Three different pathways of IgM-antibody-dependent hemolysis are mainly regulated by complement

Antibodies to red blood cells (RBCs) may hemolyze erythrocytes via Fc-mediated phagocytosis or complement-dependent. Complement activation on RBCs can be detected by C3d-direct antiglobulin test (DAT), which is the only test in immune hematology that directly targets complement. However, a positive DAT with anti-C3d cannot distinguish between C3b-mediated extravascular hemolysis, C5b-C9-mediated intravascular hemolysis and C5b-C8-mediated eryptosis. Furthermore, DAT is not suitable to estimate the strength of hemolysis. Autoimmune hemolytic anemia (AIHA) is a rare disease that is caused by autoantibodies to red blood cells that is divided in warm AIHA and in cold agglutinin disease (CAD). The causative antibodies in CAD and sometimes in warm AIHA are from the IgM class. Depending on strength of complement activation they can induce extravascular hemolysis, intravascular hemolysis and eryptosis. We studied the three types of hemolysis by use of sera from patients with CAD under various conditions. We found that additionally to the routinely applied C3d-DAT, indirect tests for complement activity (free hemoglobin and Annexin V-binding to phosphatidylserine-exposing RBCs) should be used to determine the portion of extravascular, intravascular and eryptotic hemolysis. Eryptotic hemolysis may have a significant share in clinical relevant CAD or IgM warm AIHA, which should be considered for successful treatment

Protein quality control:from mechanism to disease EMBO Workshop, Costa de la Calma (Mallorca), Spain, April 28-May 03, 2019

The cellular protein quality control machinery with its central constituents of chaperones and proteases is vital to maintain protein homeostasis under physiological conditions and to protect against acute stress conditions. Imbalances in protein homeostasis also are keys to a plethora of genetic and acquired, often age-related, diseases as well as aging in general. At the EMBO Workshop, speakers covered all major aspects of cellular protein quality control, from basic mechanisms at the molecular, cellular, and organismal level to medical translation. In this report, the highlights of the meeting will be summarized

Light management films for enhanced harvesting in printable photovoltaics

Printed organic photovoltaics promise lightweight and flexible light harvesting devices for conformable integration into buildings, portable electronics or vehicles. Besides the challenges in material synthesis and engineering of the printing processes, the optical design of these thin film layer devices is inevitable to achieve high power conversion efficiencies. In this respect, light management, which denotes the control of light in-coupling and light absorption in the device by photonic micro- and nanostructures, plays an increasingly important role. In this thesis, dielectric diffractive nanostructures are introduced as such light management solution, which stands out due to its device-independent fabrication. The optical properties of the periodic structures and the angle dependent absorption in the OPV devices are carefully analyzed and their enhancement potential is demonstrated experimentally on single-junction and tandem devices. To demonstrate the applicability of this class of light management solutions, advanced nanostructures are fabricated, on the one hand, as self-standing foils to reveal their potential for mass production and, on the other hand, as buried structures, which provide protection against abrasion. An optical model is developed in this thesis, which enables the optimization of the geometrical parameters of the nanostructure, with respect to the yearly harvested energy in different application-relevant device orientations (facade, consumer electronics, shading, automotive)

n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis

Introduction: Previous studies and a meta-analysis in surgical patients indicate that supplementing parenteral nutrition regimens with n-3 polyunsaturated fatty acids (PUFAs), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with improved laboratory and clinical outcomes in the setting of hyper-inflammatory conditions. Refined or synthetic fish oils are commonly used as a source of EPA and DHA. The objective of the present meta-analysis was to evaluate n-3 PUFA-enriched parenteral nutrition regimens in elective surgical and intensive care unit (ICU) patients.Methods: Medline was searched for randomized controlled trials comparing n-3 PUFA-enriched lipid emulsions with standard non-enriched lipid emulsions (i.e. soybean oil, MCT/LCT or olive/soybean oil emulsions) in surgical and ICU patients receiving parenteral nutrition. Extracted data were pooled by means of both random and fixed effects models, and subgroup analyses were carried forward to compare findings in ICU versus non-ICU patients.Results: A total of 23 studies (n = 1502 patients: n = 762 admitted to the ICU) were included. No statistically significant difference in mortality rate was found between patients receiving n-3 PUFA-enriched lipid emulsions and those receiving standard lipid emulsions (RR= 0.89; 0.59, 1.33), possibly reflecting a relatively low underlying mortality risk. However, n-3 PUFA-enriched emulsions are associated with a statistically and clinically significant reduction in the infection rate (RR =0.61; 0.45, 0.84) and the lengths of stay, both in the ICU (-1.92; -3.27, -0.58) and in hospital overall (-3.29; -5.13, -1.45). Other beneficial effects included reduced markers of inflammation, improved lung gas exchange, liver function, antioxidant status and fatty acid composition of plasma phospholipids, and a trend towards less impairment of kidney function.Conclusions: These results confirm and extend previous findings, indicating that n-3 PUFAs-enriched parenteral nutrition regimens are safe and effective in reducing the infection rate and hospital/ICU stay in surgical and ICU patients. © 2012 Pradelli et al.; licensee BioMed Central Ltd

Evaluation of the New Lateral Flow Card MDmulticard® Basic Extended Phenotype in Routine Clinical Practice

Background: Transfusion emergencies and critical situations require specifically designed devices to simplify and optimize the standard procedures. In addition, matching antigens over and above ABO-Rh-K would be beneficial. Methods: Routine blood samples were collected in four immunohematology centers and tested with the new MDmulticard Basic Extended Phenotype for the simultaneous detection of the Duffy, Kidd, and Ss antigens, according to the principle of the lateral flow. Results were compared with those obtained using routine serology methods. Discrepancies were analyzed by molecular techniques/genotyping. Results: 310 samples were tested (167 donors; 75 patients; 28 subjects with positive direct antiglobulin test (DAT); 15 newborns; 25 previously transfused patients). The 285 samples with non-mixed-field reaction yielded 1,710 antigen results with 8 discrepancies (0.47%) six of which in DAT-positive subjects: three false-positive (Fy(a)) for MDmulticard, and two false-positive (Fy(a)) plus three false-negative (Fy(b)) for the reference methods (MDmulticard PPA for donors/patients/newborns: 99.82%; negative percent agreement: 100%; sensitivity: 100%; specificity: 99.39%, positive predictive value: 99.75%; negative predictive value: 100%). The MDmulticard detected mixed-field in 15 antigen reactions from 13 transfused patients, undetected by the comparative method, with the opposite result in 8 antigens (5 patients). Conclusion: The MDmulticard Basic Extended Phenotype met the criteria prescribed for the testing of donor, patient, DAT-positive, and newborn samples in transfusion laboratory routine

Omega-3 fatty acids in parenteral nutrition: a systematic review with network meta-analysis on clinical outcomes

Background & aims: Accumulating scientific evidence supports the benefits of parenteral nutrition (PN) with fish oil (FO) containing intravenous lipid emulsions (ILEs) on clinical outcomes. Yet, the question of the most effective ILE remains controversial. We conducted a network meta-analysis (NMA) to compare and rank different types of ILEs in terms of their effects on infections, sepsis, ICU and hospital length of stay, and in-hospital mortality in adult patients.Methods: MEDLINE, EMBASE, and Web of Science databases were searched for randomized controlled trials (RCTs) published up to May 2022, investigating ILEs as a part of part of PN covering at least 70% of total energy provision. Lipid emulsions were classified in four categories: FO-ILEs, olive oil (OO)-ILEs, medium-chain triglyceride (MCT)/soybean oil (SO)-ILEs, and pure SO-ILEs. Data were statistically com-bined through Bayesian NMA and the Surface Under the Cumulative RAnking (SUCRA) was calculated for all outcomes. Results: 1651 publications were retrieved in the original search, 47 RCTs were included in the NMA. For FO-ILEs, very highly credible reductions in infection risk versus SO-ILEs [odds ratio (OR) = 0.43 90% credibility interval (CrI) (0.29-0.63)], MCT/soybean oil-ILEs [0.59 (0.43-0.82)], and OO-ILEs [0.56 (0.33-0.91)], and in sepsis risk versus SO-ILEs [0.22 (0.08-0.59)], as well as substantial reductions in hospital length of stay versus SO-ILEs [mean difference (MD) =-2.31 (-3.14 to-1.59) days] and MCT/SO-ILEs (-2.01 (-2.82 to-1.22 days) were shown. According to SUCRA score, FO-ILEs were ranked first for all five outcomes.Conclusions: In hospitalized patients, FO-ILEs provide significant clinical benefits over all other types of ILEs, ranking first for all outcomes investigated. Registration no: PROSPERO 2022 CRD42022328660.(c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Consensus on Wound Antisepsis: Update 2018

Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment

Zum Einsatz von geoökologisch-bodengeographischen Catenen für hochschuldidaktische Lehrpfade in ausgewählten Schutzgebieten des nordostdeutschen Jungmoränenlandes

Die Arbeiten an mehreren Bodenlehrpfaden mit einhergehender engmaschiger Kartierung ergaben einen Einblick in die Substratzusammensetzung und Bodenentwicklung. Die komplizierten Bodenmuster des jüngeren Jungmoränenlandes können Betrachtern mit unterschiedlichem Kenntnisstand differenziert dargestellt werden. Anhand verschiedener Naturraumtypen werden Darstellungsformen von Böden als Spiegel der Landschaft diskutiert. Diese sollen einerseits direkt im Gelände (Schautafeln) als auch später in einer modifizierten Internetversion die wichtigsten bodengeographischen Informationen vermitteln

CO2-Zertifikate für die Festlegung atmosphärischen Kohlenstoffs in Böden: Methoden, Maßnahmen und Grenzen

Agrarböden besitzen durch den Aufbau von organsicher Bodensubstanz (Humus), die zu etwa 58% aus Kohlenstoff (Corg) besteht, ein großes Potential zur Kohlenstoffbindung. Positive Anstrengungen im Humusmanagement könnten daher einen wesentlichen Beitrag für den Klimaschutz leisten. Für Landwirtinnen und Landwirte stellen so genannte CO2-Zertifikate für den Aufbau von Corg („Humuszertifikate“) einen zusätzlichen Anreiz dar, humusfördernde Bewirtschaftungsmaßnahmen umzusetzen. Diese CO2-Zertifikate werden von privatwirtschaftlichen Initiativen und Unternehmen im Bereich des freiwilligen CO2-Markts vergeben. Insbesondere im Bereich der Landwirtschaft wächst im deutschsprachigen Raum derzeit der Zertifikatehandel für den Aufbau von Corg in Agrarböden. Um zum Klimaschutz beizutragen, müssen bei der Vergabe von Zertifikaten bestimmte Kriterien eingehalten werden. Wissenschaftliche Mindeststandards wurden dabei in der Praxis bislang jedoch wenig berücksichtigt. In dieser Studie werden Empfehlungen hinsichtlich der Erfassung von Corg (Probenahme, Analytik, Vorratsberechnung), eine Bewertung von Maßnahmen zum Corg-Aufbau, sowie Hinweise zu generellen Einschränkungen hinsichtlich des Klimaschutzes über CO2-Zertifikate gegeben. CO2-Zertifikate können einen positiven Anstoß geben, damit sich Landwirte verstärkt mit einer nachhaltigen Bewirtschaftung und Humusversorgung ihrer Böden auseinandersetzen. Da Humus die zentrale Steuergröße für viele Funktionen des Bodens und nicht zuletzt der Bodenfruchtbarkeit darstellt, ist jede Anstrengung für mehr Humus sinnvoll. Landwirtinnen und Landwirte, die sich für Humusaufbau interessieren, sollten daher hinsichtlich standort- und betriebsspezifischen Optionen zum Aufbau von Corg umfassend unterstützt und beraten werden

Imaging of a patterned and buried molecular layer by coherent acoustic phonon spectroscopy

A molecular layer of aminopropyltriethoxysilane is patterned with a focused ion beam and subsequently covered by a gold film. The gold-polymer-substrate structures are afterwards imaged by ultrafast coherent acoustic phonon spectroscopy in reflection geometry. We demonstrate that the lateral structure of the covered polymer layer can be detected via the damping time of the vibrational mode of the gold film. Furthermore, we utilize Brillouin oscillations originating from the silicon substrate to map the structures and to estimate the molecular layer thickness.Fil: Hettich, Mike . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: Jacob, Karl . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: Ristow, Oliver . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: He, Chuan . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: Mayer, Jan . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: Schubert, Martin . University of Konstanz. Department of Physics and Center for Applied Photonics; AlemaniaFil: Gusev, Vitalyi . Centre National de la Recherche Scientifique; FranciaFil: Bruchhausen, Axel Emerico. University of Konstanz. Department of Physics and Center for Applied Photonics; Alemania. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche); Argentina. Comisión Nacional de Energía Atómica. Gerencia del Area de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Dekorsy, Thomas . University of Konstanz. Department of Physics and Center for Applied Photonics; Alemani