Clinical Features of Rapidly Progressive Alzheimer's Disease

Objective: To characterize clinical features, CSF biomarkers and genetic polymorphisms of patients suffering from a rapidly progressing subtype of Alzheimer's dementia (rpAD). Methods: Retrospective analyses of 32 neuropathologically confirmed cases differentially diagnosed as AD out of a group with rapidly progressive dementia. CSF biomarkers (14-3-3, tau, beta-amyloid 1-42) and genetic markers (PRNP codon 129, apolipoprotein E, ApoE, polymorphism) were determined. Results: Median survival was 26 months, age at onset 73 years. Biomarkers: mean beta-amyloid 1-42: 266 pg/ml, median tau: 491 pg/ml, 14-3-3 positive: 31%. Genetic polymorphisms showed a predominance of methionine homozygosity at PRNP codon 129 and a low frequency of ApoE4 (38%, no homozygous patients). Thirty-five symptoms were studied. Frequent symptoms were myoclonus (75%), disturbed gait (66%) and rigidity (50%). Discussion: rpAD is associated with a diversity of neurological signs even able to mimic Creutz feldt-Jakob disease. Biomarkers and genetic profile differ from those seen in classical AD. The findings on biomarkers, symptomatology and genetics may aid the differential diagnostic process. Copyright (C) 2010 S. Karger AG, Base

Testing of a Multiple Criteria Assessment Tool for Healthcare Facilities Quality and Sustainability: The Case of German Hospitals

Background: Hospital facilities are an essential part of healthcare systems, making the assessment of their quality and sustainability pivotal. Most existing evaluation tools lack a holistic and validated approach, while predominantly excluding the built environment. The Italian hospital evaluation tool SustHealth v2 addresses the shortcoming of existing applications through its structured and more integrated approach; there is the need for further testing it. Methods: The study aims to test for the first time in an international case study the multicriteria assessment tool previously developed and validated. The tool assesses social, environmental, and organisational qualities in hospitals with an online survey containing 199 closed questions sent to German hospitals. A total of 14 full replies have been collected and the resulting data analysed through descriptive statistics and heat maps identifying patterns in ownership and size. Results: Within the sample, higher scores are reported in Social Quality, while lower in Environmental and Organisational Quality. Respondents performed well in the sustainability dimensions of health promotion, waste management, and patient safety. Improvements can be achieved in energy management, facility management, and technological innovation criteria. Private hospitals slightly outperform both public and non-profit clinics. The findings presented in this study suggest a non-linear relationship between sustainability and hospital size since the highest scores were obtained by either small or large facilities. Conclusion: The study highlighted strengths and limitation of SustHealth v2. Further testing and comparison are encouraged in different context

Empirische Forschungsergebnisse als Grundlage für die Beratung von Scheidungsfamilien: Das Kölner Längsschnittprojekt

'In diesem Beitrag geht es um das Problem der Verbindung von Scheidungsforschung und -intervention. Das Kölner Projekt zur Entwicklung von sozialen Beziehungsmustern nach der Scheidung berücksichtigt beide Aspekte. Im Rahmen einer Längsschnittuntersuchung werden empirische Ergebnisse zum phasenspezifischen Verlauf von Veränderungen vom Zeitpunkt der elterlichen Trennung an vorgelegt.' (Autorenreferat

CFH Loss in Human RPE Cells Leads to Inflammation and Complement System Dysregulation via the NF-ƙB Pathway

Age-related macular degeneration (AMD), the leading cause of vision loss in the elderly, is a degenerative disease of the macula, where retinal pigment epithelium (RPE) cells are damaged in the early stages of the disease, and chronic inflammatory processes may be involved. Besides aging and lifestyle factors as drivers of AMD, a strong genetic association to AMD is found in genes of the complement system, with a single polymorphism in the complement factor H gene (CFH), accounting for the majority of AMD risk. However, the exact mechanism of CFH dysregulation confers such a great risk for AMD and its role in RPE cell homeostasis is unclear. To explore the role of endogenous CFH locally in RPE cells, we silenced CFH in human hTERT-RPE1 cells. We demonstrate that endogenously expressed CFH in RPE cells modulates inflammatory cytokine production and complement regulation, independent of external complement sources, or stressors. We show that loss of the factor H protein (FH) results in increased levels of inflammatory mediators (e.g., IL-6, IL-8, GM-CSF) and altered levels of complement proteins (e.g., C3, CFB upregulation, and C5 downregulation) that are known to play a role in AMD. Moreover, our results identify the NF-κB pathway as the major pathway involved in regulating these inflammatory and complement factors. Our findings suggest that in RPE cells, FH and the NF-κB pathway work in synergy to maintain inflammatory and complement balance, and in case either one of them is dysregulated, the RPE microenvironment changes towards a proinflammatory AMD-like phenotype

Replacing Mineral Fertilizer with Nitrified Human Urine in Hydroponic Lettuce (Lactuca sativa L.) Production

Source-separated, nitrified, and decontaminated human urine constitutes a promising plant fertilizer that contains a large share of the nitrogen and phosphorus in household wastewater, and other plant nutrients. However, human urine contains high levels of sodium and chloride that can affect salt-sensitive greenhouse crops. Replacing mineral fertilizer with nitrified urine fertilizer could reduce the environmental impact of lettuce production in hydroponic systems, if marketable yield, appearance, and produce quality are not affected. In the present study, a treatment combination of a nitrified urine fertilizer and mineral fertilizers was used to grow lettuce through the nutrient film technique. This was compared to a conventionally fertilized control treatment. No significant differences were observed regarding yield, phenotype, and contents of nitrate, heavy metals, phenolic acids, and chlorophyll in leaf tissue. Calcium content was significantly reduced and sodium was elevated in nitrified urine treatment. For the elements nitrogen, phosphorous, and potassium, a saving of 48%, 13%, and 15% was calculated, respectively. The calculated carbon footprint from the total fertilizer production was reduced by 34.25%, caused by the nitrified urine treatment. Based on these results, a nutrient solution composed of nitrified urine fertilizer combined with mineral fertilizer may be a promising alternative for growers to produce lettuce with a reduced environmental impact without loss of plant quantity and quality.city of BerlinPeer Reviewe

Deutsche Klimaforscher auf der Medienwelle?

Die Entdeckung des 47 Millionen Jahre alten Affenfossil "Ida" (WPK Quarterly 2009) sorgte jüngst für weltweiten Medienrummel. Ausgelöst wurde dieser durch eine großangelegte PR-Kampagne der beteiligten Wissenschaftler - noch vor der eigentlichen Beforschung des Fossils und vor der Publikation wissenschaftlicher Erkenntnisse. Die Folge: Der später erschienene Forschungsartikel wurde mehr als 100.000 Mal heruntergeladen und avancierte damit zum wohl meist nachgefragten paläontologischen Aufsatz aller Zeiten. Derartige Fälle werden in den Sozialwissenschaften unter dem Schlagwort "Mediatisierung der Wissenschaft" diskutiert. Wissenschaft sei, so die Diagnose, einerseits zu einem "Gegenstand medialer Dauerbeobachtung" geworden (Weingart 2005, 28). Andererseits dringe die Logik der Medien zunehmend in die wissenschaftliche Arbeit ein. Eine solche Mediatisierung ist auch für die Klimaforschung vorstellbar, die spätestens nach Skandalen wie ClimateGate unter medialer Beobachtung steht und deren Protagonisten sich teils mit politischen Forderungen wie dem Zwei-Grad-Ziel öffentlich positionieren. Empirische Befunde liegen dazu jedoch kaum vor. Hier setzt ein Projekt des Hamburger Exzellenzclusters für Klimaforschung "CliSAP" an: Mittels einer Online-Befragung haben wir die Mediatisierung deutscher Klimaforscher untersucht

Cerebrospinal Fluid Mitochondrial DNA in Rapid and Slow Progressive Forms of Alzheimer's Disease

Alzheimer's type dementia (AD) exhibits clinical heterogeneity, as well as differences in disease progression, as a subset of patients with a clinical diagnosis of AD progresses more rapidly (rpAD) than the typical AD of slow progression (spAD). Previous findings indicate that low cerebrospinal fluid (CSF) content of cell-free mitochondrial DNA (cf-mtDNA) precedes clinical signs of AD. We have now investigated the relationship between cf-mtDNA and other biomarkers of AD to determine whether a particular biomarker profile underlies the different rates of AD progression. We measured the content of cf-mtDNA, beta-amyloid peptide 1-42 (A beta), total tau protein (t-tau) and phosphorylated tau (p-tau) in the CSF from a cohort of 95 subjects consisting of 49 controls with a neurologic disorder without dementia, 30 patients with a clinical diagnosis of spAD and 16 patients with rpAD. We found that 37% of controls met at least one AD biomarker criteria, while 53% and 44% of subjects with spAD and rpAD, respectively, did not fulfill the two core AD biomarker criteria: high t-tau and low A beta in CSF. In the whole cohort, patients with spAD, but not with rpAD, showed a statistically significant 44% decrease of cf-mtDNA in CSF compared to control. When the cohort included only subjects selected by A beta and t-tau biomarker criteria, the spAD group showed a larger decrease of cf-mtDNA (69%), whereas in the rpAD group cf-mtDNA levels remained unaltered. In the whole cohort, the CSF levels of cf-mtDNA correlated positively with A beta and negatively with p-tau. Moreover, the ratio between cf-mtDNA and p-tau increased the sensitivity and specificity of spAD diagnosis up to 93% and 94%, respectively, in the biomarker-selected cohort. These results show that the content of cf-mtDNA in CSF correlates with the earliest pathological markers of the disease, A beta and p-tau, but not with the marker of neuronal damage t-tau. Moreover, these findings confirm that low CSF content of cf-mtDNA is a biomarker for the early detection of AD and support the hypothesis that low cf-mtDNA, together with low A beta and high p-tau, constitute a distinctive CSF biomarker profile that differentiates spAD from other neurological disorders

Spectroscopy of the circumplanetary disk around the young planet-mass companion CT Cha b

Several planet-mass companions (PMCs) on wide-orbits have been imaged around young stars (1-10 Myr). Their estimated mass is just around the brown dwarf to giant planet transition (~13 Jupiter masses), which makes them especially interesting for both star and planet formation theories. Several formation scenarios exist, but none of them can explain all properties of the currently known PMCs. There are strong theoretical reasons to expect disks around PMCs, and indirect evidence for disks around PMCs from optical and near-infrared emission exists. However, attempts to detect the dust and gas emission of the disk directly have been unsuccessful. The high sensitivity of JWST MIRI will allow detecting disks with sizes smaller than one au, masses as low 1/10000 of a Jupiter mass and will provide first constraints on the solid and gas composition of disks around PMCs. We propose to observe the PMC CT Cha b with the MIRI spectrograph to detect the dust and gas emission (water lines) of its disk. Those results allow for a comparison to the composition of the primary disk of CT Cha, which is observed simultaneously, and to observations of protoplanetary disks, providing new constraints for possible differences in disk evolution. Those observations, together with forthcoming complementary ALMA observations, will put stringent limits on the mass and size of the companion's disk; quantities most relevant for PMC formation theories and spin-evolution studies. The proposed program will be a big step forward for our understanding of the mysterious nature of wide-orbit planet-mass companions and will serve as a pioneering study for future JWST surveys of PMCs