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Background: Vagal atrophy is a hallmark of Parkinson’s disease (PD) and has been found to be associated with autonomic dysfunction, while analyses of the vagus nerve (VN) in atypical Parkinsonian syndromes (APS) have not yet been performed. We here investigate the characteristics of the VN in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) and, in a second step, its potential as a possible biomarker for orthostatic dysregulation. Objectives: The aim was to compare the VN pathology in MSA and PSP with healthy individuals and patients with PD as a differentiating factor and to further analyse the correlation of the VN with clinical parameters and cardiovascular response. Design: We conducted a monocentric, cross-sectional cohort study in 41 APS patients and compared nerve ultrasound (NUS) parameters with 90 PD patients and 39 healthy controls. Methods: In addition to a detailed neurological history and examination, several clinical severity and motor scores were obtained. Autonomic symptoms were reported in the Scales for Outcomes in Parkinson’s Disease – Autonomic questionnaire. Further scores were used to detect other non-motor symptoms, quality of life and cognition. Additionally, we performed a head up tilt test (HUTT) and NUS of the VN. We conducted correlation analyses of the VN cross-sectional area (CSA) with clinical scores and the heart rate and blood pressure variability parameters of the HUTT. Results: The examination demonstrated a high prevalence of abnormal autonomic response in both MSA (90%) and PSP (80%). The VN CSA correlated with spectral parameters of the HUTT, which are associated with sympatho-vagal imbalance. In addition, the CSA of the VN in patients with PD and PSP were significantly smaller than in healthy controls. In MSA, however, there was no marked vagal atrophy in comparison. Conclusion: The occurrence of autonomic dysfunction was high in MSA and PSP, which underlines its impact on these syndromes. Our findings indicate a connection between vagal pathology and autonomic dysfunction and might contribute to a better comprehension of APS. To further evaluate the clinical relevance and the VN as a possible marker of autonomic dysfunction in APS, prospective longitudinal observations are necessary.

Wechselwirkung ist ein zentrales, übergreifendes Konzept im Bereich Ökologie. Nahrungsbeziehungen in Ökosystemen eignen sich besonders, um das Konzept Wechselwirkung in der Sekundarstufe I beispielhaft einzuführen. Studien zeigen, dass Lernenden die elaborierte Beschreibung von Nahrungsbeziehungen schwerfällt und sie oftmals nur direkte Wechselwirkungen beschreiben. In der Forschungsliteratur wird ein Bedarf an unterrichtlichen Strategien benannt, mit deren Hilfe Schüler:innen aufbauend auf ihre bisherigen Konzepte fachlich angemessenere entwickeln können und dabei Nahrungsbeziehungen auch als indirekte und zyklische Wechselwirkungen erklären. Das Projekt entwickelt auf Basis von Conceptual Change-Texts ein innovatives Lernmedium: Conceptual Change-Stories. Diese greifen Konstruktionsprinzipien von Conceptual Change-Texts auf, bieten aber durch die narrative Textgestaltung vereinfachte Zugänge zum Verstehen von Nahrungsbeziehungen als Wechsel-wirkungen. In der vorliegenden Studie wird die Wirkung der Conceptual Change-Stories auf die Beschreibungen von Nah-rungsbeziehungen bei Schüler:innen der Klassenstufe 6 untersucht. Die Ergebnisse liefern Anhaltspunkte zur (Weiter-) Entwicklung von Conceptual Change-Stories. Erste Ergebnisse deuten an, dass Conceptual Change-Stories ein geeignetes Lern-medium darstellen können, um Wechselwirkungen im Nahrungsnetz verstehbar zu machen.

Based on the assumption that the process of understanding is partly narrative, this study explores the potential benefits and limitations of using narrative writing in biology education. We investigate what contribution a student-centered narrative intervention can make to the conceptual understanding of protein biosynthesis in the context of viral infections and virus replication. After a teaching sequence on this topic, 68 secondary school students (M = 15.7 years, SD = 0.57 years) explained virus replication in a written text. One subsample (n = 46) was instructed to write a narrative text, while the other one (n = 22) was asked to write an expository (non-fictional) text. Our data analysis encompassed an analysis of the structural narrativity in the student texts, as well as a concept-related rating of the level of scientific correctness in three categories. A post-test questionnaire (35 items) was used to depict the learners’ viewpoints on their respective text production and the learning process that they experienced. Our findings indicate that most learners actually produced the text type they were supposed to, with exceptions in both sub-samples. As to the level of concept-related scientific correctness, we found no major differences between the two interventions. However, for two concepts, compartmentalization and levels of organization, the data indicate the significant advantage of the narrative intervention. We conclude from our results that to some extent, the effective learning properties of narrative texts, derived from the theoretical foundations, could indeed successfully be demonstrated in the field of virus replication. However, narrative text production is not equally beneficial for all aspects of the biological topic, and it also poses specific problems for some learners.

Abstract Objective Previous studies in Parkinson’s disease (PD) patients have demonstrated a high prevalence of polyneuropathy (PNP) and pronounced alpha‐Synuclein pathology in dermal nerve fibers already at early disease stages. The aim of this study was to analyze associations between the prevalence and severity of PNP with nonmotor and motor symptoms in PD patients. Methods Fifty PD patients were characterized comprehensively for the presence of clinical symptoms (nonmotor and motor), electrophysiologic alterations and – for the first time – using high‐resolution ultrasound of peripheral nerves. Results Sixty‐two percent of PD patients showed electrophysiological pathology of PNP. The prevalence of patient‐reported PNP symptoms was 86% and was particularly present in patients with longer disease duration, compromised scores of nonmotor and motor symptoms as well as with a negative evaluation of quality of life. Seventy‐five percent of patients showed morphologic alterations similar to axonal PNP in high‐resolution ultrasound compared to healthy controls. Interpretation The study demonstrates the high burden of peripheral nervous system disease in Parkinson's disease. It advocates further studies to delineate the underlying pathophysiological mechanisms in order to optimize treatment approaches for PD, including the associated PNP.

C12H12Cl4NSb, monoclinic, P21/n (no. 14), a = 5.6693(2) Å, b = 20.2385(7) Å, c = 14.3908(5) Å, β = 100.3830(10)°, V = 1624.14(10) Å3, Z = 4, Rgt(F) = 0.0192, wRref(F2) = 0.0430, T = 200 K.

C14H15AsClNOS, monoclinic, P21 (no. 4), a = 5.2852(2) Å, b = 13.3035(6) Å, c = 10.7522(5) Å, β = 90.130(2) Å, V = 756.00(6) Å3, Z = 2, Rgt(F) = 0.0200, wRref(F2) = 0.0503, T = 200(2) K.

C14H13AsClNO2, triclinic, P1¯$\overline{1}$ (no. 2), a = 7.7180(7) Å, b = 8.2190(7) Å, c = 11.9620(10) Å, α = 87.438(4)°, β = 73.450(4)°, γ = 72.167(4)°, V = 691.66(10) Å3, Z = 2, Rgt(F) = 0.0203, wRref(F2) = 0.0541, T = 200 K.

Abstract Background Quality of care public reporting provides structural, process and outcome information to facilitate hospital choice and strengthen quality competition. Yet, evidence indicates that patients rarely use this information in their decision-making, due to limited awareness of the data and complex and conflicting information. While there is enthusiasm among policy makers for public reporting, clinicians and researchers doubt its overall impact. Almost no study has analyzed how users behave on public reporting portals, which information they seek out and when they abort their search. Methods This study employs web-usage mining techniques on server log data of 17 million user actions from Germany’s premier provider transparency portal Weisse-Liste.de (WL.de) between 2012 and 2015. Postal code and ICD search requests facilitate identification of geographical and treatment area usage patterns. User clustering helps to identify user types based on parameters like session length, referrer and page topic visited. First-level markov chains illustrate common click paths and premature exits. Results In 2015, the WL.de Hospital Search portal had 2,750 daily users, with 25% mobile traffic, a bounce rate of 38% and 48% of users examining hospital quality information. From 2013 to 2015, user traffic grew at 38% annually. On average users spent 7 min on the portal, with 7.4 clicks and 54 s between clicks. Users request information for many oncologic and orthopedic conditions, for which no process or outcome quality indicators are available. Ten distinct user types, with particular usage patterns and interests, are identified. In particular, the different types of professional and non-professional users need to be addressed differently to avoid high premature exit rates at several key steps in the information search and view process. Of all users, 37% enter hospital information correctly upon entry, while 47% require support in their hospital search. Conclusions Several onsite and offsite improvement options are identified. Public reporting needs to be directed at the interests of its users, with more outcome quality information for oncology and orthopedics. Customized reporting can cater to the different needs and skill levels of professional and non-professional users. Search engine optimization and hospital quality advocacy can increase website traffic.

Background: Macrophage Migration Inhibitory Factor (MIF) is highly elevated after cardiac surgery and impacts the postoperative inflammation. The aim of this study was to analyze whether the polymorphisms CATT5–7 (rs5844572/rs3063368,“-794”) and G>C single-nucleotide polymorphism (rs755622,-173) in the MIF gene promoter are related to postoperative outcome. Methods: In 1116 patients undergoing cardiac surgery, the MIF gene polymorphisms were analyzed and serum MIF was measured by ELISA in 100 patients. Results: Patients with at least one extended repeat allele (CATT7) had a significantly higher risk of acute kidney injury (AKI) compared to others (23% vs. 13%; OR 2.01 (1.40–2.88), p = 0.0001). Carriers of CATT7 were also at higher risk of death (1.8% vs. 0.4%; OR 5.12 (0.99–33.14), p = 0.026). The GC genotype was associated with AKI (20% vs. GG/CC:13%, OR 1.71 (1.20–2.43), p = 0.003). Multivariate analyses identified CATT7 predictive for AKI (OR 2.13 (1.46–3.09), p < 0.001) and death (OR 5.58 (1.29–24.04), p = 0.021). CATT7 was associated with higher serum MIF before surgery (79.2 vs. 50.4 ng/mL, p = 0.008). Conclusion: The CATT7 allele associates with a higher risk of AKI and death after cardiac surgery, which might be related to chronically elevated serum MIF. Polymorphisms in the MIF gene may constitute a predisposition for postoperative complications and the assessment may improve risk stratification and therapeutic guidance.

Background Although macrophage migration inhibitory factor (MIF) has been demonstrated to mediate cardioprotection in ischemia/reperfusion injury and antagonize fibrotic effects through its receptor, CD74, the function of the soluble CD74 receptor ectodomain (sCD74) and its interaction with circulating MIF have not been explored in cardiac disease. Methods and Results Cardiac fibroblasts were isolated from hearts of neonatal mice and differentiated into myofibroblasts. Co‐treatment with recombinant MIF and sCD74 induced cell death (P

Acute kidney injury (AKI) is one of the most frequent complications after cardiac surgery and is associated with poor outcomes. Biomarkers of AKI are crucial for the early diagnosis of this condition. Secretory leukocyte protease inhibitor (SLPI) is an alarm anti-protease that has been implicated in the pathogenesis of AKI but has not yet been studied as a diagnostic biomarker of AKI. Using two independent cohorts (development cohort (DC), n = 60; validation cohort (VC), n = 148), we investigated the performance of SLPI as a diagnostic marker of AKI after cardiac surgery. Serum and urinary levels of SLPI were quantified by ELISA. SLPI was significantly elevated in AKI patients compared with non-AKI patients (6 h, DC: 102.1 vs. 64.9 ng/mL, p < 0.001). The area under the receiver operating characteristic curve of serum SLPI 6 h after surgery was 0.87 ((0.76−0.97); DC). The addition of SLPI to standard clinical predictors significantly improved the predictive accuracy of AKI (24 h, VC: odds ratio (OR) = 3.91 (1.44−12.13)). In a subgroup, the increase in serum SLPI was evident before AKI was diagnosed on the basis of serum creatinine or urine output (24 h, VC: OR = 4.89 (1.54−19.92)). In this study, SLPI was identified as a novel candidate biomarker for the early diagnosis of AKI after cardiac surgery.

Abstract A joint analysis of five paternal half-sib Holstein families that were part of two different granddaughter designs (ADR- or Inra-design) was carried out for five milk production traits and somatic cell score in order to conduct a QTL confirmation study and to increase the experimental power. Data were exchanged in a coded and standardised form. The combined data set (JOINT-design) consisted of on average 231 sires per grandsire. Genetic maps were calculated for 133 markers distributed over nine chromosomes. QTL analyses were performed separately for each design and each trait. The results revealed QTL for milk production on chromosome 14, for milk yield on chromosome 5, and for fat content on chromosome 19 in both the ADR- and the Inra-design (confirmed within this study). Some QTL could only be mapped in either the ADR- or in the Inra-design (not confirmed within this study). Additional QTL previously undetected in the single designs were mapped in the JOINT-design for fat yield (chromosome 19 and 26), protein yield (chromosome 26), protein content (chromosome 5), and somatic cell score (chromosome 2 and 19) with genomewide significance. This study demonstrated the potential benefits of a combined analysis of data from different granddaughter designs.