Listeria monocytogenes infection rewires host metabolism with regulatory input from type I interferons.

Listeria monocytogenes (L. monocytogenes) is a food-borne bacterial pathogen. Innate immunity to L. monocytogenes is profoundly affected by type I interferons (IFN-I). Here we investigated host metabolism in L. monocytogenes-infected mice and its potential control by IFN-I. Accordingly, we used animals lacking either the IFN-I receptor (IFNAR) or IRF9, a subunit of ISGF3, the master regulator of IFN-I-induced genes. Transcriptomes and metabolite profiles showed that L. monocytogenes infection induces metabolic rewiring of the liver. This affects various metabolic pathways including fatty acid (FA) metabolism and oxidative phosphorylation and is partially dependent on IFN-I signaling. Livers and macrophages from Ifnar1-/- mice employ increased glutaminolysis in an IRF9-independent manner, possibly to readjust TCA metabolite levels due to reduced FA oxidation. Moreover, FA oxidation inhibition provides protection from L. monocytogenes infection, explaining part of the protection of Irf9-/- and Ifnar1-/- mice. Our findings define a role of IFN-I in metabolic regulation during L. monocytogenes infection. Metabolic differences between Irf9-/- and Ifnar1-/- mice may underlie the different susceptibility of these mice against lethal infection with L. monocytogenes.

Deacetylase inhibitors repress STAT5-mediated transcription by interfering with bromodomain and extra-terminal (BET) protein function.

Signal transducer and activator of transcription STAT5 is essential for the regulation of proliferation and survival genes. Its activity is tightly regulated through cytokine signaling and is often upregulated in cancer. We showed previously that the deacetylase inhibitor trichostatin A (TSA) inhibits STAT5-mediated transcription by preventing recruitment of the transcriptional machinery at a step following STAT5 binding to DNA. The mechanism and factors involved in this inhibition remain unknown. We now show that deacetylase inhibitors do not target STAT5 acetylation, as we initially hypothesized. Instead, they induce a rapid increase in global histone acetylation apparently resulting in the delocalization of the bromodomain and extra-terminal (BET) protein Brd2 and of the Brd2-associated factor TBP to hyperacetylated chromatin. Treatment with the BET inhibitor (+)-JQ1 inhibited expression of STAT5 target genes, supporting a role of BET proteins in the regulation of STAT5 activity. Accordingly, chromatin immunoprecipitation demonstrated that Brd2 is associated with the transcriptionally active STAT5 target gene Cis and is displaced upon TSA treatment. Our data therefore indicate that Brd2 is required for the proper recruitment of the transcriptional machinery at STAT5 target genes and that deacetylase inhibitors suppress STAT5-mediated transcription by interfering with Brd2 function.

Magnesocene-Based Electrolytes: A New Class of Electrolytes for Magnesium Batteries.

Unlike ferrocene, bis(η5 -cyclopentadienyl)magnesium (magnesocene, MgCp2 ) is slightly dissociated in solvents, such as ethers, resulting in electrolyte solutions with low conductivity. MgCp2 /tetrahydrofuran solutions make possible reversible magnesium plating and stripping with low over-potentials for many cycles. The Mg deposits appear with a cauliflower-like morphology. IR and NMR spectroscopy confirm that the electrolyte is stable and not decomposed during prolonged cycling. The anodic stability limit is in the range of 1.5 V (at platinum) and 1.8 V versus Mg/Mg2+ (at stainless steel), which may be sufficient for low-voltage cathode materials. MgCp2 is a first example of a completely new class of halide-free electrolytes, which may open up a new research direction for future magnesium metal and magnesium-ion batteries.

The misunderstanding of the R Classification-a survey amongst medical specialties treating breast cancer.

Frequent discussions in the tumour board about the Residual tumour (R) Classification of the UICC's "TNM Classification of Malignant Tumours", especially in the case of breast surgery specimens, raised the question about differing interpretations amongst different medical specialties. Thus, we designed a survey about the R Classification with a special focus on breast cancer specimens. An online survey was conducted, where a web link to the survey was distributed via email to various medical professional societies dealing with breast cancer in Austria and Germany with the request to distribute the link to their members. The study population consisted of physicians of all educational levels of different medical professions, who deal with breast carcinomas in their daily routine. Two hundred two participants, of which 160 (79.2%) have more than 10 years' professional experience, took part in the survey; 88 (43.6%) were surgeons/gynaecologists, 80 (39.6%) pathologists, 19 (9.4%) radiation oncologists/ therapists, 8 (4.0%) radiologists, and 7 (3.5%) oncologists. We show that the R Classification is not completely mastered by anyone and that there are significant differences in the interpretation of the R Classification between different medical specialties. For better differentiation between the residual tumour (R Classification) of the TNM and a pure resection margin assessment, we suggest the use of a Resection margin (Rm) Classification to avoid further misunderstandings. To assist better multidisciplinary cooperation and to ensure better patient care all medical disciplines should be educated about the actual meaning and correct application of the R Classification.

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients.

BACKGROUND: Painful degenerative joint disease (DJD) of the first metatarsophalangeal joint (MTP I), or hallux rigidus, mainly occurs in later stages of life. For end-stage hallux rigidus, MTP I arthrodesis is considered the gold standard. As young and active patients are affected considerably less frequently, it currently remains unclear, whether they benefit to the same extent. We hypothesized that MTP I arthrodesis in younger patients would lead to an inferior outcome with decreased rates of overall with lower rates of patient postoperative pain and function compared to an older cohort. METHODS: All patients aged <50 years who underwent MTP I arthrodesis at our institution between 1995 and 2012 were included in this study. This group was then matched and compared with a group of patients aged >60 years. Minimum follow-up was 10 years. Outcome measures were Tegner activity score (TAS), a "Virtual Tegner activity score" (VTAS), the visual analog scale (VAS), and the Foot Function index (FFI). RESULTS: Sixty-one MTP I fusions (n = 28 young, n = 33 old) in 46 patients were included in our study at an average of 14 years after surgery. Younger patients experienced significantly more pain relief as reflected by changes in VAS and FFI Pain subscale scores. No difference in functional outcomes was found with change in the FFI function subscale or in the ability to have desired functional outcomes using the ratio of TAS to VTAS. Revision rate did not differ between the two groups apart from hardware removal, which was significantly more likely in the younger group. CONCLUSION: In patients below the age of 50 years with end-stage DJD of the first metatarsal joint, MTP I arthrodesis not only yielded highly satisfactory postoperative results at least equal outcome compared to an older cohort of patients aged >60 years at an average 14 years' follow-up. Based on these findings, we consider first metatarsal joint fusion even for young patients is a valid option to treat end-stage hallux rigidus. LEVEL OF EVIDENCE: Level III, a case-control study.

Kelp forest community structure and demography in Kongsfjorden (Svalbard) across 25 years of Arctic warming.

The Arctic archipelago of Svalbard is a hotspot of global warming and many fjords experience a continuous increase in seawater temperature and glacial melt while sea-ice cover declines. In 1996/1998, 2012-2014, and 2021 macroalgal biomass and species diversity were quantified at the study site Hansneset, Kongsfjorden (W-Spitsbergen) in order to identify potential changes over time. In 2021, we repeated the earlier studies by stratified random sampling (1 × 1 m2, n = 3) along a sublittoral depth transect (0, 2.5, 5, 10, and 15 m) and investigated the lower depth limits of dominant brown algae between 3 and 19 m. The maximum fresh weight (FW) of all seaweeds was 11.5 kg m-2 at 2.5 m and to 99.9% constituted of kelp. Although biomass distribution along the depth transect in 2021 was not significantly different compared to 2012/2013, the digitate kelp community (Laminaria digitata/Hedophyllum nigripes) had transformed into an Alaria esculenta-dominated kelp forest. Consequently, a pronounced shift in kelp forest structure occurred over time as we demonstrate that biomass allocation to thallus parts is kelp species-specific. Over the past decade, kelp demography changed and in 2021 a balanced age structure of kelps (juveniles plus many older kelp individuals) was only apparent at 2.5 m. In addition, the abundances and lower depth limits of all dominant brown algae declined noticeably over the last 25 years while the red algal flora abundance remained unchanged at depth. We propose that the major factor driving the observed changes in the macroalgal community are alterations in underwater light climate, as in situ data showed increasing turbidity and decreasing irradiance since 2012 and 2017, respectively. As a consequence, the interplay between kelp forest retreat to lower depth levels caused by coastal darkening and potential macroalgal biomass gain with increasing temperatures will possibly intensify in the future with unforeseen consequences for melting Arctic coasts and fjord ecosystem services.

COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation.

CONTEXT: The LMU University Hospital is among the largest healthcare facilities in Germany. The measures implemented prior to and during the first pandemic wave of COVID-19, were evaluated in preparation of a second pandemic wave. This paper presents the pandemic management concept, evaluation and adaptation of LMU University Hospital. METHODS: Between July and September 2020 the disaster management team of LMU University Hospital conducted a mixed-method evaluation of the hospital's pandemic management. A workshop series based on the After Action Review working group format was organized to examine the management structure, decision-making processes, documentation, and crisis preparedness response for a second COVID-19 wave. Further, the satisfaction of employees with the hospital's COVID-19 management was examined through an anonymous survey. RESULTS: The workshop series highlighted a need for structural and operational adaptation of the COVID-19 management at LMU University Hospital. The results of the employee survey (N = 2182) provided positive feedback for the measures taken during the first pandemic wave. Specific actions were derived concerning the availability of personal protective equipment and emergency childcare services. A key outcome of both evaluation activities was the identified need for further improvement in communication between stakeholders. All changes were adopted prior to the second pandemic wave.

Large-scale nutrient and carbon dynamics along the river-estuary-ocean continuum.

Nutrient and carbon dynamics within the river-estuary-coastal water systems are key processes in understanding the flux of matter from the terrestrial environment to the ocean. Here, we analysed those dynamics by following a sampling approach based on the travel time of water and an advanced calculation of nutrient fluxes in the tidal part. We started with a nearly Lagrangian sampling of the river (River Elbe, Germany; 580 km within 8 days). After a subsequent investigation of the estuary, we followed the plume of the river by raster sampling the German Bight (North Sea) using three ships simultaneously. In the river, we detected intensive longitudinal growth of phytoplankton connected with high oxygen saturation and pH values and an undersaturation of CO2, whereas concentrations of dissolved nutrients declined. In the estuary, the Elbe shifted from an autotrophic to a heterotrophic system: Phytoplankton died off upstream of the salinity gradient, causing minima in oxygen saturation and pH, supersaturation of CO2, and a release of nutrients. In the shelf region, phytoplankton and nutrient concentrations were low, oxygen was close to saturation, and pH was within a typical marine range. Over all sections, oxygen saturation was positively related to pH and negatively to pCO2. Corresponding to the significant particulated nutrient flux via phytoplankton, flux rates of dissolved nutrients from river into estuary were low and determined by depleted concentrations. In contrast, fluxes from the estuary to the coastal waters were higher and the pattern was determined by tidal current. Overall, the approach is appropriate to better understand land-ocean fluxes, particularly to illuminate the importance of these fluxes under different seasonal and hydrological conditions, including flood and drought events.

Stress signaling boosts interferon-induced gene transcription in macrophages.

Promoters of antimicrobial genes function as logic boards, integrating signals of innate immune responses. One such set of genes is stimulated by interferon (IFN) signaling, and the expression of these genes [IFN-stimulated genes (ISGs)] can be further modulated by cell stress-induced pathways. Here, we investigated the global effect of stress-induced p38 mitogen-activated protein kinase (MAPK) signaling on the response of macrophages to IFN. In response to cell stress that coincided with IFN exposure, the p38 MAPK-activated transcription factors CREB and c-Jun, in addition to the IFN-activated STAT family of transcription factors, bound to ISGs. In addition, p38 MAPK signaling induced activating histone modifications at the loci of ISGs and stimulated nuclear translocation of the CREB coactivator CRTC3. These actions synergistically enhanced ISG expression. Disrupting this synergy with p38 MAPK inhibitors improved the viability of macrophages infected with Listeria monocytogenes. Our findings uncover a mechanism of transcriptional synergism and highlight the biological consequences of coincident stress-induced p38 MAPK and IFN-stimulated signal transduction.

Three different patterns of how low-intensity waves can affect the energy budget of littoral fish: a mesocosm study.

In a mesocosm study, somatic and otolith growth of six types of juvenile cyprinids differing in body size and body shape were studied in a low-intensity wave treatment and a no-wave control. Depending on fish type, somatic growth was either reduced by up to 60% or increased by up to 50% following exposure to the wave treatment. Somatic growth and otolith daily increment width (ODIW), the latter being used as a proxy for the fish energy turnover, were compared to reveal the effects of waves on the energy budget of the fish. Three different reaction types to waves, which correlated to the body morphology of the six fish groups, could be distinguished. Small and fusiform fish benefitted from low-intensity waves and showed higher somatic growth rates and greater ODIW in the wave treatment. In small, deep-bodied fish, growth and ODIW were reduced by waves. Finally, in larger fish with either a fusiform or deep-bodied shape, ODIW was decoupled from somatic growth, with larger ODIW in waves, but reduced somatic growth. These results show that low-intensity hydrodynamic stress is a much more important and complex habitat factor than previously assumed. It is concluded that hydrodynamic stress by waves should be accounted for in bioenergetic models and studies on habitat choice in littoral fish species.

Waves affect predator-prey interactions between fish and benthic invertebrates.

Little is known about the effects of waves on predator-prey interactions in the littoral zones of freshwaters. We conducted a set of mesocosm experiments to study the differential effects of ship- and wind-induced waves on the foraging success of littoral fish on benthic invertebrates. Experiments were conducted in a wave tank with amphipods (Gammarus roeseli) as prey, and age-0 bream (Abramis brama, B0), age-0 and age-1 dace (Leuciscus leuciscus, D0 and D1) as predators. The number of gammarids suspended in the water column was higher in the wave treatments compared to a no-wave control treatment, especially during pulse waves mimicking ship-induced waves in comparison to continuous waves mimicking wind-induced waves. The resulting higher prey accessibility in the water column was differently exploited by the three types of predatory fish. D0 and D1 showed significantly higher foraging success in the pulse wave treatment than in the continuous and control treatments. The foraging success of D0 appears to be achieved more easily, since significantly higher swimming activity and more foraging attempts were recorded only for D1 under the wave treatments. In contrast, B0 consumed significantly fewer gammarids in both wave treatments than in the control. Hence, waves influenced predator-prey interactions differently depending on wave type and fish type. It is expected that regular exposure to ship-induced waves can alter littoral invertebrate and fish assemblages by increasing the predation risk for benthic invertebrates that are suspended in the water column, and by shifting fish community compositions towards species that benefit from waves.

Civil protection and disaster medicine in Germany today.

PURPOSE: This paper seeks to outline the development of disaster medicine services in Germany and the preparedness of the security and rescue forces for mass casualty incidents after an accident, a natural disaster or a terrorist attack. METHOD: The method used was review of articles and interview with experts. RESULTS: The plane crash at the 1988 Ramstein air show highlighted problems in the approach to incident management. Following this event, Germany improved the medical management of major incidents. At the railway accident in Eschede in 1998, a "proof of concept" was evident. The newest increases of terrorist threats were also turning points in the further development of disaster medicine in Germany. CONCLUSIONS: Emergency medical training must be adapted to the increase in disasters, mass casualty incidents, and terrorist threats.

Altered adhesive properties of cord blood endothelial outgrowth cells expressing IL-1ra.

The aim of this study was to examine the potential of endothelial outgrowth cells (EOCs) expanded from CD34(+) cord blood-derived cells (CB-EOCs) for overexpression of therapeutic transgenes. As proof of principle, we overexpressed icIL-1ra in CB-EOCs. Proinflammatory activation of CB-EOCs in response to cytokine stimulation (IL-1beta and tumor necrosis factor (TNF)) and during coculture with monocytes showed that icIL-1ra-expressing CB-EOCs express significantly reduced levels of ICAM-1, MCP-1 and thrombin receptor expression. Moreover, overexpression of icIL-1ra attenuated the IL-1beta-mediated proinflammatory activation by diminishing the expression of ICAM-1, SELE, MCP-1 and IL-1beta. Interestingly, overexpression of icIL-1ra also inhibited TNF-induced upregulation of ICAM-1. Expression of ICAM-1, VCAM-1, tissue factor and IL-1beta was also decreased on direct contact with monocytes. These changes in gene expression were accompanied by functional reduction in leukocyte rolling, adhesion of monocytes to CB-EOCs, as well as by a reduction in transendothelial migration of monocytes. Our findings show that CB-EOCs stably expressing transgenic icIL-1ra are protected against activation by not only IL-1beta but also TNFalpha-mediated proinflammatory stimuli and inhibit decisive pathomechanisms of inflammatory processes such as rolling, adhesion and transmigration of monocytes. Therefore, icIL-ra transgenic CB-EOCs may prove to be beneficial in the treatment of IL-1beta- and TNFalpha-mediated inflammatory vasculopathies.

Acute coagulopathy in isolated blunt traumatic brain injury.

BACKGROUND: The role of acute coagulopathy after traumatic brain injury (TBI) on outcome has gained increasing appreciation over the recent years. This study was conducted to assess the frequency, outcome, and risk factors associated with this complication. PATIENTS AND METHODS: Using the large, multi-center population-based Trauma Registry of the German Society for Trauma Surgery (TR-DGU), we retrospectively analyzed adult patients with isolated blunt TBI (intracranial AIS(HEAD) >or= 3 and extracranial AIS scores <3) for the presence of acute post-traumatic coagulopathy upon emergency room (ER) arrival. Coagulopathy was defined as prothrombin time test (Quick's value) <70% and/or platelets < 100,000/microl. RESULTS: From a total of 3,114 eligible patients with isolated TBI, 706 (22.7%) presented with coagulopathy upon ER arrival. Coagulopathy was associated with higher rates of craniotomies (P = 0.02), of single and multiple organ failure and with less intubation-free days. In surviving patients, ICU length of stay and hospital length of stay were significantly longer, if coagulopathy had been present at admission. The overall hospital mortality was 50.4% (n = 356) in patients with coagulopathy vs. 17.3% (n = 417) in non-coagulopathic patients (all P < 0.001). Multivariate analysis identified AIS(HEAD) severity grade, GCS or=2,000 ml and age >or=75 years as independent risk factors for coagulopathy after TBI. Acute coagulopathy in TBI had an adjusted odds ratio for hospital mortality of 2.97 (CI(95): 2.30-3.85; P < 0.001). CONCLUSION: Coagulopathy upon ER admission is frequent after isolated blunt TBI and represents a powerful, independent predictor related to prognosis. Future research should aim to determine the beneficial effects of early treatment of TBI-associated coagulopathy.

Bone marrow cells are a rich source of growth factors and cytokines: implications for cell therapy trials after myocardial infarction.

AIMS: Results from clinical trials suggest that cardiac function after acute myocardial infarction (AMI) can be enhanced by an intracoronary infusion of autologous unselected nucleated bone marrow cells (BMCs). Release of paracrine factors has been proposed as a mechanism for these therapeutic effects; however, this hypothesis has not been tested in humans. METHODS AND RESULTS: BMCs and peripheral blood leucocytes (PBLs) were obtained from 15 patients with AMI and cultured in serum-free medium to obtain conditioned supernatants (SN). BMC-SN stimulated human coronary artery endothelial cell proliferation, migration, and tube formation, and induced cell sprouting in a mouse aortic ring assay. Moreover, BMC-SN protected rat cardiomyocytes from cell death induced by simulated ischaemia or ischaemia followed by reperfusion. While PBL-SN promoted similar effects on endothelial cells and cardiomyocytes, BMC-SN and PBL-SN in combination promoted synergistic effects. As shown by ProteinChip and GeneChip array analyses (each performed in triplicate), BMCs and PBLs expressed distinct patterns of pro-angiogenic and cytoprotective secreted factors. CONCLUSION: Our data support the paracrine hypothesis and suggest that characterization of the BMC secretome may lead to an identification of factors with therapeutic potential after AMI.

Health status as an important outcome factor after hemiarthroplasty.

The goal of this study was to determine functional results of hemiarthroplasty for 3- and 4-part proximal humeral fractures in elderly patients and to analyze factors affecting the outcome. Thirty-eight consecutive shoulders were treated with hemiarthroplasty after proximal humeral fracture. Two groups of patients with different health status were classified. Group I consisted of patients with 2 or less comorbidities and a maximum of 2 medications at the time of injury. Patients in group II had 3 or more comorbidities with a minimum of 3 medications at the time of injury. The mean of the absolute Constant score in group I was 41, compared to 27 in group II (P < .05). Furthermore, compliance of the patient and regular physiotherapy proved to be important prognostic factors. If primary hemiarthroplasty is not likely to be successful with a low functional score, this surgical procedure should be reconsidered especially in patients with more than three comorbidities.

Endothelial-like cells expanded from CD34+ blood cells improve left ventricular function after experimental myocardial infarction.

Mobilization and recruitment of endothelial progenitor cells (EPC) contributes to vasculogenesis in vivo. So far, applications for cell therapy are limited by the number of available cells. Expansion of EPC or their progeny may, therefore, facilitate its therapeutic use in ischemic disease. The aim of this study was to expand CD34+ EPC-derived progeny from different sources, characterize them, and investigate their potential for use in therapeutic vasculogenesis. CD34+ cells from G-CSF-mobilized peripheral blood (PB) and cord blood (CB) were isolated using immunomagnetic beads and cultured in endothelial cell medium. Cells were expanded up to 16 (PB) and up to 46 (CB) population doublings, respectively. Immunophenotypic and mRNA expression analyses showed a high degree of similarity between the cultured cells and human umbilical vein endothelial cells (HUVEC). By day 14 after transplantation, transplanted human CD31-positive EPC-derived cells were detected. These cells expressed the proliferation marker Ki67 and formed vessel-like structures in ischemic myocardium. Most strikingly, transplantation of EPC-derived cells improved left ventricular function after experimental ischemia, as shown by echocardiography. In conclusion, cells cultured from CD34+ EPC can be expanded in vitro to clinically relevant numbers. In vivo, these cells proliferate, form vascular structures, and improve left ventricular function after experimental myocardial infarction. Therefore, in vitro expanded EPC-derived endothelial cells may be beneficial in the treatment of ischemic disease.

Discriminative Unsupervised Feature Learning with Exemplar Convolutional Neural Networks.

Deep convolutional networks have proven to be very successful in learning task specific features that allow for unprecedented performance on various computer vision tasks. Training of such networks follows mostly the supervised learning paradigm, where sufficiently many input-output pairs are required for training. Acquisition of large training sets is one of the key challenges, when approaching a new task. In this paper, we aim for generic feature learning and present an approach for training a convolutional network using only unlabeled data. To this end, we train the network to discriminate between a set of surrogate classes. Each surrogate class is formed by applying a variety of transformations to a randomly sampled 'seed' image patch. In contrast to supervised network training, the resulting feature representation is not class specific. It rather provides robustness to the transformations that have been applied during training. This generic feature representation allows for classification results that outperform the state of the art for unsupervised learning on several popular datasets (STL-10, CIFAR-10, Caltech-101, Caltech-256). While features learned with our approach cannot compete with class specific features from supervised training on a classification task, we show that they are advantageous on geometric matching problems, where they also outperform the SIFT descriptor.

A benchmark for comparison of dental radiography analysis algorithms.

Dental radiography plays an important role in clinical diagnosis, treatment and surgery. In recent years, efforts have been made on developing computerized dental X-ray image analysis systems for clinical usages. A novel framework for objective evaluation of automatic dental radiography analysis algorithms has been established under the auspices of the IEEE International Symposium on Biomedical Imaging 2015 Bitewing Radiography Caries Detection Challenge and Cephalometric X-ray Image Analysis Challenge. In this article, we present the datasets, methods and results of the challenge and lay down the principles for future uses of this benchmark. The main contributions of the challenge include the creation of the dental anatomy data repository of bitewing radiographs, the creation of the anatomical abnormality classification data repository of cephalometric radiographs, and the definition of objective quantitative evaluation for comparison and ranking of the algorithms. With this benchmark, seven automatic methods for analysing cephalometric X-ray image and two automatic methods for detecting bitewing radiography caries have been compared, and detailed quantitative evaluation results are presented in this paper. Based on the quantitative evaluation results, we believe automatic dental radiography analysis is still a challenging and unsolved problem. The datasets and the evaluation software will be made available to the research community, further encouraging future developments in this field. (http://www-o.ntust.edu.tw/~cweiwang/ISBI2015/).