The interplay between the gut microbiota and the immune system.

The impact of the gut microbiota on immune homeostasis within the gut and, importantly, also at systemic sites has gained tremendous research interest over the last few years. The intestinal microbiota is an integral component of a fascinating ecosystem that interacts with and benefits its host on several complex levels to achieve a mutualistic relationship. Host-microbial homeostasis involves appropriate immune regulation within the gut mucosa to maintain a healthy gut while preventing uncontrolled immune responses against the beneficial commensal microbiota potentially leading to chronic inflammatory bowel diseases (IBD). Furthermore, recent studies suggest that the microbiota composition might impact on the susceptibility to immune-mediated disorders such as autoimmunity and allergy. Understanding how the microbiota modulates susceptibility to these diseases is an important step toward better prevention or treatment options for such diseases.

Plasma T-cadherin negatively associates with coronary lesion severity and acute coronary syndrome.

AIMS This study evaluated associations between plasma T-cadherin levels and severity of atherosclerotic disease. METHODS AND RESULTS Three hundred and ninety patients undergoing coronary angiography were divided into three groups based on clinical and angiographic presentation: a group (n=40) with normal coronary arteries, a group (n=250) with chronic coronary artery disease and a group (n=100) with acute coronary syndrome. Plasma T-cadherin levels were measured by double sandwich ELISA. Intravascular ultrasound data of the left-anterior descending artery were acquired in a subgroup of 284 patients. T-cadherin levels were lower in patients with acute coronary syndrome than in normal patients (p=0.007) and patients with chronic coronary artery disease (p=0.002). Levels were lower in males (p=0.002), in patients with hypertension (p=0.002) and inpatients with diabetes (p=0.008), and negatively correlated with systolic blood pressure (p=0.014), body mass index (p=0.001) and total number of risk factors (p=0.001). T-cadherin negatively associated with angiographic severity of disease (p=0.001) and with quantitative intravascular ultrasound measures of lesion severity (p<0.001 for plaque, necrotic core and dense calcium volumes). Significant associations between T-cadherin and intravascular ultrasound measurements persisted even if the regression model was adjusted for the presence of acute coronary syndrome. Multivariate analysis identified a strong (p=0.002) negative association of T-cadherin with acute coronary syndrome, and lower T-cadherin levels significantly (p=0.002) associated with a higher risk of acute coronary syndrome independently of age, gender and cardiovascular risk factors. CONCLUSIONS A reduction in plasma T-cadherin levels is associated with increasing severity of coronary artery disease and a higher risk for acute coronary syndrome.

itw : im dialog - Forschungen zum Gegenwartstheater

Die Reihe itw : im dialog – Forschungen zum Gegenwartstheater widmet sich den Ästhetiken, Themen und Tendenzen gegenwärtigen Theaterschaffens und will Impulse zu seiner Erforschung geben. Ausgehend von der besonderen Position des Gegenwartstheaters als Ort der unmittelbaren Konfrontation mit gesellschaftlichen und politischen Fragen, wird dieses zum Gegenstand wissenschaftlicher Problematisierung und Reflexion. Die neugegründete Reihe gibt den teils von Inszenierungsanalysen ausgehenden theatertheoretischen sowie theaterhistorischen Reflexionen und den Gesprächen mit Künstlerinnen und Künstlern ein erweitertes wissenschaftliches Forum. Die Bände der Reihe werden zeitnah zu den »itw : im dialog«-Veranstaltungen produziert. So können die aus dem internationalen Austausch mit den Theaterforschenden und Theaterschaffenden gewonnenen Erkenntnisse und Anregungen umgehend in den akademischen Diskurs zum Gegenwartstheater einfließen.

Arbeitsweisen im Gegenwartstheater

"Arbeitsweisen im Gegenwartstheater", Band 1 der neuen theaterwissenschaftlichen Reihe, ist im April 2015 im Berliner Alexander Verlag erschienen. Die regelmäßig erscheinenden Ausgaben sind als Arbeitsbücher zu den "itw : im dialog"-Symposien des Instituts für Theaterwissenschaft der Universität Bern konzipiert. Die Beiträge des ersten Bandes reflektieren die komplexen und divergenten Erscheinungsformen zeitgenössischen Theaters und nähern sich aus unterschiedlichen Perspektiven der Frage nach den Zusammenhängen von Arbeitsweisen und Ästhetiken: z. B. Kollektivität und Reflexivität im Gegenwartstheater, Formen und Mobilität internationalisierten Theaters, Allianzen zwischen Freier Szene und Stadttheater sowie Autorenregie. Mit Beiträgen von Annemarie Matzke, Barbara Gronau, Sandra Umathum, Philipp Schulte, Karin Nissen-Rizvani und Gesprächen mit Alexandre Devriendt und Joeri Smet (Ontroerend Goed, Gent), Sebastian Brünger (Rimini Protokoll, Berlin), Tomas Schweigen (FADC/Theater Basel), Sabine Harbeke (Autorin/Regisseurin, Zürich).

Identification and estimation of thresholds in the fixed effects ordered logit model

This paper proposes a new estimator for the fixed effects ordered logit model. In contrast to existing methods, the new procedure allows estimating the thresholds. The empirical relevance and simplicity of implementation is illustrated in an application on the effect of unemployment on life satisfaction.

Varying expectancies and attention bias in phobic and non-phobic individuals.

Phobic individuals display an attention bias to phobia-related information and biased expectancies regarding the likelihood of being faced with such stimuli. Notably, although attention and expectancy biases are core features in phobia and anxiety disorders, these biases have mostly been investigated separately and their causal impact has not been examined. We hypothesized that these biases might be causally related. Spider phobic and low spider fearful control participants performed a visual search task in which they specified whether the deviant animal in a search array was a spider or a bird. Shorter reaction times (RTs) for spiders than for birds in this task reflect an attention bias toward spiders. Participants' expectancies regarding the likelihood of these animals being the deviant in the search array were manipulated by presenting verbal cues. Phobics were characterized by a pronounced and persistent attention bias toward spiders; controls displayed slower RTs for birds than for spiders only when spider cues had been presented. More important, we found RTs for spider detections to be virtually unaffected by the expectancy cues in both groups, whereas RTs for bird detections showed a clear influence of the cues. Our results speak to the possibility that evolution has formed attentional systems that are specific to the detection of phylogenetically salient stimuli such as threatening animals; these systems may not be as penetrable to variations in (experimentally induced) expectancies as those systems that are used for the detection of non-threatening stimuli. In sum, our findings highlight the relation between expectancies and attention engagement in general. However, expectancies may play a greater role in attention engagement in safe environments than in threatening environments.

Does Stepwise Voltage Ramping Protect the Kidney from Injury During Extracorporeal Shockwave Lithotripsy? Results of a Prospective Randomized Trial

BACKGROUND Renal damage is more frequent with new-generation lithotripters. However, animal studies suggest that voltage ramping minimizes the risk of complications following extracorporeal shock wave lithotripsy (SWL). In the clinical setting, the optimal voltage strategy remains unclear. OBJECTIVE To evaluate whether stepwise voltage ramping can protect the kidney from damage during SWL. DESIGN, SETTING, AND PARTICIPANTS A total of 418 patients with solitary or multiple unilateral kidney stones were randomized to receive SWL using a Modulith SLX-F2 lithotripter with either stepwise voltage ramping (n=213) or a fixed maximal voltage (n=205). INTERVENTION SWL. OUTCOMES MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was sonographic evidence of renal hematomas. Secondary outcomes included levels of urinary markers of renal damage, stone disintegration, stone-free rate, and rates of secondary interventions within 3 mo of SWL. Descriptive statistics were used to compare clinical outcomes between the two groups. A logistic regression model was generated to assess predictors of hematomas. RESULTS AND LIMITATIONS Significantly fewer hematomas occurred in the ramping group(12/213, 5.6%) than in the fixed group (27/205, 13%; p=0.008). There was some evidence that the fixed group had higher urinary β2-microglobulin levels after SWL compared to the ramping group (p=0.06). Urinary microalbumin levels, stone disintegration, stone-free rate, and rates of secondary interventions did not significantly differ between the groups. The logistic regression model showed a significantly higher risk of renal hematomas in older patients (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05; p=0.04). Stepwise voltage ramping was associated with a lower risk of hematomas (OR 0.39, 95% CI 0.19-0.80; p=0.01). The study was limited by the use of ultrasound to detect hematomas. CONCLUSIONS In this prospective randomized study, stepwise voltage ramping during SWL was associated with a lower risk of renal damage compared to a fixed maximal voltage without compromising treatment effectiveness. PATIENT SUMMARY Lithotripsy is a noninvasive technique for urinary stone disintegration using ultrasonic energy. In this study, two voltage strategies are compared. The results show that a progressive increase in voltage during lithotripsy decreases the risk of renal hematomas while maintaining excellent outcomes. TRIAL REGISTRATION ISRCTN95762080.

[Spontaneous retropharyngeal hematoma with fatal outcome]

Halsschmerz, Dysphagie und Dyspnoe sind die häufigsten Symptomen, aufgrund derer Patienten einen Arzt aufsuchen. Hierbei handelt es sich um unspezifische Symptome mit vielfältigen Ursachen. Mögliche im Retropharyngealraum lokalisierte Pathologien sind in der überwiegenden Anzahl der Fälle selbst limitierend oder durch medikamentöse Therapien beherrschbar (Bsp.: Pharyngitis, Tonsillitis, Seitenstrangangina). Deutlich seltener sind im Spatium retropharyngeum lokalisierte Abszesse, Neoplasien (Bsp.: Lipome, Neurofibrome, Liposarkome) oder Hämatome (Schmäl F et al. HNO 2002; 50: 418 – 423). Letztlich können auch degenerative Veränderungen der Wirbelsäule, eine ektop verlaufende Arteria carotis interna oder seltene Manifestationen von Systemerkrankungen (Bsp.: Sarkoidose) zu einer unterschiedlich stark ausgeprägten Vorwölbung der Pharynxhinterwand und Einengung der Luft- und Speiseröhre führen. Anhand des vorliegenden Falls wird die klinische Präsentation sowie die radiologische Diagnose eines retropharyngealen Hämatoms diskutiert und die anatomische Beziehung der Halskompartimente mit besonderem Fokus auf den Retropharyngealraum dargestellt.

Roots under attack: contrasting plant responses to below- and aboveground insect herbivory

The distinctive ecology of root herbivores, the complexity and diversity of root–microbe interactions, and the physical nature of the soil matrix mean that plant responses to root herbivory extrapolate poorly from our understanding of responses to aboveground herbivores. For example, root attack induces different changes in phytohormones to those in damaged leaves, including a lower but more potent burst of jasmonates in several plant species. Root secondary metabolite responses also differ markedly, although patterns between roots and shoots are harder to discern. Root defences must therefore be investigated in their own ecophysiological and evolutionary context, specifically one which incorporates root microbial symbionts and antagonists, if we are to better understand the battle between plants and their hidden herbivores.

Independence Day for IgA

IgA is induced through T-cell-dependent and -independent pathways. In this issue, Bunker et al. (2015) now show that the T-cell-independent pathway is sufficient to coat most small intestinal microbes specifically, and Fransen et al. (2015) find that IgA coating promotes uptake of microbes into Peyer's patches and drives further induction in a positive-feedback loop.