27 research outputs found

    Fibroblast activation protein is expressed by rheumatoid myofibroblast-like synoviocytes

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    Fibroblast activation protein (FAP), as described so far, is a type II cell surface serine protease expressed by fibroblastic cells in areas of active tissue remodelling such as tumour stroma or healing wounds. We investigated the expression of FAP by fibroblast-like synoviocytes (FLSs) and compared the synovial expression pattern in rheumatoid arthritis (RA) and osteoarthritis (OA) patients. Synovial tissue from diseased joints of 20 patients, 10 patients with refractory RA and 10 patients with end-stage OA, was collected during routine surgery. As a result, FLSs from intensively inflamed synovial tissues of refractory RA expressed FAP at high density. Moreover, FAP expression was co-localised with matrix metalloproteinases (MMP-1 and MMP-13) and CD44 splice variants v3 and v7/8 known to play a major role in the concert of extracellular matrix degradation. The pattern of signals appeared to constitute a characteristic feature of FLSs involved in rheumatoid arthritic joint-destructive processes. These FAP-expressing FLSs with a phenotype of smooth muscle actin-positive myofibroblasts were located in the lining layer of the synovium and differ distinctly from Thy-1-expressing and non-proliferating fibroblasts of the articular matrix. The intensity of FAP-specific staining in synovial tissue from patients with RA was found to be different when compared with end-stage OA. Because expression of FAP by RA FLSs has not been described before, the findings of this study highlight a novel element in cartilage and bone destruction of arthritic joints. Moreover, the specific expression pattern qualifies FAP as a therapeutic target for inhibiting the destructive potential of fibroblast-like synovial cells

    Wirkungsanalyse bestehender Klimaschutzmaßnahmen und -programme sowie Identifizierung möglicher weiterer Maßnahmen eines Energie- und Klimaschutzprogramms der Bundesregierung

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    Eine Analyse der deutschen Energie- und Klimapolitik hat ergeben: Nur im Maßnahmenfeld "Ausbau der Erneuerbaren Energien im Strombereich" wird voraussichtlich das Ziel ereicht. Dagegen wird in allen anderen Maßnahmenfeldern das Ziel verfehlt oder es bestehen Wirkungsdefizite der eingesetzten Politikinstrumente. Das betrifft insbesondere die Energieeffizienz auf der Nachfrageseite, aber auch die Kraft-Wärme-Kopplung und Erneuerbare Energien-Wärme. Für die Maßnahmenfelder "Fluorierte Treibhausgase", "Industrieprozesse" und "Landwirtschaft" müssen überhaupt erst verbindliche Reduktionsziele festgelegt und Politikinstrumente eingeführt werden

    Dying is never beautiful, but there are beautiful moments: qualitative interviews with those affected on the subject of ‘good dying’

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    The concept of the good death has been widely considered. However, the perspectives of those affected have not received sufficient attention. In our empirical study, we conducted interviews with 32 people who were confronted with dying; these people were either terminally ill, elderly or else were bereaved carers. The findings show that for this group of people, dying is not just a physical process, but also a psychological, social and spiritual one. From the perspective of those affected, dying is never beautiful, in particular because of the associated pain and suffering. At the same time, people confronted with dying do experience beautiful moments. In the stories they tell of these beautiful moments, it is a beauty emanating from a sense of elevated emotion – of moral emotion – rather than any aesthetic beauty. We conclude that good care of the dying enables beautiful moments and creates reflective spaces for those affected to express what beauty means to them. We show that the public discourse differs significantly from the perspective of those affected and more efforts need to be made to include their voices

    The F4/AS01B HIV-1 Vaccine Candidate Is Safe and Immunogenic, But Does Not Show Viral Efficacy in Antiretroviral Therapy-Naive, HIV-1-Infected Adults: A Randomized Controlled Trial

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    The impact of the investigational human immunodeficiency virus type 1 (HIV-1) F4/AS01(B) vaccine on HIV-1 viral load (VL) was evaluated in antiretroviral therapy (ART)-naive HIV-1 infected adults.This phase IIb, observer-blind study (NCT01218113), included ART-naive HIV-1 infected adults aged 18 to 55 years. Participants were randomized to receive 2 (F4/AS01(B)_2 group, N=64) or 3 (F4/AS01(B)_3 group, N=62) doses of F4/AS01(B) or placebo (control group, N=64) at weeks 0, 4, and 28. Efficacy (HIV-1 VL, CD4(+) T-cell count, ART initiation, and HIV-related clinical events), safety, and immunogenicity (antibody and T-cell responses) were evaluated during 48 weeks.At week 48, based on a mixed model, no statistically significant difference in HIV-1 VL change from baseline was demonstrated between F4/AS01(B)_2 and control group (0.073 log(10)copies/mL [97.5% confidence interval (CI): -0.088; 0.235]), or F4/AS01(B)_3 and control group (-0.096 log(10)copies/mL [97.5% CI: -0.257; 0.065]). No differences between groups were observed in HIV-1 VL change, CD4(+) T-cell count, ART initiation, or HIV-related clinical events at intermediate timepoints. Among F4/AS01(B) recipients, the most frequent solicited symptoms were pain at injection site (252/300 doses), fatigue (137/300 doses), myalgia (105/300 doses), and headache (90/300 doses). Twelve serious adverse events were reported in 6 participants; 1 was considered vaccine-related (F4/AS01(B)_2 group: angioedema). F4/AS01(B) induced polyfunctional F4-specific CD4(+) T-cells, but had no significant impact on F4-specific CD8(+) T-cell and anti-F4 antibody levels.F4/AS01(B) had a clinically acceptable safety profile, induced F4-specific CD4(+) T-cell responses, but did not reduce HIV-1 VL, impact CD4(+) T-cells count, delay ART initiation, or prevent HIV-1 related clinical events

    Hypertrophic cardiomyopathy is characterized by alterations of the mitochondrial calcium uniporter complex proteins: insights from patients with aortic valve stenosis versus hypertrophic obstructive cardiomyopathy

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    Introduction: Hypertrophies of the cardiac septum are caused either by aortic valve stenosis (AVS) or by congenital hypertrophic obstructive cardiomyopathy (HOCM). As they induce cardiac remodeling, these cardiac pathologies may promote an arrhythmogenic substrate with associated malignant ventricular arrhythmias and may lead to heart failure. While altered calcium (Ca2+) handling seems to be a key player in the pathogenesis, the role of mitochondrial calcium handling was not investigated in these patients to date.Methods: To investigate this issue, cardiac septal samples were collected from patients undergoing myectomy during cardiac surgery for excessive septal hypertrophy and/or aortic valve replacement, caused by AVS and HOCM. Septal specimens were matched with cardiac tissue obtained from post-mortem controls without cardiac diseases (Ctrl).Results and discussion: Patient characteristics and most of the echocardiographic parameters did not differ between AVS and HOCM. Most notably, the interventricular septum thickness, diastolic (IVSd), was the greatest in HOCM patients. Histological and molecular analyses showed a trend towards higher fibrotic burden in both pathologies, when compared to Ctrl. Most notably, the mitochondrial Ca2+ uniporter (MCU) complex associated proteins were altered in both pathologies of left ventricular hypertrophy (LVH). On the one hand, the expression pattern of the MCU complex subunits MCU and MICU1 were shown to be markedly increased, especially in AVS. On the other hand, PRMT-1, UCP-2, and UCP-3 declined with hypertrophy. These conditions were associated with an increase in the expression patterns of the Ca2+ uptaking ion channel SERCA2a in AVS (p = 0.0013), though not in HOCM, compared to healthy tissue. Our data obtained from human specimen from AVS or HOCM indicates major alterations in the expression of the mitochondrial calcium uniporter complex and associated proteins. Thus, in cardiac septal hypertrophies, besides modifications of cytosolic calcium handling, impaired mitochondrial uptake might be a key player in disease progression

    The future of EU energy efficiency policies : a comprehensive analysis of gaps, shortcomings, and potential remedies

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    Energy efficiency activities are high on the current EU energy policy agenda. Key policy instruments like the Energy Efficiency Directive (EED), the Energy Performance of Buildings Directive (EPBD) and the Energy Labelling Directive are under revision. In a project for the German government, we therefore analysed the effectiveness and consistency of existing sectoral policy packages anew, to open the discussion on which policy changes to the EU's energy efficiency policy packages are crucial to reach the targets. This comprehensive review addressed the industrial, buildings, and transport sectors plus the overarching governance framework (targets and roadmaps, EED, energy taxation and EU ETS). For each of these, the first step was a gap analysis of the main deficits in the sectoral policy packages, against effective model packages. At first glance, the combination of energy efficiency policies at EU level seems already quite comprehensive. However, their design and implementation often lack a consistent and ambitious approach to leverage their full potential. To give some examples of the many shortcomings identified, the governance framework suffers from exceptions and the transport sector being only marginally considered in the EED; an outdated Energy Tax Directive has very low minimum rates and several exception clauses; there is a lack of commitment to implement energy management systems and investment projects in large companies; a clear EU-wide definition of nearly zero energy buildings (nZEB) is missing; and the labelling of energy-using products is still confusing for consumers. Subsequently, we elaborated comprehensive policy recommendations to increase the effectiveness of all these policies, and to bridge some gaps with new policies. A list of priorities was established to sort them by their relevance

    A First Course on Time Series Analysis : Examples with SAS

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    The analysis of real data by means of statistical methods with the aid of a software package common in industry and administration usually is not an integral part of mathematics studies, but it will certainly be part of a future professional work. The present book links up elements from time series analysis with a selection of statistical procedures used in general practice including the statistical software package SAS. Consequently this book addresses students of statistics as well as students of other branches such as economics, demography and engineering, where lectures on statistics belong to their academic training. But it is also intended for the practician who, beyond the use of statistical tools, is interested in their mathematical background. Numerous problems illustrate the applicability of the presented statistical procedures, where SAS gives the solutions. The programs used are explicitly listed and explained. No previous experience is expected neither in SAS nor in a special computer system so that a short training period is guaranteed. This book is meant for a two semester course (lecture, seminar or practical training) where the first three chapters can be dealt within the first semester. They provide the principal components of the analysis of a time series in the time domain. Chapters 4, 5 and 6 deal with its analysis in the frequency domain and can be worked through in the second term. In order to understand the mathematical background some terms are useful such as convergence in distribution, stochastic convergence, maximum likelihood estimator as well as a basic knowledge of the test theory, so that work on the book can start after an introductory lecture on stochastics. Each chapter includes exercises. An exhaustive treatment is recommended. Chapter 7 (case study) deals with a practical case and demonstrates the presented methods. It is possible to use this chapter independent in a seminar or practical training course, if the concepts of time series analysis are already well understood. This book is consecutively subdivided in a statistical part and an SAS-specific part. For better clearness the SAS-specific parts are highlighted. This book is an open source project under the GNU Free Documentation License
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