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Variability of Thyroid Measurements from Ultrasound and Laboratory in a Repeated Measurements Study
(2020)
Background: Variability of measurements in medical research can be due to different sources. Quantification of measurement errors facilitates probabilistic sensitivity analyses in future research to minimize potential bias in epidemiological studies. We aimed to investigate the variation of thyroid-related outcomes derived from ultrasound (US) and laboratory analyses in a repeated measurements study. Subjects and Methods: Twenty-five volunteers (13 females, 12 males) aged 22–70 years were examined once a month over 1 year. US measurements included thyroid volume, goiter, and thyroid nodules. Laboratory measurements included urinary iodine concentrations and serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroglobulin. Variations in continuous thyroid markers were assessed as coefficient of variation (CV) defined as mean of the individual CVs with bootstrapped confidence intervals and as intraclass correlation coefficients (ICCs). Variations in dichotomous thyroid markers were assessed by Cohen’s kappa. Results: CV was highest for urinary iodine concentrations (56.9%), followed by TSH (27.2%), thyroglobulin (18.2%), thyroid volume (10.5%), fT3 (8.1%), and fT4 (6.3%). The ICC was lowest for urinary iodine concentrations (0.42), followed by fT3 (0.55), TSH (0.64), fT4 (0.72), thyroid volume (0.87), and thyroglobulin (0.90). Cohen’s kappa values for the presence of goiter or thyroid nodules were 0.64 and 0.70, respectively. Conclusion: Our study provides measures of variation for thyroid outcomes, which can be used for probabilistic sensitivity analyses of epidemiological data. The low intraindividual variation of serum thyroglobulin in comparison to urinary iodine concentrations emphasizes the potential of thyroglobulin as marker for the iodine status of populations.
Coastal sand dunes near the Baltic Sea are a dynamic environment marking the boundary between land and sea and oftentimes covered by Scots pine (Pinus sylvestris L.) forests. Complex climate-environmental interactions characterize these ecosystems and largely determine the productivity and state of these coastal forests. In the face of future climate change, understanding interactions between coastal tree growth and climate variability is important to promote sustainable coastal forests. In this study, we assessed the effect of microsite conditions on tree growth and the temporal and spatial variability of the relationship between climate and Scots pine growth at nine coastal sand dune sites located around the south Baltic Sea. At each site, we studied the growth of Scots pine growing at microsites located at the ridge and bottom of a dune and built a network of 18 ring-width and 18 latewood blue intensity chronologies. Across this network, we found that microsite has a minor influence on ring-width variability, basal area increment, latewood blue intensity, and climate sensitivity. However, at the local scale, microsite effects turned out to be important for growth and climate sensitivity at some sites. Correlation analysis indicated that the strength and direction of climate-growth responses for the ring-width and blue intensity chronologies were similar for climate variables over the 1903–2016 period. A strong and positive relationship between ring-width and latewood blue intensity chronologies with winter-spring temperature was detected at local and regional scales. We identified a relatively strong, positive influence of winter-spring/summer moisture availability on both tree-ring proxies. When climate-growth responses between two intervals (1903–1959, 1960–2016) were compared, the strength of growth responses to temperature and moisture availability for both proxies varied. More specifically, for the ring-width network, we identified decreasing temperature-growth responses, which is in contrast to the latewood blue intensity network, where we documented decreasing and increasing temperature-growth relationships in the north and south respectively. We conclude that coastal Scots pine forests are primarily limited by winter-spring temperature and winter-spring/summer drought despite differing microsite conditions. We detected some spatial and temporal variability in climate-growth relationships that warrant further investigation.
Chondrosarcoma is the second most common malign bone tumor in adults. Surgical
resection of the tumor is recommended because of its resistance to clinical treatment such as
chemotherapy and radiation therapy. Thus, the prognosis for patients mainly depends on sufficient
surgical resection. Due to this, research on alternative therapies is needed. Cold atmospheric plasma
(CAP) is an ionized gas that contains various reactive species. Previous studies have shown an
anti-oncogenic potential of CAP on different cancer cell types. The current study examined the effects
of treatment with CAP on two chondrosarcoma cell lines (CAL-78, SW1353). Through proliferation
assay, the cell growth after CAP-treatment was determined. A strong antiproliferative effect for
both cell lines was detected. By fluorescein diacetate (FDA) assay and ATP release assay, alterations
in the cell membrane and associated translocation of low molecular weight particles through the
cytoplasmic membrane were observed. In supernatant, the non-membrane-permeable FDA and
endogenously synthesized ATP detected suggest an increased membrane permeability after CAP
treatment. Similar results were shown by the dextran-uptake assay. Furthermore, fluorescence
microscopic G-/F-actin assay was performed. G- and F-actin were selectively dyed, and the ratio
was measured. The presented results indicate CAP-induced changes in cell membrane function and
possible alterations in actin-cytoskeleton, which may contribute to the antiproliferative effects of CAP.
Non-alcoholic fatty liver disease (NAFLD) is gaining in importance and is linked to obesity.
Especially, the development of fibrosis and portal hypertension in NAFLD patients requires treatment.
Transgenic TGR(mREN2)27 rats overexpressing mouse renin spontaneously develop NAFLD with
portal hypertension but without obesity. This study investigated the additional role of obesity in this
model on the development of portal hypertension and fibrosis. Obesity was induced in twelve-week
old TGR(mREN2)27 rats after receiving Western diet (WD) for two or four weeks. Liver fibrosis
was assessed using standard techniques. Hepatic expression of transforming growth factor-β1
(TGF-β1), collagen type Iα1, α-smooth muscle actin, and the macrophage markers Emr1, as well as
the chemoattractant Ccl2, interleukin-1β (IL1β) and tumor necrosis factor-α (TNFα) were analyzed.
Assessment of portal and systemic hemodynamics was performed using the colored microsphere
technique. As expected, WD induced obesity and liver fibrosis as confirmed by Sirius Red and Oil Red
O staining. The expression of the monocyte-macrophage markers, Emr1, Ccl2, IL1β and TNFα were
increased during feeding of WD, indicating infiltration of macrophages into the liver, even though this
increase was statistically not significant for the EGF module-containing mucin-like receptor (Emr1)
mRNA expression levels. Of note, portal pressure increased with the duration of WD compared
to animals that received a normal chow. Besides obesity, WD feeding increased systemic vascular
resistance reflecting systemic endothelial and splanchnic vascular dysfunction. We conclude that
transgenic TGR(mREN2)27 rats are a suitable model to investigate NAFLD development with liver
fibrosis and portal hypertension. Tendency towards elevated expression of Emr1 is associated with
macrophage activity point to a significant role of macrophages in NAFLD pathogenesis, probably
due to a shift of the renin–angiotensin system towards a higher activation of the classical pathway.The hepatic injury induced by WD in TGR(mREN2)27 rats is suitable to evaluate different stages of
fibrosis and portal hypertension in NAFLD with obesity
Previous studies have reported the fundamental role of immunoregulatory
proteins in the clinical phenotype and outcome of sepsis. This study investigated two functional single
nucleotide polymorphisms (SNPs) of T cell immunoglobulin and mucin domain-containing protein 3
(TIM-3), which has a negative stimulatory function in the T cell immune response. Methods: Patients
with sepsis (n = 712) were prospectively enrolled from three intensive care units (ICUs) at the University
Medical Center Goettingen since 2012. All patients were genotyped for the TIM-3 SNPs rs1036199 and
rs10515746. The primary outcome was 28-day mortality. Disease severity and microbiological findings
were secondary endpoints. Results: Kaplan–Meier survival analysis demonstrated a significantly
lower 28-day mortality for TIM-3 rs1036199 AA homozygous patients compared to C-allele carriers
(18% vs. 27%, p = 0.0099) and TIM-3 rs10515746 CC homozygous patients compared to A-allele
carriers (18% vs. 26%, p = 0.0202). The TIM-3 rs1036199 AA genotype and rs10515746 CC genotype
remained significant predictors for 28-day mortality in the multivariate Cox regression analysis after
adjustment for relevant confounders (adjusted hazard ratios: 0.67 and 0.70). Additionally, patients
carrying the rs1036199 AA genotype presented more Gram-positive and Staphylococcus epidermidis
infections, and rs10515746 CC homozygotes presented more Staphylococcus epidermidis infections.
Conclusion: The studied TIM-3 genetic variants are associated with altered 28-day mortality and
susceptibility to Gram-positive infections in sepsis.
The local anesthetic lidocaine, which has been used extensively during liposuction, has been
reported to have cytotoxic effects and therefore would be unsuitable for use in autologous lipotransfer.
We evaluated the effect of lidocaine on the distribution, number, and viability of adipose-derived stem
cells (ASCs), preadipocytes, mature adipocytes, and leukocytes in the fatty and fluid portion of the
lipoaspirate using antibody staining and flow cytometry analyses. Adipose tissue was harvested from
11 female patients who underwent liposuction. Abdominal subcutaneous fat tissue was infiltrated
with tumescent local anesthesia, containing lidocaine on the left and lacking lidocaine on the right
side of the abdomen, and harvested subsequently. Lidocaine had no influence on the relative
distribution, cell number, or viability of ASCs, preadipocytes, mature adipocytes, or leukocytes in the
stromal-vascular fraction. Assessing the fatty and fluid portions of the lipoaspirate, the fatty portions
contained significantly more ASCs (p < 0.05), stem cells expressing the preadipocyte marker Pref-1
(p < 0.01 w/lidocaine, p < 0.05 w/o lidocaine), and mature adipocytes (p < 0.05 w/lidocaine, p < 0.01
w/o lidocaine) than the fluid portions. Only the fatty portion should be used for transplantation. This
study found no evidence that would contraindicate the use of lidocaine in lipotransfer. Limitations of
the study include the small sample size and the inclusion of only female patients.
Natural products comprise a rich reservoir for innovative drug leads and are a constant
source of bioactive compounds. To find pharmacological targets for new or already known
natural products using modern computer-aided methods is a current endeavor in drug discovery.
Nature’s treasures, however, could be used more effectively. Yet, reliable pipelines for the
large-scale target prediction of natural products are still rare. We developed an in silico workflow
Int. J. Mol. Sci. 2020, 21, 7102; doi:10.3390/ijms21197102 www.mdpi.com/journal/ijms
Int. J. Mol. Sci. 2020, 21, 7102 2 of 18
consisting of four independent, stand-alone target prediction tools and evaluated its performance
on dihydrochalcones (DHCs)—a well-known class of natural products. Thereby, we revealed
four previously unreported protein targets for DHCs, namely 5-lipoxygenase, cyclooxygenase-1,
17β-hydroxysteroid dehydrogenase 3, and aldo-keto reductase 1C3. Moreover, we provide a
thorough strategy on how to perform computational target predictions and guidance on using the
respective tools.
Membrane monocarboxylate transporter 1 (SLC16A1/MCT1) plays an important role in
hepatocyte homeostasis, as well as drug handling. However, there is no available information
about the impact of liver pathology on the transporter levels and function. The study was aimed to
quantify SLC16A1 mRNA (qRT-PCR) and MCT1 protein abundance (liquid chromatography–tandem
mass spectrometry (LC¬¬–MS/MS)) in the livers of patients diagnosed, according to the standard
clinical criteria, with hepatitis C, primary biliary cirrhosis, primary sclerosing hepatitis, alcoholic liver
disease (ALD), and autoimmune hepatitis. The stage of liver dysfunction was classified according to
Child–Pugh score. Downregulation of SLC16A1/MCT1 levels was observed in all liver pathology
states, significantly for ALD. The progression of liver dysfunction, from Child–Pugh class A to C,
involved the gradual decline in SLC16A1 mRNA and MCT1 protein abundance, reaching a clinically
significant decrease in class C livers. Reduced levels of MCT1 were associated with significant
intracellular lactate accumulation. The MCT1 transcript and protein did not demonstrate significant
correlations regardless of the liver pathology analyzed, as well as the disease stage, suggesting
posttranscriptional regulation, and several microRNAs were found as potential regulators of MCT1
abundance. MCT1 membrane immunolocalization without cytoplasmic retention was observed in all
studied liver pathologies. Overall, the study demonstrates that SLC16A1/MCT1 is involved in liver
pathology, especially in ALD
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease which is often
caused by recurrent emboli. These are also frequently found in patients with myeloproliferative
diseases. While myeloproliferative diseases can be caused by gene defects, the genetic predisposition
to CTEPH is largely unexplored. Therefore, the objective of this study was to analyse these genes
and further genes involved in pulmonary hypertension in CTEPH patients. A systematic screening
was conducted for pathogenic variants using a gene panel based on next generation sequencing.
CTEPH was diagnosed according to current guidelines. In this study, out of 40 CTEPH patients
4 (10%) carried pathogenic variants. One patient had a nonsense variant (c.2071A>T p.Lys691*)
in the BMPR2 gene and three further patients carried the same pathogenic variant (missense variant,
c.1849G>T p.Val617Phe) in the Janus kinase 2 (JAK2) gene. The latter led to a myeloproliferative
disease in each patient. The prevalence of this JAK2 variant was significantly higher than expected
(p < 0.0001). CTEPH patients may have a genetic predisposition more often than previously thought.
The predisposition for myeloproliferative diseases could be an additional risk factor for CTEPH
development. Thus, clinical screening for myeloproliferative diseases and genetic testing may be
considered also for CTEPH patients.
Liver diseases are important causes of morbidity and mortality worldwide. The aim of
this study was to identify differentially expressed microRNAs (miRNAs), target genes, and key
pathways as innovative diagnostic biomarkers in liver patients with different pathology and functional
state. We determined, using RT-qPCR, the expression of 472 miRNAs in 125 explanted livers from
subjects with six different liver pathologies and from control livers. ANOVA was employed to
obtain differentially expressed miRNAs (DEMs), and miRDB (MicroRNA target prediction database)
was used to predict target genes. A miRNA–gene differential regulatory (MGDR) network was
constructed for each condition. Key miRNAs were detected using topological analysis. Enrichment
analysis for DEMs was performed using the Database for Annotation, Visualization, and Integrated
Discovery (DAVID). We identified important DEMs common and specific to the different patient
groups and disease progression stages. hsa-miR-1275 was universally downregulated regardless
the disease etiology and stage, while hsa-let-7a*, hsa-miR-195, hsa-miR-374, and hsa-miR-378 were
deregulated. The most significantly enriched pathways of target genes controlled by these miRNAs
comprise p53 tumor suppressor protein (TP53)-regulated metabolic genes, and those involved in
regulation of methyl-CpG-binding protein 2 (MECP2) expression, phosphatase and tensin homolog
(PTEN) messenger RNA (mRNA) translation and copper homeostasis. Our findings show a novel
panel of deregulated miRNAs in the liver tissue from patients with different liver pathologies. These
miRNAs hold potential as biomarkers for diagnosis and staging of liver diseases.
Hepatocellular carcinoma (HCC) is a deadly form of liver malignancy with limited treatment
options. Amplification and/or overexpression of c-MYC is one of the most frequent genetic events
in human HCC. The mammalian target of Rapamycin Complex 1 (mTORC1) is a major functional
axis regulating various aspects of cellular growth and metabolism. Recently, we demonstrated that
mTORC1 is necessary for c-Myc driven hepatocarcinogenesis as well as for HCC cell growth in vitro.
Among the pivotal downstream effectors of mTORC1, upregulation of Fatty Acid Synthase (FASN) and
its mediated de novo lipogenesis is a hallmark of human HCC. Here, we investigated the importance
of FASN on c-Myc-dependent hepatocarcinogenesis using in vitro and in vivo approaches. In mouse
and human HCC cells, we found that FASN suppression by either gene silencing or soluble inhibitors
more effectively suppressed proliferation and induced apoptosis in the presence of high c-MYC
expression. In c-Myc/Myeloid cell leukemia 1 (MCL1) mouse liver tumor lesions, FASN expression
was markedly upregulated. Most importantly, genetic ablation of Fasn profoundly delayed (without
abolishing) c-Myc/MCL1 induced HCC formation. Liver tumors developing in c-Myc/MCL1 mice
depleted of Fasn showed a reduction in proliferation and an increase in apoptosis when compared
with corresponding lesions from c-Myc/MCL1 mice with an intact Fasn gene. In human HCC samples,
a significant correlation between the levels of c-MYC transcriptional activity and the expression
of FASN mRNA was detected. Altogether, our study indicates that FASN is an important effector
downstream of mTORC1 in c-MYC induced HCC. Targeting FASN may be helpful for the treatment
of human HCC, at least in the tumor subset displaying c-MYC amplification or activation.
Despite continuous advances in therapy, malignant melanoma is still among the deadliest
types of cancer. At the same time, owing to its high plasticity and immunogenicity, melanoma is
regarded as a model tumor entity when testing new treatment approaches. Cold physical plasma is a
novel anticancer tool that utilizes a plethora of reactive oxygen species (ROS) being deposited on the
target cells and tissues. To test whether plasma treatment would enhance the toxicity of an established
antitumor therapy, ionizing radiation, we combined both physical treatment modalities targeting
B16F10 murine melanoma cell in vitro. Repeated rather than single radiotherapy, in combination
with gas plasma-introduced ROS, induced apoptosis and cell cycle arrest in an additive fashion. In
tendency, gas plasma treatment sensitized the cells to subsequent radiotherapy rather than the other
way around. This was concomitant with increased levels of TNFα, IL6, and GM-CSF in supernatants.
Murine JAWS dendritic cells cultured in these supernatants showed an increased expression of cell
surface activation markers, such as MHCII and CD83. For PD-L1 and PD-L2, increased expression
was observed. Our results are the first to suggest an additive therapeutic effect of gas plasma and
radiotherapy, and translational tumor models are needed to develop this concept further.
Background: Cold atmospheric plasma (CAP) is increasingly used in the field of oncology.
Many of the mechanisms of action of CAP, such as inhibiting proliferation, DNA breakage, or the
destruction of cell membrane integrity, have been investigated in many different types of tumors.
In this regard, data are available from both in vivo and in vitro studies. Not only the direct treatment
of a tumor but also the influence on its blood supply play a decisive role in the success of the therapy
and the patient’s further prognosis. Whether the CAP influences this process is unknown, and the
first indications in this regard are addressed in this study. Methods: Two different devices, kINPen
and MiniJet, were used as CAP sources. Human endothelial cell line HDMEC were treated directly
and indirectly with CAP, and growth kinetics were performed. To indicate apoptotic processes,
caspase-3/7 assay and TUNEL assay were used. The influence of CAP on cellular metabolism
was examined using the MTT and glucose assay. After CAP exposure, tube formation assay was
performed to examine the capillary tube formation abilities of HDMEC and their migration was
messured in separate assays. To investigate in a possible mutagenic effect of CAP treatment,
a hypoxanthine-guanine-phosphoribosyl-transferase assay with non malignant cell (CCL-93) line was
performed. Results: The direct CAP treatment of the HDMEC showed a robust growth-inhibiting
effect, but the indirect one did not. The MMT assay showed an apparent reduction in cell metabolism
in the first 24 h after CAP treatment, which appeared to normalize 48 h and 72 h after CAP application.
These results were also confirmed by the glucose assay. The caspase 3/7 assay and TUNEL assay
showed a significant increase in apoptotic processes in the HDMEC after CAP treatment. These results
were independent of the CAP device. Both the migration and tube formation of HDMEC were
significant inhibited after CAP-treatment. No malignant effects could be demonstrated by the CAP
treatment on a non-malignant cell line.
Niemann–Pick type C1 (NPC1) is a lysosomal storage disorder, inherited as an
autosomal-recessive trait. Mutations in the Npc1 gene result in malfunction of the NPC1 protein,
leading to an accumulation of unesterified cholesterol and glycosphingolipids. Beside visceral
symptoms like hepatosplenomegaly, severe neurological symptoms such as ataxia occur. Here,
we analyzed the sphingosine-1-phosphate (S1P)/S1P receptor (S1PR) axis in different brain regions
of Npc1−/− mice and evaluated specific effects of treatment with 2-hydroxypropyl-β-cyclodextrin
(HPβCD) together with the iminosugar miglustat. Using high-performance thin-layer chromatography
(HPTLC), mass spectrometry, quantitative real-time PCR (qRT-PCR) and western blot analyses, we
Int. J. Mol. Sci. 2020, 21, 4502; doi:10.3390/ijms21124502 www.mdpi.com/journal/ijms
Int. J. Mol. Sci. 2020, 21, 4502 2 of 31
studied lipid metabolism in an NPC1 mouse model and human skin fibroblasts. Lipid analyses
showed disrupted S1P metabolism in Npc1−/− mice in all brain regions, together with distinct changes
in S1pr3/S1PR3 and S1pr5/S1PR5 expression. Brains of Npc1−/− mice showed only weak treatment
effects. However, side effects of the treatment were observed in Npc1+/+ mice. The S1P/S1PR axis
seems to be involved in NPC1 pathology, showing only weak treatment effects in mouse brain. S1pr
expression appears to be affected in human fibroblasts, induced pluripotent stem cells (iPSCs)-derived
neural progenitor and neuronal differentiated cells. Nevertheless, treatment-induced side effects
make examination of further treatment strategies indispensable
Molecular Mechanisms of Bortezomib Action: Novel Evidence for the miRNA−mRNA Interaction Involvement
(2020)
Bortezomib is an anti-tumor agent, which inhibits 26S proteasome degrading ubiquitinated
proteins. While apoptotic transcription-associated activation in response to bortezomib has been
suggested, mechanisms related to its influence on post-transcriptional gene silencing mediated
regulation by non-coding RNAs remain not fully elucidated. In the present study, we examined
changes in global gene and miRNA expression and analyzed the identified miRNA–mRNA interactions
after bortezomib exposure in human neuroblastoma cells to define pathways affected by this agent in
this type of cells. Cell viability assays were performed to assess cytotoxicity of bortezomib. Global gene
and miRNA expression profiles of neuroblastoma cells after 24-h incubation with bortezomib were
determined using genome-wide RNA and miRNA microarray technology. Obtained results were
then confirmed by qRT-PCR and Western blot. Further bioinformatical analysis was performed
to identify affected biological processes and pathways. In total, 719 genes and 28 miRNAs were
downregulated, and 319 genes and 61 miRNAs were upregulated in neuroblastoma cells treated with
bortezomib. Possible interactions between dysregulated miRNA/mRNA, which could be linked to
bortezomib-induced neurotoxicity, affect neurogenesis, cellular calcium transport, and neuron death.
Bortezomib might exert toxic effects on neuroblastoma cells and regulate miRNA–mRNA interactions
influencing vital cellular functions. Further studies on the role of specific miRNA–mRNA interactions
are needed to elucidate mechanisms of bortezomib action.
Injection of intense low-energy reactor-based positron beams into a supported magnetic dipole trap
(2020)
Abstract
An increased low-energy positron flux is obtained from the reactor based NEPOMUC source when using its primary beam at energies as low as 20 eV. First experiments with this beam in a supported magnetic dipole trap resulted in the maximum current of injected positrons to date. According to single-particle simulations, remaining limitations in the injection efficiency, observed in the experiment, can be attributed to the spatial spread of the beam. In the first trapping measurements with this beam, top-down asymmetries in the electrostatic trapping potential are found to be detrimental to confinement.
AbstractFluctuations of electron cyclotron emission (ECE) signals are analyzed for differently heated Wendelstein 7-X plasmas. The fluctuations appear to travel predominantly on flux surfaces and are used as ‘tracers’ in multivariate time series. Different statistical techniques are assessed to reveal the coupling and information entropy-based coupling analysis are conducted. All these techniques provide evidence that the fluctuation analysis allows one to check the consistency of magneto-hydrodynamic (MHD) equilibrium calculations. Expanding the suite of techniques applied in fusion data analysis, partial mutual information (PMI) analysis is introduced. PMI generalizes traditional partial correlation (Frenzel and Pompe Phys. Rev. Lett.
99 204101) and also Schreiber’s transfer entropy (Schreiber 2000 Phys. Rev. Lett.
85 461). The main additional capability of PMI is to allow one to discount for specific spurious data. Since PMI analysis allows one to study the effect of common drivers, the influence of the electron cyclotron resonance heating on the mutual dependencies of simultaneous ECE measurements was assessed. Additionally, MHD mode activity was found to be coupled in a limited volume in the plasma core for different plasmas. The study reveals an experimental test for equilibrium calculations and ECE radiation transport.
AbstractUsing measurements from high resolution monitoring of radial tree-growth we present new data of the growth reactions of four widespread broadleaved tree-species to the combined European drought years 2018 and 2019. We can show that, in contrast to field crops, trees could make better use of the winter soil moisture storage in 2018 which buffered them from severe drought stress and growth depressions in this year. Nevertheless, legacy effects of the 2018 drought accompanied by sustained low soil moisture conditions (missing recharge in winter) and again higher than average temperatures and low precipitation in spring/summer 2019 have resulted in severe growth reductions for all studied tree-species in this year. This highlights the pivotal role of soil water recharge in winter. Although short term resistance to hot summers can be high if sufficient winter precipitations buffers forest stands from drought damage, legacy effects will strongly impact tree growth in subsequent years if the drought persists. The two years 2018 and 2019 are extreme with regard to historical instrumental data but, according to regional climate models, resemble rather normal conditions of the climate in the second half of the 21st century. Therefore the observed strongly reduced growth rates can provide an outlook on future forest growth potential in northern Central Europe and beyond.
Disregarded Measurement Uncertainty Contributions and Their Magnitude in Measuring Plasma Glucose
(2020)
Background:
Each measurement is subject to measurement uncertainty (MU). Consequently, each measurement of plasma glucose concentration used for diagnosis and monitoring of diabetes mellitus (DM) is affected. Although concepts and methods of MU are well established in many fields of science and technology, they are presently only incompletely implemented by medical laboratories, neglecting MU of target values of internal quality control (IQC) materials.
Methods:
An empirical and practical approach for the estimation of MU based on the analysis of routine IQC using control samples with assigned target values is presented. Its feasibility is demonstrated exemplarily by analyzing IQC data from one year obtained for glucose employing the hexokinase method with IQC of two different concentrations.
Results:
Combined relative extended (k = 2) MU comprising bias, coefficient of variation (CV), and MU of the target values assigned to control materials were about 9% with a lower (~ 56 mg/dL; ~3.1 mmol/L) and 8% with a higher (~ 346 mg/dL; ~19.2 mmol/L) concentration sample, analyzing IQC of one year from three different devices.
Conclusions:
Estimation of MU in this study is quite reliable due to the large number of IQC data from one year. The MU of the target values of the commercial control material in this study was considerably larger than other MU contributions, ie, standard deviation and bias. In the future, the contribution of MU of commercial IQC should be addressed more carefully and technologies to measure glucose should be geared toward smaller MU possible, as needed, especially for glucose concentration measurements in diagnosis and management of DM.
For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILACS, BBO, and the Cochrane Library. The risk of bias tool from the Cochrane Collaboration and the PRISMA Statement were used for assessment of the included studies. From 101 screened articles, 2 SRs and 5 RCTs, which assessed the effectiveness of interventions in terms of pulp vitality and success of restoration, and 10 SRs and 1 RCT assessing the success of restorative materials were included. For treatments involving no carious tissue removal, the Hall technique showed lower treatment failure for approximal carious lesions compared to complete caries removal (CCR) and filling. For the treatment of deep carious lesions, techniques involving selective caries removal (SCR) showed a reduction in the incidence of pulp exposure. However, the benefit of SCR over CCR in terms of pulp symptoms or restoration success/failure was not confirmed. Regarding restorative materials, preformed metal crowns (PMCs) used to restore multisurface lesions showed the highest success rates compared to other restorative materials (amalgam, composite resin, glass ionomer cement, and compomer), and in the long term (12–48 months) these were also less likely to fail. There is limited evidence supporting the use of PMCs to restore carious lesions with single cavities. Among nonrestorative options, silver diammine fluoride was significantly more effective in arresting caries than other treatments for treating active carious lesions of different depths. Considerable heterogeneity and bias risk were observed in the included studies. Although heterogeneity observed among the studies was substantial, the trends were similar. In conclusion, less invasive caries approaches involving selective or no caries removal seem advantageous in comparison to CCR for patients presenting with vital, symptomless, carious dentin lesions in primary teeth. There is evidence in favor of PMCs for restoring multisurface carious lesions in primary molars.
Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.
Background: This randomized controlled trial investigated if uni- and bihemispheric transcranial direct current stimulation (tDCS) of the motor cortex can enhance the effects of visuo-motor grip force tracking task training and transfer to clinical assessments of upper extremity motor function.
Methods: In a randomized, double-blind, sham-controlled trial, 40 chronic stroke patients underwent 5 days of visuo-motor grip force tracking task training of the paretic hand with either unilateral or bilateral (N = 15/group) or placebo tDCS (N = 10). Immediate and long-term (3 months) effects on training outcome and motor recovery (Upper Extremity Fugl-Meyer, UE-FM, Wolf Motor Function Test, and WMFT) were investigated.
Results: Trained task performance significantly improved independently of tDCS in a curvilinear fashion. In the anodal stimulation group UE-FM scores were higher than in the sham group at day 5 (adjusted mean difference: 2.6, 95%CI: 0.6–4.5, p = 0.010) and at 3 months follow up (adjusted mean difference: 2.8, 95%CI: 0.8–4.7, p = 0.006). Neither training alone, nor the combination of training and tDCS improved WMFT performance.
Conclusions: Visuo-motor grip force tracking task training can facilitate recovery of upper extremity function. Only minimal add-on effects of anodal but not dual tDCS were observed.
Clinical Trial Registration: https://clinicaltrials.gov/ct2/results?recrs=&cond=&term=NCT01969097&cntry=&state=&city=&dist=, identifier: NCT01969097, retrospectively registered on 25/10/2013.
One of the great challenges the world faces in terms of health care is the increasing number of
people living with neuro-disabilities that affect their ability to participate in societal activities.
Various neurological conditions such as stroke, multiple sclerosis, or Parkinson’s disease, to name
just a few, change cognitive, sensory, or motor capacities, alter the emotional well-being of those
affected, and lead to disability in their everyday lives.
Over the last few decades, aging populations and reduced mortality in many regions of the world
have increased the number of people living with neuro-disabilities considerably, an effect that is
still ongoing (1): for 2017, the worldwide prevalence of stroke (thousands) has been estimated to
be as high as 104178.7 (95% confidence interval, 95% CI 98454.0–110125.0), and years lived with
disabilities (YLD) (counts in thousands) caused by stroke were reported to amount to 18695.4
(95% CI 13,574–23686.9). The stroke-related increase in YLD (percentage change in counts)
was 40% (95% CI 38.4–41.4) from 1990 to 2007 and another 43.6% (39.6–47.8) during only 10
years from 2007 to 2017. The numbers are similarly impressive for other neurological disorders
(i.e., dementias, Parkinson’s disease, epilepsy, multiple sclerosis, motor neuron disease, headache
disorders, and others). Taken together, their worldwide prevalence (in thousands) in 2017 was
3121435.3 (95% CI 2951124.5–3316268.0), while YLD (thousands) in 2017 were 3121435.3 (95%
CI 2951124.5–3316268.0), with an increase in YLD by 35.1% (95% CI 31.9–38.1) from 1990 to 2007
and by a further 17.8% (95% CI 15.8–20.2) from 2007 to 2017.
These numbers not only demonstrate the huge global burden of disease and prevailing
neuro-disabilities, but they indicate a considerable increase in the number of people living with
neuro-disabilities with an accelerating dynamic over time (for stroke).
Indium-cluster anions In−nare probed for delayed dissociation by photoexcitation in a multi-reflection time-of-flight device. In addition to prompt dissociation with below-microsecond decay constants, we observe reactionson timescales of several tens to hundreds of microseconds. These time-resolved decay-rate measurements reveala power-law behavior in time which can be traced back to the clusters’ energy distribution due to their productionby laser ablation in high vacuum. Modeling energy distributions from such a production allows us to connect thecluster-specific dissociation energy with the ensemble temperature through experimentally determined power-law exponents.
Abstract
Background and purpose:Diagnosing a patient with headache as a migraineur is critical for state-of-the-art migrainemanagement. Screening tools are imperative means to improve the diagnostic yield in the primary care settings andspecialized clinics. This study aims to translate and assess the diagnostic accuracy of a German version of theID Migraine™as a widely used and efficient screening instrument.
Methods:
The Functional Assessment of Chronic Illness Therapy translation methodology was used to translate theoriginal three-itemID Migraine™, including a fourth question for aura, from the English language into the German language.Diagnostic accuracy of the GermanID Migraine™and predictors of false screening results were assessed among patientspresenting to a headache outpatient clinic of a tertiary care center in Germany over a 6-month period.
Results:
The translation procedure yielded a harmonized GermanID Migraine™and its diagnostic accuracy was assessedin 105 patients (80 female, 46.5+17.2 years of age), including 79 patients (75.2%) with migraine. The three-item GermanID Migraine™provides a sensitivity of 99%, specificity of 68%, and positive and negative predictive values of 90% and 95%,respectively, using a cutoff of2. Positive and negative predictive values in a general headache population are estimated tobe 74% and 98%, respectively. The aura question identified 18 out of 20 migraineurs with aura.
Conclusions:
The GermanID Migraine™is an accurate screening tool for migraine even in a challenging population of aspecialized outpatient clinic. Its diagnostic accuracy indicates a potential utility for screening in primary health care.
This paper presents continuous, high resolution fossil pollen and microcharcoal records from Bo Langvlei, a lake in the Wilderness Embayment on South Africa’s southern Cape coast. Spanning the past ~1300 years and encompassing the Medieval Climate Anomaly (MCA; c. AD 950–1250) and the Little Ice Age (LIA; c. AD 1300–1850), these records provide a rare southern African perspective on past temperature, moisture and vegetation change during these much debated periods of the recent geological past. Considered together with other records from the Wilderness Embayment, we conclude that conditions in the region during the MCA chronozone were – in the context of the last 1300 years – likely relatively dry (reduced levels of Afrotemperate forest pollen) and perhaps slightly cooler (increased percentages of Stoebe-type pollen) than present. The most significant phase of forest expansion, and more humid conditions, occurred during the transition between the MCA and the most prominent cooling phase of the LIA. The LIA is clearly identified at this locality as a period of cool, dry conditions between c. AD 1600 and 1850. The mechanisms driving the changes observed in the Bo Langvlei pollen record appear to be generally linked to changes in temperature, and changes in the influence of tropical circulation systems. During warmer periods, moisture availability was higher at Bo Langvlei, and rainfall was perhaps less seasonal. During colder periods, precipitation resulting from tropical disturbances was more restricted, resulting in drier conditions. While increased precipitation has been reported during the LIA from Verlorenvlei in the Western Cape as a result of an equatorward displacement of the westerly storm-track at this time, the opposing response at Bo Langvlei suggests that any increased influence of westerlies was insufficient to compensate for the concurrent reduction in tropical/local rainfall in the region.
Thiamine is substrate of the hepatic uptake transporter organic cation transporter 1 (OCT1), and pathological lipid metabolism was associated with OCT1‐dependent thiamine transport. However, it is unknown whether clinical pharmacokinetics of thiamine is modulated by OCT1 genotype. We analyzed thiamine transport in vitro, thiamine blood concentrations after high‐dose and low‐dose (nutritional) intake, and heritability of thiamine and thiamine‐phosphate blood concentrations. The variant OCT1*2 had reduced and OCT1*3 to OCT1*6 had deficient thiamine uptake activity. However, pharmacokinetics of thiamine did not differ depending on OCT1 genotype. Further studies in primary human hepatocytes indicated that several cation transporters, including OCT1, OCT3, and THTR‐2, contribute to hepatic uptake of thiamine. As much as 54% of the variation in thiamine and 75% in variation of thiamine monophosphate plasma concentrations was determined by heritable factors. Apparently, thiamine is not useful as a probe drug for OCT1 activity, but the high heritability, particularly of thiamine monophosphate, may stimulate further genomic research.
The benefit of regular physical activity and exercise training for the prevention of cardiovascular and metabolic diseases is undisputed. Many molecular mechanisms mediating exercise effects have been deciphered. Personalised exercise prescription can help patients in achieving their individual greatest benefit from an exercise-based cardiovascular rehabilitation programme. Yet, we still struggle to provide truly personalised exercise prescriptions to our patients. In this position paper, we address novel basic and translational research concepts that can help us understand the principles underlying the inter-individual differences in the response to exercise, and identify early on who would most likely benefit from which exercise intervention. This includes hereditary, non-hereditary and sex-specific concepts. Recent insights have helped us to take on a more holistic view, integrating exercise-mediated molecular mechanisms with those influenced by metabolism and immunity. Unfortunately, while the outline is recognisable, many details are still lacking to turn the understanding of a concept into a roadmap ready to be used in clinical routine. This position paper therefore also investigates perspectives on how the advent of ‘big data’ and the use of animal models could help unravel inter-individual responses to exercise parameters and thus influence hypothesis-building for translational research in exercise-based cardiovascular rehabilitation.
Changes in the environment will alter the growth rate of trees and forests. Different disciplines assess such growth rates differently, for example, with tree-ring width data, forest inventories or with carbon-flux data from eddy covariance towers. Such data is used to quantify forests biomass increment, forest’s carbon sequestration or to reconstruct environmental variables before instrumental records. However, raw measurement data is typically not considered to be representative for the average growth rate of trees or forests. Depending on the research question, the effects of certain environmental variables or effects of tree and forest structure have to be removed first. It can be challenging to define and quantify a growth trend that can answer a specific research question because trees and forests grow and respond to environmental change in multiple ways simultaneously, for example, with altered radial increment, height growth, and stand density. Further challenges pose time-lagged feedback loops, for example, between height and radial increment or between stand density and radial increment. Generally, different environments will lead to different tree and forest structures, but because of tree’s longevity this adaptation to the new environment will take decades or even centuries. Consequently, there can be an offset between the present forest structure and what we term the potential natural forest (PNF): Similar to the potential natural vegetation (PNV), the PNF represents that forest that would develop under the current environmental conditions in the absence of human intervention. Because growth rates are affected by the tree and forest structure, growth-trend estimates will differ between the present and the potential forest. Consequently, if the legacy effects of the past are not of interest, the PNF is the theoretical baseline to correct and estimate growth trends.
Background: Granulocytes and monocytes are the first cells to invade the brain post stroke and are also being discussed as important cells in early neuroinflammation after seizures. We aimed at understanding disease specific and common pathways of brain-immune-endocrine-interactions and compared immune alterations induced by stroke and seizures. Therefore, we compared granulocytic and monocytic subtypes between diseases and investigated inflammatory mediators. We additionally investigated if seizure type determines immunologic alterations.
Material and Methods: We included 31 patients with acute seizures, 17 with acute stroke and two control cohorts. Immune cells were characterized by flow cytometry from blood samples obtained on admission to the hospital and the following morning. (i) Monocytes subpopulations were defined as classical (CD14++CD16−), (ii) intermediate (CD14++CD16+), and (iii) non-classical monocytes (CD14dimCD16+), while granulocyte subsets were characterized as (i) “classical granulocytes” (CD16++CD62L+), (ii) pro-inflammatory (CD16dimCD62L+), and (iii) anti-inflammatory granulocytes (CD16++CD62L−). Stroke patient's blood was additionally drawn on days 3 and 5. Cerebrospinal fluid mitochondrial DNA was quantified by real-time PCR. Plasma High-Mobility-Group-Protein-B1, metanephrine, and normetanephrine were measured by ELISA.
Results: HLA-DR expression on monocytes and their subpopulations (classical, intermediate, and non-classical monocytes) was reduced after stroke or seizures. Expression of CD32 was increased on monocytes and subtypes in epilepsy patients, partly similar to stroke. CD32 and CD11b regulation on granulocytes and subpopulations (classical, anti-inflammatory, pro-inflammatory granulocytes) was more pronounced after stroke compared to seizures. On admission, normetanephrine was upregulated in seizures, arguing for the sympathetic nervous system as inducer of immune alterations similar to stroke. Compared to partial seizures, immunologic changes were more pronounced in generalized tonic-clonic seizures.
Conclusion: Seizures lead to immune alterations within the immediate postictal period similar but not identical to stroke. The type of seizures determines the extent of immune alterations.
Aims
Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear.
Methods and results
An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration (n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events.
Conclusion
Averaged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints.
Objectives
Medical compression therapy is used for non-invasive treatment of venous and lymphatic diseases. Medical compression therapy-associated adverse events and contraindications have been reported, although some contraindications are theoretically based. This consensus statement provides recommendations on medical compression therapy risks and contraindications.
Methods
A systematic literature search of medical compression therapy publications reporting adverse events up until November 2017 was performed. A consensus panel comprising 15 international experts critically reviewed the publications and formulated the recommendations.
Results
Sixty-two publications reporting medical compression therapy adverse events were identified. The consensus panel issued 21 recommendations on medical compression therapy contraindications and adverse event risk mitigation, in addition to reviewing medical compression therapy use in borderline indications. The most frequently reported non-severe medical compression therapy-associated adverse events included skin irritation, discomfort and pain. Very rare but severe adverse events, including soft tissue and nerve injury, were also identified.
Conclusion
This consensus statement summarises published medical compression therapy-associated adverse events and contraindications, and provides guidance on medical compression therapy. Severe medical compression therapy-associated adverse events are very rarely encountered if compression is used correctly and contraindications are considered.
Long-chain aliphatic amines such as (S,Z)-hepta- dec-9-en-7-amine and 9-aminoheptadecane were synthesized from ricinoleic acid and oleic acid, respectively, by whole-cell cascade reactions using the combination of an alcohol dehydrogenase (ADH) from Micrococcus luteus, an engi- neered amine transaminase from Vibrio fluvialis (Vf-ATA), and a photoactivated decarboxylase from Chlorella variabilis NC64A (Cv-FAP) in a one-pot process. In addition, long chain aliphatic esters such as 10-(heptanoyloxy)dec-8-ene and octyl- nonanoate were prepared from ricinoleic acid and oleic acid, respectively, by using the combination of the ADH, a Baeyer– Villiger monooxygenase variant from Pseudomonas putida KT2440, and the Cv-FAP. The target compounds were produced at rates of up to 37 U g1 dry cells with conversions up to 90 %. Therefore, this study contributes to the preparation of industrially relevant long-chain aliphatic chiral amines and esters from renewable fatty acid resources.
ABSTRACT
In the present study, we performed gastropod analyses on loess–palaeosol sequences from northeast Armenia (Southern Caucasia) covering at least three glacial–interglacial cycles. The elaborated ecostratigraphy shows significant patterns of species composition related to the succession of pedocomplexes and loess, respectively. Pedocomplexes included species that can be associated with high‐grass to forest‐steppe biomes, indicating increased humidity for these sections compared to the loess layers. In contrast, loess layers that relate to glacial periods are associated with gastropod species of semidesert environments with shrub‐ and shortgrass‐steppes, indicating semiarid to arid conditions. Furthermore, the loess deposits do not show any evidence for cold‐adapted gastropod species. Therefore, we suggest that average July temperatures in the study area were above 10 °C, even during periods of loess deposition. Consequently, we propose that the limiting factor for tree growth during glacial periods was aridity, rather than temperature. In addition, we observe environmental differences between the various glacial times, with our results indicating a trend towards steadily increasing aridity in Southern Caucasia across the Middle to Late Pleistocene.
Background: Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population.It is unclear why transfusion rates in Germany are considerably higher (approx. 50–55 RBCs/1,000 population). Methods: We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. Results: Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC: 11.3%; 2 RBCs: 42.6%; 3 RBCs: 6.3%; 4 RBCs: 15.0%), the mean transfusion index was 4.6 RBCs due to a minority of patients with a high transfusion demand. Two thirds of all RBCs were transfused to only 25% of RBC recipients. Consistently, male patients received a higher number of RBCs (2005: 54.2%; 2015: 56.8%) and had a higher mean transfusion index than female patients (mean 5.1 ± 7.2; median 2; inter-quartile range [IQR] 2–4 vs. mean 4.0 ± 5.8; median 2; IQR 2–4). The absolute transfusion demand decreased between 2005 and 2015 by 13.5% due to a composite of active reduction (clinical practice change) and population decline in the 65- to 75-year age group (lower birth rate cohort 1940–1950); however, with major differences between hospitals (range from –61.0 to +41.4%). Conclusion: Transfusion demand in a population could largely be driven by patients with high transfusion demand. Different treatment practices in this group of patients probably add to the major differences in transfusion demand per 1,000 individuals between countries. The available data cannot prove this hypothesis. Implementation of a diagnosis-related group-based monitoring system is urgently needed to allow informative monitoring on the population level and meaningful comparisons between transfusion practices.
Introduction: Multiparametric MRI (mpMRI) and MRI targeted biopsies (MRtb) are a new standard in prostate cancer (PCa) screening and diagnosis. Guidelines already include this approach for patients at risk. We aimed to gather information from German urologists about their knowledge, routine use, and attitude toward mpMRI and consecutive biopsy methods. Materials and Methods: An anonymous online questionnaire was sent via Survey Monkey to the members of the German Society of Urology (DGU). Statistical analyses were performed using SPSS version 25.0. Results: 496 members with a median age of 48.6 years (±11.7) participated in the survey. The majority rated mpMRI of the prostate as a very useful diagnostic tool (72.7%). MRtb of the prostate was considered as very advantageous (71.5%). MpMRI was used by 95.9%, and 83.2% also recommended MRtb predominantly in clinical institutions. For targeted biopsy, MRI-ultrasound fusion biopsy was clearly favored (75.8%). MpMRI was mostly used in patients with previously negative biopsy (90.9%) and in patients under active surveillance (60.9%). Arguments against the use of prostate mpMRI are costs (84.9%) and/or lack of sufficient radiological infrastructure (17.4%). Conclusion: Our data illustrate the meanwhile high acceptance and clinical use of the prostate mpMRI and MRtb in Germany.
For an Organisation for Caries Research/European Federation of Conservative Dentistry consensus, this systematic review is aimed to assess the question of how to manage the caries process in the case of early childhood caries (ECC). Medline via PubMed was searched systematically regarding management of ECC. First priority was existing systematic reviews or randomized clinical trials otherwise cohort studies dealing with management of ECC, primarily with carious anterior teeth. After data extraction, the potential risk of bias was estimated depending on the study types, and the level of evidence was evaluated. Regarding management of ECC, results are presented for silver diamine fluoride (SDF, n = 5), nonoperative caries management (NOCM, n = 10), and restorative approaches (RA, n = 8) separately, as different kinds of studies with different levels of evidence were found for the different aspects in the management of ECC. The 5 systematic reviews on SDF showed a high potential for arrest of ECC on a high level of evidence. In NOCM, a low level of evidence for a moderate effect of fluoride varnish in arresting or remineralizing, especially non-cavitated lesions, was assessed. For RA in carious anterior upper primary teeth, a low level of evidence was found for higher failure rates of glass ionomer cement and composite fillings than composite strip crowns even if placed under general anaesthesia and especially compared to other crowns (stainless steel and zirconia). In conclusions, ECC may be managed successfully with nonoperative (SDF, regular fluoride application) and moderately well with operative approaches, but the decision is affected by many other variables such as pulpal involvement, the child’s cooperation, or a general anaesthesia setting.
Introduction: Outcome measures are key to tailor rehabilitation goals to the stroke patient's individual needs and to monitor poststroke recovery. The large number of available outcome measures leads to high variability in clinical use. Currently, an internationally agreed core set of motor outcome measures for clinical application is lacking. Therefore, the goal was to develop such a set to serve as a quality standard in clinical motor rehabilitation poststroke.
Methods: Outcome measures for the upper and lower extremities, and activities of daily living (ADL)/stroke-specific outcomes were identified and presented to stroke rehabilitation experts in an electronic Delphi study. In round 1, clinical feasibility and relevance of the outcome measures were rated on a 7-point Likert scale. In round 2, those rated at least as “relevant” and “feasible” were ranked within the body functions, activities, and participation domains of the International Classification of Functioning, Disability, and Health (ICF). Furthermore, measurement time points poststroke were indicated. In round 3, answers were reviewed in reference to overall results to reach final consensus.
Results: In total, 119 outcome measures were presented to 33 experts from 18 countries. The recommended core set includes the Fugl–Meyer Motor Assessment and Action Research Arm Test for the upper extremity section; the Fugl–Meyer Motor Assessment, 10-m Walk Test, Timed-Up-and-Go, and Berg Balance Scale for the lower extremity section; and the National Institutes of Health Stroke Scale, and Barthel Index or Functional Independence Measure for the ADL/stroke-specific section. The Stroke Impact Scale was recommended spanning all ICF domains. Recommended measurement time points are days 2 ± 1 and 7; weeks 2, 4, and 12; 6 months poststroke and every following 6th month.
Discussion and Conclusion: Agreement was found upon a set of nine outcome measures for application in clinical motor rehabilitation poststroke, with seven measurement time points following the stages of poststroke recovery. This core set was specifically developed for clinical practice and distinguishes itself from initiatives for stroke rehabilitation research. The next challenge is to implement this clinical core set across the full stroke care continuum with the aim to improve the transparency, comparability, and quality of stroke rehabilitation at a regional, national, and international level.
Background: Alexithymia is a personality trait characterized by difficulties in identifying and describing emotions and associated with various psychiatric disorders. Neuroimaging studies found evidence for morphological and functional brain alterations in alexithymic subjects. However, the neurobiological mechanisms underlying alexithymia remain incompletely understood. Methods: We study the association of alexithymia with cortical correlation networks in a large community-dwelling sample of the Study of Health in Pomerania. Our analysis includes data of n = 2,199 individuals (49.4% females, age = 52.1 ± 13.6 years) which were divided into a low and high alexithymic group by a median split of the Toronto Alexithymia Scale. Cortical correlation networks were constructed based on the mean thicknesses of 68 regions, and differences in centralities were investigated. Results: We found a significantly increased centrality of the right paracentral lobule in the high alexithymia network after correction for multiple testing. Several other regions with motoric and sensory functions showed altered centrality on a nominally significant level. Conclusions: Finding increased centrality of the paracentral lobule, a brain area with sensory as well as motoric features and involvement in bowel and bladder voiding, may contribute to explain the association of alexithymia with functional somatic disorders and chronic pain syndromes.
Abstract
Aims
To demonstrate the attitudes of general practitioners (GPs), nurses, persons with dementia, and caregiver towards suitable tasks and qualification needs for and the acceptance and impact of advanced nursing roles in German dementia primary care.
Design
Observational study using a questionnaire survey with 225 GPs, 232 nurses, 211 persons with dementia, and 197 caregivers, conducted between December 2017–August 2018.
Methods
A questionnaire was generated that includes specific assessment, prescription, and monitoring tasks of advanced nursing roles in dementia primary care as well as qualification requirements for and the acceptance and the impact of advanced nursing roles. Data were analysed using descriptive statistics. Group differences were assessed using the Fisher's exact test.
Results
Advanced nursing roles were highly appreciated across all groups. Assessment and monitoring tasks were rated as highly suitable, and prescription authorities as moderately suitable. Nurses felt less confident in assessment and monitoring, but more confident in prescribing as practitioners expected. Patients and caregivers would appreciate a takeover of tasks by nurses; nurses and practitioners preferred a delegation. A dementia‐specific qualification was rated as best suitable for advanced nursing roles, followed by ‘no specific qualification’ if medical tasks that only can be carried out by practitioners were delegated and an academic degree if tasks were substituted. Advanced nursing roles were rated as beneficial, strengthening the confidence in nursing care and improving the cooperation between professionals and the treatment. Practitioners assumed that advanced nursing roles would improve job satisfaction of nurses, which was not confirmed by nurses.
Conclusion
There is an extended consensus towards the enlargement of advanced nursing roles, represented by high endorsement, acceptance, and willingness to reorganize tasks.
Impact
Results debunk the common notion that German practitioners would be reluctant towards advanced nursing roles and a takeover of current practitioner tasks, supporting the implementation of advanced nursing roles in Germany.
Abstract
Ecosystems with highly pulsed water supply must be better understood as climate change may increase frequency and severity of intense storms, droughts and floods. Here we collected data over 3 years (2016–2018) in the episodic wetland outflow channel (Aluize), Banhine National Park, in which the system state changed from dry to wet to dry. Field sampling included vegetation records, small‐scale vegetation zoning, the seed bank and water and soil quality. The same main plant species were found in both dry and wet conditions across the riverbed of the outflow channel. We found only very few diaspores of plants in the soil after prolonged drought. In the subsequent flooded state, we examined very dense vegetation on the water surface, which was dominated by the gramineous species Paspalidium obtusifolium. This species formed a compact floating mat that was rooted to the riverbed. The Cyperaceae Bolboschoenus glaucus showed high clonal growth in the form of root tubers, which likely serve as important food reservoir during drought. Soil and water analyses do not indicate a limitation by nutrients. We outline how resident people may change the plant community structure with an increasing practice of setting fire to the meadows in the dried‐up riverbed to facilitate plant regrowth as food for their livestock.
Herein, we report the synthesis of a series of push–pull imines by considering cyclic diamino substituent at the C‐centre and fluoroaryl substituent at the N‐centre. This has been achieved by a selective aromatic nucleophilic substitution of different fluoroarenes by N‐H‐substituted N‐heterocyclic imines (NHIs) at ambient conditions without any additional reagent. Solid‐state molecular structure analysis reveals the elongation of the central C–N bond of the imine functionality, which is consistent with the push–pull nature of these imines. The push–pull nature of these imines is further validated by computational studies.
Abstract
Relatively little is known about how plant–soil feedbacks (PSFs) may affect plant growth in field conditions where factors such as herbivory may be important. Using a potted experiment in a grassland, we measured PSFs with and without aboveground insect herbivory for 20 plant species. We then compared PSF values to plant landscape abundance. Aboveground herbivory had a large negative effect on PSF values. For 15 of 20 species, PSFs were more negative with herbivory than without. This occurred because plant biomass on “home” soils was smaller with herbivory than without. PSF values with herbivory were correlated with plant landscape abundance, whereas PSF values without herbivory were not. Shoot nitrogen concentrations suggested that plants create soils that increase nitrogen uptake, but that greater shoot nitrogen values increase herbivory and that the net effect of positive PSF and greater aboveground herbivory is less aboveground biomass. Results provided clear evidence that PSFs alone have limited power in explaining species abundances and that herbivory has stronger effects on plant biomass and growth on the landscape. Our results provide a potential explanation for observed differences between greenhouse and field PSF experiments and suggest that PSF experiments need to consider important biotic interactions, like aboveground herbivory, particularly when the goal of PSF research is to understand plant growth in field conditions.
Abstract
Multiple G‐tracts within the promoter region of the c‐myc oncogene may fold into various G‐quadruplexes with the recruitment of different tracts and guanosine residues for the G‐core assembly. Thermodynamic profiles for the folding of wild‐type and representative truncated as well as mutated sequences were extracted by comprehensive DSC experiments. The unique G‐quadruplex involving consecutive G‐tracts II–V with formation of two one‐nucleotide and one central two‐nucleotide propeller loop, previously proposed to be the biologically most relevant species, was found to be the most stable fold in terms of its Gibbs free energy of formation at ambient temperatures. Its stability derives from its short propeller loops but also from the favorable type of loop residues. Whereas quadruplex folds with long propeller loops are significantly disfavored, a snap‐back loop structure formed by incorporating a 3’‐terminal guanosine into the empty position of a tetrad seems highly competitive based on its thermodynamic stability. However, its destabilization by extending the 3’‐terminus questions the significance of such a species under in vivo conditions.
Infections are often caused by pathobionts, endogenous bacteria that belong to the microbiota. Trauma and surgical intervention can allow bacteria to overcome host defences, ultimately leading to sepsis if left untreated. One of the main defence strategies of the immune system is the production of highly specific antibodies. In the present proof-of-concept study, plasma antibodies against 9 major pathogens were measured in sepsis patients, as an example of severe systemic infections. The binding of plasma antibodies to bacterial extracellular proteins was quantified using a semi-automated immunoblot assay. Comparison of the pathogen-specific antibody levels before and after infection showed an increase in plasma IgG in 20 out of 37 tested patients. This host-directed approach extended the results of pathogen-oriented microbiological and PCR diagnostics: a specific antibody response to additional bacteria was frequently observed, indicating unrecognised poly-microbial invasion. This might explain some cases of failed, seemingly targeted antibiotic treatment.
Extinction learning is suggested to be a central mechanism during exposure-based cognitive behavioralpsychotherapy. A positive association between the patients’pretreatment extinction learning performance andtreatment outcome would corroborate the hypothesis. Indeed, there isfirst correlational evidence between reducedextinction learning and therapy efficacy. However, the results of these association studies may be hampered byextinction-training protocols that do not match treatment procedures. Therefore, we developed an extinction-trainingprotocol highly tailored to the procedure of exposure therapy and tested it in two samples of 46 subjects in total. Byusing instructed fear acquisition training, including a consolidation period overnight, we wanted to ensure that theconditioned fear response was well established prior to extinction training, which is the case in patients with anxietydisorders prior to treatment. Moreover, the extinction learning process was analyzed on multiple response levels,comprising unconditioned stimulus (US) expectancy ratings, autonomic responses, defensive brain stem reflexes, andneural activation using functional magnetic resonance imaging. Using this protocol, we found robust fearconditioning and slow-speed extinction learning. We also observed within-group heterogeneity in extinction learning,albeit a stable fear response at the beginning of the extinction training. Finally, we found discordance betweendifferent response systems, suggesting that multiple processes are involved in extinction learning. The paradigmpresented here might help to ameliorate the association between extinction learning performance assessed in thelaboratory and therapy outcomes and thus facilitate translational science in anxiety disorders
Despite their very close structural similarity, CxxC/S-type (class I) glutaredoxins (Grxs) actas oxidoreductases, while CGFS-type (class II) Grxs act as FeS cluster transferases. Here weshow that the key determinant of Grx function is a distinct loop structure adjacent to theactive site. Engineering of a CxxC/S-type Grx with a CGFS-type loop switched its functionfrom oxidoreductase to FeS transferase. Engineering of a CGFS-type Grx with a CxxC/S-typeloop abolished FeS transferase activity and activated the oxidative half reaction of the oxi-doreductase. The reductive half-reaction, requiring the interaction with a second GSHmolecule, was enabled by switching additional residues in the active site. We explain howsubtle structural differences, mostly depending on the structure of one particular loop, act inconcert to determine Grx function.
Due to climate change, economically important crop plants will encounter flooding periods causing hypoxic stress more frequently. this may lead to reduced yields and endanger food security. As roots are the first organ to be affected by hypoxia, the ability to sense and respond to hypoxic stress is crucial. At the molecular level, therefore, fine-tuning the regulation of gene expression in the root is essential for hypoxia tolerance. Using an RnA-Seq approach, we investigated transcriptome modulation in tomato roots of the cultivar ‘Moneymaker’, in response to short- (6 h) and long-term (48 h) hypoxia. Hypoxia duration appeared to have a significant impact on gene expression such that the roots of five weeks old tomato plants showed a distinct time-dependent transcriptome response. We observed expression changes in 267 and 1421 genes under short- and long-term hypoxia, respectively. Among these, 243 genes experienced changed expression at both time points. We identified tomato genes with a potential role in aerenchyma formation which facilitates oxygen transport and may act as an escape mechanism enabling hypoxia tolerance. Moreover, we identified differentially regulated genes related to carbon and amino acid metabolism and redox homeostasis. Of particular interest were the differentially regulated transcription factors, which act as master regulators of downstream target genes involved in responses to short and/or long-term hypoxia. Our data suggest a temporal metabolic and anatomic adjustment to hypoxia in tomato root which requires further investigation. We propose that the regulated genes identified in this study are good candidates for further studies regarding hypoxia tolerance in tomato or other crops
inhibiting fear-related thoughts and defensive behaviors when they are no longer appropriate to the situation is a prerequisite for flexible and adaptive responding to changing environments. Such inhibition of defensive systems is mediated by ventromedial prefrontal cortex (vmpfc), limbic basolateral amygdala (BLA), and brain stem locus-coeruleus noradrenergic system (Lc-nAs). non-invasive, transcutaneous vagus nerve stimulation (tVnS) has shown to activate this circuit. Using a multiple-day single-cue fear conditioning and extinction paradigm, we investigated long-term effects of tVnS on inhibition of low-level amygdala modulated fear potentiated startle and cognitive risk assessments. We found that administration of tVnS during extinction training facilitated inhibition of fear potentiated startle responses and cognitive risk assessments, resulting in facilitated formation, consolidation and long-term recall of extinction memory, and prevention of the return of fear. these findings might indicate new ways to increase the efficacy of exposure-based treatments of anxiety disorders.
Staphylococcus aureus(S. aureus) is a pathobiont of humans as well as a multitude of animalspecies. The high prevalence of multi-resistant and more virulent strains ofS. aureusnecessitatesthe development of new prevention and treatment strategies forS. aureusinfection. Major advancestowards understanding the pathogenesis ofS. aureusdiseases have been made using conventionalmouse models, i.e., by infecting naïve laboratory mice with human-adaptedS. aureusstrains. However,the failure to transfer certain results obtained in these murine systems to humans highlights thelimitations of such models. Indeed, numerousS. aureusvaccine candidates showed promising resultsin conventional mouse models but failed to offer protection in human clinical trials. These limitationsarise not only from the widely discussed physiological differences between mice and humans, but alsofrom the lack of attention that is paid to the specific interactions ofS. aureuswith its respectivehost. For instance, animal-derivedS. aureuslineages show a high degree of host tropism and carry arepertoire of host-specific virulence and immune evasion factors. Mouse-adaptedS. aureusstrains,humanized mice, and microbiome-optimized mice are promising approaches to overcome theselimitations and could improve transferability of animal experiments to human trials in the future.
While ionizing radiation (IR) is a powerful tool in medical diagnostics, nuclear medicine,and radiology, it also is a serious threat to the integrity of genetic material. Mutagenic effects ofIR to the human genome have long been the subject of research, yet still comparatively little isknown about the genome-wide effects of IR exposure on the DNA-sequence level. In this study,we employed high throughput sequencing technologies to investigate IR-induced DNA alterationsin human gingiva fibroblasts (HGF) that were acutely exposed to 0.5, 2, and 10 Gy of 240 kVX-radiation followed by repair times of 16 h or 7 days before whole-genome sequencing (WGS).Our analysis of the obtained WGS datasets revealed patterns of IR-induced variant (SNV and InDel)accumulation across the genome, within chromosomes as well as around the borders of topologicallyassociating domains (TADs). Chromosome 19 consistently accumulated the highest SNVs andInDels events. Translocations showed variable patterns but with recurrent chromosomes of origin(e.g., Chr7 andChr16). IR-induced InDels showed a relative increase in number relative to SNVs anda characteristic signature with respect to the frequency of triplet deletions in areas without repetitiveor microhomology features. Overall experimental conditions and datasets the majority of SNVs pergenome had no or little predicted functional impact with a maximum of 62, showing damagingpotential. A dose-dependent effect of IR was surprisingly not apparent. We also observed a significantreduction in transition/transversion (Ti/Tv) ratios for IR-dependent SNVs, which could point to acontribution of the mismatch repair (MMR) system that strongly favors the repair of transitions overtransversions, to the IR-induced DNA-damage response in human cells. Taken together, our resultsshow the presence of distinguishable characteristic patterns of IR-induced DNA-alterations on agenome-wide level and implicate DNA-repair mechanisms in the formation of these signatures
Osteosarcoma and Ewing’s sarcoma are the most common malignant bone tumors.Conventional therapies such as polychemotherapy, local surgery, and radiotherapy improve theclinical outcome for patients. However, they are accompanied by acute and chronic side effectsthat affect the quality of life of patients, motivating novel research lines on therapeutic optionsfor the treatment of sarcomas. Previous experimental work with physical plasma operated atbody temperature (cold atmospheric plasma, CAP) demonstrated anti-oncogenic effects on differentcancer cell types. This study investigated the anti-cancer effect of CAP on two bone sarcomaentities, osteosarcoma and Ewing’s sarcoma, which were represented by four cell lines (U2-OS,MNNG/HOS, A673, and RD-ES). A time-dependent anti-proliferative effect of CAP on all cell lineswas observed. CAP-induced alterations in cell membrane functionality were detected by performinga fluorescein diacetate (FDA) release assay and an ATP release assay. Additionally, modifications ofthe cell membrane and modifications in the actin cytoskeleton composition were examined usingfluorescence microscopy monitoring dextran-uptake assay and G-/F-actin distribution. Furthermore,the CAP-induced induction of apoptosis was determined by TUNEL and active caspases assays.The observations suggest that a single CAP treatment of bone sarcoma cells may have significantanti-oncogenic effects and thus may be a promising extension to existing applications.
Development of the Greifswald questionnaire for the measurement of interprofessional attitudes
(2020)
Alongside biological, psychological, and social risk factors, psychotic syndromes may berelated to disturbances of neuronal migration. This highly complex process characterizesthe developing brain of the fetus, the early postnatal brain, and the adult brain, as reflectedby changes within the subventricular zone and the dentate gyrus of the hippocampus,where neurogenesis persists throughout life. Psychosis also appears to be linked tohuman cytomegalovirus (HCMV) infection. However, little is known about the connectionbetween psychosis, HCMV infection, and disruption of neuronal migration. The presentstudy addresses the hypothesis that HCMV infection may lead to mental disordersthrough mechanisms of autoimmune cross-reactivity. Searching for common peptidesthat underlie immune cross-reactions, the analyses focus on HCMV and human proteinsinvolved in neuronal migration. Results demonstrate a large overlap of viral peptides withhuman proteins associated with neuronal migration, such as ventral anterior homeobox 1and cell adhesion molecule 1 implicated in GABAergic and glutamatergicneurotransmission. The presentfindings support the possibility of immune cross-reactivity between HCMV and human proteins that—when altered, mutated, orimproperly functioning—may disrupt normal neuronal migration. In addition, thesefindings are consistent with a molecular and mechanistic framework for pathologicalsequences of events, beginning with HCMV infection, followed by immune activation,cross-reactivity, and neuronal protein variations that may ultimately contribute to theemergence of mental disorders, including psychosis
The failure of insulin-producingβ-cells is the underlying cause of hyperglycemia in diabetes mellitus.β-cell decay has been linked to hypoxia, chronic inflammation,and oxidative stress. Thioredoxin (Trx) proteins are major actors in redox signaling and essential for signal transduction and the cellular stress response. We haveanalyzed the cytosolic, mitochondrial, and extracellular Trx system proteins in hypoxic and cytokine-induced stress usingβ-cell culture, isolated pancreatic islets, andpancreatic islet transplantation modelling low oxygen supply.Protein levels of cytosolic Trx1 and Trx reductase (TrxR) 1 significantly decreased, while mitochondrial Trx2 and TrxR2 increased upon hypoxia and reox-ygenation. Interestingly, Trx1 was secreted byβ-cells during hypoxia. Moreover, murine and human pancreatic islet grafts released Trx1 upon glucose stimulation.Survival of transplanted islets was substantially impaired by the TrxR inhibitor auranofin.Since a release was prominent upon hypoxia, putative paracrine effects of Trx1 onβ-cells were examined. In fact, exogenously added recombinant hTrx1 mitigatedapoptosis and preserved glucose sensitivity in pancreatic islets subjected to hypoxia and inflammatory stimuli, dependent on its redox activity. Human subjects werestudied, demonstrating a transient increase in extracellular Trx1 in serum after glucose challenge. This increase correlated with better pancreatic islet function.Moreover, hTrx1 inhibited the migration of primary murine macrophages.In conclusion, our study offers evidence for paracrine functions of extracellular Trx1 that improve the survival and function of pancreaticβ-cells.
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers. Acquired inherited and/or somaticmutations drive its development. In order to prevent the formation of these mutations, precise and immediaterepair of any DNA damage is indispensable. Non-homologous end-joining (NHEJ) is the key mechanism of DNAdouble-strand break repair. Here, we report that miR-502 targets two components in pancreatic cell lines, Ku70and XLF of the C-NHEJ. Interestingly, we also observed an attenuated cell cycle response to gamma ionizingradiation (γ-IR) via diminished phosphorylation of checkpoint kinase 1 (Chk1) on serine 345 in these cell lines.Altogether, pancreatic cells showed increased susceptibility toγ-IR via direct inhibition of DNA double-strandbreak repair and attenuation of the cell cycle response.
Copattern of depression and alcohol use in medical care patients: cross- sectional study in Germany
(2020)
Objective
To predict depressive symptom severity and presence of major depression along the full alcohol use continuum.
Design
Cross-sectional study.
Setting
Ambulatory practices and general hospitals from three sites in Germany.
Participants
Consecutive patients aged 18–64 years were proactively approached for an anonymous health screening (participation rate=87%, N=12 828). Four continuous alcohol use measures were derived from an expanded Alcohol Use Disorder Identification Test (AUDIT): alcohol consumption in grams per day and occasion, excessive consumption in days per months and the AUDIT sum score. Depressive symptoms were assessed for the worst 2-week period in the last 12 months using the Patient Health Questionnaire (PHQ-8). Negative binomial and logistic regression analyses were used to predict depressive symptom severity (PHQ-8 sum score) and presence of major depression (PHQ-8 sum score≥10) by the alcohol use measures.
Results
Analyses revealed that depressive symptom severity and presence of major depression were significantly predicted by all alcohol use measures after controlling for sociodemographics and health behaviours (p<0.05). The relationships were curvilinear: lowest depressive symptom severity and odds of major depression were found for alcohol consumptions of 1.1 g/day, 10.5 g/occasion, 1 excessive consumption day/month, and those with an AUDIT score of 2. Higher depressive symptom severity and odds of major depression were found for both abstinence from and higher levels of alcohol consumption. Interaction analyses revealed steeper risk increases in women and younger individuals for most alcohol use measures.
Conclusion
Findings indicate that alcohol use and depression in medical care patients are associated in a curvilinear manner and that moderation by gender and age is present.
Multidrug-resistant gram-negative (MRGN) bacteria are a serious threat to global health. We used genomics tostudy MRGN obtained from houseflies in a tertiary Rwandan hospital. Our analysis revealed a high abundance ofdifferent MRGN includingE. colipathogenic lineage ST131 suggesting the important role of flies in disseminatinghighly virulent pathogens in clinical settings and beyond
Analysis based on claims data showed no clinical benefit from AGR intervention regarding theinvestigated outcomes. The slightly worse outcomes may reflect limitations in matching based on claims data,which may have insufficiently reflected morbidity and psychosocial factors. It is possible that the interventiongroup had poorer health status at baseline compared to the control group.
Abstract
In crisis communication, warning messages are key to prevent or mitigate damage by informing the public about impending risks and hazards. The present study explored the influence of hazard type, trait anxiety, and warning message on different components of risk perception. A survey examined 614 German participants (18–96 years, M = 31.64, 63.0% female) using a pre–post comparison. Participants were randomly allocated to one of five hazards (severe weather, act of violence, breakdown of emergency number, discovery of a World War II bomb, or major fire) for which they received a warning message. Four components of risk perception (perceived severity, anticipatory worry, anticipated emotions, and perceived likelihood) were measured before and after the receipt. Also, trait anxiety was assessed. Analyses of covariance of risk perception were calculated, examining the effect of warning message, trait anxiety, and hazard type while controlling for age, gender, and previous hazard experience. Results showed main effects of hazard type and trait anxiety on every component of risk perception, except for perceived likelihood. The receipt of a warning message led to a significant decrease in anticipated negative emotions. However, changes across components of risk perception, as well as hazards, were inconsistent, as perceived severity decreased while perceived likelihood and anticipatory worry increased. In addition, three interactional effects were found (perceived severity × hazard type, perceived severity × trait anxiety, and anticipated emotions × hazard type). The findings point toward differences in the processing of warning messages yet underline the importance of hazard type, as well as characteristics of the recipient.
The role of glutathione peroxidases (GPx) in cancer and their influence on tumor prognosisand the development of anticancer drug resistance has been extensively and controversially discussed.The aim of this study was to evaluate the influence of GPx1 expression on anticancer drug cytotoxicity.For this purpose, a GPx1 knockout of the near-haploid human cancer cell line HAP-1 was generatedand compared to the native cell line with regards to morphology, growth and metabolic rates,and oxidative stress defenses. Furthermore, the IC50values of two peroxides and 16 widely usedanticancer drugs were determined in both cell lines. Here we report that the knockout of GPx1 in HAP-1cells has no significant effect on cell size, viability, growth and metabolic rates. Significant increasesin the cytotoxic potency of hydrogen peroxide andtert-butylhydroperoxide, the anticancer drugscisplatin and carboplatin as well as the alkylating agents lomustine and temozolomide were found.While a concentration dependent increases in intracellular reactive oxygen species (ROS) levelswere observed for both HAP-1 cell lines treated with either cisplatin, lomustine or temozolamide,no significant enhancement in ROS levels was observed in the GPx1 knockout compared to the nativecell line except at the highest concentration of temozolamide. On the other hand, a ca. 50% decreasein glutathione levels was noted in the GPx1 knockout relative to the native line, suggesting thatfactors other than ROS levels alone play a role in the increased cytotoxic activity of these drugs in theGPx1 knockout cells.
Investigation of In-Vitro Adaptation toward Sodium Bituminosulfonate in Staphylococcus aureus
(2020)
Patients with high-risk neuroblastoma treated with continuous long-term infusion of anti-GD2 antibody dinutuximab beta (DB) in combination with IL-2 show an acceptable safety profile. Here, we compared treatment tolerance with and without IL-2. Ninety-nine patients with high-risk neuroblastoma received up to five cycles of DB given as long-term infusion (10 mg/m2/d, 100 mg/m2; per cycle) with IL-2 (53 patients; regimen A; 6 × 106 IU/m2/d; 60 × 106 IU/m2/cycle) and without IL-2 (46 patients; regimen B) in a single-center compassionate use program. Clinical parameters (body temperature, vital signs, Lansky performance score), laboratory values [C-reactive protein, IFN-γ, IL-6, and IL-18 (cycle 1)], and requirement of i.v. co-medication (e.g., morphine, metamizole) were systematically assessed. Patients with stable clinical parameters and that did not require co-medication were defined as potential “outpatient candidates.” Patients showed higher levels of body temperature and CRP in regimen A compared to B. However, IL-6 serum concentrations were similar in pts of both cohorts in the first cycle. Patients receiving regimen B showed a shorter time to achieve normal vital parameters and required less co-medication compared to patients in regimen A that resulted in a shorter median time period to discharge and to achieve a potential outpatient status (6d regimen A and 3–5d regimen B after start of antibody infusion, respectively). This study shows that omitting IL-2 from immunotherapy with DB allows reduced co-medication and hospitalization time and therefore results in improved quality of life in patients with high-risk neuroblastoma.
In a changing world, phytoplankton communities face a large variety of challenges including altered light regimes. These alterations are caused by more pronounced stratification due to rising temperatures, enhanced eutrophication, and browning of lakes. Community responses toward these effects can emerge as alterations in physiology, biomass, biochemical composition, or diversity. In this study, we addressed the combined effects of changes in light and nutrient conditions on community responses. In particular, we investigated how light intensity and variability under two nutrient conditions influence (1) fast responses such as adjustments in photosynthesis, (2) intermediate responses such as pigment adaptation and (3) slow responses such as changes in community biomass and species composition. Therefore, we exposed communities consisting of five phytoplankton species belonging to different taxonomic groups to two constant and two variable light intensity treatments combined with two levels of phosphorus supply. The tested phytoplankton communities exhibited increased fast reactions of photosynthetic processes to light variability and light intensity. The adjustment of their light harvesting mechanisms via community pigment composition was not affected by light intensity, variability, or nutrient supply. However, pigment specific effects of light intensity, light variability, and nutrient supply on the proportion of the respective pigments were detected. Biomass was positively affected by higher light intensity and nutrient concentrations while the direction of the effect of variability was modulated by light intensity. Light variability had a negative impact on biomass at low, but a positive impact at high light intensity. The effects on community composition were species specific. Generally, the proportion of green algae was higher under high light intensity, whereas the cyanobacterium performed better under low light conditions. In addition to that, the diatom and the cryptophyte performed better with high nutrient supply while the green algae as well as the cyanobacterium performed better at low nutrient conditions. This shows that light intensity, light variability, and nutrient supply interactively affect communities. Furthermore, the responses are highly species and pigment specific, thus to clarify the effects of climate change a deeper understanding of the effects of light variability and species interactions within communities is important.
Swine are regarded as promising biomedical models, but the dynamics of theirgastrointestinal microbiome have been much less investigated than that of humans or mice. The aimof this study was to establish an integrated multi-omics protocol to investigate the fecal microbiomeof healthy swine. To this end, a preparation and analysis protocol including integrated samplepreparation for meta-omics analyses of deep-frozen feces was developed. Subsequent data integrationlinked microbiome composition with function, and metabolic activity with protein inventories, i.e.,16S rRNA data and expressed proteins, and identified proteins with corresponding metabolites.16S rRNA gene amplicon and metaproteomics analyses revealed a fecal microbiome dominated byPrevotellaceae,Lactobacillaceae,Lachnospiraceae,RuminococcaceaeandClostridiaceae.Similar microbiomecompositions in feces and colon, but not ileum samples, were observed, showing that feces can serveas minimal-invasive proxy for porcine colon microbiomes. Longitudinal dynamics in composition,e.g., temporal decreased abundance ofLactobacillaceaeandStreptococcaceaeduring the experiment,were not reflected in microbiome function. Instead, metaproteomics and metabolomics showed arather stable functional state, as evident from short-chain fatty acids (SCFA) profiles and associatedmetaproteome functions, pointing towards functional redundancy among microbiome constituents.In conclusion, our pipeline generates congruent data from different omics approaches on the taxonomyand functionality of the intestinal microbiome of swine.
Exploring Virulence Factors and Alternative Therapies against Staphylococcus aureus Pneumonia
(2020)
Entropy Ratio and Entropy Concentration Coefficient, with Application to the COVID-19 Pandemic
(2020)
Abstract
Background
Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists.
Aim
To assess final‐year German dental students’ knowledge, attitudes, and beliefs regarding MIH.
Materials and methods
A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding
diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected.
Results
Twenty‐two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH; however, only 42% knew how to implement them. One‐third were able to identify MIH and 16% reported diagnostic confidence when doing so; 90% assumed the MIH prevalence to be <10%. Two‐thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training.
Conclusion
German students were familiar with MIH; however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up‐to‐date curricula should be implemented to educate future dentists in Germany.
Summary
Sphagnum farming can substitute peat with renewable biomass and thus help mitigate climate change. Large volumes of the required founder material can only be supplied sustainably by axenic cultivation in bioreactors.
We established axenic in vitro cultures from sporophytes of 19 Sphagnum species collected in Austria, Germany, Latvia, the Netherlands, Russia, and Sweden: S. angustifolium, S. balticum, S. capillifolium, S. centrale, S. compactum, S. cuspidatum, S. fallax, S. fimbriatum, S. fuscum, S. lindbergii, S. medium/divinum, S. palustre, S. papillosum, S. rubellum, S. russowii, S. squarrosum, S. subnitens, S. subfulvum and S. warnstorfii. These species cover five of the six European Sphagnum subgenera; namely, Acutifolia, Cuspidata, Rigida, Sphagnum and Squarrosa.
Their growth was measured in suspension cultures, whereas their ploidy was determined by flow cytometry and compared with the genome size of Physcomitrella patens. We identified haploid and diploid Sphagnum species, found that their cells are predominantly arrested in the G1 phase of the cell cycle, and did not find a correlation between plant productivity and ploidy. DNA barcoding was achieved by sequencing introns of the BRK1 genes.
With this collection, high‐quality founder material for diverse large‐scale applications, but also for basic Sphagnum research, is available from the International Moss Stock Center.
Abstract
Interbedded contourites, turbidites and pelagites are commonplace in many deep‐water slope environments. However, the distinction between these different facies remains a source of controversy. This detailed study of calcareous contourites and associated deep‐marine facies from an Eocene–Miocene sedimentary succession on Cyprus clearly documents the diagnostic value of microfacies in this debate. In particular, the variability of archetypical bi‐gradational contourite sequences and their internal subdivision (bedding, layering and lamination) are explored. Contourites can be distinguished from turbidites, pelagites and hemipelagites by means of carbonate microfacies in combination with bed‐scale characteristics. Particle composition provides valuable information on sediment provenance. Depositional texture, determined by the ratio between carbonate mud and bioclasts, is crucial for identifying bi‐gradational sequences in both muddy and sandy contourites, and normally‐graded sequences in turbidite beds. Equally important are the type and preservation of traction structures, as well as the temporality and impact of bioturbation. Shell fragmentation under conditions of increased hydrodynamic agitation (textural inversion) is recognized as a carbonate‐specific feature of bioclastic sandy contourites.
S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids) – Update 2020
(2020)
Objective
This study provides a comprehensive overview of the associations of five adipokines (adiponectin, chemerin, galectin‐3, leptin, and resistin) with fat deposits, behavioral risk factors, and metabolic phenotypes.
Methods
Using multivariable linear and logistic regression models, cross‐sectional data from 4,116 participants of the population‐based Study of Health in Pomerania were analyzed.
Results
Participants with obesity showed higher chemerin, galectin‐3, and leptin but showed lower adiponectin concentrations. Independently of other fat compounds, liver fat content, visceral adipose tissue, and subcutaneous adipose tissue (SAT) were inversely associated with adiponectin. Independent positive associations of liver fat content and SAT with chemerin as well as of SAT with galectin‐3 and leptin were observed. Physically inactive participants had higher chemerin and leptin concentrations. Smokers had higher chemerin and galectin‐3 as well as lower leptin. Alcohol consumption was associated with adiponectin (positive) and resistin (inverse). All adipokines were associated with at least one lipid marker. Associations with glucose metabolism were seen for adiponectin, chemerin, galectin‐3, and leptin.
Conclusions
High adiponectin concentrations were related to favorable metabolic conditions, whereas high chemerin, galectin‐3, and leptin were associated with an unfavorable metabolic profile. High leptin seems to be primarily indicative of obesity, whereas high adiponectin and chemerin are associated with a broader range of metabolic phenotypes.
Summary
This study aimed to establish a robust and reliable metaproteomics protocol for an in‐depth characterization of marine particle‐associated (PA) bacteria. To this end, we compared six well‐established protein extraction protocols together with different MS‐sample preparation techniques using particles sampled during a North Sea spring algae bloom in 2009. In the final optimized workflow, proteins are extracted using a combination of SDS‐containing lysis buffer and cell disruption by bead‐beating, separated by SDS‐PAGE, in‐gel digested and analysed by LC–MS/MS, before MASCOT search against a metagenome‐based database and data processing/visualization with the in‐house‐developed bioinformatics tools Prophane and Paver. As an application example, free‐living (FL) and particulate communities sampled in April 2009 were analysed, resulting in an as yet unprecedented number of 9354 and 5034 identified protein groups for FL and PA bacteria, respectively. Our data suggest that FL and PA communities appeared similar in their taxonomic distribution, with notable exceptions: eukaryotic proteins and proteins assigned to Flavobacteriia, Cyanobacteria, and some proteobacterial genera were found more abundant on particles, whilst overall proteins belonging to Proteobacteria were more dominant in the FL fraction. Furthermore, our data points to functional differences including proteins involved in polysaccharide degradation, sugar‐ and phosphorus uptake, adhesion, motility, and stress response.