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Facilitators and barriers to centre- and home-based exercise training in breast cancer patients - a swiss tertiary centre experience. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss Cancer Research
Background
Exercise is an effective therapy for cancer patients to reduce fatigue and to improve health-related quality of life and physical function. Yet, cancer patients often do not meet physical activity guidelines.
Purpose
To understand why recommendations are not met, we aimed at identifying facilitators and barriers to supervised, centre-based exercise within a cardio-oncologic rehabilitation (CORE) programme and to unsupervised, home-based exercise as well as strategies used to manage these barriers.
Methods
Breast cancer patients who had completed a CORE programme at a Swiss tertiary centre were recruited. Semi-structured interviews were conducted with subsequent thematic analysis.
Results
Of 37 eligible breast cancer patients, 19 patients (mean age 48.9±9.7 years) participated to our invitation. Facilitators for centre-based exercise were social support, committedness and provision of structured exercise. Barriers towards centre-based exercise included physical and environmental barriers, while psychological barriers were reported predominantly for home-based exercise. Strategies to manage barriers included the adaptation of training circumstances, behaviour change strategies and strategies to deal with side effects.
Conclusions
Our results support the importance of providing CORE programmes and suggest that a special focus should be directed at the transition from supervised to self-organized exercise in order to enhance long-term exercise participation.
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Real-world evidence for interobserver-agreement of PI-RADS-version-2 and the value of combining 4-core-targeted-MRI-TRUS-fusion and systematic-12-core-TRUS prostate biopsy for the diagnosis of prostate cancer according to biopsy-history. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03109-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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BaSAlt - A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes. Contemp Clin Trials Commun 2021; 23:100828. [PMID: 34401598 PMCID: PMC8350408 DOI: 10.1016/j.conctc.2021.100828] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction Physical activity (PA) is a major contributor to healthy aging. However, physical inactivity is prevalent among the elderly in Germany, particularly in institutionalized settings such as nursing homes. This paper aims to describe the study objectives, design, methods, assessment types, collection schedules and considerations for analyzing the data within the BaSAlt study on facilitators and barriers for PA promotion in nursing homes. Methods We designed the BaSAlt study as a participatory intervention study with multiple measurement points in six to eight nursing homes with a total of approx. 200 residents using four main modules: (1) setting-level analysis of physical activity patterns, physical activity-related climate and physical activity-related interaction with ‘significant others,’ and organizational facilitators and barriers to physical activity, (2) physical-activity related individual-level analysis of objective and self-reported physical activity and sedentary behavior, a geriatric assessment with established procedures, assessment of people's activity and health biographies (biographical mapping) as well as their motivational, subjective well-being and distress status, and (3) a counseling module that integrates counseling at the setting level as well as individual physical activity counseling for residents. In module (4) evaluation, the effects of integrated counseling with regard to the implementation of PA promotion strategies are analyzed. Discussion This study will extend our knowledge of physical activity promotion in German nursing homes. Its findings will inform governmental authorities, care professionals, and academics on how to reach a particular group, characterized by inactivity, multimorbidity, and a high prevalence of dementia, residing in nursing homes, a setting that will gain further relevance in the future.
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Development of a Complication- and Treatment-Aware Prediction Model for Favorable Functional Outcome in Aneurysmal Subarachnoid Hemorrhage Based on Machine Learning. Neurosurgery 2021; 88:E150-E157. [PMID: 33017031 DOI: 10.1093/neuros/nyaa401] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Current prognostic tools in aneurysmal subarachnoid hemorrhage (aSAH) are constrained by being primarily based on patient and disease characteristics on admission. OBJECTIVE To develop and validate a complication- and treatment-aware outcome prediction tool in aSAH. METHODS This cohort study included data from an ongoing prospective nationwide multicenter registry on all aSAH patients in Switzerland (Swiss SOS [Swiss Study on aSAH]; 2009-2015). We trained supervised machine learning algorithms to predict a binary outcome at discharge (modified Rankin scale [mRS] ≤ 3: favorable; mRS 4-6: unfavorable). Clinical and radiological variables on admission ("Early" Model) as well as additional variables regarding secondary complications and disease management ("Late" Model) were used. Performance of both models was assessed by classification performance metrics on an out-of-sample test dataset. RESULTS Favorable functional outcome at discharge was observed in 1156 (62.0%) of 1866 patients. Both models scored a high accuracy of 75% to 76% on the test set. The "Late" outcome model outperformed the "Early" model with an area under the receiver operator characteristics curve (AUC) of 0.85 vs 0.79, corresponding to a specificity of 0.81 vs 0.70 and a sensitivity of 0.71 vs 0.79, respectively. CONCLUSION Both machine learning models show good discrimination and calibration confirmed on application to an internal test dataset of patients with a wide range of disease severity treated in different institutions within a nationwide registry. Our study indicates that the inclusion of variables reflecting the clinical course of the patient may lead to outcome predictions with superior predictive power compared to a model based on admission data only.
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Decision tree analysis in subarachnoid hemorrhage: prediction of outcome parameters during the course of aneurysmal subarachnoid hemorrhage using decision tree analysis. J Neurosurg 2019; 129:1499-1510. [PMID: 29350603 DOI: 10.3171/2017.7.jns17677] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/06/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThe aim of this study was to create prediction models for outcome parameters by decision tree analysis based on clinical and laboratory data in patients with aneurysmal subarachnoid hemorrhage (aSAH).METHODSThe database consisted of clinical and laboratory parameters of 548 patients with aSAH who were admitted to the Neurocritical Care Unit, University Hospital Zurich. To examine the model performance, the cohort was randomly divided into a derivation cohort (60% [n = 329]; training data set) and a validation cohort (40% [n = 219]; test data set). The classification and regression tree prediction algorithm was applied to predict death, functional outcome, and ventriculoperitoneal (VP) shunt dependency. Chi-square automatic interaction detection was applied to predict delayed cerebral infarction on days 1, 3, and 7.RESULTSThe overall mortality was 18.4%. The accuracy of the decision tree models was good for survival on day 1 and favorable functional outcome at all time points, with a difference between the training and test data sets of < 5%. Prediction accuracy for survival on day 1 was 75.2%. The most important differentiating factor was the interleukin-6 (IL-6) level on day 1. Favorable functional outcome, defined as Glasgow Outcome Scale scores of 4 and 5, was observed in 68.6% of patients. Favorable functional outcome at all time points had a prediction accuracy of 71.1% in the training data set, with procalcitonin on day 1 being the most important differentiating factor at all time points. A total of 148 patients (27%) developed VP shunt dependency. The most important differentiating factor was hyperglycemia on admission.CONCLUSIONSThe multiple variable analysis capability of decision trees enables exploration of dependent variables in the context of multiple changing influences over the course of an illness. The decision tree currently generated increases awareness of the early systemic stress response, which is seemingly pertinent for prognostication.
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P2614Comparison of global longitudinal strain and ejection fraction in correlation to NT-proBNP in ischemic and non-ischemic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In chronic heart failure (CHF) NT-proBNP and left ventricular ejection fraction (LVEF) by echocardiography are standard diagnostic as well as follow-up markers and are known to correlate with prognosis. Speckle-tracking echocardiography is a more recent technique to quantify myocardial deformation as a measurement of left ventricular function with potential benefits over LVEF.
Purpose
The purpose of this investigation was to analyse the cross-sectional relationship between 2D speckle tracking-derived global longitudinal strain (GLS) and NT-proBNP plasma levels in a prospective cohort of ischemic and non-ischemic CHF patients.
Methods
We enrolled 205 patients with chronic heart failure. Major inclusion criteria were age over 18 years, stable disease with absence of unplanned hospitalization or change in medication or device therapy in the previous month or major surgery in the previous 3 months. CHF treatment had to be according to the recommendations of the ESC CHF guidelines 2016 and LVEF had to be below 50%.
Patient history, physical examination and an extensive echocardiography exam were performed. Lab results included NT-proBNP. Manual longitudinal strain was calculated using EchoPAC (General Electric Medical Systems, Horten, Norway) by a single and blinded examiner. LVEF was measured using Simpson's biplane method.
Results
205 patients included in the study. The baseline characteristics included mean age 65.0 years and 75% male. Mean GLS was −9.6% (SD ±4.5%) and median NT-proBNP 1269.5 (IQR 379.5–2759.5) ng/ml. The CHF aetiology was 70.0% ischemic vs 30.0% non-ischemic.
There was a significant negative correlation between GLS and NT-proBNP (Pearson r=0.239, p=0.029), this was not significant for LVEF and NT-proBNP (Pearson r=0.149, p=0.228).In a multivariate regression analysis adjusted for age, sex, NYHA classification and HF aetiology, GLS remained significantly correlated with NT-proBNP (adjusted beta-coefficient= 0.289, p=0.011). Furthermore, in contrast to LVEF, GLS showed a significant correlation to NT-proBNP in patients with ischemic (Pearson r=0.266, p=0.049) as well as non-ischemic aetiology of heart failure (Pearson r=0.434, p=0.034).
Conclusion
Global longitudinal strain, not LVEF, was significantly correlated with NT-proBNP in patients with CHF, independently of age, sex, symptoms or heart failure aetiology. This shows that speckle-tracking might be superior to LVEF for the assessment of left ventricular function in CHF.
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Innovative cascade processes for CO 2
conversion into fuels and chemicals. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Effects of Vitamin D3 on asymmetric- and symmetric dimethylarginine in arterial hypertension. J Steroid Biochem Mol Biol 2018; 175:157-163. [PMID: 28027911 DOI: 10.1016/j.jsbmb.2016.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/14/2016] [Accepted: 12/23/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Accumulating evidence has proposed a correlation between vitamin D (25(OH)D) insufficiency and cardiovascular (CV) disease. Vitamin D associated effects on endothelial function have been suggested to be a possible culprit. The present study investigated the association of vitamin D3 treatment on markers of endothelial dysfunction in patients with arterial hypertension. METHODS AND RESULTS The Styrian Vitamin D Hypertension Trial is a double-blind, placebo-controlled, single-centre study conducted at the Medical University of Graz, Austria. A total of 200 study participants with arterial hypertension and 25(OH)D levels below 30ng/mL were enrolled. The study participants were randomized to receive 2800 IU of vitamin D3 per day as oily drops (n=100) or placebo (n=100) for a duration of eight weeks. The present study uses an analysis of covariance (ANCOVA) to investigate the effect of vitamin D3 treatment on symmetric (SDMA) and asymmetric dimethylarginine (ADMA). A total of 187 participants (mean [SD] age 60.0 [11.3] years; 47% women; 25(OH)D 21.2 [5.6]ng/mL; mean systolic blood pressure of 131.4 [8.9] mmHg on a median of 2 antihypertensive drugs) completed the trial. Mean treatment effect was -0.004 (95%CI [-0.03 to 0.04]; P=0.819) on ADMA and 0.001 (95%CI [-0.05 to 0.05]; P=0.850) on SDMA. In the subgroup analysis patients with a 25(OH)D concentration <20ng/mL had a significant increase in their log l-arginine/ADMA ratio (mean treatment effect 18.4 95%CI [1.84-34.9]μmol/L/μmol/L; P=0.030). ClinicalTrials.gov Identifier: NCT02136771 EudraCT number: 2009-018125-70 CONCLUSIONS: Vitamin D3 supplementation in hypertensive patients with low 25-hydroxyvitamin D has no significant effect on ADMA and SDMA.
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Effects of maternal high-fat diet and sedentary lifestyle on susceptibility of adult offspring to ozone exposure in rats. Inhal Toxicol 2017; 29:239-254. [PMID: 28819990 DOI: 10.1080/08958378.2017.1342719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Epidemiological and experimental data suggest that obesity exacerbates the health effects of air pollutants such as ozone (O3). Maternal inactivity and calorically rich diets lead to offspring that show signs of obesity. Exacerbated O3 susceptibility of offspring could thus be manifested by maternal obesity. Thirty-day-old female Long-Evans rats were fed a control (CD) or high-fat (HF) (60% calories) diet for 6 wks and then bred. GD1 rats were then housed with a running wheel (RW) or without a wheel (SED) until parturition, creating four groups of offspring: CD-SED, CD-RW, HF-SED and HF-RW. HF diet was terminated at PND 35 and all offspring were placed on CD. Body weight and %fat of dams were greatest in order; HF-SED > HF-RW > CD-SED > CD-RW. Adult offspring were exposed to O3 for two consecutive days (0.8 ppm, 4 h/day). Glucose tolerance tests (GTT), ventilatory parameters (plethysmography), and bronchoalveolar fluid (BALF) cell counts and protein biomarkers were performed to assess response to O3. Exercise and diet altered body weight and %fat of young offspring. GTT, ventilation and BALF cell counts were exacerbated by O3 with responses markedly exacerbated in males. HF diet and O3 led to significant exacerbation of several BALF parameters: total cell count, neutrophils and lymphocytes were increased in male HF-SED versus CD-SED. Males were hyperglycemic after O3 exposure and exhibited exacerbated GTT responses. Ventilatory dysfunction was also exacerbated in males. Maternal exercise had minimal effects on O3 response. The results of this exploratory study suggest a link between maternal obesity and susceptibility to O3 in their adult offspring in a sex-specific manner.
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Photoinactivation of Legionella Rubrilucens by Visible Light. Eur J Microbiol Immunol (Bp) 2017; 7:146-149. [PMID: 28690882 PMCID: PMC5495087 DOI: 10.1556/1886.2017.00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 03/28/2017] [Indexed: 12/02/2022] Open
Abstract
In this study, the photoinactivation of Legionella by visible light is investigated. The success of this approach would offer new prospects for technical water disinfection and maybe even for therapeutic measures in cases of Legionella infections. Therefore, Legionella rubrilucens was dispensed on buffered charcoal yeast extract medium agar plates and illuminated with different doses of violet light generated by 405 nm light-emitting diodes (LEDs). A strong photoinactivation effect was observed. A dose of 125 J/ cm2 reduced the bacterial concentration by more than 5 orders of magnitude compared to Legionella on unirradiated agar plates. The necessary dose for a one log-level reduction was about 24 J/cm2. These results were obtained for extracellular L. rubrilucens, but other Legionella species may exhibit a similar behavior.
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Schmerzaktivierung bei Patientinnen mit Dysmenorrhoe – Ergebnisse einer fMRT-Studie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Effects of vitamin D supplementation on glycated haemoglobin and fasting glucose levels in hypertensive patients: a randomized controlled trial. Diabetes Obes Metab 2016; 18:1006-12. [PMID: 27334070 DOI: 10.1111/dom.12709] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/08/2016] [Accepted: 06/12/2016] [Indexed: 12/26/2022]
Abstract
AIM To investigate the efficacy of vitamin D supplementation on glycaemic control. METHODS The Styrian Vitamin D Hypertension Trial was a single-centre, double-blind, placebo-controlled study conducted between 2011 and 2014 at the Medical University of Graz, Austria. We enrolled 200 people with arterial hypertension and 25-hydroxyvitamin D [25(OH)D] concentrations <30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D or placebo per day for 8 weeks. The present study was a post hoc analysis that incorporated an analysis of covariance (ancova) approach, while adjusting for baseline differences. RESULTS A total of 185 participants [mean ± standard deviation age, 60.1 ± 11.3 years; 47% women; mean 25(OH)D 21.2 ± 5.6 ng/mL, mean glycated haemoglobin (HbA1c) 44.8 ± 11.8 mmol/mol and mean body mass index 30.4 ± 5.4 kg/m(2) ] completed the trial. ancova showed a mean treatment effect [95% confidence interval (CI)] on HbA1c of -3.52 (-6.7 to -0.34) mmol/mol (p = .045). There was no difference in fasting glucose -4.7 mg/dL (95% CI -16.3 to 6.9; p = .426). CONCLUSIONS Vitamin D supplementation in obese hypertensive patients with low 25(OH)D reduces HbA1c levels. This finding warrants further investigation into potential vitamin D effects on glucose homeostasis.
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Development of a Chassis Organism for the Heterologous Expression of Exopolysaccharide-Encoding Operons. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Enhanced Bioconversion Efficiency of Fatty Acids towards α,ω-Dicarboxylic Acids via Bioprocess Engineering. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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PM090 The Optimal Cardiovascular Screening Age in Young Swiss Males is at Fifteen to Nineteen. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Resolving the Extragalactic γ-Ray Background above 50 GeV with the Fermi Large Area Telescope. PHYSICAL REVIEW LETTERS 2016; 116:151105. [PMID: 27127954 DOI: 10.1103/physrevlett.116.151105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Indexed: 05/16/2023]
Abstract
The Fermi Large Area Telescope (LAT) Collaboration has recently released a catalog of 360 sources detected above 50 GeV (2FHL). This catalog was obtained using 80 months of data re-processed with Pass 8, the newest event-level analysis, which significantly improves the acceptance and angular resolution of the instrument. Most of the 2FHL sources at high Galactic latitude are blazars. Using detailed Monte Carlo simulations, we measure, for the first time, the source count distribution, dN/dS, of extragalactic γ-ray sources at E>50 GeV and find that it is compatible with a Euclidean distribution down to the lowest measured source flux in the 2FHL (∼8×10^{-12} ph cm^{-2} s^{-1}). We employ a one-point photon fluctuation analysis to constrain the behavior of dN/dS below the source detection threshold. Overall, the source count distribution is constrained over three decades in flux and found compatible with a broken power law with a break flux, S_{b}, in the range [8×10^{-12},1.5×10^{-11}] ph cm^{-2} s^{-1} and power-law indices below and above the break of α_{2}∈[1.60,1.75] and α_{1}=2.49±0.12, respectively. Integration of dN/dS shows that point sources account for at least 86_{-14}^{+16}% of the total extragalactic γ-ray background. The simple form of the derived source count distribution is consistent with a single population (i.e., blazars) dominating the source counts to the minimum flux explored by this analysis. We estimate the density of sources detectable in blind surveys that will be performed in the coming years by the Cherenkov Telescope Array.
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HIT Poster session 1P154Preclinical diastolic dysfunction is related to impaired endothelial function in patients with chronic kidney diseaseP155Early detection of left atrial and left ventricular abnormalities in hypertensive and obese womenP156Right ventricle preserved systolic function irrespective of right ventricular hypertrophy and disease severity in anderson fabry diseaseP157Left atrial volume and function in patients undergoing percutaneous mitral valve repairP158Impact of left ventricular dysfunction on outcomes of patients undergoing direct TAVI with a self-expanding bioprosthesisP159Anatomic Doppler spectrum – retrospective spectral tissue Doppler from ultra high frame rate tissue Doppler imaging for evaluation of tissue deformationP160Phasic dynamics of ischaemic mitral regurgitation after primary coronary intervention in acute myocardial infarction: serial echocardiographic assessment from emergency room to long-term follow-upP161Reproducibility of 3DE RV volumes - novel insights at a regional levelP162Pulmonary vascular capacitance as assessed by echocardiography in pulmonary arterial hypertensionP163Three-dimensional endocardial area strain: a novel parameter for quantitative assessment of global left ventricular systolic functionP164Role of exercise hemodynamics assessed by echocardiography on symptom reduction after MitraClipP165Early identification of ventricular dysfunction in patients with juvenile systemic sclerosisP166Heart failure with and without preserved ejection fraction - the role of biomarkers in the aspect of global longitudinal strainP167Complex systolic deformation of aortic root: insights from two dimensional speckle tracking imageP168Volumetric and deformational imaging usind 2d strain and 3d echocardiography in patients with pulmonary hypertensionP169Influence of pressure load and right ventricular morphology and function on tricuspid regurgitation in pulmonary arterial hypertensionP170Left ventricular myocardial diastolic deformation analysis by 2D speckle tracking echocardiography and relationship with conventional diastolic parameters in chronic aortic regurgitationP171Extracellular volume, and not native T1 time, distinguishes diffuse fibrosis in dilated or hypertrophic cardiomyopathy at 3TP172Left atrial strain is significantly reduced in arterial hypertensionP173Symptomatic severe secondary mitral regurgitation: LV enddiastolic diameter (LVEDD) as preferable parameter for risk stratificationP174Left ventricular mechanics in isolated left bundle branch block at rest and when exercising: exploration of the concept of conductive cardiomyopathyP175Assessment of myocardial scar by 2D contrast echocardiographyP176Chronic pericarditis - expression of a rare disease: Erdheim Chester diseaseP177Aortic arch mechanics with two-dimensional speckle tracking echocardiography to estimate the left ventricular remodelling in hypertensive patientsP178Strain analysis by tissue doppler imaging: comparison of conventional manual measurement with a semi-automated approachP179Distribution of extravascular lung water in heart failure patients assessed by lung ultrasoudP180Surrogate markers for obstructive coronary artery diseaseP181LA deformation and LV longitudinal strain by two-dimensional speckle tracking echocardiography as predictors of postoperative AF development after aortic valve replacement in ASP182Left ventricular diastolic dysfunction in type 2 diabetic patients with non alcoholic fatty liver diseaseP183Myocardial strain by speckle-tracking and evaluation of 3D ejection fraction in drug-induced cardiotoxicity's approach in breast cancer. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Imaging of single cell responses to ER stress indicates that the relative dynamics of IRE1/XBP1 and PERK/ATF4 signalling rather than a switch between signalling branches determine cell survival. Cell Death Differ 2015; 22:1502-16. [PMID: 25633195 DOI: 10.1038/cdd.2014.241] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/15/2014] [Indexed: 12/18/2022] Open
Abstract
An accumulation of misfolded proteins in the endoplasmic reticulum (ER) triggers the unfolded protein response (UPR) mediated via the activation of three transmembrane proteins IRE1, PERK and ATF6. Signalling through these proteins is aimed at enhancing the ER folding capacity and reducing the folding load. If these processes fail to re-establish protein homeostasis within the ER, then cell death prevails via apoptosis. How the shift from pro-survival to pro-apoptotic signalling is regulated remains unclear with both IRE1 and PERK signalling associated with pro-survival as well as pro-apoptotic signalling. To investigate the temporal activation of IRE1 and PERK in live cells and their relationship to cellular fate, we devised single cell reporters for both ER stress signalling branches. SH-SY5Y neural cells stably expressing these fluorescent protein reporter constructs to monitor IRE1-splicing activity and PERK-mediated ATF4-translation were imaged using single cell and high content time lapse live cell microscopy. We could correlate an early onset and attenuation of XBP1 splicing in the IRE1-reporter cells as cytoprotective. Indeed, silencing of IRE1 expression using shRNA inhibited splicing of XBP1 resulting in an early onset of cell death. In contrast, in the PERK-reporter cells, we observed that a slow rate of ATF4-translation and late re-initiation of general translation coincided with cells which were resistant to ER stress-induced cell death. Interestingly, whereas silencing of PERK did not affect overall levels of cell death in response to ER stress, it did increase sensitivity to ER stressors at early time points following treatment. Our results suggest that apoptosis activation in response to ER stress is not caused by a preferential activation of a single UPR branch, or by a switch from one branch to the other. Rather, our data indicated that the relative timing of IRE1 and PERK signalling determines the shift from cell survival to apoptosis.
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Are there sex differences in placebo analgesia during visceral pain processing? A fMRI study in healthy subjects. Neurogastroenterol Motil 2014; 26:1743-53. [PMID: 25346054 DOI: 10.1111/nmo.12454] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/16/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND We explored sex differences in the neural mechanisms mediating placebo analgesia in an established visceral pain model involving painful rectal distensions in healthy volunteers. METHODS N = 15 men and N = 15 women underwent three consecutive functional magnetic resonance imaging sessions during which cued painful rectal distensions were delivered. After an adaptation session, positive expectations were induced with deceptive instructions regarding administration of an analgesic drug (placebo session). In the other session (control), truthful information about an inert substance was given. Sex differences in placebo-induced modulation of neural activation during anticipation and pain were analyzed along with ratings of expected and perceived pain intensity. KEY RESULTS Placebo-induced reductions in pain ratings were comparable between men and women. At the level of the brain, group comparisons with respect to differences between the placebo and control conditions revealed greater modulation of the posterior insula (regions-of-interest analysis: pFWE < 0.05) and dorsolateral prefrontal cortex (whole-brain analysis: p < 0.001, uncorrected) during pain anticipation in women. During pain, placebo-induced down-regulation of the insula was altered in women compared to men (ROI analysis: pFWE < 0.05). CONCLUSIONS & INFERENCES Our data provide first evidence supporting sex differences in pain-induced neural modulation during visceral placebo analgesia despite similar placebo-induced reductions in perceived pain intensity. These preliminary findings might contribute to elucidating mechanisms mediating placebo effects in clinical conditions associated with chronic abdominal pain such as in irritable bowel syndrome.
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Cardiovascular control, autonomic function, and elite endurance performance in spinal cord injury. Scand J Med Sci Sports 2014; 25:476-85. [DOI: 10.1111/sms.12308] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 12/17/2022]
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Accuracy of prospectively ECG-triggered very low-dose coronary dual-source CT angiography using iterative reconstruction for the detection of coronary artery stenosis: comparison with invasive catheterization. Eur Heart J Cardiovasc Imaging 2014; 15:1238-45. [DOI: 10.1093/ehjci/jeu113] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aldosterone to active Renin ratio as screening test for primary aldosteronism: reproducibility and influence of orthostasis and salt loading. Horm Metab Res 2014; 46:427-32. [PMID: 24526370 DOI: 10.1055/s-0034-1367033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Measurement of the aldosterone to active renin ratio (AARR) is the recommended screening test for primary aldosteronism (PA), but several sampling conditions impact on the AARR. We aimed to evaluate the reproducibility and the influence of orthostasis and salt loading on the AARR. The Graz Endocrine Causes of Hypertension (GECOH) study is a diagnostic accuracy study among hypertensive patients at a tertiary care centre in Graz, Austria. With a median interval of 4 weeks we determined the AARR under standardized sampling conditions twice in the sitting position, after 1h in the supine position, and after a salt infusion test (SIT). We identified 9 patients with PA and 151 patients with essential hypertension (EH). The Pearson correlation coefficient between both AARR measurements in the sitting position was 0.79 (p<0.001). In EH, recumbency was associated with a significant decrease of aldosterone and, to a lesser extent, of renin, thus lowering the AARR as compared to the sitting position (p<0.001 for all). In PA, recumbency had only minor effects, but it increased the rate of false negative AARR. SIT suppressed the AARR and its components in EH, whereas in PA only renin was slightly decreased. AARR has a good intra-individual reproducibility and decreases during recumbency. These results suggest that a single AARR determination in the sitting position is a reliable screening tool for PA.
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Improved image quality after use of iterative reconstruction in coronary Dual-Source CT angiographies of obese patients: comparison to traditional filtered back projection. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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An Electromagnetic Simulation Environment, to Construct Microwave Imaging Algorithms. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-I/bmt-2013-4217/bmt-2013-4217.xml. [PMID: 24042871 DOI: 10.1515/bmt-2013-4217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Aldosterone to renin ratio is associated with 24 hour ambulatory blood pressure in essential hypertensives: the Styrian Hypertension study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aortic annulus eccentricity before and after transcatheter aortic valve implantation: comparison of balloon-expandable and self-expandable prostheses. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Identification of non-obstructive coronary artery disease by coronary CT angiography in patients with normal coronary arteries in preceding invasive catheterization. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
AIMS/HYPOTHESIS HNF1A-MODY is a monogenic form of diabetes caused by mutations in the HNF1A gene. Here we identify, for the first time, HNF1A-MODY-associated microRNAs (miRNAs) that can be detected in the serum of HNF1A-MODY carriers. METHODS An miRNA array was carried out in rat INS-1 insulinoma cells inducibly expressing the common human Pro291fsinsC-HNF1A frame shift mutation. Differentially expressed miRNAs were validated by quantitative real-time PCR. Expression of miRNAs in the serum of HNF1A-MODY carriers (n = 31), MODY-negative family members (n = 10) and individuals with type 2 diabetes mellitus (n = 17) was quantified by absolute real-time PCR analysis. RESULTS Inducible expression of Pro291fsinsC-HNF1A in INS-1 cells caused a significant upregulation of three miRNAs (miR-103, miR-224, miR-292-3p). The differential expression of two miRNAs (miR-103 and miR-224) was validated in vitro. Strongly elevated levels of miR-103 and miR-224 could be detected in the serum of HNF1A-MODY carriers compared with MODY-negative family controls. Serum levels of miR-103 distinguished HNF1A-MODY carriers from HbA1c-matched individuals with type 2 diabetes mellitus. CONCLUSIONS/INTERPRETATION Our study demonstrates that the pathophysiology of HNF1A-MODY is associated with the overexpression of miR-103 and miR-224. Furthermore, our study demonstrates that these miRNAs can be readily detected in the serum of HNF1A-MODY carriers.
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How positive and negative expectations shape the experience of visceral pain: an experimental pilot study in healthy women. Neurogastroenterol Motil 2012; 24:914-e460. [PMID: 22650270 DOI: 10.1111/j.1365-2982.2012.01950.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND In order to elucidate placebo and nocebo effects in visceral pain, we analyzed the effects of positive and negative expectations on rectal pain perception, rectal pain thresholds, state anxiety and cortisol responses in healthy women. METHODS Painful rectal distensions were delivered at baseline, following application of an inert substance combined with either positive instructions of pain relief (placebo group, N = 15), negative instructions of pain increase (nocebo group, N = 17), or neutral instructions (control, N = 15). Perceived pain intensity, unpleasantness/aversion and urge-to-defecate, state anxiety and serum cortisol were determined at baseline, immediately following group-specific instructions and on a second study day after the same instructions (test day). Rectal pain thresholds were determined at baseline and on the test day. KEY RESULTS Whereas perceived pain intensity was significantly decreased in the placebo group, the nocebo group revealed significantly increased pain intensity ratings, along with significantly greater anticipatory anxiety on the test day (all P < 0.05 vs controls). Cortisol concentrations were significantly increased in the nocebo group following treatment but not on the test day. CONCLUSIONS & INFERENCES The experience of abdominal pain can be experimentally increased or decreased by inducing positive or negative expectations. Nocebo effects involve a psychological stress response, characterized by increased anticipatory anxiety. These findings further underscore the role of cognitive and emotional factors in the experience of visceral pain, which has implications for the pathophysiology and treatment of patients with chronic abdominal complaints.
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Highly tolerant tunable waveguide polarization rotator scheme. OPTICS LETTERS 2012; 37:3534-3536. [PMID: 22940940 DOI: 10.1364/ol.37.003534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Integrated polarization rotators are known to exhibit stringent fabrication tolerances, which severely handicap their practical application. Here we present a general polarization rotator scheme that enables both the compensation of fabrication errors and wavelength tunability. The scheme is described analytically, and a condition for perfect polarization conversion is established. Simulations of a silicon-on-insulator polarization rotator show polarization extinction ratios in excess of 40 dB even in the presence of large fabrication errors that in a conventional rotator configuration degrade the extinction ratio to below 5 dB. Additionally, wavelength tuning over ±30 nm is shown.
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Potenzial von Pseudomonas putida für industrielle Biokatalysen anhand der n-Butanol-Toleranz und der Produktion von 1-Oktanol. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Process Optimization of Antibiotic Production by Actinoplanes friuliensis. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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A morphological change in the fungal symbiont Neotyphodium lolii induces dwarfing in its host plant Lolium perenne. Fungal Biol 2011; 116:234-40. [PMID: 22289769 DOI: 10.1016/j.funbio.2011.11.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 11/10/2011] [Accepted: 11/14/2011] [Indexed: 01/18/2023]
Abstract
The endophytic fungus Neotyphodium lolii forms symbiotic associations with perennial ryegrass (Lolium perenne) and infection is typically described as asymptomatic. Here we describe a naturally occurring New Zealand N. lolii isolate that can induce dwarfing of L. perenne and suppress floral meristem development in the dwarfed plants. Further to this we demonstrate that the observed host dwarfing correlates with a reversible morphological change in the endophyte that appears associated with colony age. Mycelium isolated from normally growing plants had a typical cottony appearance in culture whereas mycelium from dwarfed plants appeared mucoid. Cottony colonies could be induced to turn mucoid after prolonged incubation and seedlings inoculated with this mucoid mycelium formed dwarfed plants. Mucoid colonies on the other hand could be induced to form cottony colonies through additional further incubation and these did not induce dwarfing. The reversibility of colony morphology indicates that the mucoid dwarfing phenotype is not the result of mutation. Ten isolates from other locations in New Zealand could also undergo the reversible morphological changes in culture, induce dwarfing and had the same microsatellite genotype as the original isolate, indicating that a N. lolii genotype with the ability to dwarf host plants is common in New Zealand.
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Outbreak of acute gastroenteritis due to a washwater-contaminated water supply, Switzerland, 2008. JOURNAL OF WATER AND HEALTH 2011; 9:569-576. [PMID: 21976203 DOI: 10.2166/wh.2011.158] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An operating error in a sewage treatment plant led to severe drinking water contamination in a well-defined district of a suburban municipality of Zurich, Switzerland. Despite the alert issued to the local population on the same day advising people not to consume the contaminated water, cases of acute gastroenteric diseases were subsequently observed. Considerable faecal contamination was detected the day after the incident in water samples taken up to 500 m from the sewage plant. In a retrospective epidemiological study involving 240 persons living in the affected area, 126 cases of acute gastrointestinal illness were documented. The epidemic curve revealed a peak incidence two days after the event. Stool samples from 11 of 20 patients were positive for noroviruses or Campylobacter jejuni. Although these microorganisms were not detected in the contaminated water, the subsequently conducted case-control study among the surveyed population showed that consumption of contaminated drinking water was associated with gastrointestinal illness (odds ratio 29.1; 95% confidence interval: 9.8-86.4; p = 0.001). The study also revealed the very probable time period of infection. We present the dimension and chronology of this outbreak and discuss the reasons for its localised and temporary spread.
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The role of surface charge and hydrophobicity in the attachment of Anoxybacillus flavithermus isolated from milk powder. J Ind Microbiol Biotechnol 2010; 37:1111-9. [DOI: 10.1007/s10295-010-0758-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 05/24/2010] [Indexed: 11/28/2022]
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Continuous hypothermic low-flow-perfusion during aortic arch operations is neuroprotective and cardioprotective. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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The influence of cholesterol on the motility of cochlear outer hair cells and the motor protein prestin. Acta Otolaryngol 2009; 129:929-34. [PMID: 19153847 DOI: 10.1080/00016480802495438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSIONS We provide evidence that cholesterol reduces electromotility in a dose-dependent matter. The data show that cholesterol modulates electromotility mainly by influencing the motor protein prestin, less by affecting the passive membrane properties. OBJECTIVES Elevated serum cholesterol is linked to inner ear disorders and may influence hearing by altering membrane properties of outer hair cells (OHCs) and by affecting the motor protein prestin. In this study we wanted to determine whether cholesterol modulates the electromotility of OHCs and if this modulation results from effects on the membrane properties or on the motor protein prestin. MATERIALS AND METHODS The motile responses of 12 isolated OHCs were investigated at increasing concentrations of 0, 0.1, and 1 mM extracellular cholesterol using the patch clamp technique and continuous video image analysis. To study effects on prestin, experiments were performed in 12 cells with half activated protein function and concentrations of 0 and 1 mM cholesterol. RESULTS Cholesterol at a concentration of 0.1 mM had no effect on motility. A concentration of 1 mM reduced maximal evoked shortening significantly by 29% in the depolarizing and by 9% in the hyperpolarizing direction. Investigating half activated motor proteins, 1 mM cholesterol reduced movements significantly by 18%, elongations decreased nonsignificantly by 5%.
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Antibiotische Behandlung der Sepsis mit Teicoplanin bei knochenmarktransplantierten Patienten. Oncol Res Treat 2009. [DOI: 10.1159/000216983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Optional strategies for reduced metabolism in gray mouse lemurs. Naturwissenschaften 2009; 96:737-41. [PMID: 19277596 DOI: 10.1007/s00114-009-0523-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 02/04/2009] [Accepted: 02/21/2009] [Indexed: 10/21/2022]
Abstract
Among the order of primates, torpor has been described only for the small Malagasy cheirogaleids Microcebus and Cheirogaleus. The nocturnal, gray mouse lemur, Microcebus murinus (approx. 60 g), is capable of entering into and spontaneously arousing from apparently daily torpor during the dry season in response to reduced temperatures and low food and water sources. Mark-recapture studies indicated that this primate species might also hibernate for several weeks, although physiological evidence is lacking. In the present study, we investigated patterns of body temperature in two free-ranging M. murinus during the austral winter using temperature-sensitive data loggers implanted subdermally. One lemur hibernated and remained inactive for 4 weeks. During this time, body temperature followed the ambient temperature passively with a minimum body temperature of 11.5 degrees C, interrupted by irregular arousals to normothermic levels. Under the same conditions, the second individual displayed only short bouts of torpor in the early morning hours but maintained stable normothermic body temperatures throughout its nocturnal activity. Reduction of body temperature was less pronounced in the mouse lemur that utilized short bouts of torpor with a minimum value of 27 degrees C. Despite the small sample size, our findings provide the first physiological confirmation that free-ranging individuals of M. murinus from the humid evergreen littoral rain forest have the option to utilize short torpor bouts or hibernation under the same conditions as two alternative energy-conserving physiological solutions to environmental constraints.
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O.121 Management of arteriovenous malformations. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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O.114 Diagnostic and therapeutic advances in venous malformations. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pseudomonas aeruginosa transmission is infrequent in New Zealand cystic fibrosis clinics. Eur Respir J 2008; 32:1583-90. [PMID: 18715877 DOI: 10.1183/09031936.00099508] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pseudomonas aeruginosa is an important pathogen in cystic fibrosis (CF). Although most patients harbour unique P. aeruginosa isolates, some clinics report patients sharing common strains. The overall importance of person-to-person transmission in P. aeruginosa acquisition and whether routine patient segregation is necessary remains uncertain. The present authors therefore investigated the extent of P. aeruginosa transmission in New Zealand CF clinics. New Zealand's seven major CF centres were assessed, combining epidemiological data with computer-assisted SalI DNA fingerprinting of 496 isolates from 102 patients. One cluster of related isolates was significantly more prevalent in the largest clinic than expected by chance. The seven patients with isolates belonging to this cluster had more contact with each other than the remaining patients attending this centre. No other convincing evidence of transmission was found in any of the other smaller clinics. Three P. aeruginosa strains believed to be transmissible between patients in Australian and British CF clinics are present in New Zealand, but there was no definite evidence they had spread. Pseudomonas aeruginosa transmission is currently infrequent in New Zealand cystic fibrosis clinics. This situation could change rapidly and ongoing surveillance is required. The current results confirm that computer-assisted SalI DNA fingerprinting is ideally suited for such surveillance.
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Abstract
The Wnt signalling pathway has a key function in stem cell maintenance and differentiation of haematopoietic progenitors. Secreted Frizzled-related protein genes (SFRPs), functioning as Wnt signalling antagonists, have been found to be downregulated by promoter hypermethylation in many tumours. To analyse epigenetic dysregulation of SFRPs in acute myeloid leukaemia (AML), we examined the promoter methylation status of SFRP1, -2, -4 and -5 in AML cell lines by methylation-specific polymerase chain reaction (MSP). Aberrant CpG island methylation was found for all four SFRP genes. By real-time reverse transcription-PCR, corresponding transcriptional silencing for SFRP1 and -2 was demonstrated and treatment of cell lines with 5-aza-2'-deoxycytidine resulted in re-expression. The methylation status of the SFRP genes was analysed in 100 specimens obtained from AML patients at diagnosis. The frequencies of aberrant methylation among the patient samples were 29% for SFRP1, 19% for SFRP2, 0% for SFRP4 and 9% for SFRP5. For SFRP2, a correlation between promoter hypermethylation and transcriptional downregulation was found in primary AML samples. Among AML cases with a favourable karyotype, hypermethylation of SFRP genes was restricted to patients with core binding factor (CBF) leukaemia, and aberrant methylation of the SFRP2 promoter was an adverse risk factor for survival in CBF leukaemia.
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A benchmark exercise on the use of CFD codes for containment issues using best practice guidelines: A computational challenge. NUCLEAR ENGINEERING AND DESIGN 2008. [DOI: 10.1016/j.nucengdes.2007.01.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Advanced da Vinci Surgical System simulator for surgeon training and operation planning. Int J Med Robot 2007; 3:245-51. [PMID: 17576641 DOI: 10.1002/rcs.139] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although patients benefit considerably from minimally invasive surgery, the use of new instruments such as robotic systems is challenging for surgeons, and extensive training is required. METHOD We developed a computer-based simulator of the da Vinci Surgical System, modelling the robot and designing a new interface. RESULTS The simulator offers users a two-handed interface to control a realistic model of the da Vinci robot. The simulator can be applied (i) to provide an environment in which to practice simple surgical skills and (ii) to serve as a visualization platform on which to validate port placement and robot pose for operation planning. CONCLUSIONS Virtual reality is a useful technique for medical training. The simulator is currently in its early stages, but this preliminary work is promising.
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