48 research outputs found

    Improving mental well-being in psychocardiology—a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

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    Background: Many patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach. Methods: We translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a non-blended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease. Results: Overall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients’ subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial. Conclusion: Applying a metacognitive-based brief intervention via a non-blended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care

    Symptoms and Needs of Patients with Advanced Lung Cancer: Early Prevalence Assessment

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    Background: Little is known on symptom burden, psychosocial needs, and perception of prognosis in advanced lung cancer patients at the time of diagnosis, although early assessment is strongly recommended within the setting of daily routine care. Methods: Twelve study sites cross-sectionally assessed symptoms and psychosocial needs of patients suffering from newly diagnosed incurable lung cancer. Assessment comprised NCCN distress thermometer, FACT-L, SEIQoL-Q, PHQ-4, and shortened and modified SCNS-SF-34 questionnaires. Additional prognostic information from both patients and physicians were collected. Results: A total of 208 patients were evaluated. Mean age was 63.6 years, 58% were male, 84% suffered from stage IV lung cancer, and 71% had an ECOG performance status of 0–1. Mean distress level was 5.4 (SD 2.5), FACT-L total score was 86 (21.5), and TOI 50.5 (14.9). PHQ-4 was 4.6 (3.3), and shortened and modified SCNS-SF-34 showed 9 (8.7) unmet needs per patient. According to their physicians’ perspective, 98.1% of patients were reflecting on and 85.2% were accepting incurability, while 26.5% of patients considered the treatment to be of curative intent. Conclusion: Our findings emphasize substantial domains of symptom burden seen in newly diagnosed, incurable lung cancer patients. Oncologists should be aware of these features and address prognostic issues early in the disease trajectory to facilitate opportunities to improve coping, advance care planning, and appropriate integration of palliative care, thus improving quality of life

    Neighbourhood species richness and drought-tolerance traits modulate tree growth and δ13C responses to drought

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    Mixed-species forests are promoted as a forest management strategy for climate change mitigation and adaptation because they are more productive and can be more resistant and resilient than monospecific forests under drought stress. However, the trait-based mechanisms driving these properties remain elusive, making it difficult to predict which functional identities of species best improve tree growth and decrease tree physiological water stress under drought. We investigated tree growth and physiological stress responses (i.e. increase in wood carbon isotopic ratio; δ13C) to changes in climate-induced water availability (wet-to-dry years) along gradients in neighbourhood tree species richness and drought-tolerance traits. Using tree cores from a large-scale biodiversity experiment, we tested the overarching hypothesis that neighbourhood species richness increases growth and decreases δ13C. We further hypothesized that the abiotic (i.e. climatic conditions) and the biotic context modulate these biodiversity-ecosystem functioning relationships. We characterized the biotic context using drought-tolerance traits of focal trees and their neighbours. These traits are related to cavitation resistance vs. resource acquisition and stomatal control. We found that tree growth increased with neighbourhood species richness. However, we did not observe a universal relief of water stress in species-rich neighbourhoods, nor an increase in the strength of the relationship between richness and growth and between richness and δ13C from wet-to-dry years. Instead, these relationships depended on both the traits of the focal trees and their neighbours. At either end of each drought-tolerance gradient, species responded in opposing directions during drought and non-drought years. Synthesis. We report that the biotic context can determine the strength and nature of biodiversity-ecosystem functioning relationships in experimental tree communities. We derive two key conclusions: (1) drought-tolerance traits of focal trees and their neighbours can explain divergent tree responses to drought and diversity, and (2) contrasting, trait-driven responses of tree species to wet vs dry climatic conditions can promote forest community stability. Mixing tree species with a range of drought-tolerance traits may therefore increase forest productivity and stability

    Termite sensitivity to temperature affects global wood decay rates.

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    Deadwood is a large global carbon store with its store size partially determined by biotic decay. Microbial wood decay rates are known to respond to changing temperature and precipitation. Termites are also important decomposers in the tropics but are less well studied. An understanding of their climate sensitivities is needed to estimate climate change effects on wood carbon pools. Using data from 133 sites spanning six continents, we found that termite wood discovery and consumption were highly sensitive to temperature (with decay increasing >6.8 times per 10°C increase in temperature)-even more so than microbes. Termite decay effects were greatest in tropical seasonal forests, tropical savannas, and subtropical deserts. With tropicalization (i.e., warming shifts to tropical climates), termite wood decay will likely increase as termites access more of Earth's surface

    Hexokinase II integrates energy metabolism and cell survival regulation

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    Ziel der vorliegenden Arbeit war es die molekularen Mechanismen der neuroprotektiven Wirkung der Hexokinase II in einem in vitro Modell der zerebralen Ischämie zu untersuchen. Klassischerweise gehört die Hexokinase II (HKII) zu den vier Hexokinase Isoenzymen, die den ersten obligatorischen Schritt im Glukosestoffwechsel von Säugetieren katalysieren. Neben ihrer zentralen Rolle im Energiemetabolismus kommt der HKII eine funktionelle Bedeutung innerhalb der Apoptoseregulation zu. Zur Charakterisierung der neuroprotektiven Eigenschaften der HKII wurden Expressionsvektoren mit Punktmutationen in bereits bekannte, funktionell und strukturell wichtige HKII Domänen generiert, in eine primäre Neuronenkultur transfiziert und im Rahmen der kombinierten Sauerstoff- und Glukose-Deprivation (OGD) beziehungsweise reinen Sauerstoff-Deprivation (OD) oder Glukose-Deprivation (GD) auf ihre antiapoptotischen Effekte getestet. Die Ergebnisse demonstrieren die essentielle Bedeutung der mitochondrialen HKII-Bindung für die Vermittlung des neuronalen Zellschutzes im OGD-Modell, dargestellt durch die Aufhebung der protektiven Effekte bei Überexpression einer mitochondrialen Lokalisationssequenz defizienten HKII Mutante. Durch funktionelle Testung einer Akt-Phosphorylierungsdefizienten HKII Mutante und Akt-Phosphomimetischen HKII Mutante konnte eine apoptose-regulatorische Wirkung des HKII-Akt- Phosphorylierungsmotifs unter hypoxischen Bedingungen nachgewiesen werden. Der negative Effekt der HKII-BH-4 Domäne inaktivierten Mutante auf das Neuronenüberleben bestätigt die Funktionalität einer im C-Terminus des HKII Proteins postulierten HKII-BH-4 Domäne. In Zellkulturexperimenten mit einer katalytisch-inaktiven HKII Doppelmutante zeigte sich eine Glukoseabhängigkeit der antiapoptotischen Eigenschaften der HKII. Die katalytische Aktivität der HKII ist maßgeblich an der zellschützenden Wirkung des glykolytischen Enzyms beteiligt und macht die HKII zu einem interessanten Verknüpfungspunkt zwischen Zellmetabolismus und Apoptoseregulation. Durch die strukturell-funktionelle Charakterisierung der HKII-vermittelten Neuroprotektion erschließt sich ein besseres Verständnis der ablaufenden molekularen Mechanismen innerhalb der Apoptoseregulation. Diese Erkenntnisse bieten einen gezielteren Ansatz für die Identifizierung und Entwicklung von neuen Wirkstofftargets zur Therapie von neurodegenerativen- und Tumorerkrankungen. Da die HK neben ihrer ubiquitären Expression eine allgemein große Bedeutung für den Glukosemetabolismus in Säugetierzellen hat, könnten die nachgewiesenen funktionell- wichtigen HKII Domänen auch über neuronale Zellen hinaus relevant sein und beispielsweise zur Therapieoptimierung bei einem Myokardinfarkt beitragen.Hexokinase II (HKII) is one of 4 mammalian Hexokinase isoenzymes catalyzing the first obligatory step of glucose metabolism. In addition to their catalytical activity, HKII is also believed to play a role in regulating cell death. In the state of ischemic tolerance Hexokinase II is upregulated by Hypoxia inducible factor 1 (HIF-1). In order to investigate the role of HKII in neuroprotective signaling, site directed mutagenesis was used to generate several murine HKII expression vectors with mutations in domains relevant for glucose metabolism and apoptosis regulation. The effect of HKII and its mutants on neuronal survival was studied using a sensitive technique based on co-transfecting embryonic rat primary cortical neurons with eGFP (green cells) and HKII or HKII mutant vectors. These co-transfected cells were co-cultivated with primary neurons expressing m-orange (orange cells) and subsequently submitted to an in vitro model of cerebral ischemia (oxygen-glucose- deprivation, OGD), (glucose-deprivation, GD) or (oxygen-deprivation, OD), respectively. The ratio of green vs. orange neurons before and after the damaging event was analysed. Thereby the effect of different HKII mutants on neuronal survival could be determined. The data demonstrates that mitochondrial binding of HKII is a dynamic and adaptive response mediated by protein kinase B (PKB)/Akt kinase dependent phosphorylation, that protects neurons from OGD induced apoptosis. It is proposed that HKII may serve as a molecular switch regulating apoptosis in a glucose concentration depending fashion and may those provide a link between cellular metabolism and survival. These results might also have a therapeutic implication for vascualar diseases like stroke
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