynamic relationships between the individual and the environment, I investigated this question and tested the relationships using a latent moderating structural equation model.
The third study of my dissertation is based on Bronfenbrenner’s socio-ecological model (1975). Using a cross-lagged panel design, I investigate the within time and longitudinal relationships between variables of emotional (in-)stability (i.e., depressive symptoms, perceived stress and loneliness) and socio-environmental factors (i.e., sense of belonging, student-student and teacher-student-relationship) from early to middle adolescence.
At the end of my work there is a summary of all results, a discussion and an outlook for future research.
For the goal of individualized medicine, it is critical to have clinical phenotypes at hand which represent the individual pathophysiology. However, for most of the utilized phenotypes, two individuals with the same phenotype assignment may differ strongly in their underlying biological traits. In this paper, we propose a definition for individualization and a corresponding statistical operationalization, delivering thereby a statistical framework in which the usefulness of a variable in the meaningful differentiation of individuals with the same phenotype can be assessed. Based on this framework, we develop a statistical workflow to derive individualized phenotypes, demonstrating that under specific statistical constraints the prediction error of prediction scores contains information about hidden biological traits not represented in the modeled phenotype of interest, allowing thereby internal differentiation of individuals with the same assigned phenotypic manifestation. We applied our procedure to data of the population-based Study of Health in Pomerania to construct a refined definition of obesity, demonstrating the utility of the definition in prospective survival analyses. Summarizing, we propose a framework for the individualization of phenotypes aiding personalized medicine by shifting the focus in the assessment of prediction models from the model fit to the informational content of the prediction error.
Medical doctors sometimes make diagnoses in persons who are not their patients and who did not ask for their medical opinion, e.g., when an off-duty dermatologist diagnoses melanoma in a stranger, outside of the hospital setting. These diagnoses are referred to as unsolicited medical opinions.
The unsolicited medical opinion raises several ethical questions. Most importantly, it poses a moral challenge for the physician: a possible disease, which may lead to a serious loss of health, is recognised in a person who is not the physician’s patient, outside of the formal medical context. The fundamental ethical question addressed in this dissertation is: Does a medical doctor who makes a clinical diagnosis in a stranger, outside of the formal medical context, have an ethical obligation to offer an unsolicited medical opinion?
This ethical question involves some related questions: If physicians do have an ethical obligation to offer an unsolicited medical opinion, are there any limiting factors to this obligation, which would justify not acting? A more practical question is also raised: How should a physician approach the person in whom an unsolicited diagnosis is made?
The cumulative dissertation is based on three publications addressing the unsolicited medical opinion. Firstly, the unsolicited medical opinion is explored from the perspective of utilitarianism, and a utilitarian argument is made in favour of offering an unsolicited medical opinion. Secondly, the topic is placed in the context of the existing scientific literature and analysed from the perspective of several ethical theories: virtue ethics, care ethics, principlism and contract theory. Lastly, the unsolicited medical opinion is discussed in the context of “medically unknown symptoms”. As in the central argument of this thesis, a utilitarian principle is applied and an argument made in favour of an unsolicited mental health diagnosis.
Archaeological discoveries in the Tollense Valley represent remains of a Bronze Age battle of ca.1300–1250 BCE, documenting a violent group conflict hitherto unimagined for this period of time in Europe, changing the perception of the Bronze Age. Geoscientific, geoarchaeological and palaeobotanical investigations have reconstructed a tree- and shrubless mire characterised by sedges, reed and semiaquatic conditions with a shallow but wide river Tollense for the Bronze Age. The exact river
course cannot be reconstructed, but the distribution of fluvial deposits traces only a narrow corridor, in which the Tollense meandered close to the current riverbed. The initial formation of the valley mire dates to the transition from the Weichselian Late Glacial to the early Holocene.
A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.
A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.
A hydroxy-sodalite/cancrinite zeolite composite was synthesized from low-grade calcite-bearing kaolin by hydrothermal alkali-activation method at 160 C for 6 h. The effect of calcite addition on the formation of the hydroxy-sodalite/cancrinite composite was investigated
using artificial mixtures. The chemical composition and crystal morphology of the synthesized zeolite composite were characterized by X-ray powder diffraction, infrared spectroscopy, scanning electron microscopy, and N2 adsorption/desorption analyses. The average specific surface area is around 17–20 m2g-1, whereas the average pore size lies in the mesoporous range (19–21 nm). The synthesized zeolite composite was used as an adsorbent for the removal of heavy metals in aqueous solutions. Batch experiments were employed to study the influence of adsorbent dosage on heavy metal removal eciency. Results demonstrate the effective removal of significant quantities of Cu, Pb, Ni, and Zn from aqueous media. A comparative study of synthesized hydroxy-sodalite and
hydroxy-sodalite/cancrinite composites revealed the latter was 16–24% more effcient at removing heavy metals from water. The order of metal uptake effciency for these zeolites was determined to be Pb > Cu > Zn > Ni. These results indicate that zeolite composites synthesized from natural calcite-bearing kaolin materials could represent effective and low-cost adsorbents for heavy metal removal using water treatment devices in regions of water hortage.
The spatio-temporal reduction and oxidation of protein thiols is an essential mechanism in signal transduction inall kingdoms of life. Thioredoxin (Trx) family proteins efficiently catalyze thiol-disulfide exchange reactions andthe proteins are widely recognized for their importance in the operation of thiol switches. Trx family proteinshave a broad and at the same time very distinct substrate specificity–a prerequisite for redox switching. Despiteof multiple efforts, the true nature for this specificity is still under debate. Here, we comprehensively compare theclassification/clustering of various redoxins from all domains of life based on their similarity in amino acidsequence, tertiary structure, and their electrostatic properties. We correlate these similarities to the existence ofcommon interaction partners, identified in various previous studies and suggested by proteomic screenings. Theseanalyses confirm that primary and tertiary structure similarity, and thereby all common classification systems, donot correlate to the target specificity of the proteins as thiol-disulfide oxidoreductases. Instead, a number ofexamples clearly demonstrate the importance of electrostatic similarity for their target specificity, independent oftheir belonging to the Trx or glutaredoxin subfamilies
Background: Self-stigma is a result of internalizing negative stereotypes by the affected person. Research on self-stigma in substance use disorders (SUD) is still scarce, especially regarding the role of childhood trauma and subsequent posttraumatic disorders. Objectives: The present study investigated the progressive model of self-stigma in women with SUD and posttraumatic stress disorder (PTSD), and the predictive value of PTSD severity and childhood trauma experiences on self-stigma. Method: In a cross-sectional study with 343 women with SUD and PTSD, we used the Self-Stigma in Alcohol Dependency Scale, the Childhood Trauma Questionnaire (CTQ), the PTSD Symptom Scale Interview (PSS-I), and to control for SUD severity and depression, the Addiction Severity Index Lite and the Beck Depression Inventory-II. Hierarchical regression analyses were conducted for each stage of self-stigma (aware-agree-apply-harm). Results: The interrelated successive stages of self-stigma were largely confirmed. In the regression models, no significant effects of the PSS-I- and the CTQ-scores were observed at any stage of self-stigma. Agreeing with negative stereotypes was solely predicted by younger age, applying these stereotypes to oneself was higher in women with younger age, higher depression and SUD severity, and suffering from the application (harm) was only predicted by depression. Conclusions: The progressive model of self-stigma could be confirmed in women with SUD and PTSD, but PTSD severity and childhood trauma did not directly affect this process. Self-stigma appears to be related to depression in a stronger way than PTSD is related to women with SUD and PTSD.
Background: Self-stigma is a result of internalizing negative stereotypes by the affected person. Research on self-stigma in substance use disorders (SUD) is still scarce, especially regarding the role of childhood trauma and subsequent posttraumatic disorders. Objectives: The present study investigated the progressive model of self-stigma in women with SUD and posttraumatic stress disorder (PTSD), and the predictive value of PTSD severity and childhood trauma experiences on self-stigma. Method: In a cross-sectional study with 343 women with SUD and PTSD, we used the Self-Stigma in Alcohol Dependency Scale, the Childhood Trauma Questionnaire (CTQ), the PTSD Symptom Scale Interview (PSS-I), and to control for SUD severity and depression, the Addiction Severity Index Lite and the Beck Depression Inventory-II. Hierarchical regression analyses were conducted for each stage of self-stigma (aware-agree-apply-harm). Results: The interrelated successive stages of self-stigma were largely confirmed. In the regression models, no significant effects of the PSS-I- and the CTQ-scores were observed at any stage of self-stigma. Agreeing with negative stereotypes was solely predicted by younger age, applying these stereotypes to oneself was higher in women with younger age, higher depression and SUD severity, and suffering from the application (harm) was only predicted by depression. Conclusions: The progressive model of self-stigma could be confirmed in women with SUD and PTSD, but PTSD severity and childhood trauma did not directly affect this process. Self-stigma appears to be related to depression in a stronger way than PTSD is related to women with SUD and PTSD.
Stigma of Mental Illness in Germans and Turkish Immigrants in Germany: The Effect of Causal Beliefs
(2019)
Background: Stigma poses an additional burden for people suffering from mental illness, one that often impairs their social participation and can prevent them from seeking adequate help. It is therefore crucial to understand how stigma develops in order to counteract it by setting up effective evidence-based anti-stigma interventions. The present study examines the effect of causal beliefs on stigmatizing behavioral intentions, namely people's desire to distance themselves from persons with mental illness. In addition, we draw cross-cultural comparisons between native Germans and Turkish immigrants to investigate the influence of culture on stigma and causal beliefs and to broaden knowledge on the biggest immigrant group in Germany and on immigrants in Western countries in general.
Methods: n = 302 native Germans and n = 173 Turkish immigrants were presented either a depression or a schizophrenia vignette. Then, causal beliefs, emotional reaction and desire for social distance were assessed with questionnaires. Path analyses were carried out to investigate the influence of causal beliefs on the desire for social distance and their mediation by emotional reactions for Germans and Turkish immigrants, respectively.
Results: We found an influence of causal beliefs on the desire for social distance. Emotional reactions partly mediated this relationship. Causal attribution patterns as well as the relationship between causal attributions and stigma varied across both subsamples and mental illnesses. In the German subsample, the ascription of unfavorable personal traits resulted in more stigma. In the Turkish immigrant subsample, supernatural causal beliefs increased stigma while attribution to current stress reduced stigma.
Conclusion: Our study has implications for future anti-stigma interventions that intend to reduce stigmatization of mentally ill people. Targeting the ascription of unfavorable personal traits and supernatural causal attributions as well as promoting current stress as the cause for mental illness appears to be of particular importance. Also, the mediating influence of emotional responses to causal beliefs needs to be addressed. Furthermore, differential interventions across cultural groups and specific mental illnesses may be appropriate.
Finding suitable places to establish a mussel farm is challenging, as many aspects like mussel growth, clearance effect and the risk of low oxygen conditions, have to be considered. We present a tailor-made approach, combining field experiments with a spatially explicit model tool, to support the planning process. A case study was set up in the German part of Szczecin (Oder) Lagoon (Baltic Sea), as it shows all typical eutrophication problems and has a strong need and high potential for nutrient retention measures. Farming zebra mussels (Dreissena polymorpha) is an innovative approach that utilizes a species which is often perceived as a pest. The practical applicability and water quality improvement potential was proven by a pilot farm. Combining the gained knowledge with the simulation model led to a cascade of mussel farm options that differ in purpose, location, and biomass. Placing a mussel farm in an enclosed bay resulted in a remarkable water quality improvement (Secchi Depth increased up to 2 m), but the effect stayed local, the growth was limited and the potential annual nutrient removal reached a threshold of ~30 t N and 2.8 t P. The same nutrient removal could be reached with much smaller farms in an open sea area, whereas the change of water transparency or bottom oxygen conditions were neglectable. A maximal nutrient removal potential of 1,750 t N and 160 t P per year was estimated, when nearly the entire German part of Szczecin Lagoon with mussel farms was used. This led to a strong reduction of phytoplankton and an increase of Secchi Depth, but also a rising risk of anoxia. Overall, all mussel farm options are only a supportive measure, but not sufficient to reach the Good Environmental Status demanded by the Water Framework Directive. At once, the nutrient export from Szczecin Lagoon to the open Baltic was reduced by up to 3,500 t N and 420 t P per year, making the large-scale mussel farm option also a potential measure within the Marine Strategy Framework Directive.
Multiproxy investigations of lacustrine sediments from Laguna Azul (52 °S) document multi-millennial Holocene influences of Southern Hemispheric Westerlies (SHW) on the hydroclimatic variability of south-eastern Patagonia. During the last 4000 years, this hydroclimatic variability is overprinted by centennial warm/dry periods. A cool/wet period from 11,600 to 10,100 cal. BP is succeeded by an early Holocene dry period (10,100–8300 cal. BP) with a shallow lake, strong anoxia, methanogenesis and high salinity. Between 8300 and 4000 cal. BP the influence of SHW weakened, resulting in a freshwater lake considered to be related to less arid conditions. Since 4000 cal. BP, regional temperature decreased accompanied by re-intensification of SHW reaching full strength since 3000 cal. BP. Centred around 2200, 1000 cal. BP and in the 20th century, Laguna Azul experienced century-long warm/dry spells. Between these dry periods, two pronounced moist periods are suggested to be contemporaneous to the ‘Dark Age Cold Period’ and the ‘Little Ice Age’. Different from millennial SHW variations, centennial fluctuations appear to be synchronous for South America and the Northern Hemisphere. Changes in solar activity, large volcanic eruptions and/or modulations of ocean circulation are potential triggers for this synchronicity.
Solid Phase Assembly of Fully Protected Trinucleotide Building Blocks for Codon-Based Gene Synthesis
(2019)
We report on the effect of solar variability at the 27-day and the 11-year timescales on standard phase height measurements in the ionospheric D region carried out in central Europe. Standard phase height corresponds to the reflection height of radio waves (for constant solar zenith distance) in the ionosphere near 80 km altitude, where NO is ionized by solar Lyman radiation. Using the superposed epoch analysis (SEA) method, we extract statistically highly significant solar 27-day signatures in standard phase heights.
The 27-day signatures are roughly inversely correlated to solar proxies, such as the F10.7 cm radio flux or the Lyman-flux. The sensitivity of standard phase height change to solar forcing at the 27-day timescale is found to be in good agreement with the sensitivity for the 11-year solar cycle,suggesting similar underlying mechanisms. The amplitude of the 27-day signature in standard phase height is larger duringsolar minimum than during solar maximum, indicating that the signature is not only driven by photoionization of NO.We identified statistical evidence for an influence of ultra-long planetary waves on the quasi 27-day signature of standard phase height in winters of solar minimum periods.
The term diabetes mellitus comprises a group of metabolic diseases all distinguished by their main characteristic hyperglycaemia. With a steadily increasing prevalence diabetes displays an enormous burden for patients and health systems and is therefore of special interest for research. The development of the two main types of diabetes, type 1 and type 2, is closely linked to the formation of reactive species, especially hydrogen peroxide, inside different compartments of pancreatic beta cells. However, these cells are especially vulnerable towards oxidative stress mediated by hydrogen peroxide due to a low expression of antioxidative enzymes.
The main aims of the present thesis were to analyse the intracellular generation and to enable the site-specific detection of hydrogen peroxide to evaluate its role in the delicate equilibrium between redox signalling and oxidative stress under certain pathophysiological conditions, and moreover to monitor its movement through compartments and subcellular membranes of insulin-producing cells. Additionally, a new methodology for an artificial site-specific generation of hydrogen peroxide inside living cells was developed.
Introduction
Although shoulder girdle injuries are frequent, those of the medial part are widely unexplored.
Our aim is to improve the knowledge of this rare injury and its management in Germany
by big data analysis.
Methods
The data are based on ICD-10 codes of all German hospitals as provided by the German
Federal Statistical Office. Based on the ICD-10 codes S42.01 (medial clavicle fracture,
MCF) and S43.2 (sternoclavicular joint dislocation, SCJD), anonymized patient data from
2012 to 2014 were evaluated retrospectively for epidemiologic issues. We analyzed especially
the concomitant injuries and therapy strategies.
Results
A total of 114,003 cases with a clavicle involving shoulder girdle injury were identified with
12.5% of medial clavicle injuries (MCI). These were accompanied by concomitant injuries,
most of which were thoracic and craniocerebral injuries as well as injuries at the shoulder/
upper arm. A significant difference between MCF and SCJD concerning concomitant injuries
only appears for head injuries (p = 0.003). If MCI is the main diagnosis, soft tissue injuries
typically occur as secondary diagnoses. The MCI are significantly more often
associated with concomitant injuries (p < 0.001) for almost each anatomic region compared
with lateral clavicle injuries (LCI). The main differences were found for thoracic and upper
extremity injuries. Different treatment strategies were used, most frequently plate osteosynthesis
in more than 50% of MCF cases. Surgery on SCJD was performed with K-wires,
tension flange or absorbable materials, fewer by plate osteosynthesis.
Conclusions
We proved that MCI are rare injuries, which might be why they are treated by inhomogeneous
treatment strategies. No standard procedure has yet been established. MCI can
occur in cases of severely injured patients, often associated with severe thoracic or other
concomitant injuries. Therefore, MCI appear to be more complex than LCI. Further studies
are required regarding the development of standard treatment strategy and representative
clinical studies.
Neurobiological theories suggest that inter-individual differences in vagally mediated heart rate variability (vmHRV) have the potential to serve as a biomarker for inter-individual differences in emotion regulation that are due to inter-individual differences regarding the engagement of prefrontal and (para-)limbic brain regions during emotion processing. To test these theories, we investigated whether inter-individual differences in vmHRV would be associated with inter-individual differences in emotion regulation. We determined resting state vmHRV in a sample of 176 individuals that had also completed a short self-report measure of reappraisal and suppression use. Resting state vmHRV was derived from short-term (300 s) and ultra-short-term (120 s, 60 s) recordings of participants’ heart rate to determine the robustness of possible findings. Irrespective of recording length, we found that an increase in resting state vmHRV was associated with an increase in self-reported reappraisal but not suppression use. However, this association was only evident among male but not female participants, indicating a sex-specific association between inter-individual differences in resting state vmHRV and inter-individual differences in self-reported emotion regulation. These findings, which are consistent with previous ones, support theoretical claims that inter-individual differences in vmHRV serve as a biomarker for inter-individual differences in emotion regulation. Combing (ultra-)short-term measures of resting state vmHRV with short self-report measures of emotion regulation may, thus, be useful for researchers who have to investigate the neurobiological mechanisms of emotion regulation in a time- and resource-efficient manner.
Neurobiological theories suggest that inter-individual differences in vagally mediated heart rate variability (vmHRV) have the potential to serve as a biomarker for interindividual differences in emotion regulation that are due to inter-individual differences regarding the engagement of prefrontal and (para-)limbic brain regions during emotion processing. To test these theories, we investigated whether inter-individual differences in
vmHRV would be associated with inter-individual differences in emotion regulation. We determined resting state vmHRV in a sample of 176 individuals that had also completed a short self-report measure of reappraisal and suppression use. Resting state vmHRV was derived from short-term (300 s) and ultra-short-term (120 s, 60 s) recordings of participants’ heart rate to determine the robustness of possible findings. Irrespective of recording length, we found that an increase in resting state vmHRV was associated with an increase in self-reported reappraisal but not suppression use. However, this association was only evident among male but not female participants, indicating a sex-specific association between inter-individual differences in resting state vmHRV and inter-individual differences in self-reported emotion regulation. These findings, which are consistent with previous ones, support theoretical claims that inter-individual differences in vmHRV serve as a biomarker for inter-individual differences in emotion regulation. Combing (ultra-)short-term measures of resting state vmHRV with short selfreport measures of emotion regulation may, thus, be useful for researchers who have to investigate the neurobiological mechanisms of emotion regulation in a time- and resource-efficient manner.
Global climate change is occurring all over the world, but in the Arctic the climate is changing more rapidly and drastically than in many other parts of our planet. Many species that are already at their climatic limit need to adapt to recent climate conditions or migrate in order to not go extinct. The possibilities of adaption include phenotypic plasticity and adaptation to various extents. This is also the case for white spruce P. glauca, which belongs to the conifers and thus in the largest group of gymnosperms still living today. Among the approx. 600 extant conifer species white spruce is one of the most widespread trees in North American boreal forests. Its range extends from 69° N in the Canadian Northwest Territories to the Great Lakes at about 44° N, where it occurs from sea level to an altitude of about 1520 m (Burns and Honkala, 1990). Site related, climate-dependent differences in white spruce reproduction can be seen as a strategy to survive under the harsh climatic conditions at Alaska's treelines: Besides sexual reproduction, the vegetative propagation occurs in the white spruce as an additional reproductive mechanism. This can be realized by "layering" when the lower branches of the tree crown touch the ground and develop roots to later grow as a separate individual with or without a connection to the mother tree. Known as other mechanisms of vegetative propagation are also the rooting of fallen trees which were not completely uprooted, and the "root suckering", in which new shoots sprout from the roots of the tree. However, the latter was not yet observed in the genus Picea. With the help of short, repetitive, non-coding sequences in the genome, which are therefore not subject to selection and are called microsatellites, these clones can be determined by genotyping.
For this purpose, using different polymorphic microsatellites, an individual multilocus genotype is created for each tree, by means of which it can be compared with all other trees of the same species.
In the first part of this work (article I), the occurrence of clones in three study areas at Alaskan treelines are examined and the reasons for their appearance in variable numbers are discussed. For this purpose, 2571 white spruces (P. glauca) were genotyped and their position was determined via differential GPS in the field. The percentage of clonal trees is higher in areas with harsh climatic conditions and correlates with the height of the lowest branches of the tree crown. This suggests that the vegetative propagation of white spruce is a backup strategy for times when climatic conditions hamper sexual reproduction. The correlation between clone numbers and tree crown height suggests "layering" as the main mechanism for cloning whereas selection for vegetative reproduction seems to be very unlikely shown by the results for genetic differentiation between the clonal and the singleton trees in this study.
In the second part of this work (articles II and III), the influence of environmental factors and phenotypic traits on the mycobiome of the needles (including all fungi living on (epiphytic) and in (endophytic) the needles) in our study areas in Alaska was investigated. The mycobiome of the white spruce needles was chosen as a proxy for the parasite infection rate by fungi and thus serves as a fitness parameter. For this purpose, all epiphytic and endophytic fungal species were analyzed by a metabarcoding analysis.
In article II, 48 trees of one study area at Alaska’s northern treeline (Brooks Range) were examined for differences in mycobiome due to genetic differentiation, phenotypic characteristics and / or habitat characteristics. The trees used for this study were sampled from two adjacent plots on a south-facing mountain slope with an elevation gradient from 875 to 950 meters above sea level. It could be shown that, in contrast to the trees genotype, the height above sea level, the mountain slope, as well as the height and age of the trees have a significant impact on the mycobiome. The genetic differentiation between the tree individuals, however, showed no significant effect.
Based on article II we examined the mycobiome composition of a total of 96 trees in 2 plots (16 trees each) at three sites in Alaska over a distance of 500 kilometers. Additionally, we sampled needles of two different ages for each tree (current year and three years old needles) summing up to 192 samples in total. The incentive of this study (article III) was to investigate the influence of origin and age of spruce needles on their mycobiome and if there is a genetic predisposition that is related to the fungal species community. In addition, the sampling design was improved by collecting needles from all four orientations (North, South, East and West) and sampling trees at a standardized distance to each other to avoid systematic errors. Comparable to article II the influence of the trees genetics on the species community of the epiphytic and endophytic fungi of the white spruce needles seems to be very unlikely. In contrast, a significant influence of the geographic origin and the needle age on the species structure of the needle inhabiting fungal species was found. The phenotypic tree traits height and dbh (diameter at breast height) had only minor influence and did in fact explain less than 2% of the mycobiome variance. Using Illumina sequencing, 10.2 million reads from the nucleotide sequence between the internal transcribed spacer (ITS) genes could be obtained, which yielded in 1575 ribotypes (called operational taxonomic unit, OTU) for the fungi. These were compared with a reference database to compare and assign them to known fungal species. For example, 942 OTUs with >95% similarity could be identified as known species, with 1975 samples identified on genus level and 2683 when determined to family level. The most pronounced difference between the two studies (article II and III) were due to the fungal species of the class of Pucciniomycetes, more specifically the genus Chrysomyxa which belongs to the rust fungi and is plant pathogenic. In the study of article II (sampling in 2012), Pucciniomycetes accounted for only a minor portion of the assigned DNA sequences. In the second study (article III, sampling in 2015) they accounted for more than half of all basidiomycetes found, which in turn contain 20.0% of all DNA sequences, the second largest phylum found beside Ascomycetes (51.4%).
Central to this thesis are so-called G-quadruplex (G4) nucleic acids. These unusual structures have recently moved into the scientific limelight - mostly due to their prevalence in the human genome. Incidentally, the vast majority of G4-prone sequences is found in telomeric regions and in the promoter sequences of a large number of cancer-related genes.
Furthermore, recent studies suggest a wide applicability of these structures as therapeutic and functional agents, though the technology is still in its infancy with only a few oligonucleotides in clinical trials. Notably, G-quadruplexes are highly polymorphous, exhibiting different topologies and conformations based on sequence, solution condition and molecularity. Therefore, rational design of such structures with specific, topology-encoded functions demands a comprehensive understanding of the underlying folding parameters.
As the folding process is the result of a whole orchestra of parameters with synergistic effects, the herein proposed approach to understand the G4 structural arrangement concentrates on native G4-forming sequences with well-defined topologies. Perturbations of these structures by rational nucleotide substitutions allow for the observation of discrete effects on the folding pathway and on the resulting overall topology.
The method chosen for primary investigation in the following studies on G4 architectures was Nuclear Magnetic Resonance (NMR) as it is the most powerful tool for structure elucidation in liquids. Unique to this technique, it permits the observation of discrete species in mixtures by distinct perturbations at the atomic level as well as valuable insights into the molecular dynamics.
The included publications study the effects of site-specific bromine substitutions on native quadruplex scaffolds, thereby successfully inducing new structures. These expand the G4 structural landscape but also enhance our understanding of the driving forces in G4 folding.
Prothrombotic and Proinflammatory Activities of the β-Hemolytic Group B Streptococcal Pigment
(2019)
A prominent feature of severe streptococcal infections is the profound inflammatory response that contributes to systemic toxicity. In sepsis the dysregulated host response involves both immunological and nonimmunological pathways. Here, we report a fatal case of an immunocompetent healthy female presenting with toxic shock and purpura fulminans caused by group B streptococcus (GBS; serotype III, CC19). The strain (LUMC16) was pigmented and hyperhemolytic. Stimulation of human primary cells with hyperhemolytic LUMC16 and STSS/NF-HH strains and pigment toxin resulted in a release of proinflammatory mediators, including tumor necrosis factor, interleukin (IL)-1β, and IL-6. In addition, LUMC16 induced blood clotting and showed factor XII activity on its surface, which was linked to the presence of the pigment. The expression of pigment was not linked to a mutation within the CovR/S region. In conclusion, our study shows that the hemolytic lipid toxin contributes to the ability of GBS to cause systemic hyperinflammation and interferes with the coagulation system.
Escherichia coli has been commonly used as a platform for recombinant protein production and accounts for approximately 30% of current biopharmaceuticals on the market. Nowadays, many recombinant proteins require post-translational modifications which E. coli normally cannot facilitate. Therefore, novel technological advancements are unceasingly being developed to improve the E. coli expression system. In this work, some of the most recently engineered platforms for the production of disulfide bond-containing proteins were used to study the E. coli proteome under heterologous protein production stress. The effects of protein secretion via the Sec and Tat translocation pathways were examined using a comparative LC-MS/MS analysis. The E. coli proteome responds to foreign protein production by activation of several overlapping stress responses with a high degree of interaction. In consequence, a number of important cellular processes such as cellular metabolism, protein transport, redox state of the cytoplasm and membrane structure are altered by the production stress. These changes lead to the reduction of cellular growth and recombinant product yields. Resolving the identified bottlenecks will increase the efficiency of recombinant protein expression processes in E. coli.
Reversible posttranslational modifications play an important role during the regulation of many central processes in bacterial cells. Protein phosphorylation, in particular, can influence signal transduction processes and thus enables a distinct reaction of the cell to different stress and environmental conditions. In the case of the human pathogen Staphylococcus aureus, protein phosphorylation is involved in the adaptation to changing conditions during colonisation of human hosts. For this reason, the investigation of phosphorylations in S. aureus allows a better understanding of pathophysiology and virulence of this organism. Apart from stable phosphorylations at the amino acids serine, threonine and tyrosine, insights into energy-rich phosphorylations, for instance at arginine residues, gain more and more scientific attention. For this reason, one purpose of this study was the investigation of incidence and physiological relevance of this protein modification at a global scale. Firstly, the analysis of this modification was methodically optimised resulting in the identification of eight arginine phosphorylations in wild type cells of S. aureus COL. Secondly, the deletion mutant ΔptpB missing the gene that codes for an arginine phosphatase, was analysed. The characterisation of PtpB in vitro proved its activity and specificity towards arginine phosphorylations. This enabled the global analysis of the phosphoproteome with a focus on arginine phosphorylations. In addition to the optimisation of the phosphopeptide enrichment as part of the sample preparation, the data analysis process was adapted to the special challenges of energy-rich phosphorylations. Here, classical database search was extended by spectral library based analyses. In addition, synthetic peptides allow the generation of high quality mass spectra and the verification of database based evaluation strategies to ensure the quality of the spectral library. Next, S. aureus COL was cultivated under various conditions and several subcellular fractions were analysed with the aim to cover a broad part of the proteome. The combination of the spectra of synthetic peptides, the spectra of non-phosphorylated peptides from extensive cultivation experiments and the spectra of enriched phosphopeptides rendered the construction of a spectral library possible. This contained 2,270 proteins out of which 392 were found to be phosphorylated. A comparison of the database based analysis with spectral library based analysis showed the advantages of the latter when comparing the reproducibility of biological replicates. Thereby a permanent issue in phosphoproteomics was investigated. Hence, spectral libraries were used for the analysis of the phosphoproteome of S. aureus under control and stress conditions. 215 arginine phosphosites were identified within the mutant under control conditions and 117 under oxidative stress conditions. Oxidative stress was chosen because phenotypic characterisation of the mutant revealed that the most distinct growth changes in comparison with the wild type occurred after oxidative stress. These phenotypic changes were quantitatively approached in the last part of this work. Total proteome quantification of the wild type and mutant under control and stress conditions revealed an influence of the ptpB deletion on amino acid metabolism, oxidative stress response and virulence. The quantification of phosphopeptides by means of a combination of spectral library with Census based analysis finally confirmed the observations made during total proteome quantification.
Renal drug transporters such as the organic cation transporters (OCTs), organic anion
transporters (OATs) and multidrug resistance proteins (MRPs) play an important role in the tubular
secretion of many drugs influencing their efficacy and safety. However, only little is known about
the distinct protein abundance of these transporters in human kidneys, and about the impact of
age and gender as potential factors of inter-subject variability in their expression and function.
The aim of this study was to determine the protein abundance of MDR1, MRP1-4, BCRP, OAT1-3,
OCT2-3, MATE1, PEPT1/2, and ORCTL2 by liquid chromatography-tandem mass spectrometry-based
targeted proteomics in a set of 36 human cortex kidney samples (20 males, 16 females; median age
53 and 55 years, respectively). OAT1 and 3, OCT2 and ORCTL2 were found to be most abundant
renal SLC transporters while MDR1, MRP1 and MRP4 were the dominating ABC transporters.
Only the expression levels of MDR1 and ORCTL2 were significantly higher abundant in older donors.
Moreover, we found several significant correlations between different transporters, which may
indicate their functional interplay in renal vectorial transport processes. Our data may contribute to
a better understanding of the molecular processes determining renal excretion of drugs.
Profiling the activity and hepatotoxicity of flupirtine through medicinal chemistry approaches
(2019)
Drug induced liver injury (DILI) and tissue discoloration led to the recent discontinuation of the therapeutic use of the closely related drugs flupirtine and retigabine, respectively. Experience gained with these drugs strongly suggests that heterodimer, voltage‐gated potassium channels 2 and 3 (KV2/3) are valid targets for effective treatment of pain and epilepsy. Because the adverse effects are not related to the mechanism of action, it appears promising to investigate chemical modifications of these clinically validated, drug‐like leads. In the present retro metabolic drug design study, a series of 44 compounds were
synthesized and characterized with regards to KV7.2/3 opening activity and efficacy. The most active compounds displays excellent potency (EC50 = 4 nM) and efficacy (154%) as an Kv7.2/3 opener. Limited aqeous solubility hampered toxicity testing at concentrations higher than 63 μM, but this concentration was nontoxic to two hepatocellular cell ilnes (HEP‐G2 and TAMH) in culture.
Abstract
Background
The CRISPR/Cas9 system has opened new perspectives to study the molecular basis of cerebral cavernous malformations (CCMs) in personalized disease models. However, precise genome editing in endothelial and other hard‐to‐transfect cells remains challenging.
Methods
In a proof‐of‐principle study, we first isolated blood outgrowth endothelial cells (BOECs) from a CCM1 mutation carrier with multiple CCMs. In a CRISPR/Cas9 gene correction approach, a high‐fidelity Cas9 variant was then transfected into patient‐derived BOECs using a ribonucleoprotein complex and a single‐strand DNA oligonucleotide. In addition, patient‐specific CCM1 knockout clones were expanded after CRISPR/Cas9 gene inactivation.
Results
Deep sequencing demonstrated correction of the mutant allele in nearly 33% of all cells whereas no CRISPR/Cas9‐induced mutations in predicted off‐target loci were identified. Corrected BOECs could be cultured in cell mixtures but demonstrated impaired clonal survival. In contrast, CCM1‐deficient BOECs displayed increased resistance to stress‐induced apoptotic cell death and could be clonally expanded to high passages. When cultured together, CCM1‐deficient BOECs largely replaced corrected as well as heterozygous BOECs.
Conclusion
We here demonstrate that a non‐viral CRISPR/Cas9 approach can not only be used for gene knockout but also for precise gene correction in hard‐to‐transfect endothelial cells (ECs). Comparing patient‐derived isogenic CCM1+/+, CCM1+/−, and CCM1−/− ECs, we show that the inactivation of the second allele results in clonal evolution of ECs lacking CCM1 which likely reflects the initiation phase of CCM genesis.
Riociguat is one of several approved therapies available for patients with pulmonary arterial hypertension (PAH). Treatment should be initiated and monitored at an expert center by a physician experienced in treating PAH, and the dose adjusted in the absence of signs and symptoms of hypotension. In certain populations, including patients with hepatic or renal impairment, the elderly, and smokers, riociguat exposure may differ, and dose adjustments should therefore be made with caution according to the established scheme. Common adverse events are often easily managed, particularly if they are discussed before starting therapy. Combination therapy with riociguat and other PAH-targeted agents is feasible and generally well tolerated, although the coadministration of phosphodiesterase type 5 inhibitors (PDE5i) and riociguat is contraindicated. An open-label, randomized study is currently ongoing to assess whether patients who do not achieve treatment goals while receiving PDE5i may benefit from switching to riociguat. In this review, we provide a clinical view on the practical management of patients with PAH receiving riociguat, with a focus on the opinions and personal experience of the authors.
The reviews of this paper are available via the supplemental material section.
In times of recent climate change, mechanisms to deal with different environments (e.g. via dispersal to other habitats, or via in-situ responses such as genetic adaptation or phenotypic plasticity) are essential. In regions showing seasonality, organisms are already adapted to regular and, thus, often predictable environmental changes. One well-known strategy to survive periods of food shortage, especially during the winter, is hibernation. Although hibernation is already an adaptation to overcome unfavourable conditions, the optimal timing of hibernation to match for example food abundance peaks is likely to be influenced by changing climatic conditions, as expected during human-induced global change. Thus, the ability to respond to changes in optimal timing of hibernation can be crucial for organisms. All hibernators are positioned at the slow end of the slow-fast life history continuum. Longevity combined with a low annual reproductive output can result in slow recovery from population crashes and is expected to be associated with slow genetic adaptation. Therefore, it is assumed that phenotypic plasticity, a rather rapid and sometimes reversible process, is a crucial mechanism in long-lived organisms to adapt to changing environments. However, how differences in individual hibernation behaviour influence mortality and whether individuals are plastic with respect to their hibernation behaviour are largely unknown.
Recent studies suggest that climatic change can influence hibernation behaviour in various species differently, in a positive or negative way. Female Columbian ground squirrels (Urocitellus columbianus) delayed their emergence from hibernation with later snow melt and lower spring temperatures. Next to the environmental impact, emergence date showed a moderate heritability in female Columbian ground squirrels. Yellow-bellied marmots (Marmota flaviventris) emerged earlier from hibernation with warmer spring temperatures which resulted in a longer growing period for their offspring and, therefore, higher survival rates. In contrast, in alpine marmots (Marmota marmota) lower snow cover due to higher temperatures and, thus, less isolation led to lower juvenile survival. Negative effects, such as reduced juvenile survival, would be of high concern, especially for long-lived species with a low reproductive output.
Bats are exceptionally long-lived compared to other mammals of the same size and often show a low reproductive output with one offspring per year. This is especially true in the temperate zone where bats, furthermore, are characterized by seasonality and depend on hibernation during winter period to survive food and water shortage. Because bats are of high conservation concern it is of prime importance to understand their ability to respond to different climatic conditions and associated mortality costs.
The basis of this study was a five-year data set of 1047 RFID-tagged individuals from two bat species, Natterer’s bats (Myotis nattereri) and Daubenton’s bats (Myotis daubentonii), that were automatically tracked when entering or leaving the joint hibernaculum, “Brunnen Meyer”, located in north-western Germany. The two species are similar sized, share demographical traits and often occupy the same areas. Nevertheless, they differ in their foraging strategy and activity pattern during hibernation period. Natterer’s bats are able to glean insects from surfaces, even at low temperatures. Daubenton’s bats depend on flying arthropods and, thus, warmer temperatures. And indeed there is evidence that Natterer’s bats are able to hunt during hibernation period, while in Daubenton’s bats a lack of feeding during the hibernation period is suggested. Furthermore, Natterer’s bats are characterized by a higher activity at the hibernaculum throughout the hibernation period, while Daubenton’s bats on average arrive earlier, stay inactive through the winter and leave later in spring.
In both species, the aim was to investigate the impact of their individual hibernation behaviour, precisely the timing of departure in late winter and early spring, on mortality, their adjustment of departure timing to the North Atlantic Oscillation Index (NAO), as well as differences within and between the two species from 2011 until 2015.
To later on estimate the potential mortality costs of departure timing, gaining knowledge about the seasonal survival pattern (winter vs. summer) in the two species was a first necessity. In birds, particularly small species were described as winter-regulated populations with a higher mortality during winter. In contrast, in hibernating mammal species, such as bats, a relatively lower or similar winter survival compared to summer survival was shown. In this study, the analysed data demonstrated that the winter 2010/2011 was exceptionally catastrophic in Natterer’s bats and did not impact Daubenton’s bats. When excluding this catastrophic winter in Natterer’ bats, our results revealed a stable winter-summer-survival difference (higher winter and lower summer survival) in adult Natterer’s and Daubenton’s bats, with inter-annual variation in the level of survival which indicates a potential environmental impact on survival. This winter-summer survival pattern is in line with the survival pattern shown for other hibernators. Juveniles always had a lower survival rate than adult bats in both species. Nevertheless, the extent to which the species differ between seasons and age classes was stronger in Daubenton’s bats. They always showed a slightly higher winter survival and a lower summer survival than Natterer’s bats. Together with the catastrophic winter 2010/2011 in Natterer’s bats, this indicates a species-specific sensitivity to the timing of specific weather events which is in line with their foraging strategies and activity pattern during hibernation period.
With respect to emergence behaviour from the hibernaculum, the results of this study suggest considerable differences among individuals within as well as between bat species. In comparison to Daubenton’s bats, Natterer’s bats tuned their emergence more closely to weather conditions, specifically the NAO, a large scale weather index related to winter severity, and showed individual variation in behavioural plasticity. In Daubenton’s bats only the females responded to changing conditions and left earlier in individually-experienced warmer and milder winters, comparable to Natterer’s bats females. A potential reason might be reproductive advantages for the females resulting in a longer growing period for their offspring. The shown higher winter survival in adult bats of both species indicated already higher energy expenditure outside the hibernaculum. Thus, leaving early, being active and staying outside longer by itself bore a risk (exposure risk effect). Under consideration of longer exposure times, early departing individuals had on top of that an increased risk to die. This was not given in each year, but a species- and year-specific pattern was revealed. Natterer’s bats were only significantly affected by early departure in 2011, while the remaining years show no significant additional risk of leaving early. In Daubenton’s bats, the years 2014 and 2015 were associated with a significantly higher mortality of leaving early. This is in line with the hypothesis that Daubenton’s bats might not be able to hunt for insects leaving too early and do so as a best out of a bad job. Nevertheless, the year-specific pattern suggests that early bats might profit from advantageous weather conditions during early spring.
An additional hint for an environmental impact on early bat survival in at least Daubenton’s bats is that the median proportion of night hours above 3 °C within five days after departure was included in the model with the lowest AIC. However, the effect was not strong enough to be selected as the best model and, therefore, further analyses are needed to investigate this first hint.
In conclusion, the reduced winter survival of juveniles compared to adults highlights the importance of considering age class effects in studies that investigate seasonal survival patterns. The stable species-specific winter-summer-survival difference with a higher winter survival compared to summer survival, as well as the one catastrophic winter in Natterer’s bats underline the importance of including seasonal survival patterns in assessing potential fitness costs of changed behaviour. Furthermore, our results suggest that long-lived hibernating bat species have the potential to plastically adjust to changing climatic conditions, but this potential differs between species. Among-individual differences in emergence together with species-specific mortality costs of early emergence suggest the potential for natural selection to shape hibernation phenology. In summary, our findings suggest species-, population- and group-specific differences in the ability to respond to changing environments and, therefore, underline the necessity to further investigate local responses in various organisms to estimate consequences of recent climate change on a wider range.
Phylogeny of the Koi herpesvirus and development of a vaccine against the Koi herpesvirus disease
(2019)
The aim of this presented dissertation was a stable, live attenuated and protective KHV usable as vaccine. Moreover this vaccine should by cost effective and easy to apply. Differentiation of infected and vaccinated animals was preferred by genetic and / or serological means. After achieving an attenuated virus, whole genome sequencing should be done to examine the genetic of the vaccine as one feature of biosafety. Besides biosafety additional knowledge on the virulence of Alloherpesviruses, especially of KHV was anticipated. Additionally the diagnostics of KHV and KHVD should be improved to increase reliability and to gain more insights into the relationship of different KHVs and hopefully to detect the source of an outbreak.
Molybdenum dependent enzymes are involved in essential metabolic transformations in bacteria, plants, and human beings. The extreme instability of the molybdenum cofactor (Moco) prevents its use as an effective treatment for patients with a Moco deficiency. Therefore, the design, develop and execute the artificial molybdenum cofactor models are essential.
In the present thesis, the asymmetric molybdopterin (mpt) model precursors with oxygen functionality and various electronic structures and their Moco model complexes mimicking the natural cofactor have been synthesized and comprehensively investigated through multi-nuclear NMR, MS, IR, resonance Raman, X-ray crystallography, UV-Vis, and electrochemical methods. Notably, the asymmetrically substituted dithiolenes in this thesis are confirmed through a significant push-pull effect, which is tuning its electronic structure. The redox behavior of Moco model complexes was investigated by temperature-dependent cyclic voltammetry. Electronic and vibrational spectral studies were investigated in detail to understand substituents effect on the electronic structure of model complexes and to elucidate roles of mpt in catalysis. Since the model complexes can be considered as structural models for the Moco dependent oxidoreductases, catalytic oxygen atom transfer (OAT) reactions in DMSO/PPh3 were investigated.
The main focus of the present thesis was achieved through the development of various synthetic routes that address phosphonate bearing dithiolene ligands, inspiring the natural mpt. Simultaneously the Minisci protocol was applied for the synthesis of new pterin ketophosphonates, taking into consideration the essential aspects of the natural molybdopterin, including the phosphate anchor group. Even though some aspects of this protocol require further optimizations, but the mentioned synthetic route has exceptional potential and flexibility.
In acinar cells, cellular organelles like zymogene granule, mitochondria, endoplasmic reticulum and lysosome functions in coordinate way in order to synthesize and secrets large amounts of digestive enzyme. Dysfunction of this organelle, results into enzyme activation within acinar cell; ultimately, acute pancreatitis. While previous studies reported that mitochondrial function is disrupt but mechanism of clearance of these mitochondria remains unknown during pancreatitis. Here we reported that PINK1 and Parkin mediated pathway is activated during pancreatitis and clears dysfunctional mitochondria in-vivo. PINK1 or Parkin deficient acinar cell had energy crisis, decreased ATP production and altered acinar cell fate in-vitro. Inhibiting clearance of dysfunctional mitochondria aggravates experimental pancreatitis severity and delays regeneration/recovery of exocrine tissue after disease via PARIS-PGC-1α pathway. While an attempt to explore therapeutic target of PARIS-PGC-1α pathway by treatment of SRT1720 rescued experimental pancreatitis. Together, PINK1 and Parkin, restricts exocrine pancreatic damage in pancreatitis and accelerates tissue recovery after disease.
Background: Pancreatic exocrine insufficiency (PEI) is characterized by inadequate production, insufficient secretion, and/or inactivation of pancreatic enzymes, resulting in maldigestion. The aim of this review was to analyze the prevalence and pathophysiology of PEI resulting from gastrointestinal (GI) surgery and to examine the use of pancreatic enzyme replacement therapy (PERT) for effectively managing PEI. Summary: A targeted PubMed search was conducted for studies examining the prevalence and pathophysiology of PEI in patients following GI surgery and for studies assessing the effects of PERT in these patients. PEI is a common complication following GI surgery that can lead to nutritional deficiencies, which may contribute to morbidity and mortality in patients. Timely treatment of PEI with PERT can prevent malnutrition, increase quality of life, and possibly reduce the associated mortality. Treatment of PEI should aim not only to alleviate symptoms but also to achieve significant improvements in nutritional parameters. Dose optimization of PERT is required for effective management of PEI, in addition to regular assessment of nutritional status, appropriate patient education, and reassessment if symptoms return. Key Messages: Difficulties in detecting PEI following GI surgery can result in undiagnosed and untreated maldigestion, leading to metabolic complications and increased morbidity. Both are preventable by early administration and monitoring for optimal doses of PERT.
Background: Pancreatic exocrine insufficiency (PEI) is characterized by inadequate production, insufficient secretion, and/or inactivation of pancreatic enzymes, resulting in maldigestion. The aim of this review was to analyze the prevalence and pathophysiology of PEI resulting from gastrointestinal (GI) surgery and to examine the use of pancreatic enzyme replacement therapy (PERT) for effectively managing PEI. Summary: A targeted PubMed search was conducted for studies examining the prevalence and pathophysiology of PEI in patients following GI surgery and for studies assessing the effects of PERT in these patients. PEI is a common complication following GI surgery that can lead to nutritional deficiencies, which may contribute to morbidity and mortality in patients. Timely treatment of PEI with PERT can prevent malnutrition, increase quality of life, and possibly reduce the associated mortality. Treatment of PEI should aim not only to alleviate symptoms but also to achieve significant improvements in nutritional parameters. Dose optimization of PERT is required for effective management of PEI, in addition to regular assessment of nutritional status, appropriate patient education, and reassessment if symptoms return. Key Messages: Difficulties in detecting PEI following GI surgery can result in undiagnosed and untreated maldigestion, leading to metabolic complications and increased morbidity. Both are preventable by early administration and monitoring for optimal doses of PERT.
In our retrospective study we researched for possible injuries to the eye and orbit in patients who suffered from polytrauma. We assessed 6,000 patients with severe trauma, who were treated at the Unfallkrankenhaus Berlin (UKB) between February 2006 and August 2014. Out of them, 1,061 maxillofacial CT scans were performed additionally to a whole-body scan as further injuries to eye and/or orbit could clinically not be excluded. We used a systemic diagnostic workup to examine the frequency and severity of a trauma to osseous and soft tissue structures of the orbit. For the assessment of the bony orbital walls we included the detection of a fracture gap, a rough dislocation of bony fragments as well as the detonation of osseous sutures between facial bones. Concerning the orbital soft tissue structures we looked at injuries of the ocular globe including the lens, extraocular muscles, optic nerve and orbital vessels. Complementary, we collected clinical data of eye examinations of our patients by using the medical information system (MIS) software medico. We appraised the ophthalmic diagnostic findings based on three criteria: the intraocular pressure (IOP), the vision and eye movements and recorded whether surgery or conservative treatment was conducted.
Out of 1,061 maxillofacial CT images, 811 were excluded. 668 patients did not have a trauma to the midface and 143 patients only showed fractures of the nose and/or jaw. The remaining 250 patients revealed traumata to the orbit: 149 CT scans showed fractures of the orbital cavity without participation of soft tissue structures. Three patients presented with pure soft tissue traumata to the eye and 98 scans displayed combined injuries of bones and orbital soft tissue structures. The right orbit was concerned in 35.6%, the left orbit in 32.8% and both orbits in 31.6% of cases. The prevailing type of fracture was the single wall fracture, followed by two- and three-walled fractures. In the majority of cases the orbital roof, floor or lateral wall were concerned. Besides blow-out fractures, we detected characteristic fractures as the tripod fracture and Le Fort 2°. Regarding the soft tissue traumata of 101 CT scans, we detected an unshaped vitreous body in 23.8% and a (partially) ruptured globe in 6.9%. The ocular lens was dislocated in six cases (5.9%). A foreign body pre-orbital and within the conus was found three times. Considering the extraocular muscles, we discovered that 44.6% of muscles were dislocated. In 7.9% extraocular muscles were pierced by bone, in one case the muscle was pierced by a foreign body. Searching for structural alterations of the optic nerve, 12.9% of 101 scans presented an elongated optic nerve and 9.9% revealed an altered morphology. One nerve was transected by a metallic foreign body. Upon closer inspection of orbital vessels, we detected 9.9% prominent ophthalmic veins and 5.9% posttraumatic dCCF out of 101 CT scans. The results of the clinical eye examinations showed that 19.2% of the collective of 250 patients presented with an increased IOP. 4.8% of 250 patients had a reduced or lost vision and 10% of patients had suffered from a limited ocular movement after trauma to the midface.
In conclusion, approximately 9.5% from 1,061 polytrauma patients presented with associated orbital injuries. Ocular injuries are not often given immediate concern as patients with life-threatening conditions need to be stabilized first. Undetected serious eye injuries might lead to a reduced or lost vision, which could result in severe limitations of quality of life. The results of our study speak in favor for early ophthalmological consultations and radiological imaging. Diagnostic and treatment of possible orbital injuries should be remembered in a polytrauma patient.
Despite the widespread use of oral contraceptives (OCs), remarkably little is known about the effects of OCs on emotion, cognition, and behavior. However, coincidental findings suggest that OCs impair the ability to recognize others’ emotional expressions, which may have serious consequences in interpersonal contexts. To further investigate the effects of OCs on emotion recognition, we tested whether women who were using OCs (n = 42) would be less accurate in the recognition of complex emotional expressions than women who were not using OCs (n = 53). In addition, we explored whether these differences in emotion recognition would depend on women’s menstrual cycle phase. We found that women with OC use were indeed less accurate in the recognition of complex expressions than women without OC use, in particular during the processing of expressions that were difficult to recognize. These differences in emotion recognition did not depend on women’s menstrual cycle phase. Our findings, thus, suggest that OCs impair women’s emotion recognition, which should be taken into account when informing women about the side-effects of OC use.
Abstract
The efficient multifunctionalization by one‐pot or cascade catalytic systems has developed as an important research field, but is often challenging due to incompatibilities or cross‐reactivities of the catalysts leading to side product formation. Herein we report the stereoselective preparation of cis‐ and trans‐4‐aminocyclohexanol from the potentially bio‐based precursor 1,4‐cyclohexanedione. We identified regio‐ and stereoselective enzymes catalyzing reduction and transamination of the diketone, which can be performed in a one‐pot sequential or cascade mode. For this, we identified regioselective keto reductases for the selective mono reduction of the diketone to give 4‐hydroxycyclohexanone. The system is modular and by choosing stereocomplementary amine transaminases, both cis‐ and trans‐4‐aminocyclohexanol were synthesized with good to excellent diastereomeric ratios. Furthermore, we identified an amine transaminase that produces cis‐1,4‐cyclohexanediamine with diastereomeric ratios >98 : 2. These examples highlight that the high selectivity of enzymes enable short and stereoselective cascade multifunctionalizations to generate high‐value building blocks from renewable starting materials.
Introduction
The bacterium Staphylococcus aureus is a notorious pathogen that causes dangerous and difficult-to-treat infections. This applies especially to methicillin-resistant S. aureus, better known as MRSA. MRSA infections were originally associated with healthcare settings as a consequence of clinical antibiotic therapy. However, in recent years MRSA infections have become more common among healthy individuals in the community. The community-associated (CA-)MRSA lineages are generally more aggressive than hospital-associated (HA-) lineages. Therefore, it is alarming that such CA-MRSA lineages are now emerging in hospitals. This raises the fundamental question of how CA-MRSA adapts to this new niche. Further, since the originally distinguishing features of CA- and HA-MRSA are losing discriminative value, it is important from a healthcare perspective to identify novel distinctive markers for early recognition and elimination of hospital-adapted CA-MRSA. In the present PhD research, these challenges were tackled with a ‘multi-omics’ approach focused on the USA300 lineage of MRSA, originally identified as CA, but now also causing hospital outbreaks. The results show that hospital-adapted USA300 isolates produce an altered spectrum of virulence factors, changed their metabolism, and exploit human immune cells as a protective environment against antibiotics. Importantly, hospital-adapted CA-MRSA strains can be recognized through distinctive patterns of gene expression and secreted virulence factors. Altogether, these observations show that the epidemic behaviour of MRSA is a multi-factorial trait, and they provide new insights into the missing links between epidemiology and pathophysiology of S. aureus. Moreover, they highlight the benefits of multi-omics technologies for protecting patients and frail individuals against the aggressive CA-MRSA.
We all know the experience of different demands on ourselves. As a parent, we want to be there for our children, and in pursuit of our career, we want to invest as much time as possible. If we are committed to both being a good parent and pursuing a career, it may be impossible to satisfy the demands stemming from both commitments. It is in such moments in which our, what I call, practical identities are conflicted that our will is in a state of volitional disunity. In this dissertation, I discuss how a person may best cope with volitional disunity.
I define practical identities in line with Christine M. Korsgaard as self-descriptions under which a person finds her life worth living and her actions worth undertaking; examples of such self-descriptions are being a parent, an employee, a hobbyist pianist, the friend of Charlotte, etc. Practical identities provide the person with ideals that form a decision-making framework for her deliberations about what to do. The standard analysis of volitional disunity, is that it causes a person to not know what to do as her identities, as guides, point her in conflicting, even opposite, directions. The solutions proposed in the literature always include, what I call, the Unification Ideal: a person has to prioritize her identities by deciding which is more important to her. By unifying her identities in this way, she constitutes who she is and wants to be thereby providing herself with a clear decision-making framework regarding the question of what to do.
In this dissertation however, I argue that a person does not need to overcome her volitional disunity through unification per se. In order to know what to do, a person could also explore the disunity that defines her will, which includes that she could accept the volitional disunity as hers. I base this Exploration Ideal on two assumptions about human nature: 1) we have inner responses to how we act and 2) we are opaque to ourselves. Since a person cannot always know in advance whether she will be happy with a commitment by turning her attention inwards, she can explore who she wants to be and who she can be through the bodily, psychological, and emotive responses she has to her actions. These responses, however, are not the ultimate authority. This authority stays with her practical identities in light of which she can evaluate these inner responses. Thus, a person exposed to volitional disunity should strive to explore this disunity, how she wants it to define her and whether it is constitutive of who she is (Exploration Ideal) instead of trying to overcome the disunity by striving for unification (Unification Ideal).
Autosomal dominant cerebral cavernous malformation (CCM) represents a genetic disorder with a high mutation detection rate given that stringent inclusion criteria are used and copy number variation analyses are part of the diagnostic workflow. Pathogenic variants in either CCM1 (KRIT1), CCM2 or CCM3 (PDCD10) can be identified in 87–98% of CCM families with at least two affected individuals. However, the interpretation of novel sequence variants in the 5′-region of CCM2 remains challenging as there are various alternatively spliced transcripts and different transcription start sites. Comprehensive genetic and clinical data of CCM2 patients with variants in cassette exons that are either skipped or included into alternative CCM2 transcripts in the splicing process can significantly facilitate clinical variant interpretation. We here report novel pathogenic CCM2 variants in exon 3 and the adjacent donor splice site, describe the natural history of CCM disease in mutation carriers and provide further evidence for the classification of the amino acids encoded by the nucleotides of this cassette exon as a critical region within CCM2. Finally, we illustrate the advantage of a combined single nucleotide and copy number variation detection approach in NGS-based CCM1/CCM2/CCM3 gene panel analyses which can significantly reduce diagnostic turnaround time.
Abstract
Background
Early mobilization improves physical independency of critically ill patients at hospital discharge in a general intensive care unit (ICU)‐cohort. We aimed to investigate clinical and molecular benefits or detriments of early mobilization and muscle activating measures in a high‐risk ICU‐acquired weakness cohort.
Methods
Fifty patients with a SOFA score ≥9 within 72 h after ICU admission were randomized to muscle activating measures such as neuromuscular electrical stimulation or whole‐body vibration in addition to early protocol‐based physiotherapy (intervention) or early protocol‐based physiotherapy alone (control). Muscle strength and function were assessed by Medical Research Council (MRC) score, handgrip strength and Functional Independence Measure at first awakening, ICU discharge, and 12 month follow‐up. Patients underwent open surgical muscle biopsy on day 15. We investigated the impact of muscle activating measures in addition to early protocol‐based physiotherapy on muscle strength and function as well as on muscle wasting, morphology, and homeostasis in patients with sepsis and ICU‐acquired weakness. We compared the data with patients treated with common physiotherapeutic practice (CPP) earlier.
Results
ICU‐acquired weakness occurs within the entire cohort, and muscle activating measures did not improve muscle strength or function at first awakening (MRC median [IQR]: CPP 3.3 [3.0–4.3]; control 3.0 [2.7–3.4]; intervention 3.0 [2.1–3.8]; P > 0.05 for all), ICU discharge (MRC median [IQR]: CPP 3.8 [3.4–4.4]; control 3.9 [3.3–4.0]; intervention 3.6 [2.8–4.0]; P > 0.05 for all), and 12 month follow‐up (MRC median [IQR]: control 5.0 [4.3–5.0]; intervention 4.8 [4.3–5.0]; P = 0.342 for all). No signs of necrosis or inflammatory infiltration were present in the histological analysis. Myocyte cross‐sectional area in the intervention group was significantly larger in comparison with the control group (type I +10%; type IIa +13%; type IIb +3%; P < 0.001 for all) and CPP (type I +36%; type IIa +49%; type IIb +65%; P < 0.001 for all). This increase was accompanied by an up‐regulated gene expression for myosin heavy chains (fold change median [IQR]: MYH1 2.3 [1.1–2.7]; MYH2 0.7 [0.2–1.8]; MYH4 5.1 [2.2–15.3]) and an unaffected gene expression for TRIM63, TRIM62, and FBXO32.
Conclusions
In our patients with sepsis syndrome at high risk for ICU‐acquired weakness muscle activating measures in addition to early protocol‐based physiotherapy did not improve muscle strength or function at first awakening, ICU discharge, or 12 month follow‐up. Yet it prevented muscle atrophy.
The importance of investments by emerging country multinationals to industrialised economies has risen continuously as illustrated by the growing number of Chinese merger and acquisitions (M&A) of German Mittelstand firms. This dissertation aims to analyse the effects of institutional distances on the M&A process. To this end, William Scott’s concept of institutions is newly operationalized to investigate institutional distances on the intra-firm, regional and international level. Through interviews with involved firms, intermediaries and key persons with dual backgrounds, the effects on different dimensions of the subsidiaries’ embeddedness as well as various mechanisms of institutional work during and after the M&A are evaluated.
Background and Objective: Transcranial random noise stimulation (tRNS) is an emerging non-invasive brain stimulation technique to modulate brain function, with previous studies highlighting its considerable benefits in therapeutic stimulation of the motor system. However, high variability of results and bidirectional task-dependent effects limit more widespread clinical application. Task dependency largely results from a lack of understanding of the interaction between externally applied tRNS and the endogenous state of neural activity during stimulation. Hence, the aim of this study was to investigate the task dependency of tRNS-induced neuromodulation in the motor system using a finger-tapping task (FT) versus a go/no-go task (GNG). We hypothesized that the tasks would modulate tRNS’ effects on corticospinal excitability (CSE) and task performance in opposite directions.
Methods: Thirty healthy subjects received 10 min of tRNS of the dominant primary motor cortex in a double-blind, sham-controlled study design. tRNS was applied during two well-established tasks tied to diverging brain states. Accordingly, participants were randomly assigned to two equally-sized groups: the first group performed a simple motor training task (FT task), known primarily to increase CSE, while the second group performed an inhibitory control task (go/no-go task) associated with inhibition of CSE. To establish task-dependent effects of tRNS, CSE was evaluated prior to- and after stimulation with navigated transcranial magnetic stimulation.
Results: In an ‘activating’ motor task, tRNS during FT significantly facilitated CSE. FT task performance improvements, shown by training-related reductions in intertap intervals and increased number of finger taps, were similar for both tRNS and sham stimulation. In an ‘inhibitory’ motor task, tRNS during GNG left CSE unchanged while inhibitory control was enhanced as shown by slowed reaction times and enhanced task accuracy during and after stimulation.
Conclusion: We provide evidence that tRNS-induced neuromodulatory effects are task-dependent and that resulting enhancements are specific to the underlying task-dependent brain state. While mechanisms underlying this effect require further investigation, these findings highlight the potential of tRNS in enhancing task-dependent brain states to modulate human behavior.
Environmental activism, defined as a range of difficult pro-environmental behaviors, is analyzed within the conceptual framework of Significance Quest Theory (SQT). In Study 1, 40 interviews were carried out on two groups of people in the European Union: Committed Actors for Nature (CANs, n = 25) versus Committed Actors for Society (CASs, n = 15). Results demonstrated that Significance Quest (SQ) motivates each group to be strongly committed to their chosen action and the main difference between them being in their ideology (pro-social vs. pro-environmental). In Study 2 (N = 131), the relationship between SQ and intention to enact difficult pro-environmental behaviors was assessed. Results suggested that the higher the SQ, the higher the tendency to enact difficult pro-environmental behaviors, but not average or easy ones. Moreover, the higher the pro-environmental ideology, the stronger the indirect effect of SQ on difficult behavior through willingness to sacrifice.
Research has shown that parental pressure is negatively whereas parental support is positively associated with various scholastic outcomes, such as school engagement, motivation, and achievement. However, only few studies investigate boys' and girls' perception of mother and father pressure/support in detail. This might be particularly essential when it comes to girls' and boys' achievement in STEM subjects, as girls and boys might profit differently from parental pressure/support regarding their achievement in STEM and vice versa. This study aims to shed light on this topic and explores potential within—and over time associations between students' perception of parental pressure/support and grades in mathematics and biology. Using self-report data from 1,088 8th grade students at T1 (Mage = 13.70, SD = 0.53, 54% girls) from Brandenburg, Germany, multigroup cross-lagged models were conceptualized with Mplus. The results indicate that there are gender differences in the interplay of students' grades in mathematics, biology, and their perception of parental pressure and support: Whereas, mother support plays a central beneficial role for girls' achievement in STEM subjects as well as for the other parental variables over time, for boys mother support is negatively associated with math performance over time. Within-time associations further show that boys—in contrast to girls—do not benefit from any parental support regarding their performance in mathematics or biology. Finally, results suggest that the relationship between adolescents' STEM achievement and parental pressure/support is rather mono-directional than bi-directional over time.
Proteostasis is critical for cells to maintain the balance between protein synthesis, quality control, and degradation. This is particularly important for myeloid cells of the central nervous system as their immunological function relies on proper intracellular protein turnover by the ubiquitin-proteasome system. Accordingly, disruption of proteasome activity due to, e.g., loss-of-function mutations within genes encoding proteasome subunits, results in systemic autoinflammation. On the molecular level, pharmacological inhibition of proteasome results in endoplasmic reticulum (ER) stress-activated unfolded protein response (UPR) as well as an induction of type I interferons (IFN). Nevertheless, our understanding as to whether and to which extent UPR signaling regulates type I IFN response is limited. To address this issue, we have tested the effects of proteasome dysfunction upon treatment with proteasome inhibitors in primary murine microglia and microglia-like cell line BV-2. Our data show that proteasome impairment by bortezomib is a stimulus that activates all three intracellular ER-stress transducers activation transcription factor 6, protein kinase R-like endoplasmic reticulum kinase and inositol-requiring protein 1 alpha (IRE1α), causing a full activation of the UPR. We further demonstrate that impaired proteasome activity in microglia cells triggers an induction of IFNβ1 in an IRE1-dependent manner. An inhibition of the IRE1 endoribonuclease activity significantly attenuates TANK-binding kinase 1-mediated activation of type I IFN. Moreover, interfering with TANK-binding kinase 1 activity also compromised the expression of C/EBP homologous protein 10, thereby emphasizing a multilayered interplay between UPR and type IFN response pathway. Interestingly, the induced protein kinase R-like endoplasmic reticulum kinase-activation transcription factor 4-C/EBP homologous protein 10 and IRE1-X-box-binding protein 1 axes caused a significant upregulation of proinflammatory cytokine interleukin 6 expression that exacerbates STAT1/STAT3 signaling in cells with dysfunctional proteasomes. Altogether, these findings indicate that proteasome impairment disrupts ER homeostasis and triggers a complex interchange between ER-stress sensors and type I IFN signaling, thus inducing in myeloid cells a state of chronic inflammation.