Circulating soluble fibroblast activation protein (FAP) levels are independent of cardiac and extra-cardiac FAP expression determined by targeted molecular imaging in patients with myocardial FAP activation

INTRODUCTION

Tissue Fibroblast Activation Protein alpha (FAP) is overexpressed in various types of acute and chronic cardiovascular disease. A soluble form of FAP has been detected in human plasma, and low circulating FAP concentrations are associated with increased risk of death in patients with acute coronary syndrome. However, little is known about the regulation and release of FAP from fibroblasts, and whether circulating FAP concentration is associated with tissue FAP expression. This study characterizes the release of FAP in human cardiac fibroblasts (CF) and analyzes the association of circulating FAP concentrations with in vivo tissue FAP expression in patients with acute (ST-segment elevation myocardial infarction, STEMI) and chronic (severe aortic stenosis, AS) myocardial FAP expression.

METHODS AND RESULTS

FAP was released from CF in a time- and concentration-dependent manner. FAP concentration was higher in supernatant of TGFβ-stimulated CF, and correlated with cellular FAP concentration. Inhibition of metallo- and serine-proteases diminished FAP release in vitro. Median FAP concentrations of patients with acute (77 ng/mL) and chronic (75 ng/mL, p = 0.50 vs. STEMI) myocardial FAP expression did not correlate with myocardial nor extra-myocardial nor total FAP volume (P ≥ 0.61 in all cases) measured by whole-body FAP-targeted positron emission tomography.

CONCLUSION

We describe a time- and concentration dependent, protease-mediated release of FAP from cardiac fibroblasts. Circulating FAP concentrations were not associated with increased in vivo tissue FAP expression determined by molecular imaging in patients with both chronic and acute myocardial FAP expression. These data suggest that circulating FAP and tissue FAP expression provide complementary, non-interchangeable information.

Automated disassembly of e-waste-requirements on modeling of processes and product states

Automated disassembly is increasingly in focus for Recycling, Re-use, and Remanufacturing (Re-X) activities. Trends in digitalization, in particular digital twin (DT) technologies and the digital product passport, as well as recently proposed European legislation such as the Net Zero and the Critical materials Acts will accelerate digitalization of product documentation and factory processes. In this contribution we look beyond these activities by discussing digital information for stakeholders at the Re-X segment of the value-chain. Furthermore, we present an approach to automated product disassembly based on different levels of available product information. The challenges for automated disassembly and the subsequent requirements on modeling of disassembly processes and product states for electronic waste are examined. The authors use a top-down (e.g., review of existing standards and process definitions) methodology to define an initial data model for disassembly processes. An additional bottom-up approach, whereby 5 exemplary electronics products were manually disassembled, was employed to analyze the efficacy of the initial data model and to offer improvements. This paper reports on our suggested informal data models for automatic electronics disassembly and the associated robotic skills.

Mitochondrial-derived vesicles in metabolism, disease, and aging

Mitochondria are central hubs of cellular metabolism and are tightly connected to signaling pathways. The dynamic plasticity of mitochondria to fuse, divide, and contact other organelles to flux metabolites is central to their function. To ensure bona fide functionality and signaling interconnectivity, diverse molecular mechanisms evolved. An ancient and long-overlooked mechanism is the generation of mitochondrial-derived vesicles (MDVs) that shuttle selected mitochondrial cargoes to target organelles. Just recently, we gained significant insight into the mechanisms and functions of MDV transport, ranging from their role in mitochondrial quality control to immune signaling, thus demonstrating unexpected and diverse physiological aspects of MDV transport. This review highlights the origin of MDVs, their biogenesis, and their cargo selection, with a specific focus on the contribution of MDV transport to signaling across cell and organ barriers. Additionally, the implications of MDVs in peroxisome biogenesis, neurodegeneration, metabolism, aging, and cancer are discussed.

Evaluation of PEG-L-asparaginase in asparagine suppression and anti-drug antibody development in healthy Beagle dogs: A multi-phase preclinical study

L-asparaginase is a frequently used drug in the treatment of canine malignant lymphoma. Since production and availability of native E. coli-derived L-asparaginase are limited, PEG-L-asparaginase (PEG-ASP) is an alternative. However, recommended doses and dosing intervals are mainly empirically determined. A multi-phase clinical dose-finding study with seven healthy Beagle dogs was conducted to find the minimum effective dose and, potentially, a dosing interval for PEG-ASP in dogs. Plasma concentrations of amino acids and PEG-ASP activity were measured at various time points after administration of different doses of PEG-ASP. Anti-PEG and anti-asparaginase antibody titres were measured. Administration of 10 IU/kg PEG-ASP resulted in asparagine depletion in all dogs, albeit for various durations: for 9 days in all dogs, 15 days in five dogs, 21 days in three dogs and 29 days in one dog. Asparagine suppression occurred at PEG-ASP plasma concentrations < 25 IU/L. Subsequent administrations of a second and third dose of 20 IU/kg and 40 IU/kg PEG-ASP resulted in asparagine suppression at < 9 days in five dogs, accompanied by the development of antibodies against PEG and L-asparaginase. Two dogs with prolonged asparagine suppression after the second and third administration did not develop antibodies. Marked individual variation in the mechanism and duration of response to PEG-ASP was noted. Antibody formation against PEG-ASP was frequently observed and sometimes occurred after one injection. This study suggests that PEG-ASP doses as high as the currently used dose of 40 IU/kg might not be needed in treatment of canine malignant lymphoma.

Leveraging Dynamic Heterogeneous Networks to Study Transnational Issue Publics. The Case of the European COVID-19 Discourse on Twitter

The ongoing COVID-19 pandemic constitutes a critical phase for the transnationalization of public spheres. Against this backdrop, we ask how transnational COVID-19 related online discourse has been throughout the EU over the first year of the pandemic. Which events triggered higher transnational coherence or national structuration of this specific issue public on Twitter? In order to study these questions, we rely on Twitter data obtained from the TBCOV database, i.e., a dataset for multilingual, geolocated COVID-19 related Twitter communication. We selected corpora for the 27 member states of the EU plus the United Kingdom. We defined three research periods representing different phases of the pandemic, namely April (1st wave), August (interim) and December 2020 (2nd wave) resulting in a set of 51,893,966 unique tweets for comparative analysis. In order to measure the level and temporal variation of transnational discursive linkages, we conducted a spatiotemporal network analysis of so-called Heterogeneous Information Networks (HINs). HINs allow for the integration of multiple, heterogeneous network entities (hashtags, retweets, @-mentions, URLs and named entities) to better represent the complex discursive structures reflected in social media communication. Therefrom, we obtained an aggregate measure of transnational linkages on a daily base by relating these linkages back to their geolocated authors. We find that the share of transnational discursive linkages increased over the course of the pandemic, indicating effects of adaptation and learning. However, stringent political measures of crisis management at the domestic level (such as lockdown decisions) caused stronger national structuration of COVID-19 related Twitter discourse.

The EPINetz Twitter Politicians Dataset 2021. A New Resource for the Study of the German Twittersphere and Its Application for the 2021 Federal Elections

This research note introduces the EPINetz Twitter Politicians Dataset, a comprehensive dataset of 2449 Twitter accounts of German parliamentarians, minsters, state secretaries, parties, and ministries on a state, federal, and European Union level for the year 2021. This hand-curated dataset not only provides up-to-date information on elected officials, but it also includes additional variables such as their party affiliation, age, and gender. Furthermore, it provides linkages to additional data sources by providing the accounts' Wikidata and Abgeordnetenwatch (Parliamentwatch) IDs. While it does not provide actual tweet data, the dataset will be a valuable resource for researchers by providing easy access to elected German politicians. We demonstrate some of the dataset's uses with an analysis of the 2021 German Federal Elections. The full dataset can be accessed via 10.7802/2415.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s11615-022-00405-7) contains supplementary material, which is available to authorized users.

MIROs and DRP1 drive mitochondrial-derived vesicle biogenesis and promote quality control

Mitochondrial-derived vesicles (MDVs) are implicated in diverse physiological processes-for example, mitochondrial quality control-and are linked to various neurodegenerative diseases. However, their specific cargo composition and complex molecular biogenesis are still unknown. Here we report the proteome and lipidome of steady-state TOMM20⁺ MDVs. We identified 107 high-confidence MDV cargoes, which include all β-barrel proteins and the TOM import complex. MDV cargoes are delivered as fully assembled complexes to lysosomes, thus representing a selective mitochondrial quality control mechanism for multi-subunit complexes, including the TOM machinery. Moreover, we define key biogenesis steps of phosphatidic acid-enriched MDVs starting with the MIRO1/2-dependent formation of thin membrane protrusions pulled along microtubule filaments, followed by MID49/MID51/MFF-dependent recruitment of the dynamin family GTPase DRP1 and finally DRP1-dependent scission. In summary, we define the function of MDVs in mitochondrial quality control and present a mechanistic model for global GTPase-driven MDV biogenesis.

Serine palmitoyltransferase assembles at ER-mitochondria contact sites

The accumulation of sphingolipid species in the cell contributes to the development of obesity and neurological disease. However, the subcellular localization of sphingolipid-synthesizing enzymes is unclear, limiting the understanding of where and how these lipids accumulate inside the cell and why they are toxic. Here, we show that SPTLC2, a subunit of the serine palmitoyltransferase (SPT) complex, catalyzing the first step in de novo sphingolipid synthesis, localizes dually to the ER and the outer mitochondrial membrane. We demonstrate that mitochondrial SPTLC2 interacts and forms a complex in trans with the ER-localized SPT subunit SPTLC1. Loss of SPTLC2 prevents the synthesis of mitochondrial sphingolipids and protects from palmitate-induced mitochondrial toxicity, a process dependent on mitochondrial ceramides. Our results reveal the in trans assembly of an enzymatic complex at an organellar membrane contact site, providing novel insight into the localization of sphingolipid synthesis and the composition and function of ER-mitochondria contact sites.

Mitochondrial-derived compartments: A "fusel alcohol generator" in yeast?

Schuler et al. (2021) demonstrate that mitochondrial-derived compartments protect cells from amino acid toxicity by activation of amino acid catabolism through the Ehrlich pathway, thus highlighting the incredible plasticity of mitochondria in rewiring cellular metabolism.

Phosphoproteomics of the developing heart identifies PERM1 - An outer mitochondrial membrane protein

Heart development relies on PTMs that control cardiomyocyte proliferation, differentiation and cardiac morphogenesis. We generated a map of phosphorylation sites during the early stages of cardiac postnatal development in mice; we quantified over 10,000 phosphorylation sites and 5000 proteins that were assigned to different pathways. Analysis of mitochondrial proteins led to the identification of PGC-1- and ERR-induced regulator in muscle 1 (PERM1), which is specifically expressed in skeletal muscle and heart tissue and associates with the outer mitochondrial membrane. We demonstrate PERM1 is subject to rapid changes mediated by the UPS through phosphorylation of its PEST motif by casein kinase 2. Ablation of Perm1 in mice results in reduced protein expression of lipin-1 accompanied by accumulation of specific phospholipid species. Isolation of Perm1-deficient mitochondria revealed significant downregulation of mitochondrial transport proteins for amino acids and carnitines, including SLC25A12/13/29/34 and CPT2. Consistently, we observed altered levels of various lipid species, amino acids, and acylcarnitines in Perm1^-/- mitochondria. We conclude that the outer mitochondrial membrane protein PERM1 regulates homeostasis of lipid and amino acid metabolites in mitochondria.

Retrospective study on risk factors for repeated dental treatment of children under general anaesthesia

AIM

This retrospective study aimed to evaluate potential risk factors predicting repeated dental treatment of children under general anaesthesia.

MATERIALS AND METHODS

Children below 12 years of age receiving at least one dental treatment under general anaesthesia between 03/2010 and 10/2018 were analysed (n = 935, mean age: 4.6 ± 2.4). Dental records were analysed retrospectively for anamnestic, demographic, oral health and treatment factors. Kaplan-Meier statistics was used to estimate the time to second dental treatment under general anaesthesia. Potential risk factors for repeated dental treatment underwent univariate analysis using log-rank tests and were then submitted to a multi-variate Cox-regression analysis (a = 5%).

RESULTS

One hundred fifteen children (12.3%) received or were planned to receive repeated dental treatment under general anaesthesia. In children receiving repeated dental treatment, the time intervals between first and second general anaesthesia and second and third general anaesthesia amounted to 22 ± 18 and 23 ± 20 months, respectively. The use of fluoridated toothpaste (HR: 0.28, p < 0.01) and attending 2 or more recall appointments per year (HR: 0.6, p < 0.01) significantly decreased the risk for repeated dental treatment under general anaesthesia in the multivariate model.

CONCLUSION

Adherence to preventive recall appointments and to oral hygiene recommendations is essential to maintain oral health and avoid repeated dental treatment under general anaesthesia.

Increased risk of death associated with the use of proton-pump inhibitors in patients with dementia and controls - a pharmacoepidemiological claims data analysis

Background and purpose

The use of proton‐pump inhibitors (PPIs) was reported to be associated with increased mortality risk and has been proposed as a potential risk factor for neurodegenerative diseases. We aimed to assess the impact of PPI use on survival in patients with dementia as compared with controls.

Methods

This register‐based control‐matched cohort study included 28 428 patients with dementia ascertained by the prescription of antidementia drugs and two control individuals matched by sex, age and area of residence for each patient with dementia during the study period from 1 January 2005 to 30 June 2016. Cumulative defined daily doses (DDDs) of PPIs were extracted from the health insurance prescription registries. A multivariate Cox regression model for non‐proportional hazards was used to analyse mortality risk in dependence of PPI exposure, which was limited to 1 year preceding the date of cohort entry (index date) in order to avoid immortal time bias.

Results

The PPI exposure of 100 DDDs in the year before the index date was associated with an increased mortality risk in patients with dementia (adjusted hazard ratio, 1.07; 95% confidence intervals, 1.03–1.12), but also in controls (adjusted hazard ratio, 1.47; 95% confidence intervals, 1.31–1.64). The mortality risk in relation to PPI use was significantly lower in patients with dementia as compared with controls (P < 0.0001) and highest in the first 2 years after the index date in both cohorts.

Conclusions

Our findings promote more stringent pharmacovigilance strategies to avoid PPI use in cases lacking a clear indication for therapy or where potential risks outweigh the benefits.

Loss of the mitochondrial i-AAA protease YME1L leads to ocular dysfunction and spinal axonopathy

Disturbances in the morphology and function of mitochondria cause neurological diseases, which can affect the central and peripheral nervous system. The i‐AAA protease YME1L ensures mitochondrial proteostasis and regulates mitochondrial dynamics by processing of the dynamin‐like GTPase OPA1. Mutations in YME1L cause a multi‐systemic mitochondriopathy associated with neurological dysfunction and mitochondrial fragmentation but pathogenic mechanisms remained enigmatic. Here, we report on striking cell‐type‐specific defects in mice lacking YME1L in the nervous system. YME1L‐deficient mice manifest ocular dysfunction with microphthalmia and cataracts and develop deficiencies in locomotor activity due to specific degeneration of spinal cord axons, which relay proprioceptive signals from the hind limbs to the cerebellum. Mitochondrial fragmentation occurs throughout the nervous system and does not correlate with the degenerative phenotype. Deletion of Oma1 restores tubular mitochondria but deteriorates axonal degeneration in the absence of YME1L, demonstrating that impaired mitochondrial proteostasis rather than mitochondrial fragmentation causes the observed neurological defects.

[Multipoint pacing-more CRT or a waste of battery power?]

Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with broad QRS complex ≥130 ms and heart failure with reduced ejection fraction despite optimal guideline-directed medical therapy. However, approximately 30% of the patients implanted with a CRT system do not show clinical benefit. Reasons for nonresponse are complex and some aspects can be addressed during follow-up. Based on quadripolar lead technology, multipoint pacing (MPP) allows left ventricular stimulation at two different sites along the lead. In particular, in scarred and fibrotic ventricular myocardium stimulation at two different sites may overcome conduction barriers and lead to homogeneous ventricular depolarization. Especially for patients that do not respond to conventional CRT, activation of MPP may present an option to increase clinical response. On the other hand, MPP may significantly decrease battery longevity.This review offers an overview of the current knowledge and data on MPP balancing the potential clinical benefit and the possible disadvantages of this therapy.

PARL partitions the lipid transfer protein STARD7 between the cytosol and mitochondria

Intramembrane-cleaving peptidases of the rhomboid family regulate diverse cellular processes that are critical for development and cell survival. The function of the rhomboid protease PARL in the mitochondrial inner membrane has been linked to mitophagy and apoptosis, but other regulatory functions are likely to exist. Here, we identify the START domain-containing protein STARD7 as an intramitochondrial lipid transfer protein for phosphatidylcholine. We demonstrate that PARL-mediated cleavage during mitochondrial import partitions STARD7 to the cytosol and the mitochondrial intermembrane space. Negatively charged amino acids in STARD7 serve as a sorting signal allowing mitochondrial release of mature STARD7 upon cleavage by PARL On the other hand, membrane insertion of STARD7 mediated by the TIM23 complex promotes mitochondrial localization of mature STARD7. Mitochondrial STARD7 is necessary and sufficient for the accumulation of phosphatidylcholine in the inner membrane and for the maintenance of respiration and cristae morphogenesis. Thus, PARL preserves mitochondrial membrane homeostasis via STARD7 processing and is emerging as a critical regulator of protein localization between mitochondria and the cytosol.

Somatic increase of CCT8 mimics proteostasis of human pluripotent stem cells and extends C. elegans lifespan

Human embryonic stem cells can replicate indefinitely while maintaining their undifferentiated state and, therefore, are immortal in culture. This capacity may demand avoidance of any imbalance in protein homeostasis (proteostasis) that would otherwise compromise stem cell identity. Here we show that human pluripotent stem cells exhibit enhanced assembly of the TRiC/CCT complex, a chaperonin that facilitates the folding of 10% of the proteome. We find that ectopic expression of a single subunit (CCT8) is sufficient to increase TRiC/CCT assembly. Moreover, increased TRiC/CCT complex is required to avoid aggregation of mutant Huntingtin protein. We further show that increased expression of CCT8 in somatic tissues extends Caenorhabditis elegans lifespan in a TRiC/CCT-dependent manner. Ectopic expression of CCT8 also ameliorates the age-associated demise of proteostasis and corrects proteostatic deficiencies in worm models of Huntington's disease. Our results suggest proteostasis is a common principle that links organismal longevity with hESC immortality.

The membrane scaffold SLP2 anchors a proteolytic hub in mitochondria containing PARL and the i-AAA protease YME1L

The SPFH (stomatin, prohibitin, flotillin, HflC/K) superfamily is composed of scaffold proteins that form ring-like structures and locally specify the protein-lipid composition in a variety of cellular membranes. Stomatin-like protein 2 (SLP2) is a member of this superfamily that localizes to the mitochondrial inner membrane (IM) where it acts as a membrane organizer. Here, we report that SLP2 anchors a large protease complex composed of the rhomboid protease PARL and the i-AAA protease YME1L, which we term the SPY complex (for SLP2-PARL-YME1L). Association with SLP2 in the SPY complex regulates PARL-mediated processing of PTEN-induced kinase PINK1 and the phosphatase PGAM5 in mitochondria. Moreover, SLP2 inhibits the stress-activated peptidase OMA1, which can bind to SLP2 and cleaves PGAM5 in depolarized mitochondria. SLP2 restricts OMA1-mediated processing of the dynamin-like GTPase OPA1 allowing stress-induced mitochondrial hyperfusion under starvation conditions. Together, our results reveal an important role of SLP2 membrane scaffolds for the spatial organization of IM proteases regulating mitochondrial dynamics, quality control, and cell survival.

Loss of CLPP alleviates mitochondrial cardiomyopathy without affecting the mammalian UPRmt

The mitochondrial matrix protease CLPP plays a central role in the activation of the mitochondrial unfolded protein response (UPR(mt)) in Caenorhabditis elegans Far less is known about mammalian UPR(mt) signaling, although similar roles were assumed for central players, including CLPP To better understand the mammalian UPR(mt) signaling, we deleted CLPP in hearts of DARS2-deficient animals that show robust induction of UPR(mt) due to strong dysregulation of mitochondrial translation. Remarkably, our results clearly show that mammalian CLPP is neither required for, nor it regulates the UPR(mt) in mammals. Surprisingly, we demonstrate that a strong mitochondrial cardiomyopathy and diminished respiration due to DARS2 deficiency can be alleviated by the loss of CLPP, leading to an increased de novo synthesis of individual OXPHOS subunits. These results question our current understanding of the UPR(mt) signaling in mammals, while introducing CLPP as a possible novel target for therapeutic intervention in mitochondrial diseases.

[Primary and secondary prophylactic ICD therapy in congenital electrical and structural cardiomyopathies]

Congenital electrical and structural cardiomyopathies are rare and associated with an increased risk for syncope and sudden cardiac death in the young. Due to the young age of the patients and the limited data available, risk stratification and especially ICD therapy are challenging. In this young patient collective, ICD therapy is associated with a high complication rate, which does not justify unreserved primary prophylactic ICD implantation. The aim of this review is to elucidate risk stratification and ICD therapy of various electrical and structural cardiomyopathies.

Ultrasound texture-based CAD system for detecting neuromuscular diseases

PURPOSE

Diagnosis of neuromuscular diseases in ultrasonography is a challenging task since experts are often unable to discriminate between healthy and pathological cases. A computer-aided diagnosis (CAD) system for skeletal muscle ultrasonography was developed and tested for myositis detection in ultrasound images of biceps brachii.

METHODS

Several types of features were extracted from rectangular and polygonal image regions-of-interest (ROIs), including first-order statistics, wavelet-based features, and Haralick's features. Features were chosen that are sensitive to the change in contrast and structure for pathological ultrasound images of neuromuscular diseases. The number of features was reduced by applying different sequential feature selection strategies followed by a supervised principal component analysis. For classification, two linear approaches were investigated: Fisher's classifier and the linear support vector machine (SVM) as well as the nonlinear [Formula: see text]-nearest neighbor approach. The CAD system was benchmarked on datasets of 18 subjects, seven of which were healthy, while 11 were affected by myositis. Three expert radiologists provided pre-classification and testing interpretations.

RESULTS

Leave-one-out cross-validation on the training data revealed that the linear SVM was best suited for discriminating healthy and pathological muscle tissue, achieving 85/87 % accuracy, 90 % sensitivity, and 83/85 % specificity, depending on the radiologist.

CONCLUSION

A muscle ultrasonography CAD system was developed, allowing a classification of an ultrasound image by one-click positioning of rectangular ROIs with minimal user effort. The applicability of the system was demonstrated with the challenging example of myositis detection, showing highly accurate results that were robust to imprecise user input.

Phosphoproteomic analysis reveals regulatory mechanisms at the kidney filtration barrier

Diseases of the kidney filtration barrier are a leading cause of ESRD. Most disorders affect the podocytes, polarized cells with a limited capacity for self-renewal that require tightly controlled signaling to maintain their integrity, viability, and function. Here, we provide an atlas of in vivo phosphorylated, glomerulus-expressed proteins, including podocyte-specific gene products, identified in an unbiased tandem mass spectrometry-based approach. We discovered 2449 phosphorylated proteins corresponding to 4079 identified high-confidence phosphorylated residues and performed a systematic bioinformatics analysis of this dataset. We discovered 146 phosphorylation sites on proteins abundantly expressed in podocytes. The prohibitin homology domain of the slit diaphragm protein podocin contained one such site, threonine 234 (T234), located within a phosphorylation motif that is mutated in human genetic forms of proteinuria. The T234 site resides at the interface of podocin dimers. Free energy calculation through molecular dynamic simulations revealed a role for T234 in regulating podocin dimerization. We show that phosphorylation critically regulates formation of high molecular weight complexes and that this may represent a general principle for the assembly of proteins containing prohibitin homology domains.

Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women

OBJECTIVE

Little is known about the function of the ovarian neuronal network in humans. In many species, copulation influences endocrinology through this network. As a first step, the possible influence of ovarian mechanical manipulation on pituitary and ovarian hormones was evaluated in polycystic ovarian syndrome (PCOS) and regularly cycling women.

DESIGN

Prospective case-control study (2008-2010).

METHODS

Ten PCOS women (Rotterdam criteria) undergoing ovulation induction with recombinant-FSH and ten normal ovulatory controls were included in an academic fertility clinic. In the late follicular phase blood was drawn every 10 min for 6 h. After 3 h the ovaries were mechanically manipulated by moving a transvaginal ultrasound probe firmly over each ovary ten times. Main outcome measures were LH and FSH pulsatility and ovarian hormones before and after ovarian manipulation.

RESULTS

All PCOS patients showed an LH decline after the ovarian manipulation (before 13.0 U/l and after 10.4 U/l, P<0.01), probably based on a combination of a longer LH pulse interval and smaller amplitude (P=0.07). The controls showed no LH change (before 9.6 U/l and after 9.3 U/l, P=0.67). None of the ovarian hormones (estradiol, progesterone, anti-Müllerian hormone, inhibin B, androstenedione and testosterone) changed in either group.

CONCLUSIONS

Ovarian mechanical manipulation lowers LH secretion immediately and typically only in preovulatory PCOS patients. The immediate LH change after the ovarian manipulation without any accompanying ovarian hormonal changes point to nonhormonal communication from the ovaries to the pituitary. A neuronal pathway from the ovaries communicating to the hypothalamic-pituitary system is the most reasonable explanation.

TRIAP1/PRELI complexes prevent apoptosis by mediating intramitochondrial transport of phosphatidic acid

Cardiolipin (CL), a mitochondria-specific glycerophospholipid, is required for diverse mitochondrial processes and orchestrates the function of various death-inducing proteins during apoptosis. Here, we identify a complex of the p53-regulated protein TRIAP1 (p53CSV) and PRELI in the mitochondrial intermembrane space (IMS), which ensures the accumulation of CL in mitochondria. TRIAP1/PRELI complexes exert lipid transfer activity in vitro and supply phosphatidic acid (PA) for CL synthesis in the inner membrane. Loss of TRIAP1 or PRELI impairs the accumulation of CL, facilitates the release of cytochrome c, and renders cells vulnerable to apoptosis upon intrinsic and extrinsic stimulation. Survival of TRIAP1- and PRELI-deficient cells is conferred by an excess of exogenously provided phosphatidylglycerol. Our results reveal a p53-dependent cell-survival pathway and highlight the importance of the CL content of mitochondrial membranes in apoptosis.

[National health fund and morbidity-based risk structure equalization with focus on haemophilia]

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

Gesundheitsfonds und morbiditätsorientierter Risikostrukturausgleich

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbiditybased risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

A portable microevaporator for low temperature single atom studies by scanning tunneling and dynamic force microscopy

Here, we present a microevaporator setup for single adatom deposition at low temperature, which is a prerequisite for most single atom studies with scanning probe techniques. The construction of the microevaporator is based on the tungsten filament of a modified halogen lamp, covered with the required adsorbate. Very stable evaporation conditions were obtained, which were controlled by the filament current. The installation of this microevaporator on a manipulator enabled its transportation directly to the sample at the microscope kept at 5 K. In this way, the controlled deposition of Li onto Ag(100), Li, Pd, and Au onto MgO/Ag(001) as well as Au onto alumina/NiAl(110) at low temperature has been performed. The obtained images recorded after the deposition show the presence of single Li/Au atoms on the sample surfaces as a prove for successful dispersion of single atoms onto the sample surface using this technique.

Characterization of BAX inhibitor-1 as a novel leukemia-associated antigen

Using dendritic cells (DCs) electroporated with whole RNA isolated from blasts of a patient with acute myeloid leukemia (AML), we were able to generate leukemia-specific cytotoxic T lymphocytes (CTLs) capable of recognizing the leucemic cells. To identify T-cell epitopes mediating lysis of malignant cells, peptides were eluted from the patient's blasts and analyzed by mass spectrometry (LC/MS)-based peptide sequencing. Using this approach, an HLA-A24-binding peptide derived from Bax inhibitor-1 (BI-1), a regulator of apoptosis pathways, was identified as an epitope recognized by the generated CTLs. To further characterize this novel antigenic peptide, CTLs were induced using DCs electroporated with RNA coding for BI-1 or pulsed with the cognate peptide. These CTLs generated from healthy donors in vitro efficiently lysed the patient's blasts as well as other HLA-matched leukemic cells. In conclusion, we identified a BI-1 peptide as a novel immunogenic tumor-associated antigen (TAA) in AML. In vitro induction of BI-1-specific CTLs by RNA transfection or pulsing of DCs with the synthetically generated peptide was a feasible and highly effective method to generate leukemia-specific CTLs. As BI-1 is (over-) expressed in a broad variety of malignancies, it may represent an interesting novel TAA in the context of cancer vaccines.

Field trauma care in the 21st century

The nature of trauma care on the modern battlefield is changing quickly. Leading figures in UK field trauma care spoke at a recent meeting of the Haywood Club. The challenge of modern warfare, the evolving evacuation chain and the command and governance of field trauma care were explored.

Dexamethasone depresses the expression of l-selectin but not the in vivo migration of bovine neutrophils into the uterus

There are several indications that periparturient depression of functional properties of polymorphonuclear neutrophilic granulocytes (PMN) may be of great importance for the pathogenesis of genital infections after calving. As the periparturient period is characterized by high plasma levels of corticosteroids, the hypothesis to be tested was that high concentrations of glucocorticoids during the periparturient period suppress uterine PMN in number and functionality. An in vivo endometritis model was applied to examine uterine PMN. Recombinant human interleukin-8 (rhIL-8) was infused into the uterus of estrous cows and heifers 24 h after pretreatment with dexamethasone (0.07 mg/kg i.m.). Six hours after rhIL-8 infusion high numbers of uterine PMN were isolated and characterized as to their immunophenotype and function. Animals treated with dexamethasone animals showed leucocytosis due to neutrophilia in peripheral blood. Despite a downregulation of expressed L-selectin, cattle treated with dexamethasone showed more uterine PMN than those treated with placebo. Dexamethasone decreased plasma concentrations of the immunomodulatory steroidal hormones cortisol and estrogen. Dexamethasone directly reduced the generation of reactive oxygen species (ROS) by uterine PMN. This may be a useful mechanism since it would protect the endometrium from tissue damage by excessive extracellular ROS. However, it is not known if the net effect is in fact a reduction in ROS, as the number of uterine cells increases. Our study shows that glucocorticoids may not be considered immunosuppressive in all cases and may play an important role in the regulation of post partum uterine defense mechanisms.