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Background: The after-care treatment project KTx360° aimed to reduce graft failure and mortality after kidney transplantation (KTx)., Methods: The study was conducted in the study centers Hannover, Erlangen and Hannoversch Muenden from May 2017 to October 2020 under the trial registration ISRCTN29416382. The program provided a multimodal aftercare program including specialized case management, telemedicine support, psychological and exercise assessments, and interventions. For the analysis of graft failure, which was defined as death, re-transplantation or start of long-term dialysis, we used longitudinal claims data from participating statutory health insurances (SHI) which enabled us to compare participants with controls. To balance covariate distributions between these nonrandomized groups we used propensity score methodology, in particular the inverse probability of treatment weighting (IPTW) approach., Findings: In total, 930 adult participants were recruited at three different transplant centres in Germany, of whom 320 were incident (enrolled within the first year after KTx) and 610 prevalent (enrolled >1 year after KTx) patients. Due to differences in the availability of the claims data, the claims data of 411 participants and 418 controls could be used for the analyses. In the prevalent group we detected a significantly lower risk for graft failure in the study participants compared to the matched controls (HR = 0.13, 95% CI = 0.04-0.39, p = 0.005, n = 389 observations), whereas this difference could not be detected in the incident group (HR = 0.92, 95% CI = 0.54-1.56, p = 0.837, n = 440 observations)., Interpretation: Our findings suggest that a multimodal and multidisciplinary aftercare intervention can significantly improve outcome after KTx, specifically in patients later after KTx. For evaluation of effects on these outcome parameters in patients enrolled within the first year after transplantation longer observation times are necessary., Funding: The study was funded by the Global Innovation fund of the Joint Federal Committee of the Federal Republic of Germany, grant number 01NVF16009., Competing Interests: All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work., (© 2024 The Author(s).)

In patients after kidney transplantation (KTx) an increased rate of affective and anxiety disorders has been observed. Repeatedly, a relationship between mental health issues and increased morbidity and mortality in KTx recipients has been reported. However, information on the prevalence of mental disorders in KTx patients is scarce. As part of the structured multimodal follow-up program (KTx360°), mental disorders were examined in 726 patients after KTx through structured diagnostic interviews using the Mini-DIPS Open Access. Overall, 27.5% had a current and 49.2% a lifetime mental disorder. Only 14.5% with a current mental disorder reported to be in treatment. Affected patients were younger, more often female, reported more symptoms of anxiety and depression and less perceived social support. While comparable to the rate in general population samples, the prevalence of mental disorders should attract attention. The low treatment rate requires an improved identification of afflicted patients and provision of specialist treatment.ISRCTN registry, https://doi.org/10.1186/ISRCTN29416382 , date of registry: 03.05.2017., (© 2022. The Author(s).)

Purpose: After organ transplantation, adherence to immunosuppressive medication (ISM) is crucial to prevent organ rejection. To enable adherence, patients need to be well informed about the different aspects associated with their ISM. However, literature suggests that knowledge regarding ISM is often inadequate., Patients and Methods: In a cross-sectional study, 702 patients after kidney transplantation participating in a structured multimodal follow-up program (KTx360°) were evaluated. We utilized a self-developed questionnaire which has been successfully used before to measure patients' knowledge about the ISM. Above that we aimed to evaluate potential associations between sociodemographic, medical, donation-specific, and psychosocial variables including adherence, levels of depression and anxiety, perceived social support, and cognitive functioning with the knowledge level., Results: The mean age of the patients was 52.4 years, 58.1% were men, and 66.6% were living in a partnership. The mean time since transplantation was 65.1 months. On average, patients answered 70.9% of the questions correctly. The percentage of correct answers per question differed considerably (54%-92%). In univariate analyses, knowledge levels were positively associated with female gender, current partnership, German as first language and better cognitive functioning. However, the effect sizes were small., Conclusion: Taking into account that the patients after KTx can be expected to answer all questions correctly as they aim at basic knowledge, an average result of 70.9% corresponds to a moderate knowledge level. Consequently, the current educational approaches do not seem to be sufficient to inform all patients adequately. Further research is necessary on how to improve health knowledge in the long term., Competing Interests: The authors declare that the research was conducted in the absence of any commercial, financial, or other relationships that could be construed as a potential conflict of interest., (© 2020 de Boer et al.)

Organ transplantation is the best and to some extent only option for many patients with chronic organ failure. Usually after successful transplantation patients experience a significant improvement of their condition. Nevertheless, they are not cured but still chronically ill. Living with an organ transplant requires consequent immunosuppression intake, regular physician visits and following the recommendations regarding infection prevention. These factors are important to secure a long transplant survival. Especially non-adherence to immunosuppressants is known as a risk factor for transplant rejection. There are several reasons for non-adherent behavior. However identifying the individual motivations is crucial for addressing them correctly. The aim of this article is to give an overview of factors influencing adherence, to introduce options to assess adherence and to present ways to improve adherence. Randomized-controlled intervention studies are presented and on that basis recommendations for clinical practice are derived., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: In addition to studying the effectiveness and efficiency of removable acrylic plates in correcting anterior forced crossbite, the influence of outcome predictors were evaluated., Methods: In all, 65 patients met the inclusion criteria of anterior forced crossbite, mixed dentition, removable plate treatment, and complete case documentation. Effectiveness was assessed based on pre- and posttreatment study casts (which were analyzed for successful treatment outcomes defined as ≥ 1 mm of overjet and overbite) and efficiency was assessed based on treatment duration and number of appointments. Potential outcome predictors were also evaluated, including age, gender, dental maturity, Angle Class, number of teeth in crossbite, severity of crossbite, overbite, ANB angle, Wits appraisal, mandibular plane angle, and patient compliance., Results: Successful crossbite correction was achieved in 48 of the 65 patients (74%) within a median of 2.8 months and 2.0 appointments. Plate treatment was discontinued following another median of 11.6 months and 6.5 appointments. Promising outcome predictors are the number of teeth in crossbite (1-2 versus 3-4 teeth = success in 81 versus 42% of cases), dental maturity (early versus late mixed dentition = success in 84 versus 52% of cases), and Angle Class (I versus III = success in 83 versus 61% of cases)., Conclusion: Removable acrylic plates were found to be moderately effective and efficient in correcting anterior forced crossbite. Children presenting with Angle Class I and crossbites involving not more than two teeth when treatment is started during the period of early mixed dentition had the best prognosis for treatment success.

Color Doppler sonography has become routine for the evaluation of high-risk pregnancies in human medicine. Previous studies documenting uterine blood flow parameters in the pregnant mare have found a decrease in peripheral blood flow resistance in the first pregnancy weeks and an increase in uterine blood flow, especially in the last trimester of pregnancy. However, these studies involved only a small number of mares. No naturally occurring pregnancy abnormalities occurred that would allow blood flow changes to be retrospectively examined and analyzed. The objective of the present study was to monitor the diameter of the uterine artery, uterine blood flow, and the combined thickness of the uterus and placenta (CTUP) throughout gestation in a large number of pregnant mares of different age and parity. In the present study, 51 warmblood mares were examined by ultrasonography on Days 16 and 30, at monthly intervals until Day 300, and then every 10 days from Day 300 until parturition. After localization of the uterine artery ipsilateral and contralateral to the conceptus, the diameter of each artery, the uterine blood flow (pulsatility index [PI], blood flow volume [BFV], and the presence of early diastolic notch), and the CTUP were measured and correlated to placental and foal birth weight after delivery. Furthermore, the effect of age (3-7 years [n = 16], 8-11 years [n = 17], 12-16 years [n = 18]) and parity (0-2 foals [n = 22], 3-4 foals [n = 15], 5-8 foals [n = 14]) on these parameters were analyzed. The diameter of the uterine artery increased more than threefold in the ipsilateral artery (0.40 ± 0.07-1.33 ± 0.08 cm) and 2.7-fold in the contralateral artery (0.39 ± 0.07-1.07 ± 0.08 cm [P < 0.0001]). The early diastolic notch disappeared in the pulse waves in 98% of the ipsilateral arteries and 85.7% in the contralateral arteries on Day 150 when placentation is complete. Blood flow volume increased 50-fold in the ipsilateral artery during pregnancy and increased dramatically in the last trimester. The median foal weight was 52.6 kg. Mares with heavier foals (>52.6 kg) had a 1.38-fold higher BFV in the last 2 months (P < 0.05) compared with lighter foals. Pulsatility index decreased 2-fold until completion of placentation at around Day 150 and continued to decline until Day 240 where it then stayed constant and at a low level until delivery. Age predominantly influenced PI, whereas the diameter of the uterine arteries, which is correlated to BFV (r ipsilateral = 0.919, P < 0.0001 and r contralateral = 0.909, P < 0.000), was strongly affected by parity. Four mares spontaneously aborted (Days 200, 208, 213, and 246) and four mares spontaneously developed placentitis that was diagnosed by the presence of an increased CTUP and/or placental pathology after delivery. Although not statistically relevant, the aborting mares showed a slightly increased total BFV, but no differences in PI were seen compared with mares without abnormalities of pregnancy. Mares that developed placentitis had a late (Days 150-210) disappearance of the early diastolic notch and an increased PI in the first half of pregnancy. In conclusion, the study documented differences in uterine artery diameter and blood flow in a large number of pregnant mares. Furthermore, this is the first known report to document uteroplacental blood flow changes associated with naturally occurring placentitis and abortion in mares., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Reasons for low in vitro fertilisation rates in the horse include the difficulties in inducing capacitation and/or hyperactivation of stallion spermatozoa. The aim of this study was to analyse the effect of noncapacitating and capacitating modified Whitten's (MW) and modified Tyrode's medium (MT) and treatment with procaine (5 mmol), pentoxifylline (3.5 mmol) and trolox (120 mmol) on motility (CASA), capacitation, acrosomal status, viability and mitochondrial membrane potential of stallion spermatozoa (n = 4). While there was no influence of MW and MT on sperm motility, a significant increase in the percentage of viable-capacitated spermatozoa was observed after incubation in capacitating MW (P < 0.05). Pentoxifylline showed no significant effect on the motility pattern but increased the proportion of live-capacitated spermatozoa (P < 0.05). Trolox had no detectable effect on either capacitation or hyperactivation. Procaine was the only agent that induced hyperactivation in terms of a reduced proportion of progressively motile spermatozoa, straight line velocity, straightness, linearity and beat-cross frequency and an increase in the amplitude of lateral head displacement (P < 0.05). The combination of capacitating Whitten's medium and procaine showed the best results for the induction of capacitation and hyperactivation in stallion spermatozoa; this was possible even after short-term incubation., (© 2011 Blackwell Verlag GmbH.)

Lassa virus glycoprotein 2 (LASV GP-2) belongs to the class I fusion protein family. Its N terminus contains two stretches of highly conserved hydrophobic amino acids (residues 260-266 and 276-298) that have been proposed as N-terminal or internal fusion peptide segments (N-FPS, I-FPS) by analogy with similar sequences of other viral glycoproteins or based on experimental data obtained with synthetic peptides, respectively. By using a pH-dependent, recombinant LASV glycoprotein mediated cell-cell fusion assay and a retroviral pseudotype infectivity assay, an alanine scan of all hydrophobic amino acids within both proposed FPSs was performed. Fusogenicity and infectivity were correlated, both requiring correct processing of the glycoprotein precursor. Most point mutations in either FPS accounted for reduced or abolished fusion or infection, respectively. Some mutations also had an effect on pre-fusion steps of virus entry, possibly by inducing structural changes in the glycoprotein. The data demonstrate that several amino acids from both hydrophobic regions of the N terminus, some of which (W264, G277, Y278 and L280) are 100 % conserved in all arenaviruses, are involved in fusogenicity and infectivity of LASV GP-2.

Induction of estrus with deslorelin implants was followed by abortions in bitches that conceived during the induced estrus. Lowering the deslorelin dose and choosing a better implantation site prevented the abortions. This study investigated the hypothesis that induction of estrus with deslorelin is followed by reduced serum progesterone concentrations (SPC) during the ensuing diestrus. Assuming that reduced luteal function resulted from reduced LH secretion due to hypophyseal down-regulation of GnRH receptors, the effect of human chorionic gonadotropin (hCG) treatment on the SPC of diestrous bitches was also investigated. In Experiment 1, 10 spontaneously cycling bitches served as controls, whereas estrus was induced with deslorelin implants in 24 others. In Experiment 2, six diestrous bitches were treated with a single dose of hCG between Days 39 and 45 of diestrus. The SPC was lower in deslorelin-induced bitches from Days 35 to 56 of diestrus and hCG increased SPC during the first 24 h after treatment, followed by a dramatic decline thereafter. Although SPC recovered in pregnant bitches, it remained much lower (< or = 1 ng/mL) than in untreated, non-pregnant bitches. The suppression of progesterone secretion after hCG treatment suggested that decreased luteal activity in deslorelin-induced bitches may not be a simple consequence of down-regulation of hypophyseal GnRH receptors.

To study the contribution of inflammatory mediators to the pathogenesis of yellow fever (YF), the serum levels of several cytokines and chemokines were measured in 7 patients with fatal YF (f-YF), 11 patients with nonfatal hemorrhagic YF (nf/h-YF), and 18 patients with nonfatal nonhemorrhagic YF (nf/nh-YF). The levels of interleukin (IL)-6, monocyte chemoattractant protein-1, interferon-inducible protein (IP)-10, tumor necrosis factor- alpha , and IL-1 receptor antagonist (IL-1RA) were all statistically significantly higher in the patients with f-YF than in those with nf/nh-YF. In patients with nf/h-YF, only levels of IP-10 and IL-1RA were significantly elevated. The high levels of pro- and anti-inflammatory cytokines and chemokines in serum from patients with f-YF are reminiscent of those seen in patients with bacterial sepsis. This finding has implications for the understanding of the pathophysiology of YF and the development of therapeutic strategies.

We report on a novel pumping scheme for stimulated Raman scattering (SRS) that uses a Bessel beam. We have used this scheme for SRS from molecular vibrations in acetone and from a polariton mode in a LiIO(3) crystal. A nearly diffraction-limited Stokes beam was observed along the cone axis of the Bessel beam. The generation mechanism of the Stokes beam is identified as being due to noncollinear scattering of the component plane waves that constitute the Bessel beam. Frequency tuning of SRS from polaritons in LiIO(3) by variation of the Bessel beam cone angle is demonstrated.

A distributed-feedback (DFB) dye laser that is pumped by a standing Bessel-beam wave is constructed. Because of the long line focus of the Bessel beam, the laser medium is pumped in only a very thin filament (a few micrometers) along the optical axis. At the same time, longitudinal-mode selection is achieved because of the DFB effect. It is demonstrated that when the effective wavelength of the Bessel pump beam is varied, the Bragg wavelength for DFB is altered, and as a result the output wavelength can be tuned.

All beta-glucosidases extracted and separated from a plant of Alocasia macrorrhiza are almost entirely specific for triglochinin. The hexameric beta-glucosidase has been shown to dissociate in dimers without any alteration of activity. Reaggregation could only be demonstrated using bifunctional reagents like glutaraldehyde. Treatments of beta-glucosidase with various chemicals (e. g. glutaraldehyde, dodecyl sulfate) decreased the activity for triglochinin more than the activity for 4-nitrophenyl glucoside. On the other hand, specific reagents like bromocondurite or p-chloromercuribenzoate caused identical inactivations measured with various substrates. It seems possible that the different beta-glucosidases splitting triglochinin arose during purification from the hexameric form which occurs in the plant.