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Lippross S, Lorenz HM, Braunschweig L, Heede A, Büscher R, Siegel M, Schultheiß G, Vieten S, Lüthje A, Matzen A, Lüders KA, Jäckle K, Tsaknakis K, Hell AK. Osmotic pump with potential for bone lengthening distracts continuously in vitro and in vivo. PLoS One 2023; 18:e0291335. [PMID: 37708150 PMCID: PMC10501673 DOI: 10.1371/journal.pone.0291335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND In pediatric orthopedics, long bone lengthening procedures are routinely performed using manual, motorized or magnetically controlled implants. This study aims to prove expansion of a newly designed osmotic pump prior to long bone lengthening in living organisms and to rule out any complications related to in vivo conditions, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump, as well as to compare in vivo and in vitro expansion data. METHODS Osmotic pumps, which were designed to distract a plate osteosynthesis, were inserted in the dorsal paraspinal musculature of four piglets. To compare the performance of the pumps in in vivo and in vitro conditions, another set of pumps was submerged in physiologic saline solution at different temperatures. The lengthening progress was measured radiographically and sonographically in the study animals. RESULTS Both, in vitro and in vivo tested osmotic pumps started distraction after an intended rest phase of four days and distracted evenly over the following twelve days. No complications, clogging or damages occurred. However, we observed a temperature dependency of the distraction rate ranging from 0.98 mm/day at 39°C to 1.10 mm/day at 42°C. With a second setup, we confirmed that the distraction rate differed by 72% within a measured temperature interval of 14° C. CONCLUSIONS The data presented here confirm that the novel osmotic pump showed comparable lengthening characteristics in vivo and in vitro. No complications, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump were observed. Thus, osmotic pumps may have great potential in future applications such as long bone lengthening procedures, where continuous distraction probably provides a better bone quality than intermittent lengthening procedures. The fact that one pump failed to elongate in each condition, highlights the importance of technical improvement, but also demonstrates that this was not due to different circumstances within the in vivo or in vitro condition.
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Affiliation(s)
- Sebastian Lippross
- Department of Orthopaedics and Trauma Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Heiko M. Lorenz
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Lena Braunschweig
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
| | | | | | | | | | - Sarah Vieten
- Department of Animal Welfare, CAU Kiel, Kiel, Germany
| | - Annette Lüthje
- Department of Internal Medicine III, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Kiel, Germany
| | - Andrea Matzen
- Department of Internal Medicine III, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Kiel, Germany
| | - Katja A. Lüders
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Katharina Jäckle
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Konstantinos Tsaknakis
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Anna K. Hell
- Pediatric Orthopaedics, Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
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Ollenschläger M, Höfner P, Ullrich M, Kluge F, Greinwalder T, Loris E, Regensburger M, Eskofier BM, Winkler J, Gaßner H. Automated assessment of foot elevation in adults with hereditary spastic paraplegia using inertial measurements and machine learning. Orphanet J Rare Dis 2023; 18:249. [PMID: 37644478 PMCID: PMC10466820 DOI: 10.1186/s13023-023-02854-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Hereditary spastic paraplegias (HSPs) cause characteristic gait impairment leading to an increased risk of stumbling or even falling. Biomechanically, gait deficits are characterized by reduced ranges of motion in lower body joints, limiting foot clearance and ankle range of motion. To date, there is no standardized approach to continuously and objectively track the degree of dysfunction in foot elevation since established clinical rating scales require an experienced investigator and are considered to be rather subjective. Therefore, digital disease-specific biomarkers for foot elevation are needed. METHODS This study investigated the performance of machine learning classifiers for the automated detection and classification of reduced foot dorsiflexion and clearance using wearable sensors. Wearable inertial sensors were used to record gait patterns of 50 patients during standardized 4 [Formula: see text] 10 m walking tests at the hospital. Three movement disorder specialists independently annotated symptom severity. The majority vote of these annotations and the wearable sensor data were used to train and evaluate machine learning classifiers in a nested cross-validation scheme. RESULTS The results showed that automated detection of reduced range of motion and foot clearance was possible with an accuracy of 87%. This accuracy is in the range of individual annotators, reaching an average accuracy of 88% compared to the ground truth majority vote. For classifying symptom severity, the algorithm reached an accuracy of 74%. CONCLUSION Here, we show that the present wearable gait analysis system is able to objectively assess foot elevation patterns in HSP. Future studies will aim to improve the granularity for continuous tracking of disease severity and monitoring therapy response of HSP patients in a real-world environment.
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Affiliation(s)
- Malte Ollenschläger
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany.
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Patrick Höfner
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Ullrich
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Felix Kluge
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Teresa Greinwalder
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Evelyn Loris
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Martin Regensburger
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
- Center for Rare Diseases Erlangen (ZSEER), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
- Center for Rare Diseases Erlangen (ZSEER), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Heiko Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
- Fraunhofer IIS, Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany
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Schneider JN, Matyjek M, Weigand A, Dziobek I, Brick TR. Subjective and objective difficulty of emotional facial expression perception from dynamic stimuli. PLoS One 2022; 17:e0269156. [PMID: 35709093 PMCID: PMC9202844 DOI: 10.1371/journal.pone.0269156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to discover predictors of subjective and objective difficulty in emotion perception from dynamic facial expressions. We used a multidimensional emotion perception framework, in which observers rated the perceived emotion along a number of dimensions instead of choosing from traditionally-used discrete categories of emotions. Data were collected online from 441 participants who rated facial expression stimuli in a novel paradigm designed to separately measure subjective (self-reported) and objective (deviation from the population consensus) difficulty. We targeted person-specific (sex and age of observers and actors) and stimulus-specific (valence and arousal values) predictors of those difficulty scores. Our findings suggest that increasing age of actors makes emotion perception more difficult for observers, and that perception difficulty is underestimated by men in comparison to women, and by younger and older adults in comparison to middle-aged adults. The results also yielded an increase in the objective difficulty measure for female observers and female actors. Stimulus-specific factors–valence and arousal–exhibited quadratic relationships with subjective and objective difficulties: Very positive and very negative stimuli were linked to reduced subjective and objective difficulty, whereas stimuli of very low and high arousal were linked to decreased subjective but increased objective difficulty. Exploratory analyses revealed low relevance of person-specific variables for the prediction of difficulty but highlighted the importance of valence in emotion perception, in line with functional accounts of emotions. Our findings highlight the need to complement traditional emotion recognition paradigms with novel designs, like the one presented here, to grasp the “big picture” of human emotion perception.
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Affiliation(s)
- Jan N. Schneider
- Institut für Informatik und Computational Science, Universität Potsdam, Potsdam, Germany
- Department of Psychology, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail: (JNS); (MM)
| | - Magdalena Matyjek
- Department of Psychology, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail: (JNS); (MM)
| | - Anne Weigand
- Department of Psychology, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Isabel Dziobek
- Department of Psychology, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timothy R. Brick
- Department of Human Development and Family Studies and Institute for Computational and Data Sciences, The Pennsylvania State University, State College, PA, United States of America
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Schweiger JI, Capraz N, Akdeniz C, Braun U, Ebalu T, Moessnang C, Berhe O, Zang Z, Schwarz E, Bilek E, Meyer-Lindenberg A, Tost H. Brain structural correlates of upward social mobility in ethnic minority individuals. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2037-2047. [PMID: 34383084 PMCID: PMC9477908 DOI: 10.1007/s00127-021-02163-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 07/31/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Perigenual anterior cingulate cortex (pACC) is a neural convergence site for social stress-related risk factors for mental health, including ethnic minority status. Current social status, a strong predictor of mental and somatic health, has been related to gray matter volume in this region, but the effects of social mobility over the lifespan are unknown and may differ in minorities. Recent studies suggest a diminished health return of upward social mobility for ethnic minority individuals, potentially due to sustained stress-associated experiences and subsequent activation of the neural stress response system. METHODS To address this issue, we studied an ethnic minority sample with strong upward social mobility. In a cross-sectional design, we examined 64 young adult native German and 76 ethnic minority individuals with comparable sociodemographic attributes using whole-brain structural magnetic resonance imaging. RESULTS Results showed a significant group-dependent interaction between perceived upward social mobility and pACC gray matter volume, with a significant negative association in the ethnic minority individuals. Post-hoc analysis showed a significant mediation of the relationship between perceived upward social mobility and pACC volume by perceived chronic stress, a variable that was significantly correlated with perceived discrimination in our ethnic minority group. CONCLUSION Our findings extend prior work by pointing to a biological signature of the "allostatic costs" of socioeconomic attainment in socially disadvantaged upwardly mobile individuals in a key neural node implicated in the regulation of stress and negative affect.
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Affiliation(s)
- Janina I Schweiger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany.
| | - Necip Capraz
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Ceren Akdeniz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Tracie Ebalu
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Zhenxiang Zang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Edda Bilek
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
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Diefenbach C, Schmidt MF, Huss M, König J, Urschitz MS. Age at school entry and reported symptoms of attention-deficit/hyperactivity in first graders: results of the prospective cohort study ikidS. Eur Child Adolesc Psychiatry 2022; 31:1753-1764. [PMID: 34089381 PMCID: PMC9666310 DOI: 10.1007/s00787-021-01813-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 05/23/2021] [Indexed: 12/03/2022]
Abstract
Young age at school entry (ASE) is related to attention-deficit/hyperactivity disorder in higher grades. The reason for this association is unclear, but medical oversupply and stress-related factors are discussed. We aimed to investigate whether ASE is associated with reported symptoms of attention-deficit/hyperactivity (ADH) already in first grade. Data of a population-based prospective cohort study (N = 2003; Mainz-Bingen region; Rhineland-Palatinate; Germany) with baseline assessments prior to school entry and two follow-ups during first grade were analysed. ADH symptoms were assessed by parent and teacher versions of the Strengths and Difficulties Questionnaire. Associations between ASE and scores of the hyperactivity/inattention subscale (range 0-10) were investigated by regression analysis and adjusted for potential confounders and baseline symptoms prior to school entry. In total, 1633 children (52% boys, mean ASE 6.5 years) were included. There were no relationships between ASE and parent-reported scores of the hyperactivity/inattention subscale prior to school entry and 3 months thereafter. However, at the end of first grade, ASE was negatively associated with the hyperactivity/inattention subscale in parent (- 0.7 subscale points per year ASE, standard error = 0.16, p < 0.0001) and teacher reports (- 1.2 subscale points per year ASE, standard error = 0.25, p < 0.0001). This ASE effect appeared more pronounced in girls than in boys. Young ASE is related to more reported symptoms of ADH at the end of first grade, but not before. The evolvement of this effect during first grade may be a clue to ASE-related stress factors.
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Affiliation(s)
- Christiane Diefenbach
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
| | - Martina F Schmidt
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescence Psychiatry, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - Michael S Urschitz
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
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Charmpi K, Chokkalingam M, Johnen R, Beyer A. Optimizing network propagation for multi-omics data integration. PLoS Comput Biol 2021; 17:e1009161. [PMID: 34762640 PMCID: PMC8664198 DOI: 10.1371/journal.pcbi.1009161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/10/2021] [Accepted: 10/12/2021] [Indexed: 01/11/2023] Open
Abstract
Network propagation refers to a class of algorithms that integrate information from input data across connected nodes in a given network. These algorithms have wide applications in systems biology, protein function prediction, inferring condition-specifically altered sub-networks, and prioritizing disease genes. Despite the popularity of network propagation, there is a lack of comparative analyses of different algorithms on real data and little guidance on how to select and parameterize the various algorithms. Here, we address this problem by analyzing different combinations of network normalization and propagation methods and by demonstrating schemes for the identification of optimal parameter settings on real proteome and transcriptome data. Our work highlights the risk of a ‘topology bias’ caused by the incorrect use of network normalization approaches. Capitalizing on the fact that network propagation is a regularization approach, we show that minimizing the bias-variance tradeoff can be utilized for selecting optimal parameters. The application to real multi-omics data demonstrated that optimal parameters could also be obtained by either maximizing the agreement between different omics layers (e.g. proteome and transcriptome) or by maximizing the consistency between biological replicates. Furthermore, we exemplified the utility and robustness of network propagation on multi-omics datasets for identifying ageing-associated genes in brain and liver tissues of rats and for elucidating molecular mechanisms underlying prostate cancer progression. Overall, this work compares different network propagation approaches and it presents strategies for how to use network propagation algorithms to optimally address a specific research question at hand. Modern technologies enable the simultaneous measurement of tens of thousands of molecules in biological samples. Algorithms called network propagation or network smoothing are frequently used to integrate such data with already known molecular interaction data, such as protein and gene interaction networks. These methods distribute the information on molecular perturbations within the network and help identifying network regions that are enriched for many perturbed (affected) molecules. Despite the popularity of these methods, there is a lack of guidance on how to optimally use them. Here, we highlight possible pitfalls when using incorrect network normalization methods. Further, we present different ways for optimizing the smoothing parameters used during network smoothing: the first approach maximizes the consistency between replicate measurements within a dataset; the second one maximizes the consistency between different types of ‘omics’ measurements, such as proteomics and transcriptomics. Using two multi-omics datasets, one from a cohort of prostate cancer patients, the other one from an ageing study on rat brain and liver tissues, we exemplify the effects of these strategies on real data.
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Affiliation(s)
- Konstantina Charmpi
- CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Cologne, Germany
| | - Manopriya Chokkalingam
- CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Cologne, Germany
| | - Ronja Johnen
- CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Cologne, Germany
| | - Andreas Beyer
- CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
- Institute for Genetics, Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
- * E-mail:
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Klein K, Heß S, Nungeß S, Schulte-Oehlmann U, Oehlmann J. Particle shape does not affect ingestion and egestion of microplastics by the freshwater shrimp Neocaridina palmata. Environ Sci Pollut Res Int 2021; 28:62246-62254. [PMID: 34189691 PMCID: PMC8589796 DOI: 10.1007/s11356-021-15068-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/18/2021] [Indexed: 06/01/2023]
Abstract
The ingestion of microplastics (MPs) is well documented for various animals and spherical MPs (beads) in many studies. However, the retention time and egestion of MPs have been examined less, especially for irregular MPs (fragments) which are predominantly found in the environment. Furthermore, the accumulation of such particles in the gastrointestinal tract is likely to determine whether adverse effects are induced. To address this, we investigated if the ingestion and egestion of beads are different to those of fragments in the freshwater shrimp Neocaridina palmata. Therefore, organisms were exposed to 20-20,000 particles L-1 of either polyethylene (PE) beads (41 μm and 87 μm) or polyvinyl chloride (PVC) fragments (<63 μm). Moreover, shrimps were exposed to 20,000 particles L-1 of either 41 μm PE and 11 μm polystyrene (PS) beads or the PVC fragments for 24 h, followed by a post-exposure period of 4 h to analyze the excretion of particles. To simulate natural conditions, an additional fragment ingestion study was performed in the presence of food. After each treatment, the shrimps were analyzed for retained or excreted particles. Our results demonstrate that the ingestion of beads and fragments were concentration-dependent. Shrimps egested 59% of beads and 18% of fragments within 4 h. Particle shape did not significantly affect MP ingestion or egestion, but size was a relevant factor. Medium- and small-sized beads were frequently ingested. Furthermore, fragment uptake decreased slightly when co-exposed to food, but was not significantly different to the treatments without food. Finally, the investigations highlight that the assessment of ingestion and egestion rates can help to clarify whether MPs remain in specific organisms and, thereby, become a potential health threat.
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Affiliation(s)
- Kristina Klein
- Faculty of Biological Sciences, Department Aquatic Ecotoxicology, Goethe University Frankfurt, Max-von-Laue-Straße 13, 60438, Frankfurt am Main, Germany.
| | - Sebastian Heß
- Faculty of Biological Sciences, Department Aquatic Ecotoxicology, Goethe University Frankfurt, Max-von-Laue-Straße 13, 60438, Frankfurt am Main, Germany
| | - Sandra Nungeß
- Faculty of Biological Sciences, Department Aquatic Ecotoxicology, Goethe University Frankfurt, Max-von-Laue-Straße 13, 60438, Frankfurt am Main, Germany
| | - Ulrike Schulte-Oehlmann
- Faculty of Biological Sciences, Department Aquatic Ecotoxicology, Goethe University Frankfurt, Max-von-Laue-Straße 13, 60438, Frankfurt am Main, Germany
| | - Jörg Oehlmann
- Faculty of Biological Sciences, Department Aquatic Ecotoxicology, Goethe University Frankfurt, Max-von-Laue-Straße 13, 60438, Frankfurt am Main, Germany
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Tack A, Ambellan F, Zachow S. Towards novel osteoarthritis biomarkers: Multi-criteria evaluation of 46,996 segmented knee MRI data from the Osteoarthritis Initiative. PLoS One 2021; 16:e0258855. [PMID: 34673842 PMCID: PMC8530341 DOI: 10.1371/journal.pone.0258855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/06/2021] [Indexed: 01/16/2023] Open
Abstract
Convolutional neural networks (CNNs) are the state-of-the-art for automated assessment of knee osteoarthritis (KOA) from medical image data. However, these methods lack interpretability, mainly focus on image texture, and cannot completely grasp the analyzed anatomies' shapes. In this study we assess the informative value of quantitative features derived from segmentations in order to assess their potential as an alternative or extension to CNN-based approaches regarding multiple aspects of KOA. Six anatomical structures around the knee (femoral and tibial bones, femoral and tibial cartilages, and both menisci) are segmented in 46,996 MRI scans. Based on these segmentations, quantitative features are computed, i.e., measurements such as cartilage volume, meniscal extrusion and tibial coverage, as well as geometric features based on a statistical shape encoding of the anatomies. The feature quality is assessed by investigating their association to the Kellgren-Lawrence grade (KLG), joint space narrowing (JSN), incident KOA, and total knee replacement (TKR). Using gold standard labels from the Osteoarthritis Initiative database the balanced accuracy (BA), the area under the Receiver Operating Characteristic curve (AUC), and weighted kappa statistics are evaluated. Features based on shape encodings of femur, tibia, and menisci plus the performed measurements showed most potential as KOA biomarkers. Differentiation between non-arthritic and severely arthritic knees yielded BAs of up to 99%, 84% were achieved for diagnosis of early KOA. Weighted kappa values of 0.73, 0.72, and 0.78 were achieved for classification of the grade of medial JSN, lateral JSN, and KLG, respectively. The AUC was 0.61 and 0.76 for prediction of incident KOA and TKR within one year, respectively. Quantitative features from automated segmentations provide novel biomarkers for KLG and JSN classification and show potential for incident KOA and TKR prediction. The validity of these features should be further evaluated, especially as extensions of CNN-based approaches. To foster such developments we make all segmentations publicly available together with this publication.
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Affiliation(s)
| | | | - Stefan Zachow
- Zuse Institute Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Berlin, Germany
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Ulrich U, Pfannerstill M, Ostendorp G, Fohrer N. Omnipresent distribution of herbicides and their transformation products in all water body types of an agricultural landscape in the North German Lowland. Environ Sci Pollut Res Int 2021; 28:44183-44199. [PMID: 33847885 PMCID: PMC8357661 DOI: 10.1007/s11356-021-13626-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
The research of the environmental fate of pesticides has demonstrated that applied compounds are altered in their molecular structure over time and are distributed within the environment. To assess the risk for contamination by transformation products (TP) of the herbicides flufenacet and metazachlor, the following four water body types were sampled in a small-scale catchment of 50 km2 in 2015/2016: tile drainage water, stream water, shallow groundwater, and drinking water of private wells. The TP were omnipresent in every type of water body, more frequently and in concentrations up to 10 times higher than their parent compounds. Especially metazachlor sulfonic acid, metazachlor oxalic acid, and flufenacet oxalic acid were detected in almost every drainage and stream sample. The transformation process leads to more mobile and more persistent molecules resulting in higher detection frequencies and concentrations, which can even occur a year or more after the application of the parent compound. The vulnerability of shallow groundwater and private drinking water wells to leaching compounds is proved by numerous positives of metazachlor-TP with maximum concentrations of 0.7 μg L-1 (drinking water) and 20 μg L-1 (shallow groundwater) of metazachlor sulfonic acid. Rainfall events during the application period cause high discharge of the parent compound and lower release of TP. Later rainfall events lead to high displacement of TP. For an integrated risk assessment of water bodies, the environmental behavior of pesticide-TP has to be included into regular state-of-the-art water quality monitoring.
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Affiliation(s)
- Uta Ulrich
- Institute of Natural Resource Conservation, Christian-Albrechts University Kiel, Olshausenstr. 75, 24118, Kiel, Germany.
| | - Matthias Pfannerstill
- State Agency for Agriculture, the Environment and Rural Areas Schleswig-Holstein, Hamburger Chaussee 25, 24220, Flintbek, Germany
| | - Guido Ostendorp
- Department of Environmental Health, State Social Services Agency Schleswig-Holstein, Brunswiker Straße 4, 24105, Kiel, Germany
| | - Nicola Fohrer
- Institute of Natural Resource Conservation, Christian-Albrechts University Kiel, Olshausenstr. 75, 24118, Kiel, Germany
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10
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Kovacheva E, Gerach T, Schuler S, Ochs M, Dössel O, Loewe A. Causes of altered ventricular mechanics in hypertrophic cardiomyopathy: an in-silico study. Biomed Eng Online 2021; 20:69. [PMID: 34294108 PMCID: PMC8296558 DOI: 10.1186/s12938-021-00900-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/08/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is typically caused by mutations in sarcomeric genes leading to cardiomyocyte disarray, replacement fibrosis, impaired contractility, and elevated filling pressures. These varying tissue properties are associated with certain strain patterns that may allow to establish a diagnosis by means of non-invasive imaging without the necessity of harmful myocardial biopsies or contrast agent application. With a numerical study, we aim to answer: how the variability in each of these mechanisms contributes to altered mechanics of the left ventricle (LV) and if the deformation obtained in in-silico experiments is comparable to values reported from clinical measurements. METHODS We conducted an in-silico sensitivity study on physiological and pathological mechanisms potentially underlying the clinical HCM phenotype. The deformation of the four-chamber heart models was simulated using a finite-element mechanical solver with a sliding boundary condition to mimic the tissue surrounding the heart. Furthermore, a closed-loop circulatory model delivered the pressure values acting on the endocardium. Deformation measures and mechanical behavior of the heart models were evaluated globally and regionally. RESULTS Hypertrophy of the LV affected the course of strain, strain rate, and wall thickening-the root-mean-squared difference of the wall thickening between control (mean thickness 10 mm) and hypertrophic geometries (17 mm) was >10%. A reduction of active force development by 40% led to less overall deformation: maximal radial strain reduced from 26 to 21%. A fivefold increase in tissue stiffness caused a more homogeneous distribution of the strain values among 17 heart segments. Fiber disarray led to minor changes in the circumferential and radial strain. A combination of pathological mechanisms led to reduced and slower deformation of the LV and halved the longitudinal shortening of the LA. CONCLUSIONS This study uses a computer model to determine the changes in LV deformation caused by pathological mechanisms that are presumed to underlay HCM. This knowledge can complement imaging-derived information to obtain a more accurate diagnosis of HCM.
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Affiliation(s)
- Ekaterina Kovacheva
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany
| | - Tobias Gerach
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany
| | - Steffen Schuler
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany
| | - Marco Ochs
- Department of Cardiology, Theresienkrankenhaus, Academic Teaching Hospital of Heidelberg University, Bassermannstr.1, 68165, Mannheim, Germany
| | - Olaf Dössel
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany
| | - Axel Loewe
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany.
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Spiering S, Barrera MDV. Testing the quality of transformative science methods: the example of the Human Scale Development approach. Sustain Sci 2021; 16:1439-1457. [PMID: 34035864 PMCID: PMC8136104 DOI: 10.1007/s11625-021-00966-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/24/2021] [Indexed: 05/23/2023]
Abstract
Scholars and funding bodies alike are increasingly calling for transformative research that delivers socially robust and impact-oriented outcomes. This paper argues that the Human Scale Development approach (HSDA) introduced by Max-Neef and colleagues in Latin America during the 1980s can serve as a method for transformative science (TSc). HSDA is both a theory and a participatory methodology and thus contributes toward fulfilling the objectives of TSc, which are scientific, practical and educational. In this paper, we begin by explicating how the fundamental human needs (FHN) approach of the HSDA can support scholars and practitioners alike in addressing complex sustainability challenges. We then refer to the methodological adaptations to the original proposal that we have previously developed to illustrate how Max-Neef's methodological approach might be further extended and to demonstrate how these changes can strengthen HSDA and make it even more useful for generating knowledge needed in sustainability transformations. To inform and support research that builds on the co-production of knowledge, we test HSDA with regard to TSc quality criteria and show how it adds value to the existing canon of TSc methods. To this end, we develop an analytical framework that can be deployed to assess the quality of TSc methods.
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Affiliation(s)
- Salina Spiering
- Helmholtz Centre for Environmental Research GmbH, UFZ, Leipzig, Permoserstraße 15, 04318 Leipzig, Germany
| | - María del Valle Barrera
- Institute of Economics, Faculty of Economic and Administrative Sciences, Universidad Austral de Chile, Isla Teja, Valdivia, Chile
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12
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Xia H, Horn J, Piotrowska MJ, Sakowski K, Karch A, Tahir H, Kretzschmar M, Mikolajczyk R. Effects of incomplete inter-hospital network data on the assessment of transmission dynamics of hospital-acquired infections. PLoS Comput Biol 2021; 17:e1008941. [PMID: 33956787 PMCID: PMC8130968 DOI: 10.1371/journal.pcbi.1008941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/18/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022] Open
Abstract
In the year 2020, there were 105 different statutory insurance companies in Germany with heterogeneous regional coverage. Obtaining data from all insurance companies is challenging, so that it is likely that projects will have to rely on data not covering the whole population. Consequently, the study of epidemic spread in hospital referral networks using data-driven models may be biased. We studied this bias using data from three German regional insurance companies covering four federal states: AOK (historically “general local health insurance company”, but currently only the abbreviation is used) Lower Saxony (in Federal State of Lower Saxony), AOK Bavaria (in Bavaria), and AOK PLUS (in Thuringia and Saxony). To understand how incomplete data influence network characteristics and related epidemic simulations, we created sampled datasets by randomly dropping a proportion of patients from the full datasets and replacing them with random copies of the remaining patients to obtain scale-up datasets to the original size. For the sampled and scale-up datasets, we calculated several commonly used network measures, and compared them to those derived from the original data. We found that the network measures (degree, strength and closeness) were rather sensitive to incompleteness. Infection prevalence as an outcome from the applied susceptible-infectious-susceptible (SIS) model was fairly robust against incompleteness. At incompleteness levels as high as 90% of the original datasets the prevalence estimation bias was below 5% in scale-up datasets. Consequently, a coverage as low as 10% of the local population of the federal state population was sufficient to maintain the relative bias in prevalence below 10% for a wide range of transmission parameters as encountered in clinical settings. Our findings are reassuring that despite incomplete coverage of the population, German health insurance data can be used to study effects of patient traffic between institutions on the spread of pathogens within healthcare networks. Patterns of patients’ transfer between different hospitals contribute crucially to the risk of hospital-acquired infections (HAIs) in the health care system. To quantify this risk, network models can be applied. The estimated risk can be inaccurate in the case of incomplete data on hospital admissions, which can be a consequence of the multiplicity of insurance companies as it is the case in Germany. To develop a better understanding of how incompleteness of data affects network measures and the simulated spread of HAI, we compared those measures derived from sampled, scale-up and original data, based on hospitalization data from three AOK insurance companies. We found that common network measures were affected by incompleteness, but the simulated prevalence as a measure of epidemic spread in the network was robust over a large range of incompleteness proportions. Epidemics and the transition of the infectious diseases may be modelled on hospital data with a coverage as low as 10% of the local population, whilst maintaining accuracy to within 10% of the true population prevalence.
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Affiliation(s)
- Hanjue Xia
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Monika J. Piotrowska
- Institute of Applied Mathematics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Konrad Sakowski
- Institute of Applied Mathematics and Mechanics, University of Warsaw, Warsaw, Poland
- Institute of High Pressure Physics, Polish Academy of Sciences, Warsaw, Poland
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Hannan Tahir
- Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mirjam Kretzschmar
- Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
- * E-mail:
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13
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Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, Voigt-Radloff S, Huber R. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr 2021; 21:287. [PMID: 33933014 PMCID: PMC8087880 DOI: 10.1186/s12877-021-02232-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/19/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is a threat to ongoing clinical trials necessitating regular face-to-face, in-person meetings, particularly in participants with a high risk of complications. Guidance on how to handle and safely continue such trials is lacking. Chronically ill elderly individuals require-in addition to protection from infection-regular physical exercise and social contact to remain healthy. Solutions on how to handle these conflicting necessities are needed. The ENTAIER-randomised controlled trial was investigating the influence of mindful movements on fall risk, fear of falling, mobility, balance, life quality, and other outcomes. The study population was planned to comprise of 550 chronically ill elderly individuals with a high risk of falling. The movements were regularly performed in coached groups over 6 months. After the trial began, COVID-19 lockdowns stopped all in-person meetings, and it was expected that the limitations of this pandemic would continue for a long term. Therefore, the exercise programme, which involved complex movements and was typically conducted face-to-face in groups, had to be substituted by a telemedicine programme within a short timeframe. The objectives, therefore, were to identify challenges and tasks that could to be resolved and steps that could to be taken to achieve high-quality, efficacy, safety, and enable human encounter and motivation. METHODS We proceeded with four steps: 1) A literature review on the quality and feasibility issues of telemedicine in general, and specifically, in exercise training in elderly individuals. 2) Participation in two international telemedicine task forces on integrative medicine, particularly, mind-body medicine. 3) Interviews with study therapists, (for practical purposes, eurythmy therapists and Tai Chi teachers are summarized here as therapists) personnel, and international experts on providing mindful movement exercises and other physiotherapies via live telecommunication technology, and with scientists and patient representatives. 4) Final evaluation by the core trial team and subsequent planning and implementation of changes in the trial organisation. RESULTS Various tasks and challenges were identified: for the technical equipment for therapists and patients; for the ability of therapists and trial participants to adequately manage the technology and telemedicine intervention; the reservations and concerns about the technology among therapists and participants; safety and data protection in using the technology; and study design. The two major options found on how to continue the trial in the COVID-19 situation were a complete switch to telemedicine and a partial switch in the form of risk management implemented into the former design. CONCLUSIONS The management of an ongoing clinical trial in a national or international crisis with a minimum of available time and extra financial resources, alongside with two checklists on steps and procedures for trial continuation and telemedicine implementation, may be informative for other researchers or healthcare providers faced with similar challenges and making similar decisions in the current situation or similar future scenarios. TRAIL REGISTRATION: www.drks.de . DRKS00016609. Registered July 30, 2019.
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Affiliation(s)
- G S Kienle
- Centre for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- IFAEMM at the University of Witten/Herdecke, Freiburg, Germany.
| | - P Werthmann
- Centre for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- IFAEMM at the University of Witten/Herdecke, Freiburg, Germany
| | - B Grotejohann
- Clinical Trials Unit, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - C Schmoor
- Clinical Trials Unit, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ch Stumpe
- Shen Men Institute, Institute for Qigong, Taiji, Acupressure & Traditional Chinese Medicine (TCM), Düsseldorf, Germany
| | - S Voigt-Radloff
- Centre for Geriatric Medicine and Gerontology Freiburg, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Huber
- Centre for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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14
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Frey D, Livne M, Leppin H, Akay EM, Aydin OU, Behland J, Sobesky J, Vajkoczy P, Madai VI. A precision medicine framework for personalized simulation of hemodynamics in cerebrovascular disease. Biomed Eng Online 2021; 20:44. [PMID: 33933080 PMCID: PMC8088619 DOI: 10.1186/s12938-021-00880-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cerebrovascular disease, in particular stroke, is a major public health challenge. An important biomarker is cerebral hemodynamics. To measure and quantify cerebral hemodynamics, however, only invasive, potentially harmful or time-to-treatment prolonging methods are available. RESULTS We present a simulation-based approach which allows calculation of cerebral hemodynamics based on the patient-individual vessel configuration derived from structural vessel imaging. For this, we implemented a framework allowing segmentation and annotation of brain vessels from structural imaging followed by 0-dimensional lumped simulation modeling of cerebral hemodynamics. For annotation, a 3D-graphical user interface was implemented. For 0D-simulation, we used a modified nodal analysis, which was adapted for easy implementation by code. The simulation enables identification of areas vulnerable to stroke and simulation of changes due to different systemic blood pressures. Moreover, sensitivity analysis was implemented allowing the live simulation of changes to simulate procedures and disease progression. Beyond presentation of the framework, we demonstrated in an exploratory analysis in 67 patients that the simulation has a high specificity and low-to-moderate sensitivity to detect perfusion changes in classic perfusion imaging. CONCLUSIONS The presented precision medicine approach using novel biomarkers has the potential to make the application of harmful and complex perfusion methods obsolete.
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Affiliation(s)
- Dietmar Frey
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany.
- Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany.
| | - Michelle Livne
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
| | - Heiko Leppin
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
| | - Ela M Akay
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
- Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany
| | - Orhun U Aydin
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
- Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany
| | - Jonas Behland
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
- Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany
| | - Jan Sobesky
- Johanna Etienne Hospital Neuss, Berlin, Germany
- Centre for Stroke Research Berlin, Charité University Medicine Berlin, Berlin, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany
| | - Vince I Madai
- Charite Lab for Artificial Intelligence in Medicine, Department of Neurosurgery, Charité University Medicine Berlin, Chariteplatz 1, 10115, Berlin, Germany
- School of Computing and Digital Technology, Faculty of Computing, Engineering and the Built Environment, Birmingham City University, Birmingham, UK
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15
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Nury E, Morze J, Grummich K, Rücker G, Hoffmann G, Angele CM, Steinacker JM, Conrad J, Schmid D, Meerpohl JJ, Schwingshackl L. Effects of nutrition intervention strategies in the primary prevention of overweight and obesity in school settings: a protocol for a systematic review and network meta-analysis. Syst Rev 2021; 10:122. [PMID: 33888162 PMCID: PMC8063346 DOI: 10.1186/s13643-021-01661-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/01/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Overweight and obesity in children and adolescents are major public health challenges affecting quality of life and representing important risk factors in the development of non-communicable diseases. School environments provide great possibilities for the primary prevention of overweight and obesity and different school-based nutrition interventions are available. However, existing research on school-based nutrition interventions has important limitations and no network meta-analysis (NMA) has been performed yet to compare all available interventions. Therefore, the present research project aims to investigate the impact of different nutrition interventions in the school setting by comparing and ranking them using NMA methodology. METHODS/DESIGN A systematic literature search will be performed in 11 electronic databases (PubMed, the Cochrane Library, Web of Science, ERIC, PsycINFO, CAB Abstracts, Campbell Library, BiblioMap EPPI, Australian Education Index, Joanna Briggs Institute Evidence-Based Practice Database and Practice-based Evidence in Nutrition Database). Parallel or cluster randomized controlled trials (RCTs) meeting the following criteria will be included: (1) generally healthy school students aged 4-18 years, (2) school-based intervention with ≥ 1 nutrition component, and (3) assessed anthropometric (overweight/obesity risk, body weight change, weight Z-score, [standardized] body mass index, body fat, waist circumference) and/or diet-quality measures (daily intake of fruits and vegetables, fat, and sugar-sweetened beverages). Random effects pairwise and NMA will be performed for these outcomes and surface under the cumulative ranking curve (SUCRA) estimated (P-score). Where possible, component NMA (CNMA) will be used additionally. Subgroup analyses are carried out for intervention duration, gender, age of school students, socioeconomic status, and geographical location, and sensitivity analyses by excluding high risk of bias RCTs. DISCUSSION This systematic review and NMA will be the first to both directly and indirectly compare and rank different school-based nutrition interventions for the primary prevention of overweight and obesity in childhood and adolescence. Our analyses will provide important insights about the effects of the different interventions and show which are the most promising. The results of our study can help inform the design of new studies and will be of value to anyone interested in developing successful, evidence-based nutrition interventions in school settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42020220451 .
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Affiliation(s)
- Edris Nury
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakub Morze
- Department of Cardiology and Internal Diseases, University of Warmia and Mazury, Olsztyn, Poland
- Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany Foundation, Cochrane Germany, Freiburg, Germany
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Claudia M. Angele
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- Centre for Teacher Education, University of Vienna, Vienna, Austria
| | - Jürgen M. Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Johanna Conrad
- Science Department, German Nutrition Society, Bonn, Germany
| | - Daniela Schmid
- Division for Quantitative Methods in Public Health and Health Services Research, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - Jörg J. Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany Foundation, Cochrane Germany, Freiburg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Vollrath P, Chawla HS, Schiessl SV, Gabur I, Lee H, Snowdon RJ, Obermeier C. A novel deletion in FLOWERING LOCUS T modulates flowering time in winter oilseed rape. Theor Appl Genet 2021; 134:1217-1231. [PMID: 33471161 PMCID: PMC7973412 DOI: 10.1007/s00122-021-03768-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/06/2021] [Indexed: 05/05/2023]
Abstract
A novel structural variant was discovered in the FLOWERING LOCUS T orthologue BnaFT.A02 by long-read sequencing. Nested association mapping in an elite winter oilseed rape population revealed that this 288 bp deletion associates with early flowering, putatively by modification of binding-sites for important flowering regulation genes. Perfect timing of flowering is crucial for optimal pollination and high seed yield. Extensive previous studies of flowering behavior in Brassica napus (canola, rapeseed) identified mutations in key flowering regulators which differentiate winter, semi-winter and spring ecotypes. However, because these are generally fixed in locally adapted genotypes, they have only limited relevance for fine adjustment of flowering time in elite cultivar gene pools. In crosses between ecotypes, the ecotype-specific major-effect mutations mask minor-effect loci of interest for breeding. Here, we investigated flowering time in a multiparental mapping population derived from seven elite winter oilseed rape cultivars which are fixed for major-effect mutations separating winter-type rapeseed from other ecotypes. Association mapping revealed eight genomic regions on chromosomes A02, C02 and C03 associating with fine modulation of flowering time. Long-read genomic resequencing of the seven parental lines identified seven structural variants coinciding with candidate genes for flowering time within chromosome regions associated with flowering time. Segregation patterns for these variants in the elite multiparental population and a diversity set of winter types using locus-specific assays revealed significant associations with flowering time for three deletions on chromosome A02. One of these was a previously undescribed 288 bp deletion within the second intron of FLOWERING LOCUS T on chromosome A02, emphasizing the advantage of long-read sequencing for detection of structural variants in this size range. Detailed analysis revealed the impact of this specific deletion on flowering-time modulation under extreme environments and varying day lengths in elite, winter-type oilseed rape.
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Affiliation(s)
- Paul Vollrath
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
| | - Harmeet S Chawla
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
| | - Sarah V Schiessl
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
| | - Iulian Gabur
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
| | - HueyTyng Lee
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
| | - Rod J Snowdon
- Department of Plant Breeding, Justus Liebig University, Giessen, Germany
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Abstract
We develop the free and open-source model Multi-tissue Splicing (MTSplice) to predict the effects of genetic variants on splicing of cassette exons in 56 human tissues. MTSplice combines MMSplice, which models constitutive regulatory sequences, with a new neural network that models tissue-specific regulatory sequences. MTSplice outperforms MMSplice on predicting tissue-specific variations associated with genetic variants in most tissues of the GTEx dataset, with largest improvements on brain tissues. Furthermore, MTSplice predicts that autism-associated de novo mutations are enriched for variants affecting splicing specifically in the brain. We foresee that MTSplice will aid interpreting variants associated with tissue-specific disorders.
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Affiliation(s)
- Jun Cheng
- Department of Informatics, Technical University of Munich, Boltzmannstraße, Garching, 85748, Germany.
| | - Muhammed Hasan Çelik
- Department of Informatics, Technical University of Munich, Boltzmannstraße, Garching, 85748, Germany
| | - Anshul Kundaje
- Department of Computer Science, Stanford University, Stanford, CA, USA
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - Julien Gagneur
- Department of Informatics, Technical University of Munich, Boltzmannstraße, Garching, 85748, Germany.
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany.
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
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Loser D, Hinojosa MG, Blum J, Schaefer J, Brüll M, Johansson Y, Suciu I, Grillberger K, Danker T, Möller C, Gardner I, Ecker GF, Bennekou SH, Forsby A, Kraushaar U, Leist M. Functional alterations by a subgroup of neonicotinoid pesticides in human dopaminergic neurons. Arch Toxicol 2021; 95:2081-2107. [PMID: 33778899 PMCID: PMC8166715 DOI: 10.1007/s00204-021-03031-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/17/2021] [Indexed: 12/16/2022]
Abstract
Neonicotinoid pesticides, originally developed to target the insect nervous system, have been reported to interact with human receptors and to activate rodent neurons. Therefore, we evaluated in how far these compounds may trigger signaling in human neurons, and thus, affect the human adult or developing nervous system. We used SH-SY5Y neuroblastoma cells as established model of nicotinic acetylcholine receptor (nAChR) signaling. In parallel, we profiled dopaminergic neurons, generated from LUHMES neuronal precursor cells, as novel system to study nAChR activation in human post-mitotic neurons. Changes of the free intracellular Ca2+ concentration ([Ca2+]i) were used as readout, and key findings were confirmed by patch clamp recordings. Nicotine triggered typical neuronal signaling responses that were blocked by antagonists, such as tubocurarine and mecamylamine. Pharmacological approaches suggested a functional expression of α7 and non-α7 nAChRs on LUHMES cells. In this novel test system, the neonicotinoids acetamiprid, imidacloprid, clothianidin and thiacloprid, but not thiamethoxam and dinotefuran, triggered [Ca2+]i signaling at 10-100 µM. Strong synergy of the active neonicotinoids (at low micromolar concentrations) with the α7 nAChR-positive allosteric modulator PNU-120596 was observed in LUHMES and SH-SY5Y cells, and specific antagonists fully inhibited such signaling. To provide a third line of evidence for neonicotinoid signaling via nAChR, we studied cross-desensitization: pretreatment of LUHMES and SH-SY5Y cells with active neonicotinoids (at 1-10 µM) blunted the signaling response of nicotine. The pesticides (at 3-30 µM) also blunted the response to the non-α7 agonist ABT 594 in LUHMES cells. These data show that human neuronal cells are functionally affected by low micromolar concentrations of several neonicotinoids. An effect of such signals on nervous system development is a toxicological concern.
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Affiliation(s)
- Dominik Loser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, 72770, Reutlingen, Germany
- NMI TT GmbH, 72770, Reutlingen, Germany
- In Vitro Toxicology and Biomedicine, Department Inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Universitaetsstr. 10, 78457, Konstanz, Germany
| | - Maria G Hinojosa
- Department of Biochemistry and Biophysics, Stockholm University, 106 91, Stockholm, Sweden
| | - Jonathan Blum
- In Vitro Toxicology and Biomedicine, Department Inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Universitaetsstr. 10, 78457, Konstanz, Germany
| | - Jasmin Schaefer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, 72770, Reutlingen, Germany
- NMI TT GmbH, 72770, Reutlingen, Germany
| | - Markus Brüll
- In Vitro Toxicology and Biomedicine, Department Inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Universitaetsstr. 10, 78457, Konstanz, Germany
| | - Ylva Johansson
- Department of Biochemistry and Biophysics, Stockholm University, 106 91, Stockholm, Sweden
| | - Ilinca Suciu
- In Vitro Toxicology and Biomedicine, Department Inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Universitaetsstr. 10, 78457, Konstanz, Germany
| | - Karin Grillberger
- Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Timm Danker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, 72770, Reutlingen, Germany
- NMI TT GmbH, 72770, Reutlingen, Germany
| | - Clemens Möller
- Life Sciences Faculty, Albstadt-Sigmaringen University, 72488, Sigmaringen, Germany
| | - Iain Gardner
- CERTARA UK Limited, Simcyp Division, Level 2-Acero, 1 Concourse Way, Sheffield, S1 2BJ, UK
| | - Gerhard F Ecker
- Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | | | - Anna Forsby
- Department of Biochemistry and Biophysics, Stockholm University, 106 91, Stockholm, Sweden
| | - Udo Kraushaar
- NMI Natural and Medical Sciences Institute at the University of Tübingen, 72770, Reutlingen, Germany
| | - Marcel Leist
- In Vitro Toxicology and Biomedicine, Department Inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Universitaetsstr. 10, 78457, Konstanz, Germany.
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19
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Schwermer M, Behnert A, Dörgeloh B, Ripperger T, Kratz CP. Effective identification of cancer predisposition syndromes in children with cancer employing a questionnaire. Fam Cancer 2021; 20:257-262. [PMID: 33651299 PMCID: PMC8484089 DOI: 10.1007/s10689-021-00233-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/05/2021] [Indexed: 11/26/2022]
Abstract
Approximately 10% of children with newly diagnosed cancer have a cancer predisposition syndrome (CPS). The optimal diagnostic approach to identify them among children diagnosed with cancer is unknown. OBJECTIVE To determine whether the use of a one-page questionnaire can improve the CPS diagnosis among children with an oncologic condition. DESIGN Comparative effectiveness research. SETTING Referral center for children with cancer. RESULTS 739 children diagnosed with an oncologic condition between 2012 and 2019. All children with a newly diagnosed oncologic condition presenting to Hannover Medical School between January 1st 2017 and December 31st 2019 were prospectively evaluated with a CPS questionnaire. Children in whom the questionnaire suggested the need of a genetic workup were further evaluated. All children diagnosed with an oncologic condition between January 1st 2012 and December 31st 2016 served as control. The CPS diagnoses established during both time periods were evaluated and compared. A CPS was diagnosed in 27 out of 287 children (9.4%) during the questionnaire period versus 24 out of 452 children (5.3%) during the control period (P = 0.032). CONCLUSION The CPS questionnaire appears to significantly improve the diagnosis of children with CPS among children with a newly diagnosed oncologic condition.
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Affiliation(s)
- Miriam Schwermer
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Astrid Behnert
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Beate Dörgeloh
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Tim Ripperger
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Christian P Kratz
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany.
- Rare Disease Program, Hannover Medical School, Hannover, Germany.
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20
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Wunsch K, Nigg CR, Weyland S, Jekauc D, Niessner C, Burchartz A, Schmidt S, Meyrose AK, Manz K, Baumgarten F, Woll A. The relationship of self-reported and device-based measures of physical activity and health-related quality of life in adolescents. Health Qual Life Outcomes 2021; 19:67. [PMID: 33648492 PMCID: PMC7923541 DOI: 10.1186/s12955-021-01682-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Physical activity (PA) has beneficial effects on health and health-related quality of life (HRQoL), which is a protective factor of illness and mortality. The purpose of this examination was to investigate if self-reported and device-based measures of PA were related to HRQoL in adolescents. METHODS Participants (N = 1565; 54.3% female; Mage = 14.37 years, SDage = 1.99) were recruited from 167 sample points across Germany. Adolescents self-reported their PA, supplemented by a 1-week examination of device-based PA using accelerometry. Additionally, they completed the multidimensional KIDSCREEN-27 to assess HRQoL. RESULTS Results showed that self-reported PA was correlated with overall HRQoL, Physical Well-Being, Psychological Well-Being, Social Support & Peers, and School Environment, whereas device-based PA was only correlated with Physical as well as Psychological Well-Being. Further, self-reported PA significantly predicted all facets of HRQoL except for Autonomy and Parent Relations, whereas device-based PA solely heightened the amount of explained variance in the Physical Well-Being subscale. CONCLUSIONS Findings demonstrate the importance of self-reported PA as it is related to almost all facets of HRQoL. Both measures of PA are not congruent in their relationship with HRQoL and thus implications have to be carefully considered. Future studies should investigate the direct effect of PA on HRQoL and health in a longitudinal approach to account for the causality of effects.
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Affiliation(s)
- Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Claudio R. Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Susanne Weyland
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Steffen Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Clinical Psychology, Helmut-Schmidt University, Hamburg, Germany
| | - Kristin Manz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Franz Baumgarten
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
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21
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Poirier MJP, Bärnighausen T, Harling G, Sié A, Grépin KA. Is the lack of smartphone data skewing wealth indices in low-income settings? Popul Health Metr 2021; 19:4. [PMID: 33526039 PMCID: PMC7852097 DOI: 10.1186/s12963-021-00246-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Smartphones have rapidly become an important marker of wealth in low- and middle-income countries, but international household surveys do not regularly gather data on smartphone ownership and these data are rarely used to calculate wealth indices. METHODS We developed a cross-sectional survey module delivered to 3028 households in rural northwest Burkina Faso to measure the effects of this absence. Wealth indices were calculated using both principal components analysis (PCA) and polychoric PCA for a base model using only ownership of any cell phone, and a full model using data on smartphone ownership, the number of cell phones, and the purchase of mobile data. Four outcomes (household expenditure, education level, and prevalence of frailty and diabetes) were used to evaluate changes in the composition of wealth index quintiles using ordinary least squares and logistic regressions and Wald tests. RESULTS Households that own smartphones have higher monthly expenditures and own a greater quantity and quality of household assets. Expenditure and education levels are significantly higher at the fifth (richest) socioeconomic status (SES) quintile of full model wealth indices as compared to base models. Similarly, diabetes prevalence is significantly higher at the fifth SES quintile using PCA wealth index full models, but this is not observed for frailty prevalence, which is more prevalent among lower SES households. These effects are not present when using polychoric PCA, suggesting that this method provides additional robustness to missing asset data to measure underlying latent SES by proxy. CONCLUSIONS The lack of smartphone data can skew PCA-based wealth index performance in a low-income context for the top of the socioeconomic spectrum. While some PCA variants may be robust to the omission of smartphone ownership, eliciting smartphone ownership data in household surveys is likely to substantially improve the validity and utility of wealth estimates.
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Affiliation(s)
- Mathieu J P Poirier
- School of Global Health, Faculty of Health, York University, 4700 Keele Street, Dahdaleh Building 5022C, Toronto, Ontario, M3J 1P3, Canada.
- Global Strategy Lab, York University, 4700 Keele Street, Dahdaleh Building 5022C, Toronto, Ontario, M3J 1P3, Canada.
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Guy Harling
- Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
- Institute for Global Health, University College London, London, UK
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Institut National de Santé Publique, Nouna, Burkina Faso
| | - Karen A Grépin
- School of Public Health, University of Hong Kong, Hong Kong, China
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22
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Gomez-Alonso MDC, Kretschmer A, Wilson R, Pfeiffer L, Karhunen V, Seppälä I, Zhang W, Mittelstraß K, Wahl S, Matias-Garcia PR, Prokisch H, Horn S, Meitinger T, Serrano-Garcia LR, Sebert S, Raitakari O, Loh M, Rathmann W, Müller-Nurasyid M, Herder C, Roden M, Hurme M, Jarvelin MR, Ala-Korpela M, Kooner JS, Peters A, Lehtimäki T, Chambers JC, Gieger C, Kettunen J, Waldenberger M. DNA methylation and lipid metabolism: an EWAS of 226 metabolic measures. Clin Epigenetics 2021; 13:7. [PMID: 33413638 PMCID: PMC7789600 DOI: 10.1186/s13148-020-00957-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The discovery of robust and trans-ethnically replicated DNA methylation markers of metabolic phenotypes, has hinted at a potential role of epigenetic mechanisms in lipid metabolism. However, DNA methylation and the lipid compositions and lipid concentrations of lipoprotein sizes have been scarcely studied. Here, we present an epigenome-wide association study (EWAS) (N = 5414 total) of mostly lipid-related metabolic measures, including a fine profiling of lipoproteins. As lipoproteins are the main players in the different stages of lipid metabolism, examination of epigenetic markers of detailed lipoprotein features might improve the diagnosis, prognosis, and treatment of metabolic disturbances. RESULTS We conducted an EWAS of leukocyte DNA methylation and 226 metabolic measurements determined by nuclear magnetic resonance spectroscopy in the population-based KORA F4 study (N = 1662) and replicated the results in the LOLIPOP, NFBC1966, and YFS cohorts (N = 3752). Follow-up analyses in the discovery cohort included investigations into gene transcripts, metabolic-measure ratios for pathway analysis, and disease endpoints. We identified 161 associations (p value < 4.7 × 10-10), covering 16 CpG sites at 11 loci and 57 metabolic measures. Identified metabolic measures were primarily medium and small lipoproteins, and fatty acids. For apolipoprotein B-containing lipoproteins, the associations mainly involved triglyceride composition and concentrations of cholesterol esters, triglycerides, free cholesterol, and phospholipids. All associations for HDL lipoproteins involved triglyceride measures only. Associated metabolic measure ratios, proxies of enzymatic activity, highlight amino acid, glucose, and lipid pathways as being potentially epigenetically implicated. Five CpG sites in four genes were associated with differential expression of transcripts in blood or adipose tissue. CpG sites in ABCG1 and PHGDH showed associations with metabolic measures, gene transcription, and metabolic measure ratios and were additionally linked to obesity or previous myocardial infarction, extending previously reported observations. CONCLUSION Our study provides evidence of a link between DNA methylation and the lipid compositions and lipid concentrations of different lipoprotein size subclasses, thus offering in-depth insights into well-known associations of DNA methylation with total serum lipids. The results support detailed profiling of lipid metabolism to improve the molecular understanding of dyslipidemia and related disease mechanisms.
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Affiliation(s)
- Monica Del C Gomez-Alonso
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Anja Kretschmer
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Rory Wilson
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Liliane Pfeiffer
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Ville Karhunen
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Center for Life Course Health Research, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Ilkka Seppälä
- Department of Clinical Chemistry, Pirkanmaa Hospital District, Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, Middlesex, UK
| | - Kirstin Mittelstraß
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Simone Wahl
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Pamela R Matias-Garcia
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University Munich, Munich, Germany
| | - Sacha Horn
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Luis R Serrano-Garcia
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
- Chair of Microbiology, Technical University of Munich, Freising, Germany
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Marie Loh
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Martina Müller-Nurasyid
- Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University, 55101, Mainz, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Mikko Hurme
- Department of Microbiology and Immunology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Center for Life Course Health Research, University of Oulu, Oulu University Hospital, Oulu, Finland
- UKMRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Mika Ala-Korpela
- Center for Life Course Health Research, University of Oulu, Oulu University Hospital, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Jaspal S Kooner
- Department of Cardiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, Middlesex, UK
- National Heart and Lung Institute, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Pirkanmaa Hospital District, Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, Middlesex, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Imperial College Healthcare NHS Trust, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Johannes Kettunen
- Center for Life Course Health Research, University of Oulu, Oulu University Hospital, Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Ingolstaedter Landstraße 1, 85764, Neuherberg, Germany.
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
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23
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Scholich A, Syga S, Morales-Navarrete H, Segovia-Miranda F, Nonaka H, Meyer K, de Back W, Brusch L, Kalaidzidis Y, Zerial M, Jülicher F, Friedrich BM. Quantification of nematic cell polarity in three-dimensional tissues. PLoS Comput Biol 2020; 16:e1008412. [PMID: 33301446 PMCID: PMC7755288 DOI: 10.1371/journal.pcbi.1008412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/22/2020] [Accepted: 10/01/2020] [Indexed: 01/12/2023] Open
Abstract
How epithelial cells coordinate their polarity to form functional tissues is an open question in cell biology. Here, we characterize a unique type of polarity found in liver tissue, nematic cell polarity, which is different from vectorial cell polarity in simple, sheet-like epithelia. We propose a conceptual and algorithmic framework to characterize complex patterns of polarity proteins on the surface of a cell in terms of a multipole expansion. To rigorously quantify previously observed tissue-level patterns of nematic cell polarity (Morales-Navarrete et al., eLife 2019), we introduce the concept of co-orientational order parameters, which generalize the known biaxial order parameters of the theory of liquid crystals. Applying these concepts to three-dimensional reconstructions of single cells from high-resolution imaging data of mouse liver tissue, we show that the axes of nematic cell polarity of hepatocytes exhibit local coordination and are aligned with the biaxially anisotropic sinusoidal network for blood transport. Our study characterizes liver tissue as a biological example of a biaxial liquid crystal. The general methodology developed here could be applied to other tissues and in-vitro organoids.
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Affiliation(s)
- André Scholich
- Max Planck Institute for the Physics of Complex Systems, Dresden, Germany
| | - Simon Syga
- Max Planck Institute for the Physics of Complex Systems, Dresden, Germany
- Centre for Information Services and High Performance Computing, TU Dresden, Dresden, Germany
| | | | | | - Hidenori Nonaka
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Kirstin Meyer
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Walter de Back
- Centre for Information Services and High Performance Computing, TU Dresden, Dresden, Germany
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz Brusch
- Centre for Information Services and High Performance Computing, TU Dresden, Dresden, Germany
| | - Yannis Kalaidzidis
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Marino Zerial
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
- Center for Advancing Electronics Dresden, TU Dresden, Germany
- Cluster of Excellence Physics of Life, TU Dresden, Germany
| | - Frank Jülicher
- Max Planck Institute for the Physics of Complex Systems, Dresden, Germany
- Center for Advancing Electronics Dresden, TU Dresden, Germany
- Cluster of Excellence Physics of Life, TU Dresden, Germany
| | - Benjamin M. Friedrich
- Center for Advancing Electronics Dresden, TU Dresden, Germany
- Cluster of Excellence Physics of Life, TU Dresden, Germany
- Institute for Theoretical Physics, TU Dresden, Germany
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24
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Nijsingh N, van Bergen A, Wild V. Applying a Precautionary Approach to Mobile Contact Tracing for COVID-19: The Value of Reversibility. J Bioeth Inq 2020; 17:823-827. [PMID: 32840831 PMCID: PMC7445727 DOI: 10.1007/s11673-020-10004-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/27/2020] [Indexed: 05/21/2023]
Abstract
The COVID-19 pandemic presents unprecedented challenges to public health decision-making. Specifically, the lack of evidence and the urgency with which a response is called for, raise the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response to the various threats we face. Here we discuss the intervention of introducing technology that aims to trace and alert contacts of infected persons-contact tracing (CT) technology. Determining whether such an intervention is proportional is complicated by complex trade-offs and feedback loops. We suggest that the resulting uncertainties necessitate a precautionary approach. On the one hand, precautionary reasons support CT technology as a means to contribute to the prevention of harms caused by alternative interventions, or COVID-19 itself. On the other hand, however, both the extent to which such technology itself present risks of serious harm, as well as its effectiveness, remain unclear. We therefore argue that a precautionary approach should put reversibility of CT technology at the forefront. We outline several practical implications.
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Affiliation(s)
- Niels Nijsingh
- Institute for Ethics, History and Theory of Medicine, Ludwig Maximilians Universität, Lessingstrasse 2, 80336, München, Germany.
| | - Anne van Bergen
- Institute for Ethics, History and Theory of Medicine, Ludwig Maximilians Universität, Lessingstrasse 2, 80336, München, Germany
| | - Verina Wild
- Institute for Ethics, History and Theory of Medicine, Ludwig Maximilians Universität, Lessingstrasse 2, 80336, München, Germany
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25
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Baumann K, Shaheen SM, Hu Y, Gros P, Heilmann E, Morshedizad M, Wang J, Wang SL, Rinklebe J, Leinweber P. Speciation and sorption of phosphorus in agricultural soil profiles of redoximorphic character. Environ Geochem Health 2020; 42:3231-3246. [PMID: 32323172 PMCID: PMC7518995 DOI: 10.1007/s10653-020-00561-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/04/2020] [Indexed: 06/11/2023]
Abstract
Controlled drainage is considered as a soil management tool to improve water supply to crops and reduce nutrient losses from fields; however, its closure may affect phosphorus (P) mobilization in soil. To assess the P mobilization potential, three soil profiles with redoximorphic features were selected along a slight hill in Northern Germany. Soil samples from three depths of each profile were characterized for basic properties, total element content, oxalate- and dithionite-extractable pedogenic Al, Fe and Mn (hydr)oxides, P pools (sequential extraction), P species [P K-edge X-ray absorption near-edge structure (XANES) spectroscopy] and P sorption behavior. In topsoil (~ 10 cm depth), labile P (H2O-P + resin-P + NaHCO3-P) accounted for 26-32% of total P (Pt). Phosphorus K-edge XANES revealed that up to 49% of Pt was bound to Al and/or Fe (hydr)oxides, but sequential fractionation indicated that > 30% of this P was occluded within sesquioxide aggregates. A low binding capacity for P was demonstrated by P sorption capacity and low Kf coefficients (20-33 [Formula: see text]) of the Freundlich equation. In the subsoil layers (~ 30 and ~ 65 cm depth), higher proportions of Al- and Fe-bound P along with other characteristics suggested that all profiles might be prone to P mobilization/leaching risk under reducing conditions even if the degree of P saturation (DPS) of a profile under oxic conditions was < 25%. The results suggest that a closure of the controlled drainage may pose a risk of increased P mobilization, but this needs to be compared with the risk of uncontrolled drainage and P losses to avoid P leaching into the aquatic ecosystem.
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Affiliation(s)
- Karen Baumann
- Soil Sciences, Faculty for Agriculture and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6, 18051, Rostock, Germany.
| | - Sabry M Shaheen
- Laboratory of Soil- and Groundwater-Management, School of Architecture and Civil Engineering, Institute of Foundation Engineering, Water- and Waste-Management, University of Wuppertal, Pauluskirchstraße 7, 42285, Wuppertal, Germany
- Department of Soil and Water Sciences, Faculty of Agriculture, University of Kafrelsheikh, Kafr El-Sheikh, 33516, Egypt
| | - Yongfeng Hu
- Canadian Light Source, University of Saskatchewan, Saskatoon, SK, S7N 2V3, Canada
| | - Peter Gros
- Soil Sciences, Faculty for Agriculture and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6, 18051, Rostock, Germany
| | - Elena Heilmann
- Soil Sciences, Faculty for Agriculture and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6, 18051, Rostock, Germany
| | - Mohsen Morshedizad
- Soil Sciences, Faculty for Agriculture and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6, 18051, Rostock, Germany
| | - Jianxu Wang
- Laboratory of Soil- and Groundwater-Management, School of Architecture and Civil Engineering, Institute of Foundation Engineering, Water- and Waste-Management, University of Wuppertal, Pauluskirchstraße 7, 42285, Wuppertal, Germany
- State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang, 550082, People's Republic of China
| | - Shan-Li Wang
- Department of Agricultural Chemistry, National Taiwan University, 1 Sect. 4, Roosevelt Rd., Taipei, 10617, Taiwan
| | - Jörg Rinklebe
- Laboratory of Soil- and Groundwater-Management, School of Architecture and Civil Engineering, Institute of Foundation Engineering, Water- and Waste-Management, University of Wuppertal, Pauluskirchstraße 7, 42285, Wuppertal, Germany
- Department of Environment, Energy and Geoinformatics, University of Sejong, 98 Gunja-Dong, Guangjin-Gu, Seoul, Republic of Korea
| | - Peter Leinweber
- Soil Sciences, Faculty for Agriculture and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6, 18051, Rostock, Germany
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26
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Abstract
This paper argues that data-driven medicine gives rise to a particular normative challenge. Against the backdrop of a distinction between the good and the right, harnessing personal health data towards the development and refinement of data-driven medicine is to be welcomed from the perspective of the good. Enacting solidarity drives progress in research and clinical practice. At the same time, such acts of sharing could-especially considering current developments in big data and artificial intelligence-compromise the right by leading to injustices and affecting concrete modes of individual self-determination. In order to address this potential tension, two key elements for ethical reflection on data-driven medicine are proposed: the controllability of information flows, including technical infrastructures that are conducive towards controllability, and a paradigm shift towards output-orientation in governance and policy.
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Affiliation(s)
- Patrik Hummel
- Department of Theology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Kochstraße 6, 91054 Erlangen, Germany
| | - Matthias Braun
- Department of Theology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Kochstraße 6, 91054 Erlangen, Germany
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27
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Rezaei H, Aertsen A, Kumar A, Valizadeh A. Facilitating the propagation of spiking activity in feedforward networks by including feedback. PLoS Comput Biol 2020; 16:e1008033. [PMID: 32776924 PMCID: PMC7444537 DOI: 10.1371/journal.pcbi.1008033] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/20/2020] [Accepted: 06/08/2020] [Indexed: 01/01/2023] Open
Abstract
Transient oscillations in network activity upon sensory stimulation have been reported in different sensory areas of the brain. These evoked oscillations are the generic response of networks of excitatory and inhibitory neurons (EI-networks) to a transient external input. Recently, it has been shown that this resonance property of EI-networks can be exploited for communication in modular neuronal networks by enabling the transmission of sequences of synchronous spike volleys (’pulse packets’), despite the sparse and weak connectivity between the modules. The condition for successful transmission is that the pulse packet (PP) intervals match the period of the modules’ resonance frequency. Hence, the mechanism was termed communication through resonance (CTR). This mechanism has three severe constraints, though. First, it needs periodic trains of PPs, whereas single PPs fail to propagate. Second, the inter-PP interval needs to match the network resonance. Third, transmission is very slow, because in each module, the network resonance needs to build up over multiple oscillation cycles. Here, we show that, by adding appropriate feedback connections to the network, the CTR mechanism can be improved and the aforementioned constraints relaxed. Specifically, we show that adding feedback connections between two upstream modules, called the resonance pair, in an otherwise feedforward modular network can support successful propagation of a single PP throughout the entire network. The key condition for successful transmission is that the sum of the forward and backward delays in the resonance pair matches the resonance frequency of the network modules. The transmission is much faster, by more than a factor of two, than in the original CTR mechanism. Moreover, it distinctly lowers the threshold for successful communication by synchronous spiking in modular networks of weakly coupled networks. Thus, our results suggest a new functional role of bidirectional connectivity for the communication in cortical area networks. The cortex is organized as a modular system, with the modules (cortical areas) communicating via weak long-range connections. It has been suggested that the intrinsic resonance properties of population activities in these areas might contribute to enabling successful communication. A module’s intrinsic resonance appears in the damped oscillatory response to an incoming spike volley, enabling successful communication during the peaks of the oscillation. Such communication can be exploited in feedforward networks, provided the participating networks have similar resonance frequencies. This, however, is not necessarily true for cortical networks. Moreover, the communication is slow, as it takes several oscillation cycles to build up the response in the downstream network. Also, only periodic trains of spikes volleys (and not single volleys) with matching intervals can propagate. Here, we present a novel mechanism that alleviates these shortcomings and enables propagation of synchronous spiking across weakly connected networks with not necessarily identical resonance frequencies. In this framework, an individual spike volley can propagate by local amplification through reverberation in a loop between two successive networks, connected by feedforward and feedback connections: the resonance pair. This overcomes the need for activity build-up in downstream networks, causing the volley to propagate distinctly faster and more reliably.
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Affiliation(s)
- Hedyeh Rezaei
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
| | - Ad Aertsen
- Faculty of Biology, and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Arvind Kumar
- Faculty of Biology, and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
- Dept. of Computational Science and Technology, School of Computer Science and Communication, KTH Royal Institute of Technology, Stockholm, Sweden
- * E-mail: (AK); (AV)
| | - Alireza Valizadeh
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Niavaran, Tehran, Iran
- * E-mail: (AK); (AV)
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Rázquin-Olazarán I, Shahrour H, Martínez-de-Tejada G. A synthetic peptide sensitizes multi-drug resistant Pseudomonas aeruginosa to antibiotics for more than two hours and permeabilizes its envelope for twenty hours. J Biomed Sci 2020; 27:85. [PMID: 32762680 PMCID: PMC7412836 DOI: 10.1186/s12929-020-00678-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/30/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Pseudomonas aeruginosa is a Gram-negative pathogen that frequently causes life-threatening infections in immunocompromised patients. We previously showed that subinhibitory concentrations of short synthetic peptides permeabilize P. aeruginosa and enhance the lethal action of co-administered antibiotics. METHODS Long-term permeabilization caused by exposure of multidrug-resistant P. aeruginosa strains to peptide P4-9 was investigated by measuring the uptake of several antibiotics and fluorescent probes and by using confocal imaging and atomic force microscopy. RESULTS We demonstrated that P4-9, a 13-amino acid peptide, induces a growth delay (i.e. post-antibiotic effect) of 1.3 h on a multidrug-resistant P. aeruginosa clinical isolate. Remarkably, when an independently P4-9-treated culture was allowed to grow in the absence of the peptide, cells remained sensitive to subinhibitory concentrations of antibiotics such as ceftazidime, fosfomycin and erythromycin for at least 2 h. We designated this persistent sensitization to antibiotics occurring in the absence of the sensitizing agent as Post-Antibiotic Effect associated Permeabilization (PAEP). Using atomic force microscopy, we showed that exposure to P4-9 induces profound alterations on the bacterial surface and that treated cells need at least 2 h of growth to repair those lesions. During PAEP, P. aeruginosa mutants overexpressing either the efflux pump MexAB-OprM system or the AmpC β-lactamase were rendered sensitive to antibiotics that are known substrates of those mechanisms of resistance. Finally, we showed for the first time that the descendants of bacteria surviving exposure to a membrane disturbing peptide retain a significant level of permeability to hydrophobic compounds, including propidium iodide, even after 20 h of growth in the absence of the peptide. CONCLUSIONS The phenomenon of long-term sensitization to antibiotics shown here may have important therapeutic implications for a combined peptide-antibiotic treatment because the peptide would not need to be present to exert its antibiotic enhancing activity as long as the target organism retains sensitization to the antibiotic.
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Affiliation(s)
- Iosu Rázquin-Olazarán
- Department of Microbiology and Parasitology, University of Navarra, E-31008, Pamplona, Spain
| | - Hawraa Shahrour
- Department of Microbiology and Parasitology, University of Navarra, E-31008, Pamplona, Spain
- Laboratory of Microbiology, Department of Life & Earth Sciences, Faculty of Sciences I, Lebanese University, Hadat campus, Beirut, Lebanon
| | - Guillermo Martínez-de-Tejada
- Department of Microbiology and Parasitology, University of Navarra, E-31008, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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Nau LH, Obiegala A, Król N, Mayer-Scholl A, Pfeffer M. Survival time of Leptospira kirschneri serovar Grippotyphosa under different environmental conditions. PLoS One 2020; 15:e0236007. [PMID: 32668449 PMCID: PMC7363454 DOI: 10.1371/journal.pone.0236007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/26/2020] [Indexed: 11/28/2022] Open
Abstract
Leptospirosis is a re-emerging zoonotic disease of high medical importance that affects humans worldwide. Humans or animals acquire an infection with pathogenic leptospires either by direct contact with infected animals or by indirect contact to contaminated environment. Survival of Leptospira spp. in the environment after having been shed via animal urine is thus a key factor to estimate the risk of infection, but not much is known about the tenacity of pathogenic leptospires. Here, the survival time of both a laboratory strain and a field strain of L. kirschneri serovar Grippotyphosa in animal urine and their tenacity while drying was investigated and compared at different temperatures (15°C-37°C). Leptospira spp. are also often found in rivers and ponds. As the infection risk for humans and animals also depends on the spreading and survival of Leptospira spp. in these environments, the survival of L. kirschneri serovar Grippotyphosa was investigated using a 50-meter-long hose system simulating a water stream. Both strains did not survive in undiluted cattle or dog urine. Comparing different temperatures and dilution media, the laboratory strain survived the longest in diluted cattle urine with a slightly alkaline pH value (3 days), whilst the field strain survived in diluted dog urine with a slightly acid pH value up to a maximum of 24 h. Both strains did not survive drying on a solid surface. In a water stream, leptospires were able to move faster or slower than the average velocity of the water due to their intrinsic mobility but were not able to survive the mechanical damage caused by running water in the hose system. From our results we conclude, that once excreted via animal urine, the leptospires immediately need moisture or a water body to survive and stay infectious.
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Affiliation(s)
- L. H. Nau
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - A. Obiegala
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - N. Król
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - A. Mayer-Scholl
- Department Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - M. Pfeffer
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
- * E-mail:
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30
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Kappelmann N, Rein M, Fietz J, Mayberg HS, Craighead WE, Dunlop BW, Nemeroff CB, Keller M, Klein DN, Arnow BA, Husain N, Jarrett RB, Vittengl JR, Menchetti M, Parker G, Barber JP, Bastos AG, Dekker J, Peen J, Keck ME, Kopf-Beck J. Psychotherapy or medication for depression? Using individual symptom meta-analyses to derive a Symptom-Oriented Therapy (SOrT) metric for a personalised psychiatry. BMC Med 2020; 18:170. [PMID: 32498707 PMCID: PMC7273646 DOI: 10.1186/s12916-020-01623-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Antidepressant medication (ADM) and psychotherapy are effective treatments for major depressive disorder (MDD). It is unclear, however, if treatments differ in their effectiveness at the symptom level and whether symptom information can be utilised to inform treatment allocation. The present study synthesises comparative effectiveness information from randomised controlled trials (RCTs) of ADM versus psychotherapy for MDD at the symptom level and develops and tests the Symptom-Oriented Therapy (SOrT) metric for precision treatment allocation. METHODS First, we conducted systematic review and meta-analyses of RCTs comparing ADM and psychotherapy at the individual symptom level. We searched PubMed Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials databases, a database specific for psychotherapy RCTs, and looked for unpublished RCTs. Random-effects meta-analyses were applied on sum-scores and for individual symptoms for the Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) measures. Second, we computed the SOrT metric, which combines meta-analytic effect sizes with patients' symptom profiles. The SOrT metric was evaluated using data from the Munich Antidepressant Response Signature (MARS) study (n = 407) and the Emory Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study (n = 234). RESULTS The systematic review identified 38 RCTs for qualitative inclusion, 27 and 19 for quantitative inclusion at the sum-score level, and 9 and 4 for quantitative inclusion on individual symptom level for the HAM-D and BDI, respectively. Neither meta-analytic strategy revealed significant differences in the effectiveness of ADM and psychotherapy across the two depression measures. The SOrT metric did not show meaningful associations with other clinical variables in the MARS sample, and there was no indication of utility of the metric for better treatment allocation from PReDICT data. CONCLUSIONS This registered report showed no differences of ADM and psychotherapy for the treatment of MDD at sum-score and symptom levels. Symptom-based metrics such as the proposed SOrT metric do not inform allocation to these treatments, but predictive value of symptom information requires further testing for other treatment comparisons.
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Affiliation(s)
- Nils Kappelmann
- Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany.
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
| | - Martin Rein
- Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Julia Fietz
- Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Helen S Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Charles B Nemeroff
- Institute for Early Life Adversity Research, University of Texas Dell Medical School in Austin, Austin, TX, USA
| | - Martin Keller
- Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Bruce A Arnow
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94304, USA
| | - Nusrat Husain
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Robin B Jarrett
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jacques P Barber
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, New York, USA
| | - Andre G Bastos
- Contemporary Institute of Psychoanalysis and Transdisciplinarity of Porto Alegre, Porto Alegre, Brazil
| | - Jack Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Jaap Peen
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Martin E Keck
- Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Johannes Kopf-Beck
- Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
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31
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Kleineidam L, Chouraki V, Próchnicki T, van der Lee SJ, Madrid-Márquez L, Wagner-Thelen H, Karaca I, Weinhold L, Wolfsgruber S, Boland A, Martino Adami PV, Lewczuk P, Popp J, Brosseron F, Jansen IE, Hulsman M, Kornhuber J, Peters O, Berr C, Heun R, Frölich L, Tzourio C, Dartigues JF, Hüll M, Espinosa A, Hernández I, de Rojas I, Orellana A, Valero S, Stringa N, van Schoor NM, Huisman M, Scheltens P, Rüther E, Deleuze JF, Wiltfang J, Tarraga L, Schmid M, Scherer M, Riedel-Heller S, Heneka MT, Amouyel P, Jessen F, Boada M, Maier W, Schneider A, González-Pérez A, van der Flier WM, Wagner M, Lambert JC, Holstege H, Sáez ME, Latz E, Ruiz A, Ramirez A. PLCG2 protective variant p.P522R modulates tau pathology and disease progression in patients with mild cognitive impairment. Acta Neuropathol 2020; 139:1025-1044. [PMID: 32166339 PMCID: PMC7244617 DOI: 10.1007/s00401-020-02138-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023]
Abstract
A rare coding variant (rs72824905, p.P522R) conferring protection against Alzheimer’s disease (AD) was identified in the gene encoding the enzyme phospholipase-C-γ2 (PLCG2) that is highly expressed in microglia. To explore the protective nature of this variant, we employed latent process linear mixed models to examine the association of p.P522R with longitudinal cognitive decline in 3595 MCI patients, and in 10,097 individuals from population-based studies. Furthermore, association with CSF levels of pTau181, total tau, and Aβ1-42 was assessed in 1261 MCI patients. We found that MCI patients who carried the p.P522R variant showed a slower rate of cognitive decline compared to non-carriers and that this effect was mediated by lower pTau181 levels in CSF. The effect size of the association of p.P522R with the cognitive decline and pTau181 was similar to that of APOE-ε4, the strongest genetic risk factor for AD. Interestingly, the protective effect of p.P522R was more pronounced in MCI patients with low Aβ1-42 levels suggesting a role of PLCG2 in the response to amyloid pathology. In line with this hypothesis, we observed no protective effect of the PLCG2 variant on the cognitive decline in population-based studies probably due to the lower prevalence of amyloid positivity in these samples compared to MCI patients. Concerning the potential biological underpinnings, we identified a network of co-expressed proteins connecting PLCG2 to APOE and TREM2 using unsupervised co-regulatory network analysis. The network was highly enriched for the complement cascade and genes differentially expressed in disease-associated microglia. Our data show that p.P522R in PLCG2 reduces AD disease progression by mitigating tau pathology in the presence of amyloid pathology and, as a consequence, maintains cognitive function. Targeting the enzyme PLCG2 might provide a new therapeutic approach for treating AD.
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Affiliation(s)
- Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Vincent Chouraki
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
- Epidemiology and Public Health Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Tomasz Próchnicki
- Institute of Innate Immunity, University Hospitals Bonn, Bonn, Germany
| | - Sven J van der Lee
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Holger Wagner-Thelen
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Ilker Karaca
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Leonie Weinhold
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Évry, France
| | - Pamela V Martino Adami
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland
- Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Julius Popp
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
- Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Frederic Brosseron
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Iris E Jansen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marc Hulsman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Claudine Berr
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53127, Bonn, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Christophe Tzourio
- Inserm, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, Bordeaux, France
| | - Jean-François Dartigues
- Inserm, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, Bordeaux, France
| | - Michael Hüll
- Department of Psychiatry and Psychotherapy, Center for Psychiatry, Clinic for Geriatric Psychiatry and Psychotherapy Emmendingen, University of Freiburg, Freiburg, Germany
| | - Ana Espinosa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar de Rojas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Adelina Orellana
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
| | - Sergi Valero
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Najada Stringa
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Jean-Francois Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Évry, France
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Lluis Tarraga
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Matthias Schmid
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Merce Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jean-Charles Lambert
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Henne Holstege
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mª Eugenia Sáez
- Andalusian Bioinformatics Research Centre (CAEBi), Seville, Spain
| | - Eicke Latz
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute of Innate Immunity, University Hospitals Bonn, Bonn, Germany
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Centre for Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology, Trondheim, Norway
| | - Agustin Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.
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Broger T, Nicol MP, Székely R, Bjerrum S, Sossen B, Schutz C, Opintan JA, Johansen IS, Mitarai S, Chikamatsu K, Kerkhoff AD, Macé A, Ongarello S, Meintjes G, Denkinger CM, Schumacher SG. Diagnostic accuracy of a novel tuberculosis point-of-care urine lipoarabinomannan assay for people living with HIV: A meta-analysis of individual in- and outpatient data. PLoS Med 2020; 17:e1003113. [PMID: 32357197 PMCID: PMC7194366 DOI: 10.1371/journal.pmed.1003113] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 04/09/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) is the most common cause of death in people living with HIV (PLHIV), yet TB often goes undiagnosed since many patients are not able to produce a sputum specimen, and traditional diagnostics are costly or unavailable. A novel, rapid lateral flow assay, Fujifilm SILVAMP TB LAM (SILVAMP-LAM), detects the presence of TB lipoarabinomannan (LAM) in urine, and is substantially more sensitive for diagnosing TB in PLHIV than an earlier LAM assay (Alere Determine TB LAM lateral flow assay [LF-LAM]). Here, we present an individual participant data meta-analysis of the diagnostic accuracy of SILVAMP-LAM in adult PLHIV, including both published and unpublished data. METHODS AND FINDINGS Adult PLHIV (≥18 years) were assessed in 5 prospective cohort studies in South Africa (3 cohorts), Vietnam, and Ghana, carried out during 2012 to 2017. Of the 1,595 PLHIV who met eligibility criteria, the majority (61%) were inpatients, median age was 37 years (IQR 30-43), 43% had a CD4 count ≤ 100 cells/μl, and 35% were receiving antiretroviral therapy. Most participants (94%) had a positive WHO symptom screen for TB on enrollment, and 45% were diagnosed with microbiologically confirmed TB, using mycobacterial culture or Xpert MTB/RIF testing of sputum, urine, or blood. Previously published data from inpatients were combined with unpublished data from outpatients. Biobanked urine samples were tested, using blinded double reading, with SILVAMP-LAM and LF-LAM. Applying a microbiological reference standard for assessment of sensitivity, the overall sensitivity for TB detection was 70.7% (95% CI 59.0%-80.8%) for SILVAMP-LAM compared to 34.9% (95% CI 19.5%-50.9%) for LF-LAM. Using a composite reference standard (which included patients with both microbiologically confirmed as well as clinically diagnosed TB), SILVAMP-LAM sensitivity was 65.8% (95% CI 55.9%-74.6%), and that of LF-LAM 31.4% (95% CI 19.1%-43.7%). In patients with CD4 count ≤ 100 cells/μl, SILVAMP-LAM sensitivity was 87.1% (95% CI 79.3%-93.6%), compared to 56.0% (95% CI 43.9%-64.9%) for LF-LAM. In patients with CD4 count 101-200 cells/μl, SILVAMP-LAM sensitivity was 62.7% (95% CI 52.4%-71.9%), compared to 25.3% (95% CI 15.8%-34.9%) for LF-LAM. In those with CD4 count > 200 cells/μl, SILVAMP-LAM sensitivity was 43.9% (95% CI 34.3%-53.9%), compared to 10.9% (95% CI 5.2%-18.4%) for LF-LAM. Using a microbiological reference standard, the specificity of SILVAMP-LAM was 90.9% (95% CI 87.2%-93.7%), and that of LF-LAM 95.3% (95% CI 92.2%-97.7%). Limitations of this study include the use of biobanked, rather than fresh urine samples, and testing by skilled laboratory technicians in research laboratories, rather than at the point of care. CONCLUSIONS In this study, we found that SILVAMP-LAM identified a substantially higher proportion of TB patients in PLHIV than LF-LAM. The sensitivity of SILVAMP-LAM was highest in patients with CD4 count ≤ 100 cells/μl. Further work is needed to demonstrate accuracy when implemented as a point-of-care test.
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Affiliation(s)
| | - Mark P. Nicol
- Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Cape Town, South Africa
| | | | - Stephanie Bjerrum
- Mycobacterial Research Centre of Southern Denmark, Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Unit of Infectious Diseases, University of Southern Denmark, Odense, Denmark
| | - Bianca Sossen
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Center for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Charlotte Schutz
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Center for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Japheth A. Opintan
- Department of Medical Microbiology, School of Biomedical and Allied Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isik S. Johansen
- Mycobacterial Research Centre of Southern Denmark, Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Unit of Infectious Diseases, University of Southern Denmark, Odense, Denmark
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kinuyo Chikamatsu
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Andrew D. Kerkhoff
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, University of California, San Francisco, California, United States of America
| | | | | | - Graeme Meintjes
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Center for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Claudia M. Denkinger
- FIND, Geneva, Switzerland
- Division of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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Schulte B, O’Donnell A, Lahusen H, Lindemann C, Prilutskaya M, Yussopov O, Kaliyeva Z, Martens MS, Verthein U. Feasibility of alcohol screening and brief intervention in primary health care in Kazakhstan: study protocol of a pilot cluster randomised trial. Pilot Feasibility Stud 2020; 6:3. [PMID: 31938551 PMCID: PMC6953225 DOI: 10.1186/s40814-019-0547-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 12/20/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Identifying and addressing heavy drinking represents a major public health priority worldwide. Whilst the majority of alcohol screening and brief intervention (ASBI) research has been conducted in western, high-income countries, evidence is growing that ASBI can also impact positively on heavy drinkers in low- and middle-income country populations. This mixed methods study aims to assess the feasibility of conducting a fully randomised controlled trial of the effectiveness of ASBI in primary care in Kazakhstan and explore the feasibility and acceptability of implementing ASBI in this setting from patients' and physicians' perspectives. METHODS Six primary health care units in the region of Pavlodar will be cluster randomised to either an intervention (WHO manualised 5 min alcohol brief intervention plus alcohol leaflet) or control group (simple feedback plus alcohol leaflet). Primary feasibility measures will be rates of participation at baseline and retention of eligible patients at the 3-month follow-up point. Patient/physician questionnaires and physician focus groups will assess additional dimensions of feasibility, as well as acceptability, according to the RE-AIM framework: Reach (rates of eligible patients screened/received advice); Effectiveness (change in AUDIT-C score); Adoption (rate/representativeness of participating physicians); Implementation (quality of ASBI/barriers and facilitators to delivery); and Maintenance (potential sustainability of intervention). DISCUSSION This is the first trial of the feasibility and acceptability of ASBI in Kazakhstan. As the planning and assessment of implementation determinants is based on the RE-AIM framework, the project outcomes will be relevant for the future development, tailoring and implementation of ASBI in Kazakhstan. TRIAL REGISTRATION DRKS, DRKS00015882, Registered 17 December 2018.
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Affiliation(s)
- Bernd Schulte
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Amy O’Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Harald Lahusen
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Christina Lindemann
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | | | - Oleg Yussopov
- Monitoring Center on Alcohol and Drugs, Pavlodar, Kazakhstan
| | - Zhanar Kaliyeva
- Sanjar Dzhafarovich Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Marcus-Sebastian Martens
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Uwe Verthein
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Gouttefangeas C, Schuhmacher J, Dimitrov S. Adhering to adhesion: assessing integrin conformation to monitor T cells. Cancer Immunol Immunother 2019; 68:1855-1863. [PMID: 31309255 PMCID: PMC11028104 DOI: 10.1007/s00262-019-02365-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/02/2019] [Indexed: 11/27/2022]
Abstract
Monitoring T cells is of major importance for the development of immunotherapies. Recent sophisticated assays can address particular aspects of the anti-tumor T-cell repertoire or support very large-scale immune screening for biomarker discovery. Robust methods for the routine assessment of the quantity and quality of antigen-specific T cells remain, however, essential. This review discusses selected methods that are commonly used for T-cell monitoring and summarizes the advantages and limitations of these assays. We also present a new functional assay, which specifically detects activated β2 integrins within a very short time following CD8+ T-cell stimulation. Because of its unique and favorable characteristics, this assay could be useful for implementation into our T-cell monitoring toolbox.
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Affiliation(s)
- Cécile Gouttefangeas
- Department of Immunology, Interfaculty Institute for Cell Biology, Eberhard Karls University, Auf der Morgenstelle 15, 72076, Tübingen, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany.
| | - Juliane Schuhmacher
- Department of Immunology, Interfaculty Institute for Cell Biology, Eberhard Karls University, Auf der Morgenstelle 15, 72076, Tübingen, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Stoyan Dimitrov
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University, Otfried-Müller Straße 25, 72076, Tübingen, Germany.
- German Center for Diabetes Research, 72076, Tübingen, Germany.
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tübingen (IDM), Otfried-Müller Straße 10, 72076, Tübingen, Germany.
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Jäckle S, Eixmann T, Schulz-Hildebrandt H, Hüttmann G, Pätz T. Fiber optical shape sensing of flexible instruments for endovascular navigation. Int J Comput Assist Radiol Surg 2019; 14:2137-2145. [PMID: 31493113 PMCID: PMC6858473 DOI: 10.1007/s11548-019-02059-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/21/2019] [Indexed: 11/27/2022]
Abstract
Purpose Endovascular aortic repair procedures are currently conducted with 2D fluoroscopy imaging. Tracking systems based on fiber Bragg gratings are an emerging technology for the navigation of minimally invasive instruments which can reduce the X-ray exposure and the used contrast agent. Shape sensing of flexible structures is challenging and includes many calculations steps which are prone to different errors. To reduce this errors, we present an optimized shape sensing model. Methods We analyzed for every step of the shape sensing process, which errors can occur, how the error affects the shape and how it can be compensated or minimized. Experiments were done with one multicore fiber system with 38 cm sensing length, and the effects of different methods and parameters were analyzed. Furthermore, we compared 3D shape reconstructions with the segmented shape of the corresponding CT scans of the fiber to evaluate the accuracy of our optimized shape sensing model. Finally, we tested our model in a realistic endovascular scenario by using a 3D printed vessel system created from patient data. Results Depending on the complexity of the shape, we reached an average error of 0.35–1.15 mm and maximal error of 0.75–7.53 mm over the whole 38 cm sensing length. In the endovascular scenario, we obtained an average and maximal error of 1.13 mm and 2.11 mm, respectively. Conclusion The accuracies of the 3D shape sensing model are promising, and we plan to combine the shape sensing based on fiber Bragg gratings with the position and orientation of an electromagnetic tracking to obtain the located catheter shape. Electronic supplementary material The online version of this article (10.1007/s11548-019-02059-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sonja Jäckle
- Fraunhofer MEVIS, Institute for Digital Medicine, Lübeck, Maria-Goeppert-Straße 3, 23562, Lübeck, Germany.
| | - Tim Eixmann
- Medical Laser Center Lübeck GmbH, Peter-Monnik-Weg 4, 23562, Lübeck, Germany
| | - Hinnerk Schulz-Hildebrandt
- Medical Laser Center Lübeck GmbH, Peter-Monnik-Weg 4, 23562, Lübeck, Germany
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, 23562, Lübeck, Germany
- German Center for Lung Research, DZL, Airways Research Center North, 22927, Großhansdorf, Germany
| | - Gereon Hüttmann
- Medical Laser Center Lübeck GmbH, Peter-Monnik-Weg 4, 23562, Lübeck, Germany
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, 23562, Lübeck, Germany
- German Center for Lung Research, DZL, Airways Research Center North, 22927, Großhansdorf, Germany
| | - Torben Pätz
- Fraunhofer MEVIS, Institute for Digital Medicine, Bremen, Am Fallturm 1, 28359, Bremen, Germany
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Trautmann S, Dathe A, Csáki A, Thiele M, Müller R, Fritzsche W, Stranik O. Time-Resolved Study of Site-Specific Corrosion in a Single Crystalline Silver Nanoparticle. Nanoscale Res Lett 2019; 14:240. [PMID: 31317355 PMCID: PMC6637113 DOI: 10.1186/s11671-019-3077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/07/2019] [Indexed: 06/10/2023]
Abstract
We followed over 24 h a corrosion process in monocrystalline triangular-shaped nanoparticles at a single-particle level by atomic force microscopy and optical spectroscopy techniques under ambient laboratory conditions. The triangular-shaped form of the particles was selected, because the crystallographic orientation of the particles is well defined upon their deposition on a substrate. We observed that the particles already start to alter within this time frame. Surprisingly, the corrosion starts predominantly from the tips of the particles and it creates within few hours large protrusions, which strongly suppress the plasmon character of the particles. These observations support the crystallographic model of these particles consisting of a high-defect hexagonal closed packed layer, and they could help material scientists to design more stable silver nanoparticles. Moreover, this described technique can be used to reveal kinetics of the corrosion in the nanoscale of other materials.
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Affiliation(s)
- Steffen Trautmann
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - André Dathe
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Andrea Csáki
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Matthias Thiele
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Robert Müller
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Wolfgang Fritzsche
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Ondrej Stranik
- Leibniz Institute of Photonic Technology (IPHT) Jena, Member of the Leibniz Research Alliance - Leibniz Health Technologies, Albert-Einstein-Straße 9, 07745 Jena, Germany
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Kolte A, König R. Temporal progression of gene regulation of peripheral white blood cells explains gender dimorphism of critically ill patients after trauma. Mol Med 2019; 25:19. [PMID: 31096912 PMCID: PMC6521436 DOI: 10.1186/s10020-019-0087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The immune response of the critically ill after severe trauma is sex-specific and may explain the different progression of the disease. This may be explained by a different gene regulatory program of their peripheral immune cells. We investigated the progression of the transcription profiles of peripheral immune cells of the patients to elucidate their distinct physiological response and clinical course. METHODS We compared transcription profiles of whole blood of male and female patients from a larger longitudinal study of critically ill patients after trauma. We developed a statistical analysis pipeline that synchronized the time lapse of the profiles based on the temporal severity score of each patient. RESULTS This enabled to categorize the temporal progression of the disease into two pre-acute, an acute and two post-acute phases. Comparing gene regulation of male and female patients at each phase, we identified distinctively regulated molecular processes mainly in the immune response, but also in the regulation of metabolism allowing to cluster these discriminative gene sets into sets of highly related cellular processes. Compared to male patients and healthy controls, female patients showed upregulation of gene sets of innate immunity in the early phase, upregulation of wound healing processes during the acute phase and upregulation of adaptive immunity in the late phase indicating early recovery. In turn, during the pre-acute and acute phase, male patients showed less suppression of gene sets coding for enzymes of energy metabolism and anabolism, most prominently the tricarboxylic acid cycle and β-oxidation, and cellular maintenance, such as cell cycle, DNA replication and damage response, and RNA metabolism. CONCLUSIONS A stronger innate immune response at the very early phase of the disease may support early clearance of the pathogen and its associated molecular patterns. Upregulation of wound healing processes may explain reduced multiple organ failure during the acute phase. Down regulated energy metabolism during the acute phase may make female patients less susceptible to oxidative stress, the upregulated adaptive immune system reflects an earlier recovery and rebuilding of the adaptive immune system that may protect them from secondary infections. Follow up studies need to be performed confirming these observations experimentally.
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Affiliation(s)
- Amol Kolte
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
- Network Modeling, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute Jena, Beutenbergstrasse 11a, 07745 Jena, Germany
| | - Rainer König
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
- Network Modeling, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute Jena, Beutenbergstrasse 11a, 07745 Jena, Germany
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Loeffler-Wirth H, Kreuz M, Hopp L, Arakelyan A, Haake A, Cogliatti SB, Feller AC, Hansmann ML, Lenze D, Möller P, Müller-Hermelink HK, Fortenbacher E, Willscher E, Ott G, Rosenwald A, Pott C, Schwaenen C, Trautmann H, Wessendorf S, Stein H, Szczepanowski M, Trümper L, Hummel M, Klapper W, Siebert R, Loeffler M, Binder H. A modular transcriptome map of mature B cell lymphomas. Genome Med 2019; 11:27. [PMID: 31039827 PMCID: PMC6492344 DOI: 10.1186/s13073-019-0637-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/04/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Germinal center-derived B cell lymphomas are tumors of the lymphoid tissues representing one of the most heterogeneous malignancies. Here we characterize the variety of transcriptomic phenotypes of this disease based on 873 biopsy specimens collected in the German Cancer Aid MMML (Molecular Mechanisms in Malignant Lymphoma) consortium. They include diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), Burkitt's lymphoma, mixed FL/DLBCL lymphomas, primary mediastinal large B cell lymphoma, multiple myeloma, IRF4-rearranged large cell lymphoma, MYC-negative Burkitt-like lymphoma with chr. 11q aberration and mantle cell lymphoma. METHODS We apply self-organizing map (SOM) machine learning to microarray-derived expression data to generate a holistic view on the transcriptome landscape of lymphomas, to describe the multidimensional nature of gene regulation and to pursue a modular view on co-expression. Expression data were complemented by pathological, genetic and clinical characteristics. RESULTS We present a transcriptome map of B cell lymphomas that allows visual comparison between the SOM portraits of different lymphoma strata and individual cases. It decomposes into one dozen modules of co-expressed genes related to different functional categories, to genetic defects and to the pathogenesis of lymphomas. On a molecular level, this disease rather forms a continuum of expression states than clearly separated phenotypes. We introduced the concept of combinatorial pattern types (PATs) that stratifies the lymphomas into nine PAT groups and, on a coarser level, into five prominent cancer hallmark types with proliferation, inflammation and stroma signatures. Inflammation signatures in combination with healthy B cell and tonsil characteristics associate with better overall survival rates, while proliferation in combination with inflammation and plasma cell characteristics worsens it. A phenotypic similarity tree is presented that reveals possible progression paths along the transcriptional dimensions. Our analysis provided a novel look on the transition range between FL and DLBCL, on DLBCL with poor prognosis showing expression patterns resembling that of Burkitt's lymphoma and particularly on 'double-hit' MYC and BCL2 transformed lymphomas. CONCLUSIONS The transcriptome map provides a tool that aggregates, refines and visualizes the data collected in the MMML study and interprets them in the light of previous knowledge to provide orientation and support in current and future studies on lymphomas and on other cancer entities.
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Affiliation(s)
- Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - Markus Kreuz
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - Lydia Hopp
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - Arsen Arakelyan
- Group of Bioinformatics, Institute of Molecular Biology, National Academy of Sciences, 7 Hasratyan str, 0014 Yerevan, Armenia
| | - Andrea Haake
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
| | - Sergio B. Cogliatti
- Institute of Pathology, Kantonal Hospital St. Gallen, Rorschacher Str. 95, 9007 St. Gallen, Switzerland
| | - Alfred C. Feller
- Hematopathology Lübeck, Maria-Goeppert-Str. 9a, 23562 Lübeck, Germany
| | - Martin-Leo Hansmann
- Institute of Pathology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Dido Lenze
- AstraZeneca, Tinsdaler Weg 183, 22880 Wedel, Germany
| | - Peter Möller
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | | | - Erik Fortenbacher
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - Edith Willscher
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - German Ott
- Department of Pathology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376 Stuttgart, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Christiane Pott
- Second Medical Department, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
| | - Carsten Schwaenen
- Ortenau Hospital Offenburg-Gengenbach, Ebertpl. 12, 77654 Offenburg, Germany
- Internal Medicine III, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Heiko Trautmann
- Second Medical Department, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
| | - Swen Wessendorf
- Internal Medicine III, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Hospital Esslingen, Hirschlandstr. 97, 73730 Esslingen a. N, Germany
| | - Harald Stein
- Pathodiagnostik, Komturstr. 58-62, 12099 Berlin, Germany
| | - Monika Szczepanowski
- Second Medical Department, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
| | - Lorenz Trümper
- Department of Hematology and Oncology, Georg-August University, Robert-Koch-Str. 42, 37077 Göttingen, Germany
| | - Michael Hummel
- Institute of Pathology, Charité Universitätsmedizin, Charitéplatz 1, 10117 Berlin, Germany
| | - Wolfram Klapper
- Hematopathology Section, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
| | - Reiner Siebert
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
- Institute of Human Genetics, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Markus Loeffler
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - Hans Binder
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
| | - for the German Cancer Aid consortium Molecular Mechanisms for Malignant Lymphoma
- Interdisciplinary Centre for Bioinformatics, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany
- Group of Bioinformatics, Institute of Molecular Biology, National Academy of Sciences, 7 Hasratyan str, 0014 Yerevan, Armenia
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
- Institute of Pathology, Kantonal Hospital St. Gallen, Rorschacher Str. 95, 9007 St. Gallen, Switzerland
- Hematopathology Lübeck, Maria-Goeppert-Str. 9a, 23562 Lübeck, Germany
- Institute of Pathology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
- AstraZeneca, Tinsdaler Weg 183, 22880 Wedel, Germany
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Institute of Pathology, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
- Department of Pathology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376 Stuttgart, Germany
- Second Medical Department, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
- Ortenau Hospital Offenburg-Gengenbach, Ebertpl. 12, 77654 Offenburg, Germany
- Internal Medicine III, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Hospital Esslingen, Hirschlandstr. 97, 73730 Esslingen a. N, Germany
- Pathodiagnostik, Komturstr. 58-62, 12099 Berlin, Germany
- Department of Hematology and Oncology, Georg-August University, Robert-Koch-Str. 42, 37077 Göttingen, Germany
- Institute of Pathology, Charité Universitätsmedizin, Charitéplatz 1, 10117 Berlin, Germany
- Hematopathology Section, University Hospital Schleswig-Holstein, Arnold-Heller Str. 3, 24105 Kiel, Germany
- Institute of Human Genetics, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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Duwal S, Dickinson L, Khoo S, von Kleist M. Mechanistic framework predicts drug-class specific utility of antiretrovirals for HIV prophylaxis. PLoS Comput Biol 2019; 15:e1006740. [PMID: 30699105 PMCID: PMC6370240 DOI: 10.1371/journal.pcbi.1006740] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/11/2019] [Accepted: 12/20/2018] [Indexed: 11/21/2022] Open
Abstract
Currently, there is no effective vaccine to halt HIV transmission. However, pre-exposure prophylaxis (PrEP) with the drug combination Truvada can substantially decrease HIV transmission in individuals at risk. Despite its benefits, Truvada-based PrEP is expensive and needs to be taken once-daily, which often leads to inadequate adherence and incomplete protection. These deficits may be overcome by next-generation PrEP regimen, including currently investigated long-acting formulations, or patent-expired drugs. However, poor translatability of animal- and ex vivo/in vitro experiments, and the necessity to conduct long-term (several years) human trials involving considerable sample sizes (N>1000 individuals) are major obstacles to rationalize drug-candidate selection. We developed a prophylaxis modelling tool that mechanistically considers the mode-of-action of all available drugs. We used the tool to screen antivirals for their prophylactic utility and identify lower bound effective concentrations that can guide dose selection in PrEP trials. While in vitro measurable drug potency usually guides PrEP trial design, we found that it may over-predict PrEP potency for all drug classes except reverse transcriptase inhibitors. While most drugs displayed graded concentration-prophylaxis profiles, protease inhibitors tended to switch between none- and complete protection. While several treatment-approved drugs could be ruled out as PrEP candidates based on lack-of-prophylactic efficacy, darunavir, efavirenz, nevirapine, etravirine and rilpivirine could more potently prevent infection than existing PrEP regimen (Truvada). Notably, some drugs from this candidate set are patent-expired and currently neglected for PrEP repurposing. A next step is to further trim this candidate set by ruling out compounds with ominous safety profiles, to assess different administration schemes in silico and to test the remaining candidates in human trials. Pre-exposure prophylaxis (PrEP) is a novel, promising strategy to halt HIV transmission. PrEP with Truvada can substantially decrease the risk of infection. However, individuals often inadequately adhere to the once-daily regimen and the drug is expensive. These shortcomings may be overcome by next-generation PrEP compounds, including long-acting formulations. However, poor translatability of animal- and ex vivo/in vitro experiments, and difficulties in conducting long-term trials involving considerable sample sizes (N > 1000 individuals) make drug-candidate selection and optimization of administration schemes costly and often infeasible. We developed a simulation tool that mechanistically considers the mode-of-action of all antivirals. We used the tool to screen all available antivirals for their prophylactic utility and identified lower bound effective concentrations for designing PrEP dosing regimen in clinical trials. We found that in vitro measured drug potency may over-predict PrEP potency, for all antiviral classes except reverse transcriptase inhibitors. We could rule out a number of antivirals for PrEP repurposing and predicted that darunavir, efavirenz, nevirapine, etravirine and rilpivirine provide complete protection at clinically relevant concentrations. Further trimming of this candidate set by compound-safety and by assessing different implementation schemes is envisaged.
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Affiliation(s)
- Sulav Duwal
- Department of Mathematics & Computer Science, Freie Universität Berlin, Germany
- * E-mail: (SD); (MvK)
| | - Laura Dickinson
- Institute of Translational Medicine, University of Liverpool, United Kingdom
| | - Saye Khoo
- Institute of Translational Medicine, University of Liverpool, United Kingdom
| | - Max von Kleist
- Department of Mathematics & Computer Science, Freie Universität Berlin, Germany
- * E-mail: (SD); (MvK)
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Baldus C, Mokros L, Daubmann A, Arnaud N, Holtmann M, Thomasius R, Legenbauer T. Treatment effectiveness of a mindfulness-based inpatient group psychotherapy in adolescent substance use disorder - study protocol for a randomized controlled trial. Trials 2018; 19:706. [PMID: 30587217 PMCID: PMC6307182 DOI: 10.1186/s13063-018-3048-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/12/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Current treatments for adolescents with substance use disorder (SUD) have had only limited success. In recent years, research has underlined the role of self-regulatory processes and impulsivity in the development and maintenance of SUD in adolescents. Mindfulness has gained much attention due to its capacity to influence self-regulatory processes, particularly in adult populations. Initial studies have shown the potential of mindfulness-based approaches in younger SUD patients. The aim of the present clinical trial is to evaluate the added treatment effect of a mindfulness-based group psychotherapy ("Mind it!") for adolescents with SUD in comparison to the current standard treatment. Moreover, we seek to explore the feasibility of the intervention and possible mediators of treatment effects. METHODS/DESIGN There will be N = 340 participants aged between 13 and 19 years who are receiving child or adolescent psychiatric or psychotherapeutic inpatient or day treatment targeting their SUD and who have reported substance use 30 days before detoxification and do not show acute psychotic or suicidal symptoms at baseline. The study is a prospective randomized controlled multi-center trial in which patients are assessed: (1) after completing a prior detoxification phase (t0), (2) at 4 weeks (t1), (3) at 8 weeks (t2), and (4) at 6 months after t2 (t3). Participants in the intervention group will receive mindfulness-based group psychotherapy in addition to their existing treatment regime. The primary outcome is substance use in the past 30 days at follow-up based on the Timeline Followback self-report. Secondary outcomes include craving, severity of dependence, and abstinence motivation. Mindfulness, impulsivity, and emotion regulation will be analyzed as possible mediators of treatment effects. DISCUSSION This trial is expected to provide evidence of the added effect of a novel, safe, and feasible treatment option for adolescents with SUD. TRIAL REGISTRATION German Register of Clinical Studies, DRKS00014041 . Registered on 17 April 2018.
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Affiliation(s)
- Christiane Baldus
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Mokros
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Holtmann
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Legenbauer
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
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Kaspar U, von Lützau A, Schlattmann A, Roesler U, Köck R, Becker K. Zoonotic multidrug-resistant microorganisms among small companion animals in Germany. PLoS One 2018; 13:e0208364. [PMID: 30532196 PMCID: PMC6285998 DOI: 10.1371/journal.pone.0208364] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/15/2018] [Indexed: 01/08/2023] Open
Abstract
Antimicrobial multidrug-resistant microorganisms (MDRO) can be transmitted between companion animals and their human owners. Aim of this study was to determine the prevalence of extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) and Staphylococcus aureus including methicillin-resistant S. aureus (MRSA) in different companion animal species. Dogs (n = 192), cats (n = 74), and rabbits (n = 17), treated in a veterinary practice and hospital or living in an animal shelter and private households, were sampled. All facilities were located in a region characterized by a high density of pig production. Nasal, buccal and perianal swabs were enriched and cultured on solid chromogenic selective media. A subgroup of 20 animals (13 dogs, 3 cats, 4 rabbits) was analyzed for the presence of staphylococci other than S. aureus. Amongst all animals (n = 283), twenty dogs (10.4%) and six cats (8.1%) carried S. aureus. MRSA was found in five dogs (2.6%) and two cats (2.7%). Isolates were of spa types t011, t034, t108 (all mecA-positive, ST398), and t843 (mecC-positive, ST130), typical for livestock-associated (LA)-MRSA. Except for one dog, MRSA-positive animals did not have direct contact to husbandry. ESBL-Escherichia coli (blaCTX-M/blaTEM/blaSHV genes) were present in seven dogs (3.6%), one cat (1.4%) possessed a cefotaxime-resistant Citrobacter freundii isolate (blaTEM/blaCMY-2 genes). MDRO carriage was associated with animals from veterinary medical settings (p<0.05). One dog and one rabbit carried methicillin-resistant coagulase-negative staphylococci. The exclusive occurrence of MRSA lineages typically described for livestock stresses the impact of MDRO strain dissemination across species barriers in regional settings. Presence of ESBL-E and LA-MRSA among pets and probable dissemination in clinical settings support the necessity of a “One Health” approach to address the potential threats due to MDRO-carrying companion animals.
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Affiliation(s)
- Ursula Kaspar
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Alexa von Lützau
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Andreas Schlattmann
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Uwe Roesler
- Institute for Animal Hygiene and Environmental Health, FU Berlin, Department of Veterinary Medicine, Berlin, Germany
| | - Robin Köck
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
- * E-mail:
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Cabrera LY, Bittlinger M, Lou H, Müller S, Illes J. Reader comments to media reports on psychiatric neurosurgery: past history casts shadows on the future. Acta Neurochir (Wien) 2018; 160:2501-2507. [PMID: 30357485 DOI: 10.1007/s00701-018-3696-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/02/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Comments made by readers in response to news articles about current events can provide profound insights into public understanding of and perspectives on those events. Here, in follow up to a paper published last year in this journal, we examined reader comments to articles in newspapers and magazines about neurosurgical interventions for treating psychiatric illness. METHOD We conducted a thematic analysis of these comments (N = 662 coded units of data) posted in response to 115 newspaper and magazine articles from four countries (Canada, USA, Germany, and Spain) between 2006 and 2017. The comments were coded using an iteratively refined coding scheme that was structured around four a priori categories based on results from the parent study and two new categories that emerged. RESULTS We found many references to historical psychosurgery and mostly negative and pessimistic comments about ablative neurosurgical interventions. Comments to deep brain stimulation were more positive, and comments to optogenetics most controversial. We also found many expressions of distrust of medical professionals in the context of interventions on the brain and concerns about social and individual control. CONCLUSIONS Overall, results suggest there is still much work to be done to raise public awareness about re-emerging and new neurosurgical interventions. Balanced discussion is needed if these approaches are to find a place in health care for psychiatric disorders.
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Affiliation(s)
- Laura Y Cabrera
- Center for Ethics and Humanities in the Life Sciences, Department of Translational Science and Molecular Medicine, Michigan State University, East Fee Hall, 965 Wilson Road, Rm C211, East Lansing, MI, 48824, USA
| | - Merlin Bittlinger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, CCM, Division of Mind and Brain Research, Berlin Institute of Health, Berlin, Germany
| | - Hayami Lou
- Neuroethics Canada, The University of British Columbia, Vancouver, Canada
| | - Sabine Müller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, CCM, Division of Mind and Brain Research, Berlin Institute of Health, Berlin, Germany
| | - Judy Illes
- Canada Research Chair in Neuroethics, Neuroethics Canada, Division of Neurology, Department of Medicine, The University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada.
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Wallner S, Orsó E, Grandl M, Konovalova T, Liebisch G, Schmitz G. Phosphatidylcholine and phosphatidylethanolamine plasmalogens in lipid loaded human macrophages. PLoS One 2018; 13:e0205706. [PMID: 30308051 PMCID: PMC6181407 DOI: 10.1371/journal.pone.0205706] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/28/2018] [Indexed: 12/22/2022] Open
Abstract
Background Plasmalogens are either phosphatidylcholine (PC P) or phosphatidylethanolamine (PE P) glycerophospholipids containing a vinyl ether moiety in sn-1-position and an esterified fatty acid in sn-2 position. Multiple functions have been proposed, including reservoir of precursors for inflammatory mediators, modulation of membrane fluidity, and anti-oxidative properties. They could therefore play a role under conditions of metabolic stress. Especially enzymatically modified LDL (eLDL) and oxidatively modified LDL (oxLDL) represent modifications of LDL that are taken up by macrophages in atherosclerotic plaques. The aim of this study was to analyze plasmalogen related effects of eLDL and oxLDL in human monocyte derived macrophages, as well as the effects of HDL3 mediated deloading. Methods Elutriated monocytes from nine healthy donors were differentiated in vitro for four days. Macrophages were then loaded with native LDL, eLDL and oxLDL for 24h and subsequently deloaded with HDL3 for another 24h. Lipidomic and transcriptomic profiles were obtained. Results Loading of macrophages with eLDL and oxLDL led to a transient but strong elevation of lysophosphatidylcholine (LPC) most likely through direct uptake. Only eLDL induced increased levels of total PC, presumably through an induction of PC synthesis. On the other hand treatment with oxLDL led to a significant increase in PC P. Analysis of individual lipid species showed lipoprotein and saturation specific effects for LPC, PC P and PE P species. Membrane fluidity was decreased by the large amount of FC contained in the lipoproteins, as indicated by a lower PC to FC ratio after lipoprotein loading. In contrast the observed changes in the saturated to mono-unsaturated fatty acid (SFA to MUFA) and saturated to poly-unsaturated fatty acid (SFA to PUFA) ratios in PE P could represent a cellular reaction to counteract this effect by producing more fluid membranes. Transcriptomic analysis showed considerable differences between eLDL and oxLDL treated macrophages. As a common feature of both lipoproteins we detected a strong downregulation of pathways for endogenous lipid synthesis as well as for exogenous lipid uptake. Deloading with HDL3 had only minor effects on total lipid class as well as on individual lipid species levels, most of the time not reaching significance. Interestingly treatment with HDL3 had no effect on membrane fluidity under these conditions, although incubation with HDL3 was partially able to counteract the oxLDL induced transcriptomic effects. To investigate the functional effect of lipoprotein treatment on macrophage polarization we performed surface marker flow cytometry. Under our experimental conditions oxLDL was able to partially shift the surface marker pattern towards a pro-inflammatory M1-like phenotype. This is consistent with the consumption of arachidonic acid containing PE P species in oxLDL treated cells, presumably for the synthesis of inflammatory mediators. Summary Our findings provide novel data on the lipoprotein induced, lipidomic and transcriptomic changes in macrophages. This can help us better understand the development of metabolic, inflammatory diseases as well as improve our background knowledge on lipid biomarkers in serum.
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Affiliation(s)
- Stefan Wallner
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
- * E-mail:
| | - Evelyn Orsó
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Margot Grandl
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Tatiana Konovalova
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Gerd Schmitz
- Institute of Clinical Chemistry and Laboratory Medicine, Regensburg University Medical Center, Regensburg, Germany
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Abstract
Understanding how crop plants evolved from their wild relatives and spread around the world can inform about the origins of agriculture. Here, we review how the rapid development of genomic resources and tools has made it possible to conduct genetic mapping and population genetic studies to unravel the molecular underpinnings of domestication and crop evolution in diverse crop species. We propose three future avenues for the study of crop evolution: establishment of high-quality reference genomes for crops and their wild relatives; genomic characterization of germplasm collections; and the adoption of novel methodologies such as archaeogenetics, epigenomics, and genome editing.
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Affiliation(s)
- Mona Schreiber
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) Gatersleben, Corrensstraße 3, 06466, Seeland, Germany
| | - Nils Stein
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) Gatersleben, Corrensstraße 3, 06466, Seeland, Germany
| | - Martin Mascher
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) Gatersleben, Corrensstraße 3, 06466, Seeland, Germany.
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, 04103, Leipzig, Germany.
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45
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Bloos F, Held J, Schlattmann P, Brillinger N, Kurzai O, Cornely OA, Thomas-Rüddel D. (1,3)-β-D-glucan-based diagnosis of invasive Candida infection versus culture-based diagnosis in patients with sepsis and with an increased risk of invasive Candida infection (CandiSep): study protocol for a randomized controlled trial. Trials 2018; 19:472. [PMID: 30180873 PMCID: PMC6124015 DOI: 10.1186/s13063-018-2868-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/21/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The time to diagnosis of invasive Candida infection (ICI) is often too long to initiate timely antifungal therapy in patients with sepsis. Elevated serum (1,3)-β-D-glucan (BDG) concentrations have a high diagnostic sensitivity for detecting ICI. However, the clinical significance of elevated BDG concentrations is unclear in critically ill patients. The goal of this study is to investigate whether measurement of BDG in patients with sepsis and a high risk for ICI can be used to decrease the time to empiric antifungal therapy and thus, increase survival. METHODS/DESIGN This prospective multicenter open randomized controlled trial is being conducted in 19 German intensive care units. All adult patients with severe sepsis or septic shock and an increased risk for ICI are eligible for enrolment. Risk factors are total parenteral nutrition, previous abdominal surgery, previous antimicrobial therapy, and renal replacement therapy. Patients with proven ICI or those already treated with systemic antifungal substances are excluded. Patients are allocated to a BDG or standard care group. The standard care group receives targeted antifungal therapy as necessary. In the BDG group, BDG serum samples are taken after randomization and 24 h later. Antifungal therapy is initiated if BDG is ≥80 pg/ml in at least one sample. We plan to enroll 312 patients. The primary outcome is 28-day mortality. Other outcomes include antifungal-free survival within 28 days after enrolment, time to antifungal therapy, and the diagnostic performance of BDG compared to other laboratory tests for early ICI diagnosis. The statistical analysis will be performed according to the intent-to-treat principle. DISCUSSION Because of the high risk of death, American guidelines recommend empiric antifungal therapy in sepsis patients with a high risk of ICI despite the limited evidence for such a recommendation. In contrast, empiric antifungal therapy is not recommended by European guidelines. BDG may offer a way out of this dilemma since BDG potentially identifies patients in need of early antifungals. However, the evidence for such an approach is inconclusive. This clinical study will generate solid evidence for health-care providers and authors of guidelines for the use of BDG in critically ill patients. TRIAL REGISTRATION Clinicaltrials.gov, NCT02734550 . Registered 12 April 2016.
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Affiliation(s)
- Frank Bloos
- Center for Sepsis Control & Care, Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Jürgen Held
- Mikrobiologisches Institut, Universitätsklinik Erlangen und Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany
| | - Nicole Brillinger
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Oliver Kurzai
- Center for Sepsis Control & Care, Jena University Hospital, Jena, Germany
- German National Reference Center for Invasive Fungal Infections NRZMyk, Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll-Institute, Jena, Germany
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg,, Germany
| | - Oliver A. Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, University Hospital of Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
| | - Daniel Thomas-Rüddel
- Center for Sepsis Control & Care, Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
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Bauer C, Abdul Pari AA, Umansky V, Utikal J, Boukamp P, Augustin HG, Goerdt S, Géraud C, Felcht M. T-lymphocyte profiles differ between keratoacanthomas and invasive squamous cell carcinomas of the human skin. Cancer Immunol Immunother 2018; 67:1147-1157. [PMID: 29799076 PMCID: PMC11028118 DOI: 10.1007/s00262-018-2171-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 05/10/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND T-lymphocytes are involved in tumor progression and regression. Actinic keratoses (AK) are atypical proliferations of keratinocytes of the skin. Some AK progress into invasive cutaneous squamous cell carcinomas (cSCC). Keratoacanthomas (KA) are either classified as a cSCC subtype or a benign tumor with histologic resemblance to well-differentiated cSCC as it is supposed to regress spontaneously. In contrast, cSCC represent malignant tumors that may metastasize. OBJECTIVES To compare the T-lymphocyte profiles of AK, KA and cSCC in relation to PD-L1 expression. METHODS Tissue micro-arrays of 103 cases of AK, 43 cases of KA and 106 cases of cSCC were stained by immunohistochemistry for E-cadherin, CD3, CD4, CD8, FOXp3, and the receptor-ligand pair PD-1/PD-L1. Immunohistological scores were computationally determined to assess PD-L1 expression as well as the expression profiles of T-lymphocytes. RESULTS AK had lower numbers of CD3+ and PD-1+ cells compared to KA and lower numbers of CD3+, CD8+ and PD-1+ cells in comparison with cSCC. KA showed significantly higher numbers of CD4+ and FOXp3+ cells as well as lower numbers of CD8+ cells in comparison with invasive cSCC. cSCC expressed significantly more PD-L1 in comparison with AK and KA. Among cSCC PD-L1 expression was higher in moderately and poorly-differentiated cSCC than in well-differentiated cSCC. Increased PD-L1 expression also correlated with increased numbers of CD4+, CD8+ and FOXp3+ cells in cSCC. CONCLUSIONS Tumor-associated T-lymphocyte infiltrates showed significant differences between AK, KA and invasive cSCC. PD-L1 expression correlated with invasion of T-cell infiltrates in invasive cSCC.
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Affiliation(s)
- Corinne Bauer
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - Ashik Ahmed Abdul Pari
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Viktor Umansky
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jochen Utikal
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Boukamp
- Genetics of Skin Carcinogenesis, German Cancer Research Center (DKFZ), Heidelberg, Germany
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Hellmut G Augustin
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Section of Molecular and Clinical Dermatology, Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Moritz Felcht
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany.
- German Cancer Consortium, Heidelberg, Germany.
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Welzel FD, Stein J, Pabst A, Luppa M, Kersting A, Blüher M, Luck-Sikorski C, König HH, Riedel-Heller SG. Five A's counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT). BMC Fam Pract 2018; 19:97. [PMID: 29935541 PMCID: PMC6015469 DOI: 10.1186/s12875-018-0785-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 05/31/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs). METHODS The INTERACT study is a cluster randomized controlled trial aimed at implementing and evaluating an online-tutorial for obesity management based on the 5As approach in cooperating primary health care practices. Effectiveness of the 5As intervention will be evaluated by assessing patients and doctors perspectives on obesity management in primary care before and after the training. GPs in the intervention group will get access to the 5As obesity management online-tutorial while GPs in the control group will be assigned to a waiting list. Outcome measures for patients and GPs will be compared between the intervention group (treatment as usual + training of the GP) and the control group (treatment as usual). Hierarchical regression models will be used to analyze effects over time pre- and post-intervention. DISCUSSION The 5As present physicians with a simple mnemonic for patient counseling in the primary care context. While the use of the 5As in weight counseling seems to be associated with improved doctor-patient interaction and motivation to lose weight, intervention studies assessing the effectiveness of a short 5A eLearning tutorial for physicians on secondary outcomes, such as weight development, are lacking. TRIAL REGISTRATION The study has been registered at the German Clinical Trials Register ( DRKS00009241 ; date of registration: 03.02.2016).
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Affiliation(s)
- Franziska D. Welzel
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Anette Kersting
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany
| | - Claudia Luck-Sikorski
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany
- University of Applied Sciences SRH Gera, Gera, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
- Institute of General Medicine, University of Leipzig, Leipzig, Germany
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Rasche P, Mertens A, Miron-Shatz T, Berzon C, Schlick CM, Jahn M, Becker S. Seamless recording of glucometer measurements among older experienced diabetic patients - A study of perception and usability. PLoS One 2018; 13:e0197455. [PMID: 29799861 PMCID: PMC5969745 DOI: 10.1371/journal.pone.0197455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 05/02/2018] [Indexed: 11/19/2022] Open
Abstract
Self-measurement and documentation of blood-glucose are critical elements of diabetes management, particularly in regimes including insulin. In this study, we analyze the usability of iBG-STAR, the first blood glucose meter connectable to a smartphone. This technology records glucometer measurements, removing the burden of documentation from diabetic patients. This study assesses the potential for implementation of iBG-STAR in routine care. Twelve long-term diabetic patients (4 males; median age of 66.5 years) were enrolled in the study. N = 4/12 reported diabetic polyneuropathy. Reported subjective mental workload for all tasks related to iBG-STAR was on average lower than 12 points, corresponding to the verbal code 'nearly no effort needed'. A "Post Study System Usability Questionnaire", evaluated the glucometer at an average value of 2.06 (SD = 1.02) on a 7-Likert-scale (1 = 'I fully agree' to 7 = 'I completely disagree') for usability. These results represent a positive user-experience. Patients with polyneuropathy may experience physical difficulties in completing the tasks, thereby affecting usability. Technologically savvy patients (n = 6) with a positive outlook on diabetes assessed the product as a suitable tool for themselves and would recommend to other diabetic patients. The main barrier to regular use was treating physicians' inability to retrieve digitally recorded data. This barrier was due to a shortcoming in interoperability of mobile devices and medical information systems.
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Affiliation(s)
- Peter Rasche
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Alexander Mertens
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Talya Miron-Shatz
- Center for Medical Decision Making, Business School, Ono Academic College, Kiryat Ono, Israel
- Center for Medicine in the Public Interest, New York, NY, United States of America
| | - Corinne Berzon
- Center for Medical Decision Making, Business School, Ono Academic College, Kiryat Ono, Israel
| | - Christopher M. Schlick
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Michael Jahn
- Department of Nephrology, University Duisburg-Essen, Essen, Germany
| | - Stefan Becker
- Department of Nephrology, University Duisburg-Essen, Essen, Germany
- * E-mail:
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Wolff A, Bayerlová M, Gaedcke J, Kube D, Beißbarth T. A comparative study of RNA-Seq and microarray data analysis on the two examples of rectal-cancer patients and Burkitt Lymphoma cells. PLoS One 2018; 13:e0197162. [PMID: 29768462 PMCID: PMC5955523 DOI: 10.1371/journal.pone.0197162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 04/27/2018] [Indexed: 12/17/2022] Open
Abstract
Background Pipeline comparisons for gene expression data are highly valuable for applied real data analyses, as they enable the selection of suitable analysis strategies for the dataset at hand. Such pipelines for RNA-Seq data should include mapping of reads, counting and differential gene expression analysis or preprocessing, normalization and differential gene expression in case of microarray analysis, in order to give a global insight into pipeline performances. Methods Four commonly used RNA-Seq pipelines (STAR/HTSeq-Count/edgeR, STAR/RSEM/edgeR, Sailfish/edgeR, TopHat2/Cufflinks/CuffDiff)) were investigated on multiple levels (alignment and counting) and cross-compared with the microarray counterpart on the level of gene expression and gene ontology enrichment. For these comparisons we generated two matched microarray and RNA-Seq datasets: Burkitt Lymphoma cell line data and rectal cancer patient data. Results The overall mapping rate of STAR was 98.98% for the cell line dataset and 98.49% for the patient dataset. Tophat’s overall mapping rate was 97.02% and 96.73%, respectively, while Sailfish had only an overall mapping rate of 84.81% and 54.44%. The correlation of gene expression in microarray and RNA-Seq data was moderately worse for the patient dataset (ρ = 0.67–0.69) than for the cell line dataset (ρ = 0.87–0.88). An exception were the correlation results of Cufflinks, which were substantially lower (ρ = 0.21–0.29 and 0.34–0.53). For both datasets we identified very low numbers of differentially expressed genes using the microarray platform. For RNA-Seq we checked the agreement of differentially expressed genes identified in the different pipelines and of GO-term enrichment results. Conclusion In conclusion the combination of STAR aligner with HTSeq-Count followed by STAR aligner with RSEM and Sailfish generated differentially expressed genes best suited for the dataset at hand and in agreement with most of the other transcriptomics pipelines.
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Affiliation(s)
- Alexander Wolff
- Dept. of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Michaela Bayerlová
- Dept. of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Jochen Gaedcke
- Dept. of General-, Visceral- and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Dieter Kube
- Dept. of Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Beißbarth
- Dept. of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
- * E-mail:
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50
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Aspart F, Remme MWH, Obermayer K. Differential polarization of cortical pyramidal neuron dendrites through weak extracellular fields. PLoS Comput Biol 2018; 14:e1006124. [PMID: 29727454 PMCID: PMC5955601 DOI: 10.1371/journal.pcbi.1006124] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/16/2018] [Accepted: 04/06/2018] [Indexed: 01/13/2023] Open
Abstract
The rise of transcranial current stimulation (tCS) techniques have sparked an increasing interest in the effects of weak extracellular electric fields on neural activity. These fields modulate ongoing neural activity through polarization of the neuronal membrane. While the somatic polarization has been investigated experimentally, the frequency-dependent polarization of the dendritic trees in the presence of alternating (AC) fields has received little attention yet. Using a biophysically detailed model with experimentally constrained active conductances, we analyze the subthreshold response of cortical pyramidal cells to weak AC fields, as induced during tCS. We observe a strong frequency resonance around 10-20 Hz in the apical dendrites sensitivity to polarize in response to electric fields but not in the basal dendrites nor the soma. To disentangle the relative roles of the cell morphology and active and passive membrane properties in this resonance, we perform a thorough analysis using simplified models, e.g. a passive pyramidal neuron model, simple passive cables and reconstructed cell model with simplified ion channels. We attribute the origin of the resonance in the apical dendrites to (i) a locally increased sensitivity due to the morphology and to (ii) the high density of h-type channels. Our systematic study provides an improved understanding of the subthreshold response of cortical cells to weak electric fields and, importantly, allows for an improved design of tCS stimuli.
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Affiliation(s)
- Florian Aspart
- Department of Software Engineering and Theoretical Computer Science, Technische Universität Berlin, Berlin, Germany
- * E-mail: (FA); (MWHR); (KO)
| | - Michiel W. H. Remme
- Institute for Theoretical Biology, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail: (FA); (MWHR); (KO)
| | - Klaus Obermayer
- Department of Software Engineering and Theoretical Computer Science, Technische Universität Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany
- * E-mail: (FA); (MWHR); (KO)
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