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- Institut für Psychologie (73)
- Zoologisches Institut und Museum (73)
- Institut für Geographie und Geologie (60)
Publisher
- MDPI (568)
- Frontiers Media S.A. (364)
- Wiley (223)
- S. Karger AG (156)
- Springer Nature (112)
- IOP Publishing (60)
- BioMed Central (BMC) (59)
- SAGE Publications (50)
- Nature Publishing Group (39)
- Copernicus (20)
Aims
Sphingosine-1-phosphate (S1P) is a signaling lipid, which is involved in several cellular processes including cell growth, proliferation, migration and apoptosis. The associations of serum S1P levels with cardiac geometry and function are still not clear. We investigated the associations of S1P with cardiac structure and systolic function in a population-based sample.
Methods and results
We performed cross-sectional analyses of 858 subjects (467 men; 54.4%), aged 22 to 81 years, from a sub-sample of the population-based Study of Health in Pomerania (SHIP-TREND-0). We analyzed the associations of serum S1P with structural and systolic function left ventricular (LV) and left atrial (LA) parameters as determined by magnetic resonance imaging (MRI) using sex-stratified multivariable-adjusted linear regression models. In men, MRI data showed that a 1 µmol/L lower S1P concentration was associated with an 18.1 mL (95% confidence interval [CI] 3.66–32.6; p = 0.014) larger LV end-diastolic volume (LVEDV), a 0.46 mm (95% CI 0.04–0.89; p = 0.034) greater LV wall thickness (LVWT) and a 16.3 g (95% CI 6.55–26.1; p = 0.001) higher LV mass (LVM). S1P was also associated with a 13.3 mL/beat (95% CI 4.49–22.1; p = 0.003) greater LV stroke volume (LVSV), an 18.7 cJ (95% CI 6.43–30.9; p = 0.003) greater LV stroke work (LVSW) and a 12.6 mL (95% CI 1.03–24.3; p = 0.033) larger LA end-diastolic volume (LAEDV). We did not find any significant associations in women.
Conclusions
In this population-based sample, lower levels of S1P were associated with higher LV wall thickness and mass, larger LV and LA chamber sizes and greater stroke volume and work of the LV in men, but not in women. Our results indicate that lower levels of S1P were associated with parameters related with cardiac geometry and systolic function in men, but not in women.
Marine algae produce complex polysaccharides, which can be degraded by marine heterotrophic bacteria utilizing carbohydrate-active enzymes. The red algal polysaccharide porphyran contains the methoxy sugar 6-O-methyl-D-galactose (G6Me). In the degradation of porphyran, oxidative demethylation of this monosaccharide towards D-galactose and formaldehyde occurs, which is catalyzed by a cytochrome P450 monooxygenase and its redox partners. In direct proximity to the genes encoding for the key enzymes of this oxidative demethylation, genes encoding for zinc-dependent alcohol dehydrogenases (ADHs) were identified, which seem to be conserved in porphyran utilizing marine Flavobacteriia. Considering the fact that dehydrogenases could play an auxiliary role in carbohydrate degradation, we aimed to elucidate the physiological role of these marine ADHs. Although our results reveal that the ADHs are not involved in formaldehyde detoxification, a knockout of the ADH gene causes a dramatic growth defect of Zobellia galactanivorans with G6Me as a substrate. This indicates that the ADH is required for G6Me utilization. Complete biochemical characterizations of the ADHs from Formosa agariphila KMM 3901T (FoADH) and Z. galactanivorans DsijT (ZoADH) were performed, and the substrate screening revealed that these enzymes preferentially convert aromatic aldehydes. Additionally, we elucidated the crystal structures of FoADH and ZoADH in complex with NAD+ and showed that the strict substrate specificity of these new auxiliary enzymes is based on a narrow active site.
Transcriptional corepressors Sin3, Cyc8 and Tup1 are important for downregulation of gene expression by recruiting various histone deacetylases once they gain access to defined genomic locations by interaction with pathway-specific repressor proteins. In this work we systematically investigated whether 17 yeast repressor proteins (Cti6, Dal80, Fkh1, Gal80, Mig1, Mot3, Nrg1, Opi1, Rdr1, Rox1, Sko1, Ume6, Ure2, Xbp1, Yhp1, Yox1 and Whi5) representing several unrelated regulatory pathways are able to bind to Sin3, Cyc8 and Tup1. Our results show that paired amphipathic helices 1 and 2 (PAH1 and PAH2) of Sin3 are functionally redundant for some regulatory pathways. WD40 domains of Tup1 proved to be sufficient for interaction with repressor proteins. Using length variants of selected repressors, we mapped corepressor interaction domains (CIDs) in vitro and assayed gene repression in vivo. Systematic comparison of CID minimal sequences allowed us to define several related positional patterns of hydrophobic amino acids some of which could be confirmed as functionally supported by site-directed mutagenesis. Although structural predictions indicated that certain CIDs may be α-helical, most repression domains appear to be randomly structured and must be considered as intrinsically disordered regions (IDR) adopting a defined conformation only by interaction with a corepressor.
Purpose
The WHO 2016 re-classification of myeloproliferative neoplasms resulted in a separation of essential thrombocythemia (ET) from the pre-fibrotic and fibrotic (overt) phases of primary myelofibrosis (MF). This study reports on a chart review conducted to evaluate the real life approach regarding clinical characteristics, diagnostic assessment, risk stratification and treatment decisions for MPN patients classified as ET or MF after implementation of the WHO 2016 classification.
Methods
In this retrospective chart review, 31 office-based hematologists/oncologists and primary care centers in Germany participated between April 2021 and May 2022. Physicians reported available data obtained from patient charts via paper–pencil based survey (secondary use of data). Patient features were evaluated using descriptive analysis, also including diagnostic assessment, therapeutic strategies and risk stratification.
Results
Data of 960 MPN patients diagnosed with essential thrombocythemia (ET) (n = 495) or myelofibrosis (MF) (n = 465) after implementation of the revised 2016 WHO classification of myeloid neoplasms was collected from the patient charts. While they met at least one minor WHO-criteria for primary myelofibrosis, 39.8% of those diagnosed with ET did not have histological BM testing at diagnosis. 63.4% of patients who were classified as having MF, however, did not obtain an early prognostic risk assessment. More than 50% of MF patients showed characteristics consistent with the pre-fibrotic phase, which was emphasized by the frequent use of cytoreductive therapy. Hydroxyurea was the most frequently used cytoreductive medication in 84.7% of ET and 53.1% of MF patients. While both ET and MF cohorts showed cardiovascular risk factors in more than 2/3 of the cases, the use of platelet inhibitors or anticoagulants varied between 56.8% in ET and 38.1% in MF patients.
Conclusions
Improved histopathologic diagnostics, dynamic risk stratification including genetic risk factors for cases of suspected ET and MF are recommended for precise risk assessment and therapeutic stratification according to WHO criteria.
Monitoring and assessing groundwater quality according to European directives and national regulations is usually based on interpolation techniques, e.g. Kriging. However, contour maps of hydrochemical parameters often suggest a spurious local accuracy and can therefore lead to inappropriate action measures. Here, the early concept of extension variance combined with the Voronoi tessellation regionalization is proposed. The mosaic-like representation of pollutant concentrations in Voronoi polygons avoids misinterpretations caused by interpolation. The additional calculation of the extension variance, which is based on fundamental geostatistical assumptions, allows for estimating the probability that a given threshold is exceeded. This concept is further extended to hydraulically delimitable groundwater bodies, thus ensuring that hydraulic boundaries are considered. A method is here described for the assessment of groundwater quality with respect to nitrate concentration in the principal aquifer of the state Mecklenburg-Western Pomerania in Germany.
Mobile Apps for Sexual and Reproductive Health Education: a Systematic Review and Quality Assessment
(2023)
Purpose of Review
The aim of this study was to present the current state of research on mobile health apps for sexual and reproductive health (SRH) education. Apps were analysed based on contents (by using the World Health Organization’s SRH framework), features, intended audiences and quality of evidence (by applying the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach). Taking German sexuality education apps as an example, the rapid development in the field of SRH apps over the last 3 years has been revealed by comparing the quality of apps available in 2019 with apps from 2022.
Recent Findings
SRH apps allow health information to be disseminated quickly, at low thresholds and in a practical and cost-effective manner. Moreover, they allow for anonymous usage independently of time and place. In the absence of network coverage, offline use is also possible. Previous research focused on individual SRH aspects (e.g. human immunodeficiency virus (HIV), contraception). However, some studies were designed to cover a broader range of SRH topics, but identified only a few relevant apps.
Summary
To improve SRH, it would be helpful if the apps would be of high-quality design and be made up of relevant content. Furthermore, they should be tailored to the target group and have been tested in real-life settings. A total of 50 SRH apps with sufficiently high-quality ratings were included. The apps cover a variety of SRH topics, but they often lack field-based evaluation. The effectiveness of SRH apps has not yet been sufficiently studied in a scientific manner. Only 9 apps were deemed to be adequate for a moderate GRADE level. Despite this grading, the study nevertheless shows that there are several apps that could potentially promote SRH.
The potential of several ion-sensitive electrodes responds to the incorporated cations and anions. This has led some authors to misinterpret the potential of metal salt membrane electrodes and of electrodes of the second kind. Neglecting the kinetics of potential establishment and interpreting the potentials solely based on thermodynamics produce completely irrelevant data and suggest that ion concentrations down to 10−45 mol L−1 are accessible by simple potentiometric measurements. The switching from cation to anion response mechanism cannot be derived from thermodynamic equations. It bears complete similarity to the switching of response in the case of foreign interfering ions.
Purpose
A setting-sensitive instrument for assessing Quality of Life (QoL) in Telemedicine (TM) was unavailable. To close this gap, a content-valid “add-on” measure was developed. In parallel, a brief index was derived featuring six items that summarise the main content of the multidimensional assessment. After pre- and pilot-testing, the psychometric performance of the final measures was investigated in an independent validation study.
Methods
The questionnaires were applied along with other standardised instruments of similar concepts as well as associated, yet disparate concepts for validation purposes. The sample consisted of patients with depression or heart failure, with or without TM (n = 200). Data analyses were aimed at calculating descriptive statistics and testing the psychometric performance on item, scale, and instrument level, including different types of validity and reliability.
Results
The proposed factor structure of the multidimensional Tele-QoL measure has been confirmed. Reliability coefficients for internal consistency, split-half, and test-retest reliability of the subscales and index reached sufficient values. The Tele-QoL subscales and the index demonstrated Rasch scalability. Validity of both instruments can be assumed. Evidence for discriminant construct validity was provided. Known-groups validity was indicated by respective score differences for various classes of disease severity.
Conclusion
Both measures show convincing psychometric properties. The final multidimensional Tele-QoL assessment consists of six outcome scales and two impact scales assessing (un-)intended effects of TM on QoL. In addition, the Tele-QoL index provides a short alternative for outcome assessment. The Tele-QoL measures can be used as complementary modules to existing QoL instruments capturing healthcare-related aspects of QoL from the patients’ perspective.
SLC35F1 is a member of the sugar-like carrier (SLC) superfamily that is expressed in the mammalian brain. Malfunction of SLC35F1 in humans is associated with neurodevelopmental disorders. To get insight into the possible roles of Slc35f1 in the brain, we generated Slc35f1-deficient mice. The Slc35f1-deficient mice are viable and survive into adulthood, which allowed examining adult Slc35f1-deficient mice on the anatomical as well as behavioral level. In humans, mutation in the SLC35F1 gene can induce a Rett syndrome-like phenotype accompanied by intellectual disability (Fede et al. Am J Med Genet A 185:2238–2240, 2021). The Slc35f1-deficient mice, however, display only a very mild phenotype and no obvious deficits in learning and memory as, e.g., monitored with the novel object recognition test or the Morris water maze test. Moreover, neuroanatomical parameters of neuronal plasticity (as dendritic spines and adult hippocampal neurogenesis) are also unaltered. Thus, Slc35f1-deficient mice display no major alterations that resemble a neurodevelopmental phenotype.
How can powerful states best extract domestic concessions from their junior allies? What are the conditions under which the powerful state is more likely to succeed in inducing such domestic policy change? This article explores the link between US security commitments and Washington’s ability to attain favourable policy outcomes within the allied domestic arena. It provides an illustrative case of how the USA, using security guarantees as leverage, can enter allied domestic space and shape its decision-making process. After it was revealed that Latvia had served as a key node through which North Korea attempted to evade the sanctions regime, the USA, by playing its security guarantor card, pressured Riga to carry out substantial policy reforms in relation to its financial system. This approach yielded considerable results. In order to preserve the existing security arrangements with the dominant alliance member, Latvia offered significant policy concessions. This finding demonstrates that US security alliances come with side benefits that are often underrated or neglected in the scholarly literature.
Background
A bidirectional functional link between vestibular and fear-related disorders has been previously suggested.
Objective
To test a potential overlap of vestibular and fear systems with regard to their brain imaging representation maps.
Methods
By use of voxel-based mapping permutation of subject images, we conducted a meta-analysis of earlier functional magnetic resonance imaging (fMRI) studies applying vestibular stimulation and fear conditioning in healthy volunteers.
Results
Common clusters of concordance of vestibular stimulation and fear conditioning were found in the bilateral anterior insula cortex, ventrolateral prefrontal cortex and the right temporal pole, bilaterally in the adjacent ventrolateral prefrontal cortex, cingulate gyrus, secondary somatosensory cortex, superior temporal and intraparietal lobe, supplementary motor area and premotor cortex, as well as subcortical areas, such as the bilateral thalamus, mesencephalic brainstem including the collicular complex, pons, cerebellar vermis and bilateral cerebellar hemispheres. Peak areas of high concordance for activations during vestibular stimulation but deactivations during fear conditioning were centered on the posterior insula and S2.
Conclusions
The structural overlap of both networks allows the following functional interpretations: first, the amygdala, superior colliculi, and antero-medial thalamus might represent a release of preprogramed sensorimotor patterns of approach or avoidance. Second, the activation (vestibular system) and deactivation (fear system) of the bilateral posterior insula is compatible with the view that downregulation of the fear network by acute vestibular disorders or unfamiliar vestibular stimulation makes unpleasant perceived body accelerations less distressing. This also fits the clinical observation that patients with bilateral vestibular loss suffer from less vertigo-related anxiety.
Background and objective
Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions.
Methods
We develop a conceptual framework model of cross-border healthcare and apply it to the Polish–German border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve.
Results
Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients.
Conclusion
Strong effort should be invested to overcome political and cultural borders to improve the health of the population in border regions. Similarly, increased cross-border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.
Animals often respond to climate change with changes in morphology, e.g., shrinking body size with increasing temperatures, as expected by Bergmann’s rule. Because small body size can have fitness costs for individuals, this trend could threaten populations. Recent studies, however, show that morphological responses to climate change and the resulting fitness consequences cannot be generalized even among related species. In this long-term study, we investigate the interaction between ambient temperature, body size and survival probability in a large number of individually marked wild adult female Natterer’s bats (Myotis nattereri). We compare populations from two geographical regions in Germany with a different climate. In a sliding window analysis, we found larger body sizes in adult females that were raised in warmer summers only in the northern population, but not in the southern population that experienced an overall warmer climate. With a capture-mark-recapture approach, we showed that larger individuals had higher survival rates, demonstrating that weather conditions in early life could have long-lasting fitness effects. The different responses in body size to warmer temperatures in the two regions highlight that fitness-relevant morphological responses to climate change have to be viewed on a regional scale and may affect local populations differently.
Cationic and anionic clusters of the group-14 elements carbon, silicon, germanium, tin, and lead are produced by high-vacuum laser ablation and studied with a multi-reflection time-of-flight mass spectrometer. In-trap photodissociation is performed for cluster species in the size range n=2–10. The clusters’ production rates as well as their dissociation pathways are used to probe the nonmetal–metal transition throughout the group. Carbon clusters show neutral-trimer break-off, while those of the other elements evaporate neutral monomers and, in some cases, form specific charged fragment sizes.
Purpose
Outcomes of multiple myeloma (MM) patients who are refractory to daratumumab are dismal and no standard of treatment exists for this patients’ population. Here, we investigate the role of pomalidomide combinations in daratumumab-refractory MM patients.
Methods
We performed a retrospective analysis of myeloma patients treated at four referral centers (three in Germany and one in Italy). Review chart identified 30 patients with relapsed and refractory myeloma, who progressed during treatment with daratumumab and were treated with pomalidomide-based combinations in the subsequent lines of therapy.
Results
Responses improved from 37% with daratumumab to 53% with pomalidomide. Of seven patients with extramedullary MM (EMM), four achieved a clinical stabilization with pomalidomide, including one patient with a long-lasting complete response. Median progression-free survival and overall survival were 6 and 12 months, respectively. Pomalidomide combinations were well tolerated, no patient discontinued treatment due to adverse events.
Conclusion
These data show that pomalidomide-based combinations can be an effective and safe salvage regimen for daratumumab-refractory patients, including those with EMM.
In teaching electrochemistry, it is of primary importance to make students always aware of the relations between electrochemistry and all the non-electrochemical topics, which are taught. The vast majority of students will not specialise in electrochemistry, but they all can very much benefit from the basics and concepts of electrochemistry. This paper is aimed to give suggestions how the teaching of electrochemistry can easily be interrelated to topics of inorganic, organic, analytical, environmental chemistry, biochemistry and biotechnology.
There is still considerable controversy surrounding the impact of mastication on obesity. The aim of this study was to identify the interplay between the masticatory muscles, teeth, and general muscular fitness and how they contribute to body adiposity in a general German population. This cross-sectional study included 616 participants (300 male, 316 female, age 31–93 years) from the population-based Study of Health in Pomerania. The cross-sectional areas of the masseter, medial and lateral pterygoid muscles were measured using magnetic resonance imaging (MRI), muscular fitness assessed by hand grip strength (HGS) and body fat distribution was measured by bioelectrical impedance analysis (BIA) and MRI. The overall prevalence of obesity was high in our cohort. The cross-sectional area of the masseter muscles was positively associated with the number of teeth, body mass index (BMI) and HGS, and negatively associated with the BIA-assessed body fat when adjusted for age, sex, teeth, and BMI. Especially the correlation was strong (p < 0.001). Analogous relationships were observed between the masseter, HGS and MRI-assessed subcutaneous fat. These associations were most pronounced with masseter, but also significant with both pterygoid muscles. Though the masticatory muscles were affected by the number of teeth, teeth had no impact on the relations between masseter muscle and adiposity. Physical fitness and masticatory performance are associated with body shape, controlled and directed by the relevant muscles.
Electrochemical Raman spectroscopy can provide valuable insights into electrochemical reaction mechanisms. However, it also shows various pitfalls and challenges. This paper gives an overview of the necessary theoretical background, crucial practical considerations for successful measurement, and guidance for in situ/in operando electrochemical Raman spectroscopy. Several parameters must be optimized for suitable reaction and measurement conditions. From the experimental side, considerations for the setup, suitable signal enhancement methods, choice of material, laser, and objective lens are discussed. Different interface phenomena are reviewed in the context of data interpretation and evaluation.
Objectives
To investigate the effect of layer height of FFF-printed models on aligner force transmission to a second maxillary premolar during buccal torquing, distalization, extrusion, and rotation using differing foil thicknesses.
Materials and methods
Utilizing OnyxCeph3™ Lab (Image Instruments GmbH, Chemnitz, Germany, Release Version 3.2.185), the following movements were programmed for the second premolar: buccal torque (0.1–0.5 mm), distalization (0.1–0.4 mm), extrusion (0.1–0.4 mm), rotation (0.1–0.5 mm), and staging 0.1 mm. Via FFF, 91 maxillary models were printed for each staging at different layer heights (100 µm, 150 µm, 200 µm, 250 µm, 300 µm). Hence, 182 aligners, made of polyethylene terephthalate glycol (PET-G) with two thicknesses (0.5 mm and 0.75 mm), were prepared. The test setup comprised an acrylic maxillary model with the second premolar separated and mounted on a sensor, measuring initial forces and moments exerted by the aligners. A generalized linear model for the gamma distribution was applied, evaluating the significance of the factors layer height, type of movement, aligner thickness, and staging on aligner force transmission.
Results
Foil thickness and staging were found to have a significant influence on forces delivered by aligners, whereas no significance was determined for layer height and type of movement. Nevertheless, at a layer height of 150 µm, the most appropriate force transmission was observed.
Conclusions
Printing aligner models at particularly low layer heights leads to uneconomically high print time without perceptible better force delivery properties, whereas higher layer heights provoke higher unpredictability of forces due to scattering. A z-resolution of 150 µm appears ideal for in-office aligner production combining advantages of economic print time and optimal force transmission.
Flies form high-density associations with human settlements and groups of nonhuman primates and are implicated in transmitting pathogens. We investigate the movement of nonhuman primate-associated flies across landscapes surrounding Kibale National Park, Uganda, using a mark–recapture experiment. Flies were marked in nine nonhuman primate groups at the forest edge (x̄ = 929 flies per group), and we then attempted to recapture them in more anthropized areas (50 m, 200 m and 500 m from where marked; 2–21 days after marking). Flies marked in nonhuman primate groups were recaptured in human areas (19/28,615 recaptured). Metabarcoding of the flies in nonhuman primate groups revealed the DNA of multiple eukaryotic primate parasites. Taken together, these results demonstrate the potential of flies to serve as vectors between nonhuman primates, livestock and humans at this biodiverse interface.
Background
Telephone-Cardiopulmonary Resuscitation (T-CPR) significantly increases rate of bystander resuscitation and improves patient outcomes after out-of-hospital cardiac arrest (OHCA). Nevertheless, securing correct execution of instructions remains a difficulty. ERC Guidelines 2021 recommend standardised instructions with continuous evaluation. Yet, there are no explicit recommendations on a standardised wording of T-CPR in the German language. We investigated, whether a modified wording regarding check for breathing in a German T-CPR protocol improved performance of T-CPR.
Methods
A simulation study with 48 OHCA scenarios was conducted. In a non-randomised trial study lay rescuers were instructed using the real-life-CPR protocol of the regional dispatch centre and as the intervention a modified T-CPR protocol, including specific check for breathing (head tilt-chin lift instructions). Resuscitation parameters were assessed with a manikin and video recordings.
Results
Check for breathing was performed by 64.3% (n = 14) of the lay rescuers with original wording and by 92.6% (n = 27) in the group with modified wording (p = 0.035). In the original wording group the head tilt-chin manoeuvre was executed by 0.0% of the lay rescuers compared to 70.3% in the group with modified wording (p < 0.001). The average duration of check for breathing was 1 ± 1 s in the original wording group and 4 ± 2 s in the group with modified wording (p < 0.001). Other instructions (e.g. check for consciousness and removal of clothing) were well performed and did not differ significantly between groups. Quality of chest compression did not differ significantly between groups, with the exception of mean chest compression depth, which was slightly deeper in the modified wording group.
Conclusion
Correct check for breathing seems to be a problem for lay rescuers, which can be decreased by describing the assessment in more detail. Hence, T-CPR protocols should provide standardised explicit instructions on how to perform airway assessment. Each protocol should be evaluated for practicability.
Platelet factor 4 (PF4, synonym: CXCL4) is an evolutionary old chemokine with proposed roles in hemostasis and antimicrobial defense. In addition, PF4 has attracted considerable attention as a crucial mediator of one of the most prothrombotic adverse drug effects affecting blood cells, heparin-induced thrombocytopenia (HIT). Interest in PF4 substantially increased in 2021 when it was identified as the target antigen in the life-threatening adverse effect, vaccine-induced immune thrombotic thrombocytopenia (VITT). We address the concept that a major biological function of PF4—a strongly cationic chemokine—is to bind to negatively-charged prokaryotic microorganisms, resulting in structural changes in PF4 that trigger a danger signal recognized by the adaptive immune system. Application of biophysical tools has provided substantial insights into the molecular mechanisms by which PF4 becomes immunogenic, providing insights into a new mechanism of autoimmunity. Binding of autoantibodies with high affinity induces conformational change(s) in the endogenous protein, which are then recognized as foreign antigen, as exemplified by the prothrombotic disorders, autoimmune HIT and VITT. The final part of our review summarizes current assays for HIT and VITT, explaining how structural aspects of anti-PF4 pathobiology relate to assay design and performance characteristics. Currently, functional (platelet activation) assays using washed platelets detect HIT antibodies when heparin is added, and VITT antibodies when PF4 is added. Solid-phase PF4-dependent immunoassays using microtiter plates are sensitive for both HIT and VITT antibodies, while rapid immunoassays, in which the PF4/heparin antigen is coated on beads, are sensitive and specific for HIT, but not for VITT antibodies.
Heteroleptic molybdenum complexes bearing 1,5-diaza-3,7-diphosphacyclooctane (P2N2) and non-innocent dithiolene ligands were synthesized and electrochemically characterized. The reduction potentials of the complexes were found to be fine-tuned by a synergistic effect identified by DFT calculations as ligand-ligand cooperativity via non-covalent interactions. This finding is supported by electrochemical studies combined with UV/Vis spectroscopy and temperature-dependent NMR spectroscopy. The observed behavior is reminiscent of enzymatic redox modulation using second ligand sphere effects.
Background: Methanogenic archaea represent a less investigated and likely underestimated part of the intestinal tract microbiome in swine.
Aims/Methods: This study aims to elucidate the archaeome structure and function in the porcine intestinal tract of healthy and H1N1 infected swine. We performed multi-omics analysis consisting of 16S rRNA gene profiling, metatranscriptomics and metaproteomics.
Results and discussion: We observed a significant increase from 0.48 to 4.50% of archaea in the intestinal tract microbiome along the ileum and colon, dominated by genera Methanobrevibacter and Methanosphaera. Furthermore, in feces of naïve and H1N1 infected swine, we observed significant but minor differences in the occurrence of archaeal phylotypes over the course of an infection experiment. Metatranscriptomic analysis of archaeal mRNAs revealed the major methanogenesis pathways of Methanobrevibacter and Methanosphaera to be hydrogenotrophic and methyl-reducing, respectively. Metaproteomics of archaeal peptides indicated some effects of the H1N1 infection on central metabolism of the gut archaea.
Conclusions/Take home message: Finally, this study provides the first multi-omics analysis and high-resolution insights into the structure and function of the porcine intestinal tract archaeome during a non-lethal Influenza A virus infection of the respiratory tract, demonstrating significant alterations in archaeal community composition and central metabolic functions.
Background and purpose
The insula has important functions in monitoring and integrating physiological responses to a personal experience of multimodal input. The experience of chills in response to auditory stimuli is an important example for a relevant arousing experience coupled with bodily response. A group study about altered chill experiences in patients with insula lesions is lacking.
Methods
Twenty-eight stroke patients with predominantly insula lesions in the chronic stage and 14 age-matched controls were investigated using chill stimuli of both valences (music, harsh sounds). Group differences were analyzed in subjective chill reports, associated bodily responses (skin conductance response), lesion mapping, diffusion-weighted imaging and functional magnetic resonance imaging. Other neuropsychological deficits were excluded by comprehensive testing. Diffusion-weighted imaging was quantified for four insula tracts using fractional anisotropy.
Results
The frequency of chill experiences was comparable between participant groups. However, bodily responses were decreased for the stroke group. Whereas there was no association of lesion location, a positive association was found for the skin conductance response during aversive sounds and the tract connecting anterior inferior insula and left temporal pole in the stroke group. Similarly, functional magnetic resonance imaging activation in areas hypothesized to compensate for damage was increased with bodily response.
Conclusions
A decoupling of felt arousal and bodily response after insula lesion was observed. Impaired bodily response was related to an impaired interaction of the left anterior insula and the temporal pole.
Marine Bacteroidetes that degrade polysaccharides contribute to carbon cycling in the ocean. Organic matter, including glycans from terrestrial plants, might enter the oceans through rivers. Whether marine bacteria degrade structurally related glycans from diverse sources including terrestrial plants and marine algae was previously unknown. We show that the marine bacterium Flavimarina sp. Hel_I_48 encodes two polysaccharide utilization loci (PULs) which degrade xylans from terrestrial plants and marine algae. Biochemical experiments revealed activity and specificity of the encoded xylanases and associated enzymes of these PULs. Proteomics indicated that these genomic regions respond to glucuronoxylans and arabinoxylans. Substrate specificities of key enzymes suggest dedicated metabolic pathways for xylan utilization. Some of the xylanases were active on different xylans with the conserved β-1,4-linked xylose main chain. Enzyme activity was consistent with growth curves showing Flavimarina sp. Hel_I_48 uses structurally different xylans. The observed abundance of related xylan-degrading enzyme repertoires in genomes of other marine Bacteroidetes indicates similar activities are common in the ocean. The here presented data show that certain marine bacteria are genetically and biochemically variable enough to access parts of structurally diverse xylans from terrestrial plants as well as from marine algal sources.
Background
Both vulnerability and integrity represent action-guiding concepts in nursing practice. However, they are primarily discussed regarding patients—not nurses—and considered independently from rather than in relation to each other.
Aim
The aim of this paper is to characterize the moral dimension of nurses' vulnerability and integrity, specify the concepts' relationship in nurses' clinical practice and, ultimately, allow a more fine-grained understanding.
Design
This discursive paper demonstrates how vulnerability and integrity relate to each other in nursing practice and carves out which types of vulnerability pose a threat to nurses' moral integrity. The concept of vulnerability developed by Mackenzie et al. (2014) is applied to the situation of nurses and expanded to include the concept of moral integrity according to Hardingham (2004). Four scenarios are used to demonstrate where and how nurses' vulnerabilities become particularly apparent in clinical practice. This leads to a cross-case discussion, in which the vulnerabilities identified are examined against the background of moral integrity and the relationship between the two concepts is determined in more detail.
Results and Conclusion
Vulnerability and integrity do not only form a conceptual pair but also represent complementary moral concepts. Their joint consideration has both a theoretical and practical added value. It is shown that only specific forms of vulnerability pose a threat to moral integrity and the vulnerability–integrity relationship is mediated via moral distress.
Implications for the Profession and/or Patient Care
The manuscript provides guidance on how the concrete threat(s) to integrity can be buffered and moral resilience can be promoted. Different types of threats also weigh differently and require specific approaches to assess and handle them at the micro-, meso- and macro-level of the healthcare system.
Flupirtine and retigabine were essential drugs to combat pain and epilepsy. However, the Kv7 potassium channel openers are fraught with hepatotoxicity and tissue discoloration, respectively, limiting their therapeutic value. Both adverse events are likely due to reactive metabolites arising from oxidative metabolism. Designing safer analogues lacking the structural elements leading to described side effects is an active area of current research. One of the main metabolites of flupirtine is the biologically inactive 4-fluorohippuric acid. Hitherto unexplained, the proposed metabolic pathway leading to the formation of 4-fluorohippuric acid from flupirtine is verified here. Through the use of eighteen flupirtine analogues, mechanistic details of this pathway could be elucidated. A possible connection with the in vitro hepatotoxicity of the flupirtine analogues and the levels of 4-fluorobenzoic acid formed in enzyme incubations was examined by correlation analysis. These findings provide important information for the design of new flupirtine analogues as potential drug candidates.
How well populations can cope with global warming will often depend on the evolutionary potential and plasticity of their temperature-sensitive, fitness-relevant traits. In Bechstein's bats (Myotis bechsteinii), body size has increased over the last decades in response to warmer summers. If this trend continues it may threaten populations as larger females exhibit higher mortality. To assess the evolutionary potential of body size, we applied a Bayesian ‘animal model’ to estimate additive genetic variance, heritability and evolvability of body size, based on a 25-year pedigree of 332 wild females. Both heritability and additive genetic variance were reduced in hot summers compared to average and cold summers, while evolvability of body size was generally low. This suggests that the observed increase in body size was mostly driven by phenotypic plasticity. Thus, if warm summers continue to become more frequent, body size likely increases further and the resulting fitness loss could threaten populations.
The vast majority of RNA splicing in today‘s organisms is achieved by the highly regulated and precise removal of introns from pre-mRNAs via the spliceosome. Here we present a model of how RNA splicing may have occurred in earlier life forms. We have designed a hairpin ribozyme derived spliceozyme that mediates two RNA cleavages and one ligation event at specific positions and thus cuts a segment (intron) out of a parent RNA and ligates the remaining fragments (exons). The cut-out intron then performs a downstream function, acting as a positive regulator of the activity of a bipartite DNAzyme. This simple scenario shows how small RNAs can perform complex RNA processing dynamics, involving the generation of new phenotypes by restructuring segments of given RNA species, as well as delivering small RNAs that may play a functional role in downstream processes.
Parental gender preferences in Central and Eastern Europe and differential early life disadvantages
(2023)
Parental gender preferences may affect partnership decisions and as a result lead to early life disadvantages. We study these preferences in five post-communist countries of Central and Eastern Europe, a region with strong traditional gender norms and persisting inequalities between women and men in labour market outcomes. Using subsamples of census from Belarus, Hungary, Poland, Romania and Russia around 2000 and 2010, we follow Dahl and Moretti (2008), The demand for sons, to examine the effect of the gender of the first-born child(ren) on fertility decisions and relationship stability of their parents. We only find strong evidence of ‘boy preferences’ in fertility decisions in the cases of Romania and Russia. However, unlike Dahl and Moretti (2008), The demand for sons, for the US, we cannot confirm a relationship between the children's gender and parental partnership decisions. This is the case for all examined Central and Eastern European countries, as well as for a number of countries from Western Europe. The cases of Romania and Russia raise questions about other potential consequences of the documented gender preferences. We argue that our approach can be applied more broadly to identify other countries characterised by parental gender preferences, and to motivate further examination of different forms of gender driven early life disadvantages.
Background
Adolescents and young adults (AYAs) with chronic conditions face a transfer, defined as an actual shift from paediatric to adult-oriented health care. Transition competence as the self-perceived knowledge, skills and abilities regarding the transition process was considered extremely useful.
Aim
This study was designed to investigate the impact of transition competence before and after the transfer on disease-specific quality of life (QoL) and health care satisfaction of AYAs with diabetes.
Results
In total, a sample of N = 90 AYAs with diabetes self-reported their transition competence, diabetes-specific QoL and satisfaction with care. Multiple linear regressions were used to analyse the impact of transition competence on satisfaction with care and QoL. Transition competence positively influenced the outcomes of satisfaction with care and QoL.
Conclusion
Young adults with diabetes showed higher transition competence scores than adolescents with diabetes.
Background
Chronic pain of different aetiologies and localization has been associated with less grey matter volume (GMV) in several cortical and subcortical brain areas. Recent meta-analyses reported low reproducibility of GMV alterations between studies and pain syndromes.
Methods
To investigate GMV in common chronic pain conditions defined by body location (chronic back pain, n = 174; migraine, n = 92; craniomandibular disorder, n = 39) compared to controls (n = 296), we conducted voxel-based morphometry and determined GMV from high-resolution cranial MRIs obtained in an epidemiologic survey. Mediation analyses were performed between the presence of chronic pain and GMV testing the mediators stress and mild depression. The predictability of chronic pain was investigated with binomial logistic regression.
Results
Whole-brain analyses yielded reduced GMV within the left anterior insula and the anterior cingulate cortex, for a ROI approach additionally the left posterior insula and left hippocampus showing less GMV across all patients with chronic pain. The relationship of pain with GMV in the left hippocampus was mediated by self-reported stressors in the last 12 months. Binomial logistic regression revealed a predictive effect for GMV in the left hippocampus and left anterior insula/temporal pole for the presence of chronic pain.
Conclusions
Chronic pain across three different pain conditions was characterized by less GMV in brain regions consistently described for different chronic pain conditions before. Less GMV in the left hippocampus mediated by experienced stress during the last year might be related to altered pain learning mechanisms in chronic pain patients.
Significance
Grey matter reorganization could serve as a diagnostic biomarker for chronic pain. In a large cohort, we here replicated findings of less grey matter volume across three pain conditions in the left anterior and posterior insula, anterior cingulate and left hippocampus. Less hippocampal grey matter was mediated by experienced stress.
Objective: Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample.
Methods: For a subsample (N = 1209) of the Study of Health in Pomerania (N = 4420), complete polysomnography data was available. Of these, 559 females completed a structured interview about their menstrual cycle. Splines and ordinal regression analysis were used to analyze the resulting data.
Results: In the ordinal regression analysis, a significant association between the apnea–hypopnea index (AHI) and menopause indicated that post-menopausal women had a substantially higher risk of OSA. In accordance with previous studies, risk indicators such as body mass index (BMI), age, and the influence of hysterectomies or total oophorectomies were included in the model.
Conclusions: Our results clearly confirmed the assumed connection between menopause and OSA. This is important because OSA is most often associated with male patients, and it warrants further research into the underlying mechanisms.
Manual sleep scoring for research purposes and for the diagnosis of sleep disorders is labor-intensive and often varies significantly between scorers, which has motivated many attempts to design automatic sleep stage classifiers. With the recent introduction of large, publicly available hand-scored polysomnographic data, and concomitant advances in machine learning methods to solve complex classification problems with supervised learning, the problem has received new attention, and a number of new classifiers that provide excellent accuracy. Most of these however have non-trivial barriers to use. We introduce the Greifswald Sleep Stage Classifier (GSSC), which is free, open source, and can be relatively easily installed and used on any moderately powered computer. In addition, the GSSC has been trained to perform well on a large variety of electrode set-ups, allowing high performance sleep staging with portable systems. The GSSC can also be readily integrated into brain-computer interfaces for real-time inference. These innovations were achieved while simultaneously reaching a level of accuracy equal to, or exceeding, recent state of the art classifiers and human experts, making the GSSC an excellent choice for researchers in need of reliable, automatic sleep staging.
Physiological and neural synchrony in emotional and neutral stimulus processing: A study protocol
(2023)
Background: As psychotherapy involves at least two individuals, it is essential to include the interaction perspective research. During interaction, synchrony, i.e., the occurrence of simultaneous responses, can be observed at the physiological, neural, and behavioral level. Physiological responses include heart rate and electrodermal activity; neural markers can be measured using electroencephalogram. Emotionally arousing stimuli are allocated more attentional resources (motivated attention), which is reflected in physiological activation and brain potentials. Here we present a protocol for a pilot study implementing a new research methodology, and replication of the motivated attention to emotion effect in in dyads. There is evidence that higher synchrony is associated with more positive (therapeutic) relationships. Thus, the secondary outcome will be the association between physiological and neural synchrony and subjective ratings.
Methods and design: Individuals (18−30 years) will participate in same-sex pairs in two experiments. In the first experiment (triadic interaction), both participants attentively watch unpleasant, neutral and pleasant pictures, and read/listen to standardized scripts (unpleasant, neutral, and pleasant, respectively) for the imagination task. In the second experiment, participants will read out three scripts (unpleasant, neutral, pleasant) to each other, followed by a joint imagination period. Stimuli will be presented in counterbalanced orders. After each picture and imagination, participants rate their subjective arousal and valence. In the beginning and in the end of the procedure, dyads rate their relationship, sympathy, and bonds (Working Alliance Inventory subscale). Heart rate, electrodermal activity and electroencephalogram will be continuously measured during both experiments using portable devices (EcgMove4 and EdaMove4, nine-channel B-Alert X-Series mobile-wireless EEG). Synchrony analyses will include the dual electroencephalography analysis pipeline, correlational analyses and Actor–Partner Interdependence Models.
Discussion: The present study protocol provides an experimental approach to investigate interpersonal synchrony during emotion processing, allowing for the establishment of research methods in a pilot study, which can later be translated into real-life psychotherapy research. In the future, fundamental understanding of such mechanisms in dyadic interactions is essential in order to promote therapeutic relationships, and thus, treatment effectiveness and efficiency.
Objective: To characterize a socially active humanoid robot’s therapeutic interaction as a therapeutic assistant when providing arm rehabilitation (i.e., arm basis training (ABT) for moderate-to-severe arm paresis or arm ability training (AAT) for mild arm paresis) to stroke survivors when using the digital therapeutic system Evidence-Based Robot-Assistant in Neurorehabilitation (E-BRAiN) and to compare it to human therapists’ interaction.
Methods: Participants and therapy: Seventeen stroke survivors receiving arm rehabilitation (i.e., ABT [n = 9] or AAT [n = 8]) using E-BRAiN over a course of nine sessions and twenty-one other stroke survivors receiving arm rehabilitation sessions (i.e., ABT [n = 6] or AAT [n = 15]) in a conventional 1:1 therapist–patient setting. Analysis of therapeutic interaction: Therapy sessions were videotaped, and all therapeutic interactions (information provision, feedback, and bond-related interaction) were documented offline both in terms of their frequency of occurrence and time used for the respective type of interaction using the instrument THER-I-ACT. Statistical analyses: The therapeutic interaction of the humanoid robot, supervising staff/therapists, and helpers on day 1 is reported as mean across subjects for each type of therapy (i.e., ABT and AAT) as descriptive statistics. Effects of time (day 1 vs. day 9) on the humanoid robot interaction were analyzed by repeated-measures analysis of variance (rmANOVA) together with the between-subject factor type of therapy (ABT vs. AAT). The between-subject effect of the agent (humanoid robot vs. human therapist; day 1) was analyzed together with the factor therapy (ABT vs. AAT) by ANOVA.
Main results and interpretation: The overall pattern of the therapeutic interaction by the humanoid robot was comprehensive and varied considerably with the type of therapy (as clinically indicated and intended), largely comparable to human therapists’ interaction, and adapted according to needs for interaction over time. Even substantially long robot-assisted therapy sessions seemed acceptable to stroke survivors and promoted engaged patients’ training behavior.
Conclusion: Humanoid robot interaction as implemented in the digital system E-BRAiN matches the human therapeutic interaction and its modification across therapies well and promotes engaged training behavior by patients. These characteristics support its clinical use as a therapeutic assistant and, hence, its application to support specific and intensive restorative training for stroke survivors.
Objective: The instrument THERapy-related InterACTion (THER-I-ACT) was developed to document therapeutic interactions comprehensively in the human therapist–patient setting. Here, we investigate whether the instrument can also reliably be used to characterise therapeutic interactions when a digital system with a humanoid robot as a therapeutic assistant is used.
Methods: Participants and therapy: Seventeen stroke survivors receiving arm rehabilitation (i.e., arm basis training (ABT) for moderate-to-severe arm paresis [n = 9] or arm ability training (AAT) for mild arm paresis [n = 8]) using the digital therapy system E-BRAiN over a course of nine sessions. Analysis of the therapeutic interaction: A total of 34 therapy sessions were videotaped. All therapeutic interactions provided by the humanoid robot during the first and the last (9th) session of daily training were documented both in terms of their frequency and time used for that type of interaction using THER-I-ACT. Any additional therapeutic interaction spontaneously given by the supervising staff or a human helper providing physical assistance (ABT only) was also documented. All ratings were performed by two trained independent raters.
Statistical analyses: Intraclass correlation coefficients (ICCs) were calculated for the frequency of occurrence and time used for each category of interaction observed.
Results: Therapeutic interactions could comprehensively be documented and were observed across the dimensions provision of information, feedback, and bond-related interactions. ICCs for therapeutic interaction category assessments from 34 therapy sessions by two independent raters were high (ICC ≥0.90) for almost all categories of the therapeutic interaction observed, both for the occurrence frequency and time used for categories of therapeutic interactions, and both for the therapeutic interaction performed by the robot and, even though much less frequently observed, additional spontaneous therapeutic interactions by the supervisory staff and a helper being present. The ICC was similarly high for an overall subjective rating of the concentration and engagement of patients (0.87).
Conclusion: Therapeutic interactions can comprehensively and reliably be documented by trained raters using the instrument THER-I-ACT not only in the traditional patient–therapist setting, as previously shown, but also in a digital therapy setting with a humanoid robot as the therapeutic agent and for more complex therapeutic settings with more than one therapeutic agent being present.
The reduction of individual carbon consumption could make an important contribution to the worldwide effort to limit global warming. Based on Bandura’s theory of moral disengagement, we hypothesized that the propensity to morally disengage concerning high-carbon behaviors (e.g., eating meat or traveling by plane) is one important factor that prevents individuals from reducing their carbon footprint. To measure the propensity to morally disengage in high-carbon-related behavior contexts, a questionnaire (MD-HCB) was developed and psychometrically validated in an online study with a German sample (N = 220). Confirmatory factor analyses revealed that the final nine-item scale had a one-dimensional structure, as intended. The internal consistency of the scale was excellent (Cronbach’s α = 0.94) and the scale interpretation had predictive validity for both past low-carbon consumption behavior and the intention to engage in such behavior in the future. Correlational analyses with relevant existing instruments confirmed the construct validity of the interpretations that can be drawn from the MD-HCB, as its resulting score is related to, yet separable from, the general tendency to morally disengage and is meaningfully connected to related constructs. A pre-study with a student sample (N = 89) not only helped to identify limitations in the study design but also showed a weak predictive ability of moral competence concerning high-carbon consumption behavior and intention to change. Based on our findings, future media campaigns designed to increase people’s intention to reduce high-carbon behavior could focus on the modification of common cognitive disengagement strategies.
In rural areas, healthcare providers, patients and relatives have to cover long distances. For specialised ambulatory palliative care (SAPV), a supply radius of max. 30 km is recommended. The aim of this study was to analyse whether there are regional disparities in the supply of SAPV and whether it is associated with the distance between the SAPV team’s site and the patient’s location. Therefore, anonymised data of the Association of Statutory Health Insurance Physicians of the Federal State of Mecklenburg-Western Pomerania (M-V) were retrospectively analysed for the period of 2014–2017. Identification as a palliative patient was based on palliative-specific items from the ambulatory reimbursement catalogue. In total, 6940 SAPV patients were identified; thereof, 48.9% female. The mean age was 73.3 years. For 28.3% of the identified SAPV patients (n = 1961), the SAPV teams had a travel distance of >30 km. With increasing distance, the average number of treatment days per patient increased. It was found that there are regional disparities in the provision of SAPV services in M-V and that local structures have an important impact on regional supply patterns. The distance between the SAPV team’s site and the patient’s location is not the only determining factor; other causes must be considered.
In micro-densitometry of wood it is standard procedure to extract resin and other soluble compounds before X-ray analysis to eliminate the influence of these extractives on wood-density. Dendrochemical studies using X-ray fluorescence analysis on the other hand are commonly conducted without previous extraction. However, it is well known that translocation processes of elements during heartwood formation in trees or (temporal) differences in sap content of wood samples can influence dendrochemical element profiles. This might bias environmental signals stored in time series of element concentrations in wood proxies. We hypothesize that metals tightly bound to cell walls show a more robust proxy potential for environmental conditions than easily translocated ones. To eliminate the noise of these soluble substances in wood elemental time series, their extraction prior to analysis might be necessary. In our study we tested the effect of different solvents (water, alcohol, and acetone) and different extraction times on elemental time series of three tree species with differing wood structure (Pinus sylvestris; Quercus robur and Populus tremula). Micro-XRF analysis was conducted on nine replicates per species using an ITRAX-Multiscanner. A set of elements commonly detected in wood (S, Cl, K, Ca, Ti, Mn, Fe, and Ni) was analysed at high resolution before and after several extraction runs. Besides lowering their levels, extraction did not significantly change the temporal trends for most elements. However, for some elements, e.g., Potassium, Chlorine or Manganese, especially the water extraction led to significant decreases in concentrations and altered temporal trends. Apparently the dipole effect of water produced the strongest extraction power of all three solvents. In addition we observed a dependency of extraction intensity from wood density which differed between wood types. Our results help in interpreting and evaluating element profiles and mark a step forward in establishing dendrochemistry as a robust proxy in dendro-environmental research.
Background
Lower cortisol concentrations in adulthood were repeatedly associated with more severe childhood maltreatment. Additionally, childhood maltreatment was reported to promote health risk behavior, such as smoking or alcohol consumption, and to increase the risk of mental and somatic diseases during adulthood, such as major depressive disorders or obesity. The present study investigated if health risk behavior and disease symptoms in adults mediate the associations between past childhood maltreatment and present basal serum cortisol concentrations.
Methods
Data from two independent adult cohorts of the general population-based Study of Health in Pomerania (SHIP-TREND-0: N = 3,517; SHIP-START-2: N = 1,640) was used. Childhood maltreatment was assessed via the Childhood Trauma Questionnaire (CTQ). Cortisol concentrations were measured in single-point serum samples. Health risk behavior and mental and physical symptoms were used as mediators. Mediation analyses were calculated separately for both cohorts; results were integrated via meta-analyses.
Results
In mediator-separated analyses, associations between childhood maltreatment and basal serum cortisol concentrations were partly mediated by depressive symptoms (BDI-II: βindirect effect = -.011, pFDR = .017, 21.0% mediated) and subjective somatic health complaints (somatic complaints: βindirect effect = -.010, pFDR = .005, 19.4% mediated). In the second step, both mediators were simultaneously integrated into one mediation model. The model replicated the mediation effects of the subjective somatic health complaints (whole model: βindirect effect = -.014, p = .001, 27.6% mediated; BDI-II: βindirect effect = -.006, p = .163, 11.4% mediated, somatic complaints: βindirect effect = -.020, p = .020, 15.5% mediated).
Conclusion
The results support the hypothesis that the long-lasting effects of childhood maltreatment on the stress response system are partly mediated through self-perceived disease symptoms. However, no mediation was found for health risk behavior or physically measured mediators. Mediation models with multiple simultaneous mediators pointed to a relevant overlap between the potential mediators. This overlap should be focused on in future studies.
Overexpression of polo-like kinase 1 (PLK1) has been found in many different types of cancers. With its essential role in cell proliferation, PLK1 has been determined to be a broad-spectrum anti-cancer target. In this study, 3D-QSAR, molecular docking, and molecular dynamics (MD) simulations were applied on a series of novel pteridinone derivatives as PLK1 inhibitors to discover anti-cancer drug candidates. In this work, three models—CoMFA (Q² = 0.67, R² = 0.992), CoMSIA/SHE (Q² = 0.69, R² = 0.974), and CoMSIA/SEAH (Q² = 0.66, R² = 0.975)—of pteridinone derivatives were established. The three models that were established gave R²(pred) = 0.683, R²(pred) = 0.758, and R²(pred) = 0.767, respectively. Thus, the predictive abilities of the three proposed models were successfully evaluated. The relations between the different champs and activities were well-demonstrated by the contour chart of the CoMFA and CoMSIA/SEAH models. The results of molecular docking indicated that residues R136, R57, Y133, L69, L82, and Y139 were the active sites of the PLK1 protein (PDB code: 2RKU), in which the more active ligands can inhibit the enzyme of PLK1. The results of the molecular dynamic MD simulation diagram were obtained to reinforce the previous molecular docking results, which showed that both inhibitors remained stable in the active sites of the PLK1 protein (PDB code: 2RKU) for 50 ns. Finally, a check of the ADME-Tox properties of the two most active molecules showed that molecular N° 28 could represent a good drug candidate for the therapy of prostate cancer diseases.
Phylogenetic (i.e., leaf-labeled) trees play a fundamental role in evolutionary research. A typical problem is to reconstruct such trees from data like DNA alignments (whose columns are often referred to as characters), and a simple optimization criterion for such reconstructions is maximum parsimony. It is generally assumed that this criterion works well for data in which state changes are rare. In the present manuscript, we prove that each binary phylogenetic tree T with n ≥ 20k leaves is uniquely defined by the set Ak (T), which consists of all characters with parsimony score k on T. This can be considered as a promising first step toward showing that maximum parsimony as a tree reconstruction criterion is justified when the number of changes in the data is relatively small.
Objectives
Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs).
Material and methods
In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models.
Results
A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants).
Conclusions
Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs.
Clinical relevance
The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants.
Clinical trial registration
German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015.
The renal renin-angiotensin system (RAS) is involved in the development of chronic kidney disease. Here, we investigated whether mice with reduced renal angiotensin I-converting enzyme (ACE−/−) are protected against aristolochic acid nephropathy (AAN). To further elucidate potential molecular mechanisms, we assessed the renal abundances of several major RAS components. AAN was induced using aristolochic acid I (AAI). Glomerular filtration rate (GFR) was determined using inulin clearance and renal protein abundances of renin, angiotensinogen, angiotensin I-converting enzyme (ACE) 2, and Mas receptor (Mas) were determined in ACE−/− and C57BL/6J control mice by Western blot analyses. Renal ACE activity was determined using a colorimetric assay and renal angiotensin (Ang) (1–7) concentration was determined by ELISA. GFR was similar in vehicle-treated mice of both strains. AAI decreased GFR in controls but not in ACE−/− mice. Furthermore, AAI decreased renal ACE activity in controls but not in ACE−/− mice. Vehicle-treated ACE−/− mice had significantly higher renal ACE2 and Mas protein abundances than controls. AAI decreased renal ACE2 protein abundance in both strains. Furthermore, AAI increased renal Mas protein abundance, although the latter effect did not reach statistical significance in the ACE−/− mice. Renal Ang(1–7) concentration was similar in vehicle-treated mice of both strains. AAI increased renal Ang(1–7) concentration in the ACE−/− mice but not in the controls. Mice with reduced renal ACE are protected against AAN. Our data suggest that in the face of renal ACE deficiency, AAI may activate the ACE2/Ang(1–7)/Mas axis, which in turn may deploy its reno-protective effects.
To a large extent health-related quality of life (HRQoL) is a product of life-course experiences. Therefore, we examined employment, marital, and reproductive life-course typologies as predictors of HRQoL in women and men. To determine life course clusters, sequence and cluster analysis were performed on the annual (waves 1990–2019) employment, marital, and children in household states of the German Socio-Economic Panel data (N = 8,998; age = 53.57, 52.52% female); separately for men and women. Using hierarchical linear regression analyses, and Tukey HSD post-hoc tests, associations between clusters and change in life satisfaction, subjective mental, and physical health were examined. Five life-course clusters were identified in the female and six in the male sample. Life courses differed greatly across gender regarding employment aspects (e.g., men generally work full-time vs. women underwent frequent transitions). The family aspects appeared similar – e.g., ‘starting a family’ or ‘marital separation’ clusters – but still differed in the particulars. Life course typologies were related to distinct patterns of HRQoL. For instance, both for men and women the ‘separated’ clusters, as well as the male ‘entering non-employment’ cluster were associated with a steeper decline in HRQoL. However, change in subjective mental health showed few associations. Distinct types of life courses and differential associations with sociodemographic background and HRQoL emerged for women and men. The analyses reveal a burden on individuals who experienced marital separation, and non-employment and thus present important target groups for health prevention, e.g., for physical health problems.
We consider Walsh’s conformal map from the exterior of a compact set E ⊆ C onto a lemniscatic domain. If E is simply connected, the lemniscatic domain is the exterior of a circle, while if E has several components, the lemniscatic domain is the exterior of a generalized lemniscate and is determined by the logarithmic capacity of E and by the exponents and centers of the generalized lemniscate. For general E, we characterize the exponents in terms of the Green’s function of Ec. Under additional symmetry conditions on E, we also locate the centers of the lemniscatic domain. For polynomial pre-images E = P−1(Ω) of a simply-connected infinite compact set Ω, we explicitly determine the exponents in the lemniscatic domain and derive a set of equations to determine the centers of the lemniscatic domain. Finally, we present several examples where we explicitly obtain the exponents and centers of the lemniscatic domain, as well as the conformal map.
The multi-level perspective has been criticized for being functionalistic and paying little attention to actor-based perspectives. Nevertheless, for the identification and assessment of potential change agents in a sustainability transition, a clear conceptual and methodological approach is necessary. This paper, thus, develops a multi-dimensional typology of niche, regime, and hybrid actors, which is conceptually grounded in transition studies and empirically illustrated by a cluster analysis based on a survey of pig and poultry farmers in Germany, France, and the Netherlands. Animal husbandry is chosen as a case study because a significant share of the environmental impact within the agri-food system is attributed to this sector and there is evidence for resistance to change by mainstream actors. Conceptually, the paper provides a framework of constitutive elements for different kinds of actors and contributes to an extension of the niche–regime dichotomy by adding the group of hybrid actors. The empirical results show that cluster analysis is a suitable approach to identify conceptually meaningful differences among interviewed farmers. Among pig and poultry farmers, the regime actors are by far the largest group. The smaller group of hybrid actors, however, has large potential to act as boundary spanners. A particularly interesting finding is that several larger farms are among the group of niche actors which hints at the possibility that larger farms are not necessarily resistant to change.
Purpose
Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting are well-established treatments of obstructive hydrocephalus (HCP) in adult and pediatric patients. However, there is a lack of data with regard to the quality of life (QoL) of these patients during long-term follow-up
Methods
Inclusion criteria were pediatric patients with endoscopic treatment of hydrocephalus at the University Medicine Greifswald between 1993 and 2016. Patients older than 14 years at present were assessed with the Short Form-12 (SF-12) questionnaire. Patients younger than 14 years of age were assessed with the KINDL-R questionnaire that was completed by their parents. Patients’ values were compared with the scores of a corresponding age-matched group of the healthy population and with patients who received later shunt treatment. Information about comorbidities, current symptoms, and educational level were gained by an additional part. Comparative analysis between patients with ETV success and failure (defined as shunt implantation after ETV) was performed.
Results
A total of 107 patients (53 m, 54f) were included. Fifty-seven/107 patients (53.3%) were considered as ETV success. Mean age at ETV was 6.9 ± 5.9 years. Fifty-four statements of 89 patients that are still alive were gained (response rate 63%). Of these, 49 questionnaires were complete and evaluable (23 m, 26f; mean age 19.8 ± 10.0 years with an average follow-up period of 13.7 ± 7.2 years). Twenty-six/49 patients (53.1%) are considered ETV success. No statistically significant differences could be obtained between patients with ETV success and ETV failure. Patients older 14 years show QoL within normal range, patients younger than 14 years show significantly lower result regarding their environment of peers and social contacts. Patients younger than 6 months at the time of ETV and patients with posthemorrhagic HCP show significantly lower physical QoL. Gait disturbance, fatigue, and seizures are associated with a lower QoL, and educational level is lower than in the normal population.
Conclusions
Patients who underwent ETV in childhood do not have a lower health-related QoL in general. Subsequent insertions of ventriculoperitoneal (vp) shunts do not lower QoL. Certain subgroups of the patients show lower results compared to the healthy population.
Self-nanoemulsifying drug delivery systems (SNEDDS) represent an interesting platform for improving the oral bioavailability of poorly soluble lipophilic drugs. While Liquid-SNEDDS (L-SNEDDS) effectively solubilize the drug in vivo, they have several drawbacks, including poor storage stability. Solid-SNEDDS (S-SNEDDS) combine the advantages of L-SNEDDS with those of solid dosage forms, particularly stability. The aim of the present study was to convert celecoxib L-SNEDDS into S-SNEDDS without altering their release behavior. Various commercially available adsorptive carrier materials were investigated, as well as novel cellulose-based microparticles prepared by spray drying from an aqueous dispersion containing Diacel® 10 and methyl cellulose or gum arabic as a binder prior to their use. Particle size and morphology of the carrier materials were screened by scanning electron microscopy and their effects on the loading capacity for L-SNEDDS were investigated, and comparative in vitro dissolution studies of celecoxib L-SNEDDS and the different S-SNEDDS were performed immediately after preparation and after 3 months of storage. Among the adsorptive carrier materials, the novel cellulose-based microparticles were found to be the most suitable for the preparation of celecoxib S-SNEDDS from L-SNEDDS, enabling the preparation of a solid, stable formulation while preserving the in vitro release performance of the L-SNEDDS formulation.
Target proteins in biotechnological applications are highly diverse. Therefore, versatile flexible expression systems for their functional overproduction are required. In order to find the right heterologous gene expression strategy, suitable host-vector systems, which combine different genetic circuits, are useful. In this study, we designed a novel Bacillus subtilis expression toolbox, which allows the overproduction and secretion of potentially toxic enzymes. This toolbox comprises a set of 60 expression vectors, which combine two promoter variants, four strong secretion signals, a translation-enhancing downstream box, and three plasmid backbones. This B. subtilis toolbox is based on a tailor-made, clean deletion mutant strain, which is protease and sporulation deficient and exhibits reduced autolysis and secondary metabolism. The appropriateness of this alternative expression platform was tested for the overproduction of two difficult-to-produce eukaryotic model proteins. These included the sulfhydryl oxidase Sox from Saccharomyces cerevisiae, which forms reactive hydrogen peroxide and undesired cross-linking of functional proteins, and the human interleukin-1β, a pro-inflammatory cytokine. For the best performing Sox and interleukin, overproducing and secreting variants of these new B. subtilis toolbox fermentation strategies were developed and tested. This study demonstrates the suitability of the prokaryotic B. subtilis host-vector system for the extracellular production of two eukaryotic proteins with biotechnological relevance.
Indications for surgery of pineal cysts without ventriculomegaly are still under debate. In view of the limited data for pineal cyst resection in the absence of hydrocephalus, and the potential risk of this approach, we have analyzed our patient cohort focusing on strategies to avoid complications according to our experience in a series of 73 pineal cyst patients. From 2003 to 2015, we reviewed our database retrospectively for all patients operated on a pineal cyst. Furthermore, we prospectively collected patients from 2016 to 2020. In summary, 73 patients with a pineal cyst were treated surgically between 2003 and 2020. All patients were operated on via a microscopic supracerebellar-infratentorial (SCIT) approach. The mean follow-up period was 26.6 months (range: 6–139 months). Seventy-three patients underwent surgery for a pineal cyst. An absence of enlarged ventricles was documented in 62 patients (51 female, 11 male, mean age 28.1 (range 4–59) years). Main presenting symptoms included headache, visual disturbances, dizziness/vertigo, nausea/emesis, and sleep disturbances. Complete cyst resection was achieved in 59/62 patients. Fifty-five of 62 (89%) patients improved after surgery with good or even excellent results according to the Chicago Chiari Outcome Scale, with complete or partial resolution of the leading symptoms. Pineal cysts resection might be an indication in certain patients for surgery even in the absence of ventriculomegaly. The high percentage of postoperative resolution of quality-of-life impairing symptoms in our series seems to justify surgery. Preoperatively, other causes of the leading symptoms have to be excluded.
The goal of our study was to examine the effects of low abundances of nylon fibers on feeding rates of calanoid copepods (Crustacea, Copepoda) and doliolids (Tunicata, Thaliacea) in the presence of diatoms at near environmental concentration levels. In addition, we examined microscopically the fecal pellets produced by copepods and doliolids in the presence of fibers. Adult females of the calanoid Eucalanus pileatus and early gonozooids of Dolioletta gegenbauri (both of similar dry weight) cleared the diatom Rhizosolenia alata at similar rates. Nylon fibers were cleared at higher rates by Dolioletta gegenbauri compared to Eucalanus pileatus. Examination of fecal pellets revealed that copepods and doliolids could ingest the about 300 µm long fibers. The latter also ingested the occasionally occurring fibers of > 1 mm length. It appears that in seawater fiber abundances of about seven fibers ml−1 did not have a negative effect on feeding of either E. pileatus or D. gegenbauri. As doliolids and copepods remove plastic fibers from seawater by packing them into their pellets, they might play a role in the reduction of microplastic pollution and the microplastic transfer from the water column to the seafloor. Calanoid copepods may limit ingesting fibers by not perceiving them, as compared to doliolids which do not seem to be able to avoid ingesting them.
Characterization of proteins from the 3N5M family reveals an operationally stable amine transaminase
(2022)
Amine transaminases (ATA) convert ketones into optically active amines and are used to prepare active pharmaceutical ingredients and building blocks. Novel ATA can be identified in protein databases due to the extensive knowledge of sequence-function relationships. However, predicting thermo- and operational stability from the amino acid sequence is a persisting challenge and a vital step towards identifying efficient ATA biocatalysts for industrial applications. In this study, we performed a database mining and characterized selected putative enzymes of the β-alanine:pyruvate transaminase cluster (3N5M) — a subfamily with so far only a few described members, whose tetrameric structure was suggested to positively affect operational stability. Four putative transaminases (TA-1: Bilophilia wadsworthia, TA-5: Halomonas elongata, TA-9: Burkholderia cepacia, and TA-10: Burkholderia multivorans) were obtained in a soluble form as tetramers in E. coli. During comparison of these tetrameric with known dimeric transaminases we found that indeed novel ATA with high operational stabilities can be identified in this protein subfamily, but we also found exceptions to the hypothesized correlation that a tetrameric assembly leads to increased stability. The discovered ATA from Burkholderia multivorans features a broad substrate specificity, including isopropylamine acceptance, is highly active (6 U/mg) in the conversion of 1-phenylethylamine with pyruvate and shows a thermostability of up to 70 °C under both, storage and operating conditions. In addition, 50% (v/v) of isopropanol or DMSO can be employed as co-solvents without a destabilizing effect on the enzyme during an incubation time of 16 h at 30 °C.
Purpose
The continuum of mental health/illness has been subject to scientific debate for decades. While current research indicates that continuum belief interventions can reduce mental health stigma and improve treatment seeking in affected populations, no study has yet systematically examined measures of continuum beliefs.
Methods
This preregistered systematic review summarizes measures of continuum beliefs. Following the PRISMA statement, three scientific databases (PubMed, PsycInfo and PsycArticles via EBSCOhost, Web of Science) are searched, instruments are described and discussed regarding their scope, and methodological quality.
Results
Overall, 7351 records were identified, with 35 studies reporting relevant findings on 11 measures. Most studies examined general population samples and used vignette-based measures. Schizophrenia and depression were most commonly examined, few studies focused on dementia, ADHD, OCD, eating disorders, and problematic alcohol use, or compared continuum beliefs across disorders. Validity was very good for most measures, but reliability was rarely tested. Measures mostly assessed beliefs in the normality of mental health symptoms or the normality of persons with such symptoms but rarely nosological aspects (i.e., categorical v continuous conceptualization of mental disorders).
Conclusions
Current research provides psychometrically sound instruments to examine continuum beliefs for a variety of mental disorders. While studies suggest utility for general population samples and mental health professionals, more research is necessary to corroborate findings, for instance, regarding age (e.g., in adolescents), gender, or type of mental disorder. Future research should also compare self-report ratings, and vignette-based measures, include measures of nosological concepts to fully grasp the continuum concept of mental illness.
Preregistration
PROSPERO: CRD42019123606.
The occurrence and distribution of organochlorine pesticides (OCPs) in aquatic systems is a matter of global concern and poses significant toxicological threats to both organisms and human health. Despite the extensive use of OCPs for pest and disease control in southern Africa, relatively few studies have examined the occurrence and toxicological risks of OCP residues in the region. This study investigates the composition, distribution, and potential sources of OCP contamination in sediments from Richards Bay, a rapidly developing industrial port on the northeast coast of South Africa. Surface sediments collected from Richards Bay Harbour and surrounding areas indicate that OCP contamination in the region is widespread. Total concentrations (∑OCP) in surface samples ranged from 135 to 1020 ng g−1, with hexachlorocyclohexanes (∑HCH; 35–230 ng g−1) and dichlorodiphenyltrichloroethanes (∑DDT; 12–350 ng g−1) the dominant contaminant groups detected. Metabolite isomeric compositions indicate that the presence of aldrin and endosulfan likely result from historical agricultural usage, while recent input of γ-HCH, heptachlor, and endrin may be linked to the illegal use of old pesticide stockpiles. Total DDT concentrations were dominated by p,p′-DDT (80 ± 64 ng g−1), which was attributed to its ongoing use in malaria vector control in the region. A 210Pb-dated sediment core revealed that OCP input to the local environment increased dramatically from relatively low concentrations in the mid-1940s (∑OCP, 355 ng g−1) to peak levels (∑OCP, 781 ng g−1) in the 1980s/1990s. An overall decrease in ∑OCP concentration from the mid-2000s is likely related to restrictions on use following the Stockholm Convention in 2004. Despite current restrictions on use, OCP concentrations exceeded sediment quality guidelines in the vast majority of cases, raising concerns for protected estuarine and mangrove habitats in the area, as well as for local fishing and farming communities.
This study deals with attitudes and opinions of the population on the Ukrainian Black Sea coast in 2020/2021, a good year before the Russian invasion of Ukraine. The basis is a sociological survey conducted in the regions of Odesa, Mykolajiv and Kherson with 1,200 respondents. These regions are a clear target of the Russian offensive against Ukraine, on the grounds of an alleged ideological and linguistic affinity of these areas with Russia. The attitudes and opinions sought in the study cover three domains: firstly, attitudes and opinions on language policy, secondly, on Ukrainian autonomy and identity and the role played by languages in this context, and thirdly, Ukraine’s geopolitical orientation. Respondents were grouped according to their “ethnic/national” self-identification and language preferences, and a comparison was made. Overall, the attitudes of the respondents showed a clear identification with Ukraine and the Ukrainian language and a skepticism towards the Russian state, but by no means a hostile attitude towards the Russian language. A picture emerges that clearly contradicts Russian propaganda and also puts into perspective the difference between southern Ukraine and the center and the west, which has often been emphasized in the past.
Haematophagous leeches express a broad variety of secretory proteins in their salivary glands, among them are hirudins and hirudin-like factors. Here, we describe the identification, molecular and initial functional characterization of Tandem-Hirudin (TH), a novel salivary gland derived factor identified in the Asian medicinal leech, Hirudinaria manillensis. In contrast to the typical structure of hirudins, TH comprises two globular domains arranged in a tandem-like orientation and lacks the elongated C-terminal tail. Similar structures of thrombin inhibitors have so far been identified only in kissing bugs and ticks. Expression of TH was performed in both cell-based and cell-free bacterial systems. A subsequent functional characterization revealed no evidence for a thrombin-inhibitory potency of TH.
Facing climate change, the development of innovative agricultural technologies securing food production becomes increasingly important. Plasma-treated water (PTW) might be a promising tool to enhance drought stress tolerance in plants. Knowledge about the effects of PTW on the physiology of plants, especially on their antioxidative system on a long-term scale, is still scarce. In this work, PTW was applied to barley leaves (Hordeum vulgare cv. Kosmos) and various constituents of the plants’ antioxidative system were analyzed 30 days after treatment. An additional drought stress was performed after foliar PTW application followed by a recovery period to elucidate whether PTW treatment improved stress tolerance. Upon PTW treatment, the Total Antioxidant Capacity (TAC) in leaves and roots was lower in comparison to deionized water treated plants. In contrast, PTW treatment caused a higher content of chlorophyll, quantum yield and total ascorbate content in leaves compared to deionized water treated plants. After additional drought application and subsequent recovery period, an enhancement of values for TAC, contents of malondialdehyde, glutathione as well as activity of ascorbate peroxidase indicated a possible upregulation of antioxidative properties in roots. Hydrogen peroxide and nitric oxide might mediate abiotic stress tolerance and are considered as key components of PTW.
Aim
A shortage in primary care physicians has been a well-known challenge in many Western countries for several years. In addition, we currently see a trend in primary care, where an increasing number of physicians work as employees instead of being self-employed, even among general practitioners. To address this shortage, knowledge of the future specialists’ attitudes toward working self-employed is needed. This qualitative systematic review aims to explore the attitudes of future specialists towards self-employment in private practice, and what factors influence these attitudes.
Subject and methods
We conducted a systematic search using PubMed, Embase, and Web of Science. We developed a search strategy that collected terms for future specialists, career choices, and self-employment and linked these with the Boolean operator “AND”. We analysed the results using a qualitative content analysis, as both qualitative and quantitative studies were included in the research.
Results
Self-employment is less attractive to future specialists. In particular, women prefer to be employed and receive a fixed salary. The main factors that influence the decision as to whether to become self-employed or not are financial conditions, bureaucracy and non-medical tasks, organisation, job satisfaction during residency, personal responsibility, career opportunities, specialty-dependent factors, personal environment, and education.
Conclusion
Among future specialists, being self-employed is less attractive than being an employee. Students should be better informed about future career opportunities to make an informed decision. However, it should be examined whether other forms of organisation are more in line with the wishes of future specialists.
Background
Out-of-hospital cardiac arrest is one of the most frequent causes of death in Europe. Emergency medical services often struggle to reach the patient in time, particularly in rural areas. To improve outcome, early defibrillation is required which significantly increases neurologically intact survival. Consequently, many countries place Automated External Defibrillators (AED) in accessible public locations. However, these stationary devices are frequently not available out of hours or too far away in emergencies. An innovative approach to mustering AED is the use of unmanned aerial systems (UAS), which deliver the device to the scene.
Methods
This paper evaluates the economic implications of stationary AED versus airborne delivery using scenario-based cost analysis. As an example, we focus on the rural district of Vorpommern-Greifswald in Germany. Formulae are developed to calculate the cost of stationary and airborne AED networks. Scenarios include different catchment areas, delivery times and unit costs.
Results
UAS-based delivery of AEDs is more cost-efficient than maintaining traditional stationary networks. The results show that equipping cardiac arrest hot spots in the district of Vorpommern-Greifswald with airborne AEDs with a response time < 4 min is an effective method to decrease the time to the first defibrillation The district of Vorpommern-Greifswald would require 45 airborne AEDs resulting in annual costs of at least 1,451,160 €.
Conclusion
In rural areas, implementing an UAS-based AED system is both more effective and cost-efficient than the conventional stationary solution. When regarding urban areas and hot spots of OHCA, complementing the airborne network with stationary AEDs is advisable.
Magnetooptical properties of one-dimensional aperiodic structures formed by stacking together magnetic and nonmagnetic layers according to the Kolakoski self-generation scheme are studied theoretically using the 4x4 transfer matrix method. The effect of the generation stage of the sequence, and the helicity and direction of light propagation through the magneto-photonic crystals on the transmission/reflection spectra as well as Faraday and ellipticity rotations, have been investigated. Our results reveal that this kind of aperiodic magneto-photonic crystals can be used for the fabrication of multifrequency laser cavities, and optical filters/sensors.
Purpose
Despite being rarely reported, ischemic insults resulting from compromising small brainstem perforators following microvascular decompression (MVD) remain a potential devastating complication. To avoid this complication, we have been using indocyanine green (ICG) angiography intraoperatively to check the flow within the small brainstem perforators. We aim to evaluate the safety and usefulness of ICG videoangiography in MVD.
Methods
We extracted retrospective data of patients who received ICG videoangiography from our prospectively maintained database for microvascular decompression. We noted relevant data including demographics, offending vessels, operative technique, outcome, and complications.
Results
Out of the 438 patients, 15 patients with a mean age (SD) of 53 ± 10.5 years underwent intraoperative ICG angiography. Male:female was 1:1.14. The mean disease duration prior to surgery was 7.7 ± 5.3 years. The mean follow-up (SD) was 50.7 ± 42.0 months. In 14 patients, the offending vessel was an artery, and in one patient, a vein. Intraoperative readjustment of the Teflon pledget or sling was required in 20% (3/15) of the cases. No patient had any sort of brainstem ischemia. Eighty percent of the patients (12/15) experienced complete resolution of the spasms. 86.7% (13/15) of the patients reported a satisfactory outcome with marked improvement of the spasms. Three patients experienced slight hearing affection after surgery, which improved in two patients later. There was no facial or lower cranial nerve affection.
Conclusion
Intraoperative ICG is a safe tool for evaluating the flow within the brain stem perforators and avoiding brainstem ischemia in MVD for hemifacial spasm.
The European Organisation for Caries Research education platform 2020 had the aim to assess the undergraduate curriculum in cariology in Asian and Arabian countries in order to support structured teaching of cariology in these countries with about almost half of the global population. Representatives of 4 Asian and 4 Arabian countries completed a comprehensive questionnaire on structure of dental education in their country in general and the extent, the content, the responsibilities, structure and standardization regarding cariology in particular. In spite of a wide range from very few universities (Lebanon 3) to larger numbers of dental schools (India 313, China 121, Russia 52) there were similar statements on the list of content for cariology teaching. Often the catalogue was close to the Undergraduate Core Curriculum in Cariology (UCCC) covering most of the 5 domains from basic science to dental public health, but a national curriculum for cariology or dentistry was mostly missing. With various departments being involved, a need of coordination is obvious. Most representatives thought it possible and feasible to teach a standardized curriculum in cariology on the basis of the UCCC. In conclusion, many Arabian and Asian countries have implemented modern, evidence-based curricula in their universities, but an obligatory national curriculum in cariology would be advisable to standardize the quality in teaching.
Introduction: The aim of this study was to test whether brief alcohol interventions at general hospitals work equally well for males and females and across age-groups.
Methods: The current study includes a reanalysis of data reported in the PECO study (testing delivery channels of individualized motivationally tailored alcohol interventions among general hospital patients: in PErson vs. COmputer-based) and is therefore of exploratory nature. At-risk drinking general hospital patients aged 18–64 years (N = 961) were randomized to in-person counseling, computer-generated individualized feedback letters, or assessment only. Both interventions were delivered on the ward and 1 and 3 months later. Follow-ups were conducted at months 6, 12, 18, and 24. The outcome was grams of alcohol/day. Study group × sex and study group × age interactions were tested as predictors of change in grams of alcohol/day over 24 months in latent growth models. If rescaled likelihood ratio tests indicated improved model fit due to the inclusion of interactions, moderator level-specific net changes were calculated.
Results: Model fit was not significantly improved due to the inclusion of interaction terms between study group and sex (χ2[6] = 5.9, p = 0.439) or age (χ2[6] = 5.5, p = 0.485).
Discussion: Both in-person counseling and computer-generated feedback letters may work equally well among males and females as well as among different age-groups. Therefore, widespread delivery of brief alcohol interventions at general hospitals may be unlikely to widen sex and age inequalities in alcohol-related harm.
Introduction: Cisplatin is extensively used in the treatment of head and neck carcinomas. Cetuximab combination therapy is employed in recurrent and metastatic settings. Sunitinib showed positive results in the treatment of head and neck carcinomas, both as monotherapy or in combination with cetuximab. Nonetheless, the mechanism governing these pharmacological interactions is largely unresolved. This study investigates the impact of cetuximab on the cytotoxicity of cisplatin and sunitinib using cells representative of head and neck carcinoma and the oral epithelium.
Methods: The uptake and efflux activities of cells were determined using the prototypical fluorescent substrates 4-[4-[dimethylamino]styryl)-1-methyl pyridinium iodide, Hoechst 33342, and calcein-AM in the presence or absence of specific inhibitors in cells pretreated with cetuximab. The expression of key uptake and efflux drug transporters was analyzed using qPCR and immunofluorescence. Cisplatin and sunitinib cytotoxicities after cetuximab pretreatment were evaluated using the PrestoBlue viability assay.
Results: Both tumor and nontumor cells showed significant active drug transport activity. Cetuximab substantially deregulated the expression of key transporters involved in drug resistance in head and neck cancer cells. Transporter expression in the nontumor cell was unaffected. Upon cetuximab pretreatment, the half maximal effective toxic concentration of cisplatin was reduced by 0.75-fold and sunitinib by 0.82-fold in cancer cells. Nontumor cells were not sensitive to cisplatin or sunitinib under the conditions tested.
Conclusion: Cetuximab regulates the expression and activity of key membrane drug transporters in head and neck cancer cells, involved in drug resistance. The deregulation of the transport mechanism behind cisplatin and sunitinib uptake reverses drug resistance and enhances the cytotoxicity of both drugs.
Background
Even with high standards of acute care and neurological early rehabilitation (NER) a substantial number of patients with neurological conditions still need mechanical ventilation and/or airway protection by tracheal cannulas when discharged and hence home-based specialised intensive care nursing (HSICN). It may be possible to improve the home care situation with structured specialized long-term neurorehabilitation support and following up patients with neurorehabilitation teams. Consequently, more people might recover over an extended period to a degree that they were no longer dependent on HSICN.
Methods
This healthcare project and clinical trial implements a new specialised neurorehabilitation outreach service for people being discharged from NER with the need for HSICN. The multicentre, open, parallel-group RCT compares the effects of one year post-discharge specialized outpatient follow-up to usual care in people receiving HSICN. Participants will randomly be assigned to receive the new form of healthcare (intervention) or the standard healthcare (control) on a 2:1 basis. Primary outcome is the rate of weaning from mechanical ventilation and/or decannulation (primary outcome) after one year, secondary outcomes include both clinical and economic measures. 173 participants are required to corroborate a difference of 30 vs. 10% weaning success rate statistically with 80% power at a 5% significance level allowing for 15% attrition.
Discussion
The OptiNIV-Study will implement a new specialised neurorehabilitation outreach service and will determine its weaning success rates, other clinical outcomes, and cost-effectiveness compared to usual care for people in need for mechanical ventilation and/or tracheal cannula and hence HSICN after discharge from NER.
Trial registration
The trial OptiNIV has been registered in the German Clinical Trials Register (DRKS) since 18.01.2022 with the ID DRKS00027326.
Background
Person-Centered-Care (PCC) requires knowledge about patient preferences. Among People-living-with-Dementia (PlwD) data on quantitative, choice-based preferences, which would allow to quantify, weigh and rank patient-relevant elements of dementia-care, and identify most/least preferred choices, are limited. The Analytic-Hierarchy-Process (AHP) may be one approach to elicit quantitative, choice-based preferences with PlwD, due to simple pairwise comparisons of individual criteria from a complex decision-problem, e.g. health care decisions. Furthermore, data on congruence of patient preferences with physicians’ judgements for PCC are missing. If patient preferences and physicians’ judgements differ, provision of PCC becomes unlikely. An understanding of patient preferences compared to physician’s judgements will support the implementation of truly PCC, i.e. state of the art dementia-care aligned with patient preferences.
Methods
This mixed-methods-study will be based on the results from a previous systematic review and conducted in three phases: (I) literature-based key intervention-categories of PCC will be investigated during qualitative interviews with Dementia-Care-Managers (DCMs) and PlwD to identify actually patient-relevant (sub) criteria of PCC; (II) based on findings from phase I, an AHP-survey will be designed and pre-tested for face- and content-validity, and consistency during face-to-face “thinking-aloud”-interviews with PlwD and two expert panels (DCMs and physicians); (III) the developed survey will elicit patient preferences and physicians’ judgements for PCC. To assess individual importance weights for (sub) criteria in both groups, the Principal-Eigenvector-Method will be applied. Weights will be aggregated per group by Aggregation-of-Individual-Priorities-mode. Descriptive and interferential statistical analyses will be conducted to assess congruence of importance-weights between groups. Subgroup-analyses shall investigate participant-heterogeneities, sensitivity of AHP-results shall be tested by inclusion/exclusion of inconsistent respondents.
Discussion
Little research is published on quantitative, choice-based preferences in dementia care. We expect that (1) PlwD have preferences and can express these, (2) that the AHP is a suitable technique to elicit quantitative, choice-based preferences among PlwD, and (3) to identify a divergence between patient preferences and physicians’ judgements for PCC. With the help of the AHP-technique, which supports systematic decision-making including multiple criteria, it may be possible to involve PlwD in future care decisions (patient participation) and ensure implementation of truly Person-Centered-Dementia-Care.
Trial registration
Approval of the study was granted by the Ethics Committee at the University Medicine Greifswald the 09Apr2021 (Reg.-Nr.: BB 018–21, BB 018-21a, BB 018-21b).
Mechanical properties have been proven to be a pivotal parameter to enhance our understanding of living systems. While research during the last decades focused on cells and tissues, little is known about the role of organelle mechanics in cell function. Here, mitochondria are of specific interest due to their involvement in numerous physiological and pathological processes, e.g., in the production and homeostasis of reactive oxygen species (ROS). Using real-time fluorescence and deformability cytometry, we present a microfluidic technology that is capable to determine the mechanical properties of individual mitochondria at a throughput exceeding 100 organelles per second. Our data on several thousands of viable mitochondria isolated from rat C6 glial cells yield a homogenous population with a median deformation that scales with the applied hydrodynamic stress. In two proof-of-principle studies, we investigated the impact of exogenously and endogenously produced ROS on mitochondria mechanics. Exposing C6 cells to hydrogen peroxide (H2O2) triggers superoxide production and leads to a reduction in mitochondria size while deformation is increased. In a second study, we focused on the knockout of tafazzin, which has been associated with impaired remodeling of the mitochondrial membrane and elevated levels of ROS. Interestingly, our results reveal the same mechanical alterations as observed after the exposure to H2O2, which points to a unified biophysical mechanism of how mitochondria respond to the presence of oxidative stress. In summary, we introduce high-throughput mechanical phenotyping into the field of organelle biology with potential applications for understanding sub-cellular dynamics that have not been accessible before.
We investigate local THz field generation using spintronic THz emitters to enhance the resolution for micrometer-sized imaging. Far-field imaging with wavelengths above 100 µm limits the resolution to this order of magnitude. By using optical laser pulses as a pump, THz field generation can be confined to the area of laser beam focusing. The divergence of the generated THz beam due to laser beam focusing requires the imaged object to be close to the generation spot at a distance below the THz field wavelength. We generate THz-radiation by fs-laser pulses in CoFeB/Pt heterostructures, based on spin currents, and detect them by commercial low-temperature grown-GaAs (LT-GaAs) Auston switches. The spatial resolution of THz radiation is determined by applying a 2D scanning technique with motorized stages allowing step sizes in the sub-micrometer range. Within the near-field limit, we achieve spatial resolution in the dimensions of the laser spot size on the micrometer scale. For this purpose, a gold test pattern is evaporated on the spintronic emitter separated by a 300 nm SiO2 spacer layer. Moving these structures with respect to the femtosecond laser spot, which generates THz radiation, allows for resolution determination. The knife-edge method yields a full-width half-maximum beam diameter of 4.9 +- 0.4 µm at 1 THz. The possibility to deposit spintronic emitter heterostructures on simple glass substrates makes them attractive candidates for near-field imaging in many imaging applications.
The capability to parameterize shapes is of essential importance in biomechanics to identify cells, to track their motion, and to quantify deformation. While various shape descriptors have already been investigated to study the morphology and migration of adherent cells, little is known of how the mathematical definition of a contour impacts the outcome of rheological experiments on cells in suspension. In microfluidic systems, hydrodynamic stress distributions induce time-dependent cell deformation that needs to be quantified to determine viscoelastic properties. Here, we compared nine different shape descriptors to characterize the deformation of suspended cells in an extensional as well as shear flow using dynamic real-time deformability cytometry. While stress relaxation depends on the amplitude and duration of stress, our results demonstrate that steady-state deformation can be predicted from single cell traces even for translocation times shorter than their characteristic time. Implementing an analytical simulation, performing experiments, and testing various data analysis strategies, we compared single cell and ensemble studies to address the question of computational costs vs experimental accuracy. Results indicate that high-throughput viscoelastic measurements of cells in suspension can be performed on an ensemble scale as long as the characteristic time matches the dimensions of the microfluidic system. Finally, we introduced a score to evaluate the shape descriptor-dependent effect size for cell deformation after cytoskeletal modifications. We provide evidence that single cell analysis in an extensional flow provides the highest sensitivity independent of shape parametrization, while inverse Haralick's circularity is mostly applicable to study cells in shear flow.
Many democracies are witnessing the rise and continuing success of parties and politicians who oppose fundamental principles of liberal democracy. Recent research finds that voters support illiberal politicians, because they trade off policy congruence against attitudes toward liberal democracy. Other studies, however, suggest that authoritarian and populist voters might actually have a preference to vote for illiberal candidates. We argue that both factors interact: Authoritarian and populist voters are more willing to trade off policy representation against support for liberal democracy. To test this mechanism, we rely on a survey experiment conducted in Germany. The results clearly demonstrate that voters indeed trade off policy congruence against liberal democracy. Moreover, this effect is particularly strong for populist and authoritarian voters. Overall, the results have important implications for understanding when and which voters support or oppose liberal democracy.
We examine the turbulence driven by the ion and electron temperature gradients in selected magnetic configurations of the Wendelstein 7-X (W7-X) stellarator. The inherent flexibility in the configuration space of W7-X enables us to find candidate configurations manifesting low turbulent transport. We follow insights gained by stellarator optimization techniques, in order to identify key geometric features, which are directly related to the ion and electron heat fluxes produced by plasma turbulence. One such a feature is the flux expansion at locations where the curvature is particularly unfavourable. Starting from a configuration routinely used in the W7-X experiment, we end up with an optimized configuration. Based on this equilibrium, we select a configuration from W7-X configuration database with a similar feature as the optimized one. With the help of nonlinear gyrokinetic simulations, we show that the heat flux in this configuration is less stiff than in the initial configuration, both for ion temperature gradient and electron temperature gradient turbulence.
Extensive scholarly work engages with the growing number of women in legislatures around the world and highlights their role as advocates of women’s interests during parliamentary decision-making processes. This article sheds light on the reactions of men MPs (members of parliament) to this trend by uncovering how women's numerical strength in party parliamentary groups shapes the issues that their men colleagues emphasize when speaking about women during plenary debates. I argue that, the higher the share of women in a party parliamentary group, the more will men representatives emphasize women’s interests in the context of issues they can easily relate to—either because the issues lie in men’s area of responsibility according to ideas about traditional role distributions in the society, for example, the financing of gender equality projects, or because they are part of broader patterns of societal inequality, such as poverty or health. I provide empirical evidence for this argument based on original time-series cross-sectional data from plenary debates in six German states between 2005 and 2021 using a structural topic model. These findings shed light on men’s role as critical actors and have implications for gender equality and the functioning of representative democracy more broadly.
The political science literature often points to populism as the cause of democratic backsliding. The literature purports that populism undermines democracy's liberal component, meaning the horizontal checks and balances on executive power by legislatures and courts and the vertical checks and balances by civil society, such as a free press and social movements. Populists promote political polarization to build sustainable ruling coalitions during and between elections that legitimize and support the illiberal policies above. However, this debate often ignores the economic tools that populists in power possess, such as capturing direct and indirect international rents to finance clientelist mechanisms to co-opt political support. This paper contributes to the rich literature on how economic rent conditions the negative relationship between populism and liberalism by disaggregating the moderating effects of direct and indirect international rents through panel regression models in 18 Latin American countries from 1991 to 2019. I find that direct international rents, such as natural resource rents, moderated a deepening in processes of democratic backsliding. Contrastingly, indirect international rents, such as remittances, moderately mitigated democratic backsliding.
This article gives an initial overview of the explanatory power of established approaches in comparative political science of various lockdown strategies in connection with the COVID-19 pandemic in 35 democracies. In a macro-comparative statistical analysis of the first wave of the pandemic, I test partisan and veto player theories. I distinguish two phases of the first wave of the COVID-19 pandemic, which show distinct patterns of political impacts. In the first phase of implementing lockdown strategies, central governments were relatively uncontested and partisan theory has strong explanatory power. In the second phase of lifting lockdowns, party differences lose relevance, but veto players have a strong influence during this time. The analysis shows that political science theories are useful for analysing political processes not only under normal conditions but also in extreme social crises. Moreover, it provides deeper insights into the democratic decision-making process of advanced democracies in exceptional situations.
Chills are emotional peaks especially in response toward acoustic stimuli. In the present study, we examined facial expressions associated with pleasant and unpleasant chill experiences during music and harsh sounds by measuring electromyographic activity from facial corrugator and zygomatic muscles. A rubber bulb could be pressed by the participants to report chill intensities. During harsh sounds, increased activation of both corrugator and zygomatic muscle was observed. Zygomatic muscle activity was even more pronounced when a chill experience was reported during such sounds. In contrast, pleasant chill experiences during music were associated with slightly increased corrugator activity compared with absent chills. Our data suggest that harsh sounds produce a painful facial expression that is even intensified when a chill experience is reported. Increased corrugator activity during chills toward music might refer to states of being moved. The results are discussed in the light of a proposed role of the chill in regulating social behavior. Our results suggest that recording facial muscle activity can be a valuable method for the examination of pleasant and unpleasant peak emotions induced by acoustic stimuli.
Background:
Post-stroke delirium (PSD) is a modifiable predictor for worse outcome in stroke. Knowledge of its risk factors would facilitate clinical management of affected patients, but recently updated national guidelines consider available evidence insufficient.
Aims:
The study aimed to establish risk factors for PSD incidence and duration using high-frequency screening.
Methods:
We prospectively investigated patients with ischemic stroke admitted within 24 h. Patients were screened twice daily for the presence of PSD throughout the treatment period. Sociodemographic, treatment-related, and neuroimaging characteristics were evaluated as predictors of either PSD incidence (odds ratios (OR)) or duration (PSD days/unit of the predictor, b), using logistic and linear regression models, respectively.
Results:
PSD occurred in 55/141 patients (age = 73.8 ± 10.4 years, 61 female, National Institutes of Health Stroke Scale (NIHSS) = 6.4 ± 6.5). Age (odds ratio (OR) = 1.06 (95% confidence interval (CI): 1.02–1.10), b = 0.08 (95% CI = 0.04–0.13)), and male gender (b = 0.99 (95% CI = 0.05–1.93)) were significant non-modifiable risk factors. In a multivariable model adjusted for age and gender, presence of pain (OR < sub > mvar </sub >= 1.75 (95% CI = 1.12–2.74)), urinary catheter (OR < sub > mvar </sub > = 3.16 (95% CI = 1.10–9.14)) and post-stroke infection (PSI; OR < sub > mvar </sub > = 4.43 (95% CI = 1.09–18.01)) were predictors of PSD incidence. PSD duration was impacted by presence of pain (b < sub > mvar </sub >= 0.49 (95% CI = 0.19–0.81)), urinary catheter (b < sub > mvar </sub > = 1.03 (95% CI = 0.01–2.07)), intravenous line (b < sub > mvar </sub >= 0.36 (95% CI = 0.16–0.57)), and PSI (b < sub > mvar </sub >= 1.60 (95% CI = 0.42–2.78)). PSD (OR = 3.53 (95% CI = 1.48–5.57)) and PSI (OR = 5.29 (95% CI = 2.92–7.66)) independently predicted inferior NIHSS at discharge. Insular and basal ganglia lesions increased the PSD risk about four- to eight-fold.
Discussion/Conclusion:
This study identified modifiable risk factors, the management of which might reduce the negative impact PSD has on outcome.
Introduction
Supplementation with spermidine may support healthy aging, but elevated spermidine tissue levels were shown to be an indicator of Alzheimer's disease (AD).
Methods
Data from 659 participants (age range: 21–81 years) of the population-based Study of Health in Pomerania TREND were included. We investigated the association between spermidine plasma levels and markers of brain aging (hippocampal volume, AD score, global cortical thickness [CT], and white matter hyperintensities [WMH]).
Results
Higher spermidine levels were significantly associated with lower hippocampal volume (ß = −0.076; 95% confidence interval [CI]: −0.13 to −0.02; q = 0.026), higher AD score (ß = 0.118; 95% CI: 0.05 to 0.19; q = 0.006), lower global CT (ß = −0.104; 95% CI: −0.17 to −0.04; q = 0.014), but not WMH volume. Sensitivity analysis revealed no substantial changes after excluding participants with cancer, depression, or hemolysis.
Discussion
Elevated spermidine plasma levels are associated with advanced brain aging and might serve as potential early biomarker for AD and vascular brain pathology.
Background and Purpose
Development and progression of heart failure involve endothelial and myocardial dysfunction as well as a dysregulation of the NO-sGC-cGMP signalling pathway. Recently, we reported that the sGC stimulator riociguat has beneficial effects on cardiac remodelling and progression of heart failure in response to chronic pressure overload. Here, we examined if these beneficial effects of riociguat were also reflected in alterations of the myocardial proteome and microRNA profiles.
Experimental Approach
Male C57BL/6N mice underwent transverse aortic constriction (TAC) and sham-operated mice served as controls. TAC and sham animals were randomised and treated with either riociguat or vehicle for 5 weeks, starting 3 weeks after surgery, when cardiac hypertrophy was established. Afterwards, we performed mass spectrometric proteome analyses and microRNA sequencing of proteins and RNAs, respectively, isolated from left ventricles (LVs).
Key Results
TAC-induced changes of the LV proteome were significantly reduced by treatment with riociguat. Bioinformatics analyses revealed that riociguat improved TAC-induced cardiovascular disease-related pathways, metabolism and energy production, for example, reversed alterations in the levels of myosin heavy chain 7, cardiac phospholamban and ankyrin repeat domain-containing protein 1. Riociguat also attenuated TAC-induced changes of microRNA levels in the LV.
Conclusion and Implications
The sGC stimulator riociguat exerted beneficial effects on cardiac structure and function during pressure overload, which was accompanied by a reversal of TAC-induced changes of the cardiac proteome and microRNA profile. Our data support the potential of riociguat as a novel therapeutic agent for heart failure.
Inherited platelet disorders affecting the human platelet cytoskeleton result in increased bleeding risk. However, deciphering their impact on cytoskeleton-dependent intrinsic biomechanics of platelets remains challenging and represents an unmet need from a diagnostic and prognostic perspective. It is currently unclear whether ex vivo anticoagulants used during collection of peripheral blood impact the mechanophenotype of cellular components of blood. Using unbiased, high-throughput functional mechanophenotyping of single human platelets by real-time deformability cytometry, we found that ex vivo anticoagulants are a critical pre-analytical variable that differentially influences platelet deformation, their size, and functional response to agonists by altering the cytoskeleton. We applied our findings to characterize the functional mechanophenotype of platelets from a patient with Myosin Heavy Chain 9 (MYH9) related macrothrombocytopenia. Our data suggest that platelets from MYH9 p.E1841K mutation in humans affecting platelet non-muscle myosin heavy chain IIa (NMMHC-IIA) are biomechanically less deformable in comparison to platelets from healthy individuals.
Obstructive sleep apnea is known to be an overall public health problem that, among other things, increases morbidity and mortality. Risk factors as well as symptoms of this multidimensional sleep-related breathing disorder negatively affect quality of life. With our study we aimed to expose the association between obstructive sleep apnea and quality of life in the population of Pomerania, Germany. We utilized data from the population-based Study of Health in Pomerania (SHIP). Information on health status and risk factors about 4420 participants (2275 women) were gathered within the cohort SHIP-TREND, of which 1209 (559 women) underwent an overnight polysomnography and completed sleep questionnaires. The quality of life of the participants was measured using the Short-Form 12 questionnaire. For our study, an ordinal regression analysis with age, sex, body mass index and the Short-Form 12 health survey as predictors for apnea–hypopnea index was computed. The potential factors affecting quality of life are different between physical and mental dimensions of quality of life. Significant effects were found regarding age, sex, body mass index and the Short-Form 12 Mental Component Score, but not the Physical Component Score.
Background
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a prothrombotic, heparin-induced thrombocytopenia (HIT)-mimicking, adverse reaction caused by platelet-activating anti-platelet factor 4 (PF4) antibodies that occurs rarely after adenovirus vector-based COVID-19 vaccination. Strength of PF4-dependent enzyme immunoassay (EIA) reactivity—judged by optical density (OD) measurements—strongly predicts platelet-activating properties of HIT antibodies in a functional test. Whether a similar relationship holds for VITT antibodies is unknown.
Objectives
To evaluate probability for positive platelet activation testing for VITT antibodies based upon EIA OD reactivity; and to investigate simple approaches to minimize false-negative platelet activation testing for VITT.
Methods
All samples referred for VITT testing were systematically evaluated by semiquantitative in-house PF4/heparin-EIA (OD readings) and PF4-induced platelet activation (PIPA) testing within a cohort study. EIA-positive sera testing PIPA-negative were retested following 1/4 to 1/10 dilution. Logistic regression was performed to predict the probability of a positive PIPA per magnitude of EIA reactivity.
Results
Greater EIA ODs in sera from patients with suspected VITT correlated strongly with greater likelihood of PIPA reactivity. Of 61 sera (with OD values >1.0) testing negative in the PIPA, a high proportion (27/61, 44.3%) became PIPA positive when tested at 1/4 to 1/10 dilution.
Conclusions
VITT serology resembles HIT in that greater EIA OD reactivity predicts higher probability of positive testing for platelet-activating antibodies. Unlike the situation with HIT antibodies, however, diluting putative VITT serum increases probability of a positive platelet activation assay, suggesting that optimal complex formation depends on the stoichiometric ratio of PF4 and anti-PF4 VITT antibodies.
Background
This study examines the relationship between adolescents’ biophysiological stress (i.e. cortisol, alpha-amylase and oxidative stress) and the development of grit and school engagement over one school year.
Aims
The study aims to identify how objective stress affects grit and three dimensions of school engagement. Based on the conservation of resources (COR) theory, the study considers lower- and higher-track school students and their genders.
Sample
The sample consists of secondary school students (N = 82; MAge = 13.71; SD = 0.67; 48% girls) from Germany.
Methods
Students participated in a questionnaire and a biophysiological study in the first semester (t1) of the school year and completed the same questionnaire at the end of the school year (t2). After conducting whole-sample analysis, a multi-group cross-lagged panel model was calculated to identify differences among students at lower- and higher-track schools.
Results
Whole-sample analysis reveals that students who exhibit high levels of cortisol report lower cognitive school engagement at t2, whereas students who exhibit high levels of alpha-amylase exhibit less grit at t2. Additionally, lower-track students who exhibited high cortisol levels reported lower cognitive and emotional school engagement throughout the school year. Furthermore, higher-track students with high oxidative stress levels reported lower grit and behavioural school engagement at t2.
Conclusions
Examining the relationship between biophysiological stress markers and grit and school engagement of students at lower- and higher-track schools indicates that the educational context and its specific subculture shapes physiological stress reactions, which are related differently to grit and engagement dimensions.
The notion of moral expertise poses a variety of challenges concerning both the question of existence of such experts and their identification by laypeople. I argue for a view of ethics expertise, based on moral understanding instead of on moral knowledge, that is less robust than genuine moral expertise and that does not rely on deference to testimony. I propose identification criteria that focus mainly on the awareness and communication of implicit biases and situated ignorance. According to the account of ethics expertise presented in this paper, the expert's testimony is not an epistemic reason for the layperson's belief, but merely an epistemic influence. The epistemic reasons for the layperson's belief are largely independent from the expert. But there is still some epistemic risk involved in the proposed method of knowledge transfer, and therefore criteria for the identification of a trustworthy expert are necessary. The risk involved in knowledge transfer can be both due to willful manipulation and due to the expert's implicit biases and situated ignorance. While willful manipulation cannot really be avoided, the influence from biases and ignorance can be minimized. I argue that the best way to do this is if the expert is aware of their own biases and ignorance and communicates them. Combined with evidence of the expert's education in moral philosophy and experience with the topic in question, this gives the layperson the best chance to identify someone who can really help them consider all relevant aspects of a situation and come to a better justified decision.
KV7 channel openers have proven their therapeutic value in the treatment of pain as well as epilepsy and, moreover, they hold the potential to expand into additional indications with unmet medical needs. However, the clinically validated but meanwhile discontinued KV7 channel openers flupirtine and retigabine bear an oxidation‐sensitive triaminoraryl scaffold, which is suspected of causing adverse drug reactions via the formation of quinoid oxidation products. Here, we report the design and synthesis of nicotinamide analogs and related compounds that remediate the liability in the chemical structure of flupirtine and retigabine. Optimization of a nicotinamide lead structure yielded analogs with excellent KV7.2/3 opening activity, as evidenced by EC50 values approaching the single‐digit nanomolar range. On the other hand, weighted KV7.2/3 opening activity data including inactive compounds allowed for the establishment of structure–activity relationships and a plausible binding mode hypothesis verified by docking and molecular dynamics simulations.
Background
Multimedia multi-device measurement platforms may make the assessment of prevention-related medical variables with a focus on cardiovascular outcomes more attractive and time-efficient. The aim of the studies was to evaluate the reliability (Study 1) and the measurement agreement with a cohort study (Study 2) of selected measures of such a device, the Preventiometer.
Methods
In Study 1 (N = 75), we conducted repeated measurements in two Preventiometers for four examinations (blood pressure measurement, pulse oximetry, body fat measurement, and spirometry) to analyze their agreement and derive (retest-)reliability estimates. In Study 2 (N = 150), we compared somatometry, blood pressure, pulse oximetry, body fat, and spirometry measurements in the Preventiometer with corresponding measurements used in the population-based Study of Health in Pomerania (SHIP) to evaluate measurement agreement.
Results
Intraclass correlations coefficients (ICCs) ranged from .84 to .99 for all examinations in Study 1. Whereas bias was not an issue for most examinations in Study 2, limits of agreement for most examinations were very large compared to results of similar method comparison studies.
Conclusion
We observed a high retest-reliability of the assessed clinical examinations in the Preventiometer. Some disagreements between Preventiometer and SHIP examinations can be attributed to procedural differences in the examinations. Methodological and technical improvements are recommended before using the Preventiometer in population-based research.
Primary and acquired therapy resistance is a major problem in patients with BRAF-mutant melanomas being treated with BRAF and MEK inhibitors (BRAFI, MEKi). Therefore, development of alternative therapy regimes is still required. In this regard, new drug combinations targeting different pathways to induce apoptosis could offer promising alternative approaches. Here, we investigated the combination of proteasome and Kv1.3 potassium channel inhibition on chemo-resistant, BRAF inhibitor-resistant as well as sensitive human melanoma cells. Our experiments demonstrated that all analyzed melanoma cell lines were sensitive to proteasome inhibitor treatment at concentrations that are not toxic to primary human fibroblasts. To further reduce proteasome inhibitor-associated side effects, and to foster apoptosis, potassium channels, which are other targets to induce pro-apoptotic effects in cancer cells, were blocked. In support, combined exposure of melanoma cells to proteasome and Kv1.3 channel inhibitor resulted in synergistic effects and significantly reduced cell viability. On the molecular level, enhanced apoptosis correlated with an increase of intracellular Kv1.3 channels and pro-apoptotic proteins such as Noxa and Bak and a reduction of anti-apoptotic proteins. Thus, use of combined therapeutic strategies triggering different apoptotic pathways may efficiently prevent the outgrowth of drug-resistant and -sensitive BRAF-mutant melanoma cells. In addition, this could be the basis for an alternative approach to treat other tumors expressing mutated BRAF such as non-small-cell lung cancer.
Organic anion transporters 1 and 3 (OAT1 and OAT3) play a crucial role in kidney function by regulating the secretion of multiple renally cleared small molecules and toxic metabolic by-products. Assessing the activity of these transporters is essential for drug development purposes as they can significantly impact drug disposition and safety. OAT1 and OAT3 are amongst the most abundant drug transporters expressed in human renal proximal tubules. However, their expression is lost when cells are isolated and cultured in vitro, which is a persistent issue across all human and animal renal proximal tubule cell models, including primary cells and cell lines. Although it is well known that the overall expression of drug transporters is affected in vitro, the underlying reasons for the loss of OAT1 and OAT3 are still not fully understood. Nonetheless, research into the regulatory mechanisms of these transporters has provided insights into the molecular pathways underlying their expression and activity. In this review, we explore the regulatory mechanisms that govern the expression and activity of OAT1 and OAT3 and investigate the physiological changes that proximal tubule cells undergo and that potentially result in the loss of these transporters. A better understanding of the regulation of these transporters could aid in the development of strategies, such as introducing microfluidic conditions or epigenetic modification inhibitors, to improve their expression and activity in vitro and to create more physiologically relevant models. Consequently, this will enable more accurate assessment for drug development and safety applications.
Acute pancreatitis (AP) is one of the most common inflammatory diseases of the gastrointestinal tract and a steady rising diagnosis for inpatient hospitalization. About one in four patients, who experience an episode of AP, will develop chronic pancreatitis (CP) over time. While the initiating causes of pancreatitis can be complex, they consistently elicit an immune response that significantly determines the severity and course of the disease. Overall, AP is associated with a significant mortality rate of 1-5%, which is caused by either an excessive pro-inflammation, or a strong compensatory inhibition of bacterial defense mechanisms which lead to a severe necrotizing form of pancreatitis. At the time-point of hospitalization the already initiated immune response is the only promising common therapeutic target to treat or prevent a severe disease course. However, the complexity of the immune response requires fine-balanced therapeutic intervention which in addition is limited by the fact that a significant proportion of patients is in danger of development or progress to recurrent and chronic disease. Based on the recent literature we survey the disease-relevant immune mechanisms and evaluate appropriate and promising therapeutic targets for the treatment of acute and chronic pancreatitis.
In wet peatlands, plant growth conditions are largely determined by local soil conditions, leading to locally adapted vegetation. Despite that Carex species are often the prevailing vascular plant species in fen peatlands of the temperate zone, information about how these species adapt to local environmental conditions is scarce. This holds true especially for below-ground plant traits and for adaptations to fen-typical nutrient level variations. To address this research gap, we investigated how different geographic origins (Germany, Poland, The Netherlands) of C. acutiformis and C. rostrata relate to their response to varying nutrient availability. We performed a common garden experiment with a controlled gradient of nutrient levels, and analyzed above- and below-ground biomass production of both Carex species from the different geographic origins. We related these traits to environmental conditions of the origins as characterized by vegetation composition-derived indicator values for ecological habitat conditions. While we detected high above-ground phenotypic plasticity of Carex from different origins, our data point to below-ground genotypic differences, potentially indicating local adaptation: Rhizome traits of C. rostrata differed significantly between origins with different nutrient indicator values. These results point towards differences in C. rostrata clonal spread behavior depending on local peatland conditions. Therefore, local adaptations of plant species and below-ground biomass traits should be taken into account when studying peatland vegetation ecology, as key functional traits can differ between genotypes within a single species depending on local conditions.
A hollow cathode discharge with a Ti cathode and a positively biased ring anode was operated in Ar + N2 or Ar + O2 gas mixtures. The energy distribution of plasma ions is investigated with the help of energy-resolved mass spectrometry. Singly and doubly charged Ar+ and Ar2+ ions and molecular N+2 or O+2 ions are the most abundant ionic species. The kinetic energy of all plasma ions is enhanced by a positive anode voltage.
The polysaccharide β-mannan, which is common in terrestrial plants but unknown in microalgae, was recently detected during diatom blooms. We identified a β-mannan polysaccharide utilization locus (PUL) in the genome of the marine flavobacterium Muricauda sp. MAR_2010_75. Proteomics showed β-mannan induced translation of 22 proteins encoded within the PUL. Biochemical and structural analyses deduced the enzymatic cascade for β-mannan utilization. A conserved GH26 β-mannanase with endo-activity depolymerized the β-mannan. Consistent with the biochemistry, X-ray crystallography showed the typical TIM-barrel fold of related enzymes found in terrestrial β-mannan degraders. Structural and biochemical analyses of a second GH26 allowed the prediction of an exo-activity on shorter manno-gluco oligosaccharides. Further analysis demonstrated exo-α-1,6-galactosidase- and endo-β-1,4-glucanase activity of the PUL-encoded GH27 and GH5_26, respectively, indicating the target substrate is a galactoglucomannan. Epitope deletion assays with mannanases as analytic tools indicate the presence of β-mannan in the diatoms Coscinodiscus wailesii and Chaetoceros affinis. Mannanases from the PUL were active on diatom β-mannan and polysaccharide extracts sampled during a microalgal bloom at the North Sea. Together these results demonstrate that marine microorganisms use a conserved enzymatic cascade to degrade β-mannans of marine and terrestrial origin and that this metabolic pathway plays a role in marine carbon cycling.
Introduction
Tibial tubercle osteotomy (TTO) is a common procedure used to treat patients with patellofemoral instability (PFI) and osteoarthritis (PFOA). Medial patellar maltracking due to previous excessive medialization of the tibial tubercle has rarely been reported. Therefore, the goal of this study was to assess patient-reported outcome measures (PROMs) after revision osteotomy with lateralization of the tibial tubercle (RL-TTO) to correct medial patellofemoral maltracking.
Materials and methods
Between 2017 and 2021, a series of 11 patients (male/female 1/10; age 35.8 ± 10.5 years) were treated by RL-TTO, of whom 8 patients could be retrospectively evaluated after a mean of 32.4 ± 15.1 months (range 18–61 months) postoperatively. The Kujala anterior knee pain scale, the patellofemoral subscale of the Knee Osteoarthritis and Outcome Score (KOOS-PF), and a numeric analog scale (NAS; 0–10) regarding anterior knee pain (AKP) at rest and during activity were assessed from pre- to postoperatively.
Results
The preoperative mean tibial tubercle-trochlear groove (TT-TG) and tibial tubercle-posterior cruciate ligament (TT-PCL) distances were − 6.5 ± 6.5 mm and 0.7 ± 4.6 mm, respectively. The intraoperatively determined amount of tibial tubercle lateralization averaged 10.7 ± 3.6 mm. The Kujala score and KOOS-PF improved significantly from 33.6 ± 10.1 (23–51) points to 94.4 ± 6.2 points (82–100) (p < 0.001) and from 20.6 ± 13.2 points (0–43.3) to 87.3 ± 9.9 points (72.8–100) (p < 0.001) from pre- to postoperatively, respectively. Pain at rest decreased from 5.8 ± 1.9 to 0.8 ± 0.9 (p < 0.001), and pain during activity decreased from 8.6 ± 1.3 to 1.6 ± 1.5 (p < 0.001).
Conclusion
RL-TTO significantly improved subjective knee function and AKP in patients suffering from medial patellar maltracking due to previous excessive tibial tubercle medialization osteotomy at short-term follow-up.
Electrochemically active ϵ‐MnO2 and ɣ‐MnO2 as tunnel‐type host‐guest structures have been extensively studied by crystallography and electrochemical techniques for application in battery cathode materials. However, the Gibbs energies of the underlying ion and electron transfer processes across the electrode interfaces have not yet been determined. Here we report for the first time these data for ϵ‐MnO2. This was possible by measuring the mid‐peak potentials in cyclic voltammetry and the open‐circuit potentials under electrochemically reversible conditions.
Herein, a new type of carbodicarbene (CDC) comprising two different classes of carbenes is reported; NHC and CAAC as donor substituents and compare the molecular structure and coordination to Au(I)Cl to those of NHC‐only and CAAC‐only analogues. The conjugate acids of these three CDCs exhibit notable redox properties. Their reactions with [NO][SbF6] were investigated. The reduction of the conjugate acid of CAAC‐only based CDC with KC8 results in the formation of hydrogen abstracted/eliminated products, which proceed through a neutral radical intermediate, detected by EPR spectroscopy. In contrast, the reduction of conjugate acids of NHC‐only and NHC/CAAC based CDCs led to intermolecular reductive (reversible) carbon–carbon sigma bond formation. The resulting relatively elongated carbon–carbon sigma bonds were found to be readily oxidized. They were, thus, demonstrated to be potent reducing agents, underlining their potential utility as organic electron donors and n‐dopants in organic semiconductor molecules.
How organisms that are part of the same trophic network respond to environmental variability over small spatial scales has been studied in a multitude of systems. Prevailing theory suggests a large role for plasticity in key traits among interacting species that allows matching of life cycles or life‐history traits across environmental gradients, for instance insects tracking host‐plant phenology across variable environments (Posledovich et al. 2018). A key aspect that remains understudied is the extent of intrapopulation variability in plasticity and whether stressful conditions canalize plasticity to an optimal level, or alternatively if variation in plasticity indeed could increase fitness in itself via alternative strategies. In a From the Cover article in this issue of Molecular Ecology, Kahilainen et al. (2022) investigate this issue in a classical insect study system, the metapopulation of the Glanville fritillary butterfly (Melitea cinxia) in the Åland archipelago of Finland. The authors first establish how a key host plant responds to water limitation, then quantify among‐family variation in larval growth and development across control and water‐limited host plants. Finally, they use RNA sequencing to gain mechanistic insights into some of these among‐family differences in larval performance in response to host‐plant variation, finding results suggesting the existence of heritable, intrapopulation variability in ecologically relevant plasticity. This final step represents a critically important and often overlooked component of efforts to predict sensitivity of biological systems to changing environmental conditions, since it provides a key metric of adaptive resilience present in the system.
Alterations in the organization of the cytoskeleton precede the escape of adherent cells from the framework of cell–cell and cell‐matrix interactions into suspension. With cytoskeletal dynamics being linked to cell mechanical properties, many studies elucidated this relationship under either native adherent or suspended conditions. In contrast, tethered cells that mimic the transition between both states have not been the focus of recent research. Using human embryonic kidney 293 T cells we investigated all three conditions in the light of alterations in cellular shape, volume, as well as mechanical properties and relate these findings to the level, structure, and intracellular localization of filamentous actin (F‐actin). For cells adhered to a substrate, our data shows that seeding density affects cell size but does not alter their elastic properties. Removing surface contacts leads to cell stiffening that is accompanied by changes in cell shape, and a reduction in cellular volume but no alterations in F‐actin density. Instead, we observe changes in the organization of F‐actin indicated by the appearance of blebs in the semi‐adherent state. In summary, our work reveals an interplay between molecular and mechanical alterations when cells detach from a surface that is mainly dominated by cell morphology.