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Antons S, Liebherr M, Brand M, Brandtner A. From game engagement to craving responses - The role of gratification and compensation experiences during video-gaming in casual and at-risk gamers. Addict Behav Rep 2023; 18:100520. [PMID: 38149224 PMCID: PMC10749870 DOI: 10.1016/j.abrep.2023.100520] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/25/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Although playing videogames is a common leisure activity some individuals develop problematic gaming behaviors or even symptoms of a gaming disorder. Game engagement may be involved in reinforcement learning that may result in experiences of craving, an important feature of gaming disorder. In the following study we aimed to approach the question which aspects contribute to increased craving for gaming. Methods Overall, 439 individuals participated in an online survey, answering questionnaires on game engagement, experience of gratification and compensation, craving, and symptoms of gaming disorder. A mediation model testing if the association between game engagement and facets of craving are mediated by the experience of gratification and compensation during gaming. Results Three facets of craving (reward/relief, physiological, obsessive craving) were statistically explained by game engagement and the experience of gratification and compensation. Models differed between casual gamers and at-risk gamers. The effects on reward/relief and physiological craving were fully mediated in the casual group and partially mediated in the at-risk group by gratification and compensation experiences. Conclusion Game engagement may contribute to the development of craving by increasing the experience of gratification and compensation and thus might be important in reinforcement learning. Games evoking a high engagement may therefore have a higher addictive potential. Further processes potentially related to game engagement, such as intrusive thoughts and desire thinking, which are related to craving experiences, should be considered in future studies.
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Affiliation(s)
- S. Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - M. Liebherr
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
| | - M. Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - A. Brandtner
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
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2
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Brandtner A, Tymoszuk P, Nairz M, Lehner GF, Fritsche G, Vales A, Falkner A, Schennach H, Theurl I, Joannidis M, Weiss G, Pfeifhofer-Obermair C. Linkage of alterations in systemic iron homeostasis to patients' outcome in sepsis: a prospective study. J Intensive Care 2020; 8:76. [PMID: 33014378 PMCID: PMC7528491 DOI: 10.1186/s40560-020-00495-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022] Open
Abstract
Background Sepsis, a dysregulated host response following infection, is associated with massive immune activation and high mortality rates. There is still a need to define further risk factors and laboratory parameters predicting the clinical course. Iron metabolism is regulated by both, the body’s iron status and the immune response. Iron itself is required for erythropoiesis but also for many cellular and metabolic functions. Moreover, iron availability is a critical determinant in infections because it is an essential nutrient for most microbes but also impacts on immune function and intravascular oxidative stress. Herein, we used a prospective study design to investigate the putative impact of serum iron parameters on the outcome of sepsis. Methods Serum markers of iron metabolism were measured in a prospective cohort of 61 patients (37 males, 24 females) with sepsis defined by Sepsis-3 criteria in a medical intensive care unit (ICU) and compared between survivors and non-survivors. Regulation of iron parameters in patients stratified by focus of infection and co-medication as well as association of the markers with sepsis severity scores and survival were investigated with linear and logistic regression corrected for sex and age effects. Results Positive correlations of increased serum iron and ferritin concentrations upon ICU admission with the severity of organ failure (SOFA score) and with mortality were observed. Moreover, high TF-Sat, elevated ferritin and serum iron levels and low transferrin concentrations were associated with reduced survival. A logistic regression model consisting of SOFA and transferrin saturation (SOFA–TF-Sat) had the best predictive power for survival in septic ICU patients. Of note, administration of blood transfusions prior to ICU admission resulted in increased TF-Sat and reduced survival of septic patients. Conclusions Our study could show an important impact of serum iron parameters on the outcome of sepsis. Furthermore, we identified transferrin saturation as a stand-alone predictor of sepsis survival and as a parameter of iron metabolism which may in a combined model improve the prediction power of the SOFA score. Trial registration The study was carried out in accordance with the recommendations of the Declaration of Helsinki on biomedical research. The study was approved by the institutional ethics review board of the Medical University Innsbruck (study AN2013-0006).
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Affiliation(s)
- Anna Brandtner
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Georg F Lehner
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Gernot Fritsche
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Anja Vales
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
| | - Andreas Falkner
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
| | - Harald Schennach
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
| | - Igor Theurl
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, Austria.,Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Innsbruck, Austria
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Wiethaler M, Slotta-Huspenina J, Brandtner A, Horstmann J, Wein F, Baumeister T, Radani N, Gerland S, Anand A, Lange S, Schmidt M, Janssen KP, Conrad A, Johannes W, Strauch K, Quante AS, Linkohr B, Kuhn KA, Blaser R, Lehmann A, Kohlmayer F, Weichert W, Schmid RM, Becker KF, Quante M. BarrettNET-a prospective registry for risk estimation of patients with Barrett's esophagus to progress to adenocarcinoma. Dis Esophagus 2019; 32:5479247. [PMID: 31329831 DOI: 10.1093/dote/doz024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Risk stratification in patients with Barrett's esophagus (BE) to prevent the development of esophageal adenocarcinoma (EAC) is an unsolved task. The incidence of EAC and BE is increasing and patients are still at unknown risk. BarrettNET is an ongoing multicenter prospective cohort study initiated to identify and validate molecular and clinical biomarkers that allow a more personalized surveillance strategy for patients with BE. For BarrettNET participants are recruited in 20 study centers throughout Germany, to be followed for progression to dysplasia (low-grade dysplasia or high-grade dysplasia) or EAC for >10 years. The study instruments comprise self-administered epidemiological information (containing data on demographics, lifestyle factors, and health), as well as biological specimens, i.e., blood-based samples, esophageal tissue biopsies, and feces and saliva samples. In follow-up visits according to the individual surveillance plan of the participants, sample collection is repeated. The standardized collection and processing of the specimen guarantee the highest sample quality. Via a mobile accessible database, the documentation of inclusion, epidemiological data, and pathological disease status are recorded subsequently. Currently the BarrettNET registry includes 560 participants (23.1% women and 76.9% men, aged 22-92 years) with a median follow-up of 951 days. Both the design and the size of BarrettNET offer the advantage of answering research questions regarding potential causes of disease progression from BE to EAC. Here all the integrated methods and materials of BarrettNET are presented and reviewed to introduce this valuable German registry.
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Affiliation(s)
- Maria Wiethaler
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Julia Slotta-Huspenina
- Institute of Pathology, University Hospital rechts der Isar, Technical University of Munich.,Tissue Bank of the Klinikum rechts der Isar Munich and Technical University of Munich
| | - Anna Brandtner
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Julia Horstmann
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Frederik Wein
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Theresa Baumeister
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Nikole Radani
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Sophie Gerland
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Akanksha Anand
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Sebastian Lange
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Melissa Schmidt
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Klaus-Peter Janssen
- Klinik und Poliklinik für Chirurgie, University Hospital rechts der Isar, Technical University of Munich
| | - Anja Conrad
- Institute of Pathology, University Hospital rechts der Isar, Technical University of Munich.,Tissue Bank of the Klinikum rechts der Isar Munich and Technical University of Munich
| | - Widya Johannes
- Institute of Pathology, University Hospital rechts der Isar, Technical University of Munich.,Tissue Bank of the Klinikum rechts der Isar Munich and Technical University of Munich
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, München
| | - Anne S Quante
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, München.,Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Klaus A Kuhn
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, Technical University of Munich
| | - Rainer Blaser
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, Technical University of Munich
| | - Andreas Lehmann
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, Technical University of Munich
| | - Florian Kohlmayer
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, Technical University of Munich
| | - Wilko Weichert
- Institute of Pathology, University Hospital rechts der Isar, Technical University of Munich.,Tissue Bank of the Klinikum rechts der Isar Munich and Technical University of Munich
| | - Roland M Schmid
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
| | - Karl-Friedrich Becker
- Institute of Pathology, University Hospital rechts der Isar, Technical University of Munich.,Tissue Bank of the Klinikum rechts der Isar Munich and Technical University of Munich
| | - Michael Quante
- Klinik und Poliklinik für Innere Medizin II, University Hospital rechts der Isar, Technical University of Munich
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Schellnegger R, Quante A, Rospleszcz S, Schernhammer M, Höhl B, Tobiasch M, Pastula A, Brandtner A, Abrams JA, Strauch K, Schmid RM, Vieth M, Wang TC, Quante M. Goblet Cell Ratio in Combination with Differentiation and Stem Cell Markers in Barrett Esophagus Allow Distinction of Patients with and without Esophageal Adenocarcinoma. Cancer Prev Res (Phila) 2016; 10:55-66. [PMID: 27807078 DOI: 10.1158/1940-6207.capr-16-0117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 05/01/2016] [Revised: 09/23/2016] [Accepted: 10/11/2016] [Indexed: 12/20/2022]
Abstract
The increasing incidence of esophageal adenocarcinoma (EAC) is mirrored by the increasing prevalence of Barrett esophagus, a precursor lesion resulting in a large number of individuals "at risk" for this lethal malignancy. Among patients with Barrett esophagus, only about 0.3% annually will develop EAC. Because large numbers of patients are followed in endoscopic surveillance, there is a need for risk prediction among a growing population of patients with Barrett esophagus. We identified four potential biomarkers from an inflammation (IL1β)-dependent mouse model of Barrett esophagus and tested them in 189 patients with Barrett esophagus with and without high-grade dysplasia (HGD)/early cancer (T1). The primary goal was to distinguish patients with Barrett esophagus with no evidence of dysplasia from those with dysplasia. Increasing stem cell marker LGR5 and niche cell marker DCLK1 and decreasing differentiation marker (secretory mucus cells, TFF2+ cells) correlated with elevated tumor score in the mouse. Having outlined the origin of those markers in the Barrett esophagus mouse model, we showed the applicability for human Barrett esophagus. We compared 94 patients with nondysplastic Barrett esophagus tissue with 95 patients with Barrett esophagus and HGD or early cancer. Low levels of TFF2 (AUC 87.2%) provided the best discrimination between nondysplastic Barrett esophagus and Barrett esophagus with cancer, followed by high levels of DCLK1 (AUC 83.4%), low goblet cell ratio (AUC 79.4%), and high LGR5 (AUC 71.4%). The goblet cell ratio, rather than the presence of goblet cells per se, was found to be an important discriminator. These findings may be useful in developing future risk prediction models for patients with Barrett esophagus and ultimately to improve EAC surveillance. Cancer Prev Res; 10(1); 55-66. ©2016 AACR.
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Affiliation(s)
- Raphael Schellnegger
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Anne Quante
- Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universitaet, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Martina Schernhammer
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Bettina Höhl
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Moritz Tobiasch
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Agnieszka Pastula
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Anna Brandtner
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Julian A Abrams
- Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, New York
| | - Konstantin Strauch
- Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universitaet, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Roland M Schmid
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany
| | - Michael Vieth
- Klinikum Bayreuth, Institut für Pathologie, Bayreuth, Germany
| | - Timothy C Wang
- Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, New York
| | - Michael Quante
- II. Medizinische Klinik, Klinilkum rechts der Isar, Technische Universitaet München, Munich, Germany.
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Westphalen CB, Asfaha S, Hayakawa Y, Takemoto Y, Lukin DJ, Nuber AH, Brandtner A, Setlik W, Remotti H, Muley A, Chen X, May R, Houchen CW, Fox JG, Gershon MD, Quante M, Wang TC. Long-lived intestinal tuft cells serve as colon cancer-initiating cells. J Clin Invest 2014; 124:1283-95. [PMID: 24487592 DOI: 10.1172/jci73434] [Citation(s) in RCA: 287] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 11/14/2013] [Indexed: 01/10/2023] Open
Abstract
Doublecortin-like kinase 1 protein (DCLK1) is a gastrointestinal tuft cell marker that has been proposed to identify quiescent and tumor growth-sustaining stem cells. DCLK1⁺ tuft cells are increased in inflammation-induced carcinogenesis; however, the role of these cells within the gastrointestinal epithelium and their potential as cancer-initiating cells are poorly understood. Here, using a BAC-CreERT-dependent genetic lineage-tracing strategy, we determined that a subpopulation of DCLK1⁺ cells is extremely long lived and possesses rare stem cell abilities. Moreover, genetic ablation of Dclk1 revealed that DCLK1⁺ tuft cells contribute to recovery following intestinal and colonic injury. Surprisingly, conditional knockdown of the Wnt regulator APC in DCLK1⁺ cells was not sufficient to drive colonic carcinogenesis under normal conditions; however, dextran sodium sulfate-induced (DSS-induced) colitis promoted the development of poorly differentiated colonic adenocarcinoma in mice lacking APC in DCLK1⁺ cells. Importantly, colonic tumor formation occurred even when colitis onset was delayed for up to 3 months after induced APC loss in DCLK1⁺ cells. Thus, our data define an intestinal DCLK1⁺ tuft cell population that is long lived, quiescent, and important for intestinal homeostasis and regeneration. Long-lived DCLK1⁺ cells maintain quiescence even following oncogenic mutation, but are activated by tissue injury and can serve to initiate colon cancer.
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