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Sophie de Boer,1,2 Felix Klewitz,1,2 Maximilian Bauer-Hohmann,1,2 Lena Schiffer,2,3 Uwe Tegtbur,2,4 Lars Pape,2,3 Mario Schiffer,2,5,6 Martina de Zwaan,1,2 Mariel Nöhre1,2 1Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; 2Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany; 3Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; 4Department of Sports Medicine, Hannover Medical School, Hannover, Germany; 5Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany; 6Department of Nephrology and Hypertension, Hannover Medical School, Hannover, GermanyCorrespondence: Mariel Nöhre Department of Psychosomatic Medicine and PsychotherapyHannover Medical School, Carl-Neuberg-Strasse 1, Hannover 30625, GermanyTel +49 511 532 3932Fax +49 511 532 3190Email noehre.mariel@mh-hannover.dePurpose: 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.Keywords: health literacy, kidney transplantation, renal transplantation, adherence, immunosuppressive medication

Marietta Lieb,1 Mario Schiffer,2 Yesim Erim1 1Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany; 2Department of Nephrology and Hypertension, University Hospital of Erlangen, Erlangen, GermanyCorrespondence: Marietta LiebDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Schwabachanlage 6, Erlangen 91054, GermanyTel +49-9131-8545930Email Marietta.Lieb@uk-erlangen.deBackground: Non-adherence (NA) after renal transplantation poses a major risk for allograft rejection, graft loss, and patient mortality. Yet, there is still ambiguity about its etiology and its possible relationships with patient-related factors. In order to prevent poor outcomes after transplantation, it is crucial to gain a more refined understanding of potential determinants, to identify patients at risk, and to intervene accordingly. The objective of this study was to assess potential risk factors of NA by prospectively applying electronic monitoring.Materials and Methods: This was a single-center prospective observational study. Prior to study initiation, sociodemographic, biomedical, and psychosocial variables (depression, health-related quality of life, self-efficacy, social support, attachment, experiences and attitudes towards immunosuppressive medication, emotional responses after organ transplantation, satisfaction with information about immunosuppressive medication, and perceptions and beliefs about medications) were assessed. Thereafter, immunosuppressive adherence behavior was measured prospectively via electronic monitoring (EM, VAICA©) during a 3-month period to receive the percentage frequency of Taking and Timing Adherence (± 2h, ± 30min) for each patient. Focus of this study was the phase of medication implementation.Results: A total of 78 patients participated in our study (mean age 55.28, 56% male). We found rates of 99.39% for Taking Adherence, 98.34% for Timing Adherence ± 2h, and 93.34% for Timing Adherence ± 30min, respectively. Multiple regression analyses revealed that the type of medication could significantly predict Taking Adherence. Patients receiving Advagraf© (once daily) depicted better Taking Adherence than patients receiving Prograf© (twice daily) (p=0.04). No associations were found for Timing Adherence (± 2h, ± 30min). Sociodemographic, biomedical, or psychosocial variables were not found to be associated with adherence behavior.Discussion: In highly adherent populations, only a few factors can be altered to improve adherence. Changing the immunosuppressive regimen from twice-daily to once-daily could be an option for optimizing adherence. However, risk factors for NA could be different in a less adherent population.Keywords: adherence, patient-related factors, psychosocial variables, electronic monitoring, immunosuppressive medication

Robert Faulhaber-Walter, 1–3 Lanping Jiang, 4 Diane Mizel, 2 Patricia M Zerfas, 2 Jeffrey B Kopp, 2 Jurgen B Schnermann, 2 Limeng Chen, 2, 4 Mario Schiffer 3, 5 1Facharztzentrum Aarberg, Waldshut-Tiengen, Germany; 2NIDDK, National Institutes of Health, Bethesda, MD, USA; 3Department of Nephrology, Medical School Hannover, Hannover, Germany; 4Peking Union Medical College Hospital, Beijing, People’s Republic of China; 5Department of Nephrology, University of Erlangen, Erlangen, GermanyCorrespondence: Robert Faulhaber-WalterFacharztzentrum Aarberg, Tannenstrasse 4, Waldshut-Tiengen 79761, GermanyTel +49-151-27164882Fax +49-321-21036268Email rofaulhaber@web.deAim of Study: To investigate podocyte density in aging diabetic Ins2± and Ins2±, A1AR-/- mouse models in C57Bl/6 background.Methods: Ins2± mice and especially Ins2±, adenosine A1 receptor knockout mice (Ins2±, A1AR-/-) are mouse models with a phenotype of diabetic nephropathy. Aged mice (at ∼ 40 weeks) were assessed for glomerular filtration barrier function by measuring albuminuria, glomerular filtration, glomerular damage by electron microscopy, and podocyte numbers by Wilms Tumor protein (WT-1) staining.Results: Compared to healthy wild-type mice, both diabetic mouse models developed diabetic nephropathy, including hyperfiltration (p< 0.01) and albuminuria (p< 0.05). Typical diabetic structural glomerular and podocyte damage was visualized by electron microscopy. Podocyte count per glomerular area (podocyte density) was significantly decreased in both diabetic mouse models (p< 0.01). In contrast, no significant correlation was detected between albuminuria and absolute podocyte count per glomerulus.Conclusion: The amount of albuminuria as marker of diabetic nephropathy does not correlate with the podocytes density; however, a relative podocyte deficiency became evident with an increase in glomerular area in the diabetic animals, suggesting a relative podocytopenia.Keywords: diabetes nephropathy podocyte mouse Akita WT-1

Prior species distribution models identified temperature as one of the most important environmental variables defining the present and future distribution of anadromous allis shad (Alosa alosa). The current study analysed effects of temperature on the recruitment-potential of allis shad by investigating growth and survival at 16, 20, 24 and 28 °C during a ten day rearing trial and by measuring mass-specific respiration. Highest growth in length was at 28 °C; growth at 16 °C was minimal. At the end of the rearing-period, no significant differences in survival between tested rearing-temperatures were found. Exposure to temperatures of 13 to 30 °C and subsequent measurement of mass-specific respiration revealed tolerance of temperatures up to 30 °C and a lower temperature limitation close to 16 °C. After acclimatization of larvae to temperatures ranging from 16−28 °C for 10 days, Q10-values of mass-specific respiration indicated a high adaptive capacity to increasing temperatures, but also the ability to adapt to temperatures as low as 16 °C. Our results indicate that the predicted temperature sensitivity of A. alosa cannot be explained by a direct physiological relationship. The obtained results can help to improve predictive modelling and the conservation of allis shad throughout its current distribution range.

In this contribution we report on the measurements performed so far at CologneAMS and on the quality which has been obtained for the isotopes 10Be, 14C and 26Al. We also describe the procedure developed to measure plutonium-isotopes at CologneAMS and first results for 239,240,242Pu are presented. In addition we report on modifications made on our new TOF device with beam profile capabilities.