High-Sensitivity Cardiac Troponin T in Patients with Severe Chronic Kidney Disease and Suspected Acute Coronary Syndrome

(1) Background: Patients with severe chronic kidney disease (CKD G4–G5) often have chronically elevated high-sensitivity cardiac troponin T (hs-cTnT) values above the 99th percentile of the upper reference limit. In these patients, optimal cutoff levels for diagnosing non-ST-elevation acute coronary syndrome (NSTE-ACS) requiring revascularization remain undefined. (2) Methods: Of 11,912 patients undergoing coronary angiography from 2012 to 2017 for suspected NSTE-ACS, 325 (3%) had severe CKD. Of these, 290 with available serial hs-cTnT measurements were included, and 300 matched patients with normal renal function were selected as a control cohort. (3) Results: In the CKD cohort, 222 patients (76%) had NSTE-ACS with indication for coronary revascularization. Diagnostic performance was high at presentation and similar to that of the control population (AUC, 95% CI: 0.81, 0.75–0.87 versus 0.85, 0.80–0.89, p = 0.68), and the ROC-derived cutoff value was 4 times higher compared to the conventional 99th percentile. Combining the ROC-derived cutoff levels for hs-cTnT at presentation and absolute 3 h changes, sensitivity increased to 98%, and PPV and NPV improved up to 93% and 86%, respectively. (4) Conclusions: In patients with severe CKD and suspected ACS, the diagnostic accuracy of hs-cTnT for the diagnosis of NSTE-ACS requiring revascularization is improved by using higher assay-specific cutoff levels combined with early absolute changes

The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study

Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP

The Code of Protest. Images of Peace in the West German Peace Movements, 1945-1990

The article examines posters produced by the peace movements in the Federal Republic of Germany during the ColdWar, with an analytical focus on the transformation of the iconography of peace in modernity. Was it possible to develop an independent, positive depiction of peace in the context of protests for peace and disarmament? Despite its name, the pictorial selfrepresentation of the campaign ‘Fight against Nuclear Death’ in the late 1950s did not draw on the theme of pending nuclear mass death. The large-scale protest movement in the 1980s against NATO’s 1979 ‘double-track’ decision contrasted female peacefulness with masculine aggression in an emotionally charged pictorial symbolism. At the same time this symbolism marked a break with the pacifist iconographic tradition that had focused on the victims of war. Instead, the movement presented itself with images of demonstrating crowds, as an anticipation of its peaceful ends. Drawing on the concept of asymmetrical communicative ‘codes’ that has been developed in sociological systems theory, the article argues that the iconography of peace in peace movement posters could not develop a genuinely positive vision of peace, since the code of protest can articulate the designation value ‘peace’ only in conjunction with the rejection value ‘war’

DNMT3A mutations mediate the epigenetic reactivation of the leukemogenic factor MEIS1 in acute myeloid leukemia

Close to half of de novo acute myeloid leukemia (AML) cases do not exhibit any cytogenetic aberrations. In this regard, distortion of the DNA methylation setting and the presence of mutations in epigenetic modifier genes can also be molecular drivers of the disease. In recent years, somatic missense mutations of the DNA methyltransferase 3A (DNMT3A) have been reported in ~20% of AML patients; however, no obvious critical downstream gene has been identified that could explain the role of DNMT3A in the natural history of AML. Herein, using whole-genome bisulfite sequencing and DNA methylation microarrays, we have identified a key gene undergoing promoter hypomethylation-associated transcriptional reactivation in DNMT3 mutant patients, the leukemogenic HOX cofactor MEIS1. Our results indicate that, in the absence of mixed lineage leukemia fusions, an alternative pathway for engaging an oncogenic MEIS1-dependent transcriptional program can be mediated by DNMT3A mutations

Quantitative assessment of the asphericity of pretherapeutic FDG uptake as an independent predictor of outcome in NSCLC

Background The aim of the present study was to evaluate the predictive value of a novel quantitative measure for the spatial heterogeneity of FDG uptake, the asphericity (ASP) in patients with non-small cell lung cancer (NSCLC). Methods FDG-PET/CT had been performed in 60 patients (15 women, 45 men; median age, 65.5 years) with newly diagnosed NSCLC prior to therapy. The FDG-PET image of the primary tumor was segmented using the ROVER 3D segmentation tool based on thresholding at the volume-reproducing intensity threshold after subtraction of local background. ASP was defined as the relative deviation of the tumor’s shape from a sphere. Univariate and multivariate Cox regression as well as Kaplan-Meier (KM) analysis and log-rank test with respect to overall (OAS) and progression-free survival (PFS) were performed for clinical variables, SUVmax/mean, metabolically active tumor volume (MTV), total lesion glycolysis (TLG), ASP and “solidity”, another measure of shape irregularity. Results ASP, solidity and “primary surgical treatment” were significant independent predictors of PFS in multivariate Cox regression with binarized parameters (HR, 3.66; p < 0.001, HR, 2.11; p = 0.05 and HR, 2.09; p = 0.05), ASP and “primary surgical treatment” of OAS (HR, 3.19; p = 0.02 and HR, 3.78; p = 0.01, respectively). None of the other semi-quantitative PET parameters showed significant predictive value with respect to OAS or PFS. Kaplan-Meier analysis revealed a probability of 2-year PFS of 52% in patients with low ASP compared to 12% in patients with high ASP (p < 0.001). Furthermore, it showed a higher OAS rate in the case of low versus high ASP (1-year-OAS, 91% vs. 67%: p = 0.02). Conclusions The novel parameter asphericity of pretherapeutic FDG uptake seems to provide better prognostic value for PFS and OAS in NCSLC compared to SUV, metabolic tumor volume, total lesion glycolysis and solidity

Ubiquitin carboxyl-terminal hydrolase 1 (UCHL1) is a potential tumour suppressor in prostate cancer and is frequently silenced by promoter methylation

<p>Abstract</p> <p>Background</p> <p>We have previously reported significant downregulation of ubiquitin carboxyl-terminal hydrolase 1 (UCHL1) in prostate cancer (PCa) compared to the surrounding benign tissue. UCHL1 plays an important role in ubiquitin system and different cellular processes such as cell proliferation and differentiation. We now show that the underlying mechanism of UCHL1 downregulation in PCa is linked to its promoter hypermethylation. Furthermore, we present evidences that UCHL1 expression can affect the behavior of prostate cancer cells in different ways.</p> <p>Results</p> <p>Methylation specific PCR analysis results showed a highly methylated promoter region for UCHL1 in 90% (18/20) of tumor tissue compared to 15% (3/20) of normal tissues from PCa patients. Pyrosequencing results confirmed a mean methylation of 41.4% in PCa whereas only 8.6% in normal tissues. To conduct functional analysis of UCHL1 in PCa, UCHL1 is overexpressed in LNCaP cells whose UCHL1 expression is normally suppressed by promoter methylation and found that UCHL1 has the ability to decrease the rate of cell proliferation and suppresses anchorage-independent growth of these cells. In further analysis, we found evidence that exogenous expression of UCHL1 suppress LNCaP cells growth probably via p53-mediated inhibition of Akt/PKB phosphorylation and also via accumulation of p27kip1 a cyclin dependant kinase inhibitor of cell cycle regulating proteins. Notably, we also observed that exogenous expression of UCHL1 induced a senescent phenotype that was detected by using the SA-ß-gal assay and might be due to increased p14ARF, p53, p27kip1 and decreased MDM2.</p> <p>Conclusion</p> <p>From these results, we propose that UCHL1 downregulation via promoter hypermethylation plays an important role in various molecular aspects of PCa biology, such as morphological diversification and regulation of proliferation.</p

The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature

Background: During the COVID-19 pandemic people are facing risks of adverse health effects due to the restrictions implemented such as quarantine measures, reduced social contact, and self-isolation. In this qualitative review, we collected data on potential preventive and therapeutic health benefits of Complementary and Integrative Medicine (CIM) that might be useful during the COVID-19 pandemic. We have reviewed the scientific literature to summarize CIM practices that could be beneficial for improving physical and mental health and well-being of the population under the current pandemic circumstances. It must be noted that this review is not SARS-CoV-2 specific and we explicitly do not intend to make any SARS-CoV-2 specific health claims in this article. Methods and Findings: A qualitative, non-systematic literature review was conducted in Medline to identify literature describing preventive and therapeutic CIM approaches for strengthening mental and physical health. For a variety of CIM approaches clinical evidence was identified, indicating beneficial effects. CIM approaches include specific dietary measures and selected micronutrients, physical activity, techniques from Mind-Body Medicine, single botanicals or botanical compounds, and spending time in nature among others. The effects of CIM measures on conditions like obesity and hypertension are of special relevance here, as these conditions are considered as risk factors for a severe course of COVID-19. Moreover, a possibly direct effect of CIM approaches on immune functions and clinical parameters in respiratory tract infections, such as influenza, were identified. The findings of this review could be helpful for clinicians, patients, and the general population during the current pandemic when discussing and/or considering CIM options. Conclusions: CIM offers a variety of preventive and therapeutic options for strengthening physical and mental resilience, which could also be useful in the current COVID-19 pandemic. The evidence of CIM approaches with a potential benefit in the COVID-19 pandemic in different areas is worth to be analyzed. While this qualitative review has several obvious limitations, it might serve as useful starting point for further research on this topic

50 Jahre Neubau Universitätsbibliothek Stuttgart 2011

T e i l 1 Impressum, Sponsoren - Seite 4 Stephan, Werner: Einleitung und Dank - Seite 9 Einfachheit in Form und Material - less is more: Klaus-Jürgen Zabel über den Bau der Universitätsbibliothek (Interview mit Ottmar Pertschi und Christiane Rambach) - Seite 13 Paulus, Stefan: Amerika als Vorbild? Anmerkungen zu den politischen und kulturhistorischen Bedingungen an (west)deutschen Universitäten in den 1950er Jahren - Seite 19 Hering, Jürgen: Max Kade und die Technische Hochschule Stuttgart - Seite 41 Becker, Norbert: Die Technische Hochschule Stuttgart und ihre Bibliothek in der Nachkriegszeit - Seite 63 T e i l 2 Rambach, Christiane: Eine Bibliothek sucht ihren Standort - Seite 75 T e i l 3 Rambach, Christiane: Architekten auf Reisen: "new standards in library design" in Stuttgart - Seite 97 T e i l 4 Philipp, Klaus Jan: Die Universitätsbibliothek im architekturgeschichtlichen Kontext - Seite 125 Huster-Braumann, Henriette: Maximilian Debus: die Universitätsbibliothek und ihre Schrift - Seite 145 T e i l 5 Jost, Holger; Stürzebecher, Jörg: Moderate Moderne: Innenraumgestaltung der Universitätsbibliothek Stuttgart - Seite 153 T e i l 6 Küster, Bärbel: Kunst und Konsens 1958 - 1962: zur Ankaufsgeschichte der Plastik von Hans Uhlmann für die Universitätsbibliothek Stuttgart - Seite 171 Szymczyk-Eggert, Elisabeth: Die Zweigbibliothek auf dem Campus in Stuttgart-Vaihingen: vom Provisorium zur Dauereinrichtung - Seite 191 T e i l 7 Stephan, Werner: Bibliotheken der Zukunft - Seite 221 T e i l 8 Anhang: Architekten der Universitätsbibliothek: Volkart, Zabel, Klauss und Koschlig (Christiane Rambach) - Seite 233 Richtfest am 31. Juli 1959 (Schwäbisches Stück zum Richtfest der THB am 31. Juli 1959 von Hans Volkart - Richtspruch des Zimmerpoliers der AG Kübler und Züblin zum Richtfest der Universitätsbibliothek am 31. Juli 1959) - Seite 237 "Es lebe die Bibliothek!" Interne Bibliothekseinweihung am 17. Februar 1962 - Seite 243 Skizzen (Gedanken zu einem Anbau an die Universitätsbibliothek Stuttgart von Klaus-Jürgen Zabel 2011 - Ihre Universitätsbibliothek zum Selberbauen von Stefan Pertschi) - Seite 247 Literatur zum Bau der Universitätsbibliothek Stuttgart (eine Auswahl - Christiane Rambach) - Seite 253 Abkürzungsverzeichnis, Abbildungsnachweise - Seite 258 Namen- und Sachregister (Ottmar Pertschi) - Seite 263 Autorenverzeichnis - S. 27