Clinical outcome and biological characteristics of Chronic Myeloid Leukemia patients treated with nilotinib front-line

The present work reports the outcome of the GIMEMA CML WP study CML0811, an independent trial investigating nilotinib as front-line treatment in chronic phase chronic myeloid leukemia (CML). Moreover, the results of the proteomic analysis of the CD34+ cells collected at CML diagnosis, compared to the counterpart from healthy donors, are reported. Our study confirmed that nilotinib is highly effective in the prevention of the progression to accelerated/blast phase, a condition that today is still associated with high mortality rates. Despite the relatively short follow-up, cardiovascular issues, particularly atherosclerotic adverse events (AE), have emerged, and the frequency of these AEs may counterbalance the anti-leukemic efficacy. The deep molecular response rates in our study compare favorably to those obtained with imatinib, in historic cohorts, and confirm the findings of the Company-sponsored ENESTnd study. Considering the increasing rates of deep MR over time we observed, a significant proportion of patients will be candidate to treatment discontinuation in the next years, with higher probability of remaining disease-free in the long term. The presence of the additional and complex changes we found at the proteomic level in CML CD34+ cells should be taken into account for the investigation on novel targeted therapies, aimed at the eradication of the disease.

Untersuchungen zu Mechanismen der Laser-Teilchenbeschleunigung

Auf dem Gebiet der Teilchenbeschleunigung mittels Hochintensitäts-Lasern wurden in der letzten Dekade viele erfolgreiche Entwicklungen hin zu immer höheren Energien und größeren Teilchenzahlen veröffentlicht. In den meisten Fällen wurde der sogenannte TNSA-Prozess (engl. Target-Normal-Sheath-Acceleration (TNSA)) untersucht. Bei diesem Prozess erfolgt die Beschleunigung in dem an der Oberfläche durch Ladungstrennung erzeugten Potential. Ein kaum vermeidbares Problem ist hierbei das resultierende breite Energie-Spektrum der beschleunigten Teilchen. Diese Situation konnte in den letzten Jahren zwar verbessert, aber nicht vollständig gelöst werden. Für Intensitäten größer 10^(20..21) W/cm^2 sagen theoretische Modellrechnungen eine auf dem Lichtdruck basierende Beschleunigung (engl. Radiation-Pressure-Acceleration (RPA)) mit deutlich eingegrenztem, fast monoenergetischem Spektrum voraus. Im Rahmen dieser Arbeit wurde ein Experiment zur Untersuchung dieses Prozesses bei Intensitäten von einigen 10^19 W/cm^2 durchgeführt. Dazu wurden zunächst spezielle Targets entwickelt und als Patent angemeldet, welche den Experimentbedingungen angepasst sind. Durch die Auslegung des experimentellen Aufbaus und der Diagnostiken auf hohe Repetitionsraten, in Verbindung mit einem geeigneten Lasersystem, konnte auf Basis einer Statistik von mehreren Tausend Schüssen ein großer Parameterraum untersucht werden. Untersucht wurden unter anderem die Abhängigkeit von Targetmaterial und Dicke, Intensität, Laserpolarisation und Vorplasmabedingungen. Aus den gewonnenen Daten und Vergleichen mit 2-dimensionalen numerischen Simulationen konnte ein Modell des Beschleunigungsprozesses aufgestellt und durch Vergleich mit den experimentellen Ergebnissen geprüft werden. Dabei wurden klare Indizien für die Existenz eines neuen, nicht feldinduzierten, Beschleunigungsprozesses gefunden. Darüber hinaus wurde zur Polarisationsbeeinflussung ein optisches System entwickelt, das ausschließlich mit reflexiven Elementen arbeitet. Damit konnten viele Nachteile bestehender, auf Verzögerungsplatten beruhender Elemente vermieden, und die Anwendbarkeit bei hohen Laserenergien erreicht werden.

What users think about the differences between caffeine and illicit,prescription stimulants for cognitive enhancement

Pharmacological cognitive enhancement (CE) is a topic of increasing public awareness. In the scientific literature on studentrnuse of CE as a study aid for academic performance enhancement, there are high prevalence rates regarding the use ofrncaffeinated substances (coffee, caffeinated drinks, caffeine tablets) but remarkably lower prevalence rates regarding the usernof illicit/prescription stimulants such as amphetamines or methylphenidate. While the literature considers the reasons andrnmechanisms for these different prevalence rates from a theoretical standpoint, it lacks empirical data to account for healthyrnstudents who use both, caffeine and illicit/prescription stimulants, exclusively for the purpose of CE. Therefore, wernextensively interviewed a sample of 18 healthy university students reporting non-medical use of caffeine as well as illicit/rnprescription stimulants for the purpose of CE in a face-to-face setting about their opinions regarding differences in generalrnand morally-relevant differences between caffeine and stimulant use for CE. 44% of all participants answered that there is arngeneral difference between the use of caffeine and illicit/prescription stimulants for CE, 28% did not differentiate, 28% couldrnnot decide. Furthermore, 39% stated that there is a moral difference, 56% answered that there is no moral difference andrnone participant was not able to comment on moral aspects. Participants came to their judgements by applying threerndimensions: medical, ethical and legal. Weighing the medical, ethical and legal aspects corresponded to the students’rnindividual preferences of substances used for CE. However, their views only partly depicted evidence-based medical aspectsrnand the ethical issues involved. This result shows the need for well-directed and differentiated information to prevent thernpotentially harmful use of illicit or prescription stimulants for CE.

Expressionsunterschiede verschiedener miRNAs bei chronisch-entzündlichen Darmerkrankungen

Chronisch-entzündliche Darmerkrankungen konfrontieren unsere heutige Gesellschaft mit hohen Inzidenzraten in der westlichen Welt und zunehmend steigenden Inzidenzraten im asiatischen Raum. Die Folgen für die Patienten sind eine starke Beeinträchtigung der Lebensqualität, mit sozialen und wirtschaftlichen Folgen sowie ein erhöhtes Risiko für die Entwicklung kolorektaler Karzinome. Durch die Entdeckung von 22 nt langen, regulierenden RNAs, auch genannt miRNAs, wurde ein neuer Baustein im Verständnis zellulärer Regelprozesse und der Differenzierung und Aktivierung von Antworten etwa des Immunsystems entdeckt. Somit stellt sich die Frage nach der Bedeutung von miRNAs im Rahmen von chronisch-entzündlichen Darmerkrankungen. Hierzu wurden in dieser Arbeit über ein miRNA-Array System 12 miRNAs als potentiell relevante Ziele identifiziert und an einem Kollektiv aus insgesamt 131 Patienten und 163 Biopsien aus dem Bereich des Darmes überprüft. Es zeigte sich hierbei, dass im Rahmen eines Morbus Crohn mit Befall des Dickdarms die miRNAs let-7d und miR-22 in gesteigerter Expression vorlagen. Da im terminalen Ileum eine gesonderte Immunsituation vorliegt, wurde dieser Bereich zusätzlich bei der Erkrankung Morbus Crohn untersucht. Es zeigten sich Expressionsveränderungen für die miRNAs miR-30e, miR-185, miR-374b und miR-424. Bei Patienten mit einer Colitis ulcerosa waren die miRNAs let-7d, miR-185 und miR-424 in ihrem Expressionsverhalten verändert. Zusätzlich konnte gezeigt werden, dass in Abhängigkeit vom Entzündungsgrad bei bestehender Colitis ulcerosa eine zunehmenden Überexpression der miRNAs let-7d, miR-185 und miR-424 erfolgte. Die miRNAs miR-18a und miR-185 wiesen unter Remissionsbedingungen Expressionsveränderungen auf und lassen somit den Verdacht eines protektiven Effektes aufkommen. Mit Hilfe von computerbasierten Datenbankanalysen konnten gemeinsam regulierenden miRNAs Proteine und Pathways zugeordnet werden, welche einen Zusammenhang mit bereits pathogenetisch bestätigten Signalwegen wie etwa dem nF-ĸB und MAPK-Signalweg nahelegen. Auch konnte herausgearbeitet werden, dass einige, der von diesen miRNAs regulierten Proteine, bereits in veröffentlichten Arbeiten als fehlreguliert festgestellt wurden, jedoch blieb die Ursache dieser Fehlregulation gänzlich unbekannt. Mit den in dieser Arbeit erhobenen Daten konnte gezeigt werden, dass eine Kongruenz der Befunde vorliegt, welche einen Zusammenhang der miRNA-Expression mit der Fehlregulation bestimmter Proteine nicht nur nahelegt, sondern darüber hinaus auch noch einige weitere potentielle Proteinziele für weitere Untersuchungen aufführt. Dazu ist es jedoch notwendig, die Relevanz der hier entdeckten, computerbasierten Proteine in zukünftigen Untersuchungen einer genauen Prüfung zu unterziehen.

Global modeling of pollutant transport and deposition from anthropogenic emission hot spots on global scale

Urban centers significantly contribute to anthropogenic air pollution, although they cover only a minor fraction of the Earth's land surface. Since the worldwide degree of urbanization is steadily increasing, the anthropogenic contribution to air pollution from urban centers is expected to become more substantial in future air quality assessments. The main objective of this thesis was to obtain a more profound insight in the dispersion and the deposition of aerosol particles from 46 individual major population centers (MPCs) as well as the regional and global influence on the atmospheric distribution of several aerosol types. For the first time, this was assessed in one model framework, for which the global model EMAC was applied with different representations of aerosol particles. First, in an approach with passive tracers and a setup in which the results depend only on the source location and the size and the solubility of the tracers, several metrics and a regional climate classification were used to quantify the major outflow pathways, both vertically and horizontally, and to compare the balance between pollution export away from and pollution build-up around the source points. Then in a more comprehensive approach, the anthropogenic emissions of key trace species were changed at the MPC locations to determine the cumulative impact of the MPC emissions on the atmospheric aerosol burdens of black carbon, particulate organic matter, sulfate, and nitrate. Ten different mono-modal passive aerosol tracers were continuously released at the same constant rate at each emission point. The results clearly showed that on average about five times more mass is advected quasi-horizontally at low levels than exported into the upper troposphere. The strength of the low-level export is mainly determined by the location of the source, while the vertical transport is mainly governed by the lifting potential and the solubility of the tracers. Similar to insoluble gas phase tracers, the low-level export of aerosol tracers is strongest at middle and high latitudes, while the regions of strongest vertical export differ between aerosol (temperate winter dry) and gas phase (tropics) tracers. The emitted mass fraction that is kept around MPCs is largest in regions where aerosol tracers have short lifetimes; this mass is also critical for assessing the impact on humans. However, the number of people who live in a strongly polluted region around urban centers depends more on the population density than on the size of the area which is affected by strong air pollution. Another major result was that fine aerosol particles (diameters smaller than 2.5 micrometer) from MPCs undergo substantial long-range transport, with about half of the emitted mass being deposited beyond 1000 km away from the source. In contrast to this diluted remote deposition, there are areas around the MPCs which experience high deposition rates, especially in regions which are frequently affected by heavy precipitation or are situated in poorly ventilated locations. Moreover, most MPC aerosol emissions are removed over land surfaces. In particular, forests experience more deposition from MPC pollutants than other land ecosystems. In addition, it was found that the generic treatment of aerosols has no substantial influence on the major conclusions drawn in this thesis. Moreover, in the more comprehensive approach, it was found that emissions of black carbon, particulate organic matter, sulfur dioxide, and nitrogen oxides from MPCs influence the atmospheric burden of various aerosol types very differently, with impacts generally being larger for secondary species, sulfate and nitrate, than for primary species, black carbon and particulate organic matter. While the changes in the burdens of sulfate, black carbon, and particulate organic matter show an almost linear response for changes in the emission strength, the formation of nitrate was found to be contingent upon many more factors, e.g., the abundance of sulfuric acid, than only upon the strength of the nitrogen oxide emissions. The generic tracer experiments were further extended to conduct the first risk assessment to obtain the cumulative risk of contamination from multiple nuclear reactor accidents on the global scale. For this, many factors had to be taken into account: the probability of major accidents, the cumulative deposition field of the radionuclide cesium-137, and a threshold value that defines contamination. By collecting the necessary data and after accounting for uncertainties, it was found that the risk is highest in western Europe, the eastern US, and in Japan, where on average contamination by major accidents is expected about every 50 years.

Rupture forces of split aptamers

Rupture forces of ligand-receptor interactions, such as proteins-proteins, proteins-cells, and cells-tissues, have been successfully measured by atomic force spectroscopy (AFS). For these measurements, the ligands and receptors were chemically modified so that they can be immobilized on the tip and on a substrate, respectively. The ligand interact the receptor when the tip approaches the substrate. This interaction can be studied by measuring rupture force upon retraction. However, this technique is not feasible for measurements involving small molecules, since they form only few H-bonds with their corresponding receptors. Modifying small molecules for immobilization on surfaces may block or change binding sites. Thus, recorded rupture forces might not reflect the full scope of the involved small ligand-receptor interactions.rnIn my thesis, a novel concept that allows measuring the rupture force of small involved ligand-receptor interactions and does not require molecular modification for immobilization was introduced. The rupture force of small ligand-receptor interaction is not directly measured but it can be determined from measurements in the presence and in the absence of the ligand. As a model system, the adenosine mono phosphate (AMP) and the aptamer that binds AMP were selected. The aptamer (receptor) is a single stranded DNA that can partially self-hybridize and form binding pockets for AMP molecules (ligands). The bonds between AMP and aptamer are provided by several H-bonds and pair stacking.rnIn the novel concept, the aptamer was split into two parts (oligo a and oligo b). One part was immobilized on the tip and the other one on the substrate. Approaching the tip to the substrate, oligo a and oligo b partially hybridized and the binding pockets were formed. After adding AMP into the buffer solution, the AMP bound in the pockets and additional H-bonds were formed. Upon retraction of the tip, the rupture force of the AMP-split aptamer complex was measured. In the presence of excess AMP, the rupture force increased by about 10 pN. rnThe dissociation constant of the AMP-split aptamer complex was measured on a single molecular level (~ 4 µM) by varying the AMP concentrations and measuring the rupture force at each concentration. Furthermore, the rupture force was amplified when more pockets were added to the split aptamer. rnIn the absence of AMP, the thermal off-rate was slightly reduced compared to that in the presence of AMP, indicating that the AMP stabilized the aptamer. The rupture forces at different loading rates did not follow the logarithmic fit which was usually used to describe the dependence of rupture forces at different loading rates of oligonucleotides. Two distinguished regimes at low and high loading rates were obtained. The two regimes were explained by a model in which the oligos located at the pockets were stretched at high loading rates. rnThe contribution of a single H-bond formed between the AMP molecule and the split aptamer was measured by reducing the binding groups of the AMP. The rupture forces reduce corresponding to the reduction of the binding groups. The phosphate group played the most important role in the formation of H-bond network between the AMP molecule and the split aptamer. rn

Konzept eines aktiven Pulverinhalators

In dieser Arbeit wird das Konzept eines aktiven Pulverinhalators entwickelt. Im Gegensatz zu einem passiven Pulverinhalator ist bei solch einem Gerät die Abgabe und Dispergierung der Arzneistoffformulierung nicht von einem Inhalationsmanöver abhängig, welches von Patient zu Patient variiert. Solch ein System würde folglich die Zuverlässigkeit und Effizienz der inhalativen Therapie verbessern. Mögliche Anwendungen für einen aktiven Pulverinhalator wären vor allem Indikationen, die die Abgabe hoher Dosen erfordern, wie z.B. in der Therapie mit Antibiotika.rnIn einem Designprozess, der alle aus Kundenwünschen ermittelten Konstruktionsanforderungen sammelt und verschiedene Lösungsansätze vergleicht, wird ein mit Treibgas betriebener atemzugsausgelöster, Mehrfach-Dosis Pulverinhalator als aussichtsreichstes Konzept ermittelt. Dieses Konzept wird in Form von eigens konstruierten Labor-Test-Rigs entwickelt und vor allem hinsichtlich Höhe der Dosierung, Dosiergenauigkeit, und Flussratenabhängigkeit evaluiert. In der Spitze können über 16 mg lungengängiger Dosis erreicht werden, bei im Vergleich zu dem eingesetzten passiven Inhalator mindestens nur halb so großer Streuung. Bei niedrigen Flussraten können immer noch bis zu 80 % der erzielten inhalierbaren Dosis von hohen Flussraten erreicht werden und damit die Ergebnisse des passiven Inhalators deutlich übertreffen.rnTeil der Aufgabe war es, dieses treibgasbetriebene Labor-Test-Rig so zu entwickeln, dass es implementierbar in einen atemzugsausgelösten Mehrfachdosis-Pulverinhalator ist. Dieser treibgasbetriebene, atemzugsausgelöste Mehrfachdosis-Pulverinhalator würde die Kundenwünsche und Konstruktionsanforderungen in sehr hohen Maße erfüllen, so dass hier die Möglichkeit besteht einen Inhalator mit sehr hohem Grad an Patienten-Compliance zu verwirklichen. Durch die Verwendung und Neukombination bereits etablierter Technologien und einen akzeptablen Stückkostenpreis besteht die Möglichkeit den Inhalator tatsächlich zu realisieren und zu vermarkten.

Mesozoic fold structure of the Otago and Alpine Schist Belt and its implications on the tectonic evolution of South Island, New Zealand

Erneute Untersuchungen der mesozoischen Faltenstruktur des Otago Schiefergürtels, Südinsel, Neuseeland, zeigen, dass diese aus zwei aufeinander folgenden, ähnlichen, asymmetrischen, offenen bis mäßig engen Großfaltengenerationen im km- Größenbereich besteht anstatt aus den vorher angenommenen Decken- oder Halbfalten. Hauptproblem der Großfaltenstruktur sind Zonen von durchgreifender Boudinage, die in der Nähe der Großfaltenscharniere entstanden sind. Vorherige Bearbeiter deuteten diese Zonen als 'starke Verformungszonen' oder Überschiebungszonen. Diese Arbeit zeigt, dass in diesen Zonen nur durch die asymmetrische Faltung die unteren liegenden Schenkel der Großfalten boudiniert und somit häufig die ansonsten typischen Faltenstrukturen des liegenden Schenkels einer symmetrischen Faltung überprägt wurden. Ein weiteres Problem dieser mesozoischen Großfaltenstruktur ist die Überprägung einer Faltengeneration auf eine frühere. Weil die Verkürzungsrichtung der überprägenden Faltengeneration nicht subparallel zur älteren Faltenachse ist, sondern einen Winkel von rund 30 Grad einschließt, ist ein Wechsel von orthogonalen zu koaxialen Interferenzmustern der Kleinfalten beobachtbar. Folglich ist die Orientierung der Scheitellinie einer überprägenden und überprägten Kleinfalte nicht unbedingt subparallel zur Orientierung der Faltenachse der Großfalte trotz zylindrischer Faltung. Im letzten Teil dieser Arbeit wird die Überprägung der mesozoischen Großfaltenstruktur durch das känozoisch entstandene, transpressionale Alpine Störungssystem, das einen zweiseitigen Falten- und Überschiebungsgürtel im Otago und im Nordwesten anschließenden Alpinen Schiefergürtel bildet, beschrieben.

Vascularised fibula grafts for early tibia reconstruction in infants with congenital pseudarthrosis

Congenital pseudarthrosis of the tibia (CPT) is caused by an ill-defined, segmental disturbance of periosteal bone formation leading to spontaneous bowing, followed by fracture and subsequent pseudarthrosis in the first 2 years of life. The results of conventional treatment modalities (e.g., bracing, internal and external fixation and bone grafting) are associated with high failure rates in terms of persisting pseudarthrosis, malunion and impaired growth. As a more promising alternative, a more aggressive approach, including wide resection of the affected bone, reconstruction with free vascularised fibula grafts from the healthy contralateral leg and stable external fixation at a very early stage has been suggested. Between 1995 and 2007, 10 children (age 12-31 months, median 20 months) suffering from CPT were treated at our institutions according to this principle. Two patients were treated before a fracture had occurred. The length of the fibula graft was 7-9cm. End-to-end anastomoses were performed at the level of the distal tibia stump. The follow-up was 80 months (median, range 12 months to 12 years). Radiologic examination at 6 weeks postoperatively showed normal bone density and structure of the transplanted fibula in all cases and osseous consolidation at 19 of the 20 graft/tibia junctions. One nonunion was sucessfully treated with bone grafting and plate osteosynthesis. Pin-tract infection occurred in three patients. Five children sustained graft fractures that were successfully treated with internal or external fixation. Two patients developed diminished growth of the affected limb or foot; all others had equal limb length and shoe size. At long-term follow-up, tibialisation of the transplant had occurred, and normal gait and physical activities were possible in all children. We conclude that in spite of a relatively high complication rate and the reluctance to perform free flap surgery in infants at this young age, the present concept may successfully prevent the imminent severe sequelae associated with CPT.

On Ribosome Load, Codon Bias and Protein Abundance

Different codons encoding the same amino acid are not used equally in protein-coding sequences. In bacteria, there is a bias towards codons with high translation rates. This bias is most pronounced in highly expressed proteins, but a recent study of synthetic GFP-coding sequences did not find a correlation between codon usage and GFP expression, suggesting that such correlation in natural sequences is not a simple property of translational mechanisms. Here, we investigate the effect of evolutionary forces on codon usage. The relation between codon bias and protein abundance is quantitatively analyzed based on the hypothesis that codon bias evolved to ensure the efficient usage of ribosomes, a precious commodity for fast growing cells. An explicit fitness landscape is formulated based on bacterial growth laws to relate protein abundance and ribosomal load. The model leads to a quantitative relation between codon bias and protein abundance, which accounts for a substantial part of the observed bias for E. coli. Moreover, by providing an evolutionary link, the ribosome load model resolves the apparent conflict between the observed relation of protein abundance and codon bias in natural sequences and the lack of such dependence in a synthetic gfp library. Finally, we show that the relation between codon usage and protein abundance can be used to predict protein abundance from genomic sequence data alone without adjustable parameters.

On Ribosome Load, Codon Bias and Protein Abundance

Different codons encoding the same amino acid are not used equally in protein-coding sequences. In bacteria, there is a bias towards codons with high translation rates. This bias is most pronounced in highly expressed proteins, but a recent study of synthetic GFP-coding sequences did not find a correlation between codon usage and GFP expression, suggesting that such correlation in natural sequences is not a simple property of translational mechanisms. Here, we investigate the effect of evolutionary forces on codon usage. The relation between codon bias and protein abundance is quantitatively analyzed based on the hypothesis that codon bias evolved to ensure the efficient usage of ribosomes, a precious commodity for fast growing cells. An explicit fitness landscape is formulated based on bacterial growth laws to relate protein abundance and ribosomal load. The model leads to a quantitative relation between codon bias and protein abundance, which accounts for a substantial part of the observed bias for E. coli. Moreover, by providing an evolutionary link, the ribosome load model resolves the apparent conflict between the observed relation of protein abundance and codon bias in natural sequences and the lack of such dependence in a synthetic gfp library. Finally, we show that the relation between codon usage and protein abundance can be used to predict protein abundance from genomic sequence data alone without adjustable parameters.

Technical Feasibility and Application of Mechanical Thrombectomy with the Solitaire FR Revascularization Device in Acute Basilar Artery Occlusion

Acute BAO is a devastating neurological condition associated with a poor clinical outcome and a high mortality rate. Recanalization has been identified as a major prognostic factor for good outcome in BAO. Mechanical thrombectomy using retrievable stents is an emerging treatment option for acute stroke. First clinical trials using stent retrievers have shown promising high recanalization rates. However, these studies mainly included large artery occlusions in the anterior circulation with only a few or single cases of BAO. Therefore, the purpose of this study was to evaluate technical feasibility, safety, and efficacy of mechanical thrombectomy using retrievable stent in the treatment of acute BAO.

The GABRIEL Advanced Surveys: study design, participation and evaluation of bias

Exposure to farming environments has been shown to protect substantially against asthma and atopic disease across Europe and in other parts of the world. The GABRIEL Advanced Surveys (GABRIELA) were conducted to determine factors in farming environments which are fundamental to protecting against asthma and atopic disease. The GABRIEL Advanced Surveys have a multi-phase stratified design. In a first-screening phase, a comprehensive population-based survey was conducted to assess the prevalence of exposure to farming environments and of asthma and atopic diseases (n = 103,219). The second phase was designed to ascertain detailed exposure to farming environments and to collect biomaterial and environmental samples in a stratified random sample of phase 1 participants (n = 15,255). A third phase was carried out in a further stratified sample only in Bavaria, southern Germany, aiming at in-depth respiratory disease and exposure assessment including extensive environmental sampling (n = 895). Participation rates in phase 1 were around 60% but only about half of the participating study population consented to further study modules in phase 2. We found that consenting behaviour was related to familial allergies, high parental education, wheeze, doctor diagnosed asthma and rhinoconjunctivitis, and to a lesser extent to exposure to farming environments. The association of exposure to farm environments with asthma or rhinoconjunctivitis was not biased by participation or consenting behaviour. The GABRIEL Advanced Surveys are one of the largest studies to shed light on the protective 'farm effect' on asthma and atopic disease. Bias with regard to the main study question was able to be ruled out by representativeness and high participation rates in phases 2 and 3. The GABRIEL Advanced Surveys have created extensive collections of questionnaire data, biomaterial and environmental samples promising new insights into this area of research.

Treatment of clinically diagnosed equine sarcoid with a mistletoe extract (Viscum album austriacus)

BACKGROUND: Equine sarcoids (ES) are common, difficult to treat, and have high recurrence rates. Viscum album extracts (VAE) are used in human cancer treatment. HYPOTHESIS: That therapy with VAE (Iscador P) is effective in the treatment of ES. ANIMALS: Fifty-three horses (444 ES); 42 were treated with VAE or placebo as monotherapy; 11 were treated with VAE or placebo after selective excision of ES. METHODS: Prospective, randomised, blinded, clinical trial. Horses were randomly assigned to treatment (VAE; n=32) or control group (Placebo; n=21). One milliliter of VAE (Iscador P) in increasing concentrations from 0.1 to 20 mg/mL or physiological NaCl solution was given SC 3 times a week over 105 days. Number, localization, and type of the ES were documented over 12 months. A subset of 163 clinically diagnosed equine sarcoid (CDES) lesions (95 VAE, 68 Placebo) was evaluated in detail, considering clinical findings and tumor volume. RESULTS: No undesired adverse effects were observed except for mild edema at the injection site in 5 of 32 horses (16%). Complete or partial regression was observed in 13 horses of the VAE group (41%) and in 3 of the control horses (14%; P<.05). After VAE treatment, 48 of 95 CDES (67%) showed an improvement compared with 17 of 68 CDES in the control group (40%; P<.01). Twenty-seven CDES had disappeared completely in the VAE group (38%) compared with 9 CDES in the control group (13% NS). CONCLUSIONS AND CLINICAL IMPORTANCE: VAE (Iscador P) represents a safe and effective treatment for CDES.

Restructuring Justice: Moving Towards Gender-Responsive Programming and Alternatives to Incarceration for Non-Violent Female Offenders

The United States¿ Federal and State laws differentiate between acceptable (or, legal) and unacceptable (illegal) behavior by prescribing restrictive punishment to citizens and/or groups that violate these established rules. These regulations are written to treat every person equally and to fairly serve justice; furthermore, the sanctions placed on offenders seek to reform illegal behavior through limitations on freedoms and rehabilitative programs. Despite the effort to treat all offenders fairly regardless of social identity categories (e.g., sex, race, ethnicity, socioeconomic status, age, ability, and gender and sexual orientation) and to humanely eliminate illegal behavior, the American penal system perpetuates de facto discrimination against a multitude of peoples. Furthermore, soaring recidivism rates caused by unsuccessful re-entry of incarcerated offenders puts economic stress on Federal and State budgets. For these reasons, offenders, policy-makers, and law-abiding citizens should all have a vested interest in reforming the prison system. This thesis focuses on the failure of the United States corrections system to adequately address the gender-specific needs of non-violent female offenders. Several factors contribute to the gender-specific discrimination that women experience in the criminal justice system: 1) Trends in female criminality that skew women¿s crime towards drug-related crimes, prostitution, and property offenses; 2) Mandatory minimum sentences for drug crimes that are disproportionate to the crime committed; 3) So-called ¿gender-neutral¿ educational, vocational, substance abuse, and mental health programming that intends to equally rehabilitate men and women, but in fact favors men; and 4) The isolating nature of prison structures that inhibits smooth re-entry into society. I argue that a shift in the placement and treatment of non-violent female offenders is necessary for effective rehabilitation and for reducing recidivism rates. The first component of this shift is the design and implementation of gender- responsive treatment (GRT) rather than gender-neutral approaches in rehabilitative programming. The second shift is the utilization of alternatives to incarceration, which provide both more humane treatment of offenders and smoother reintegration to society. Drawing on recent scholarship, information from prison advocacy organizations, and research with men in an alternative program, I provide a critical analysis of current policies and alternative programs, and suggest several proposals for future gender- responsive programs in prisons and in place of incarceration. I argue that the expansion of gender-responsive programming and alternatives to incarceration respond to the marginalization of female offenders, address concerns about the financial sustainability of the United States criminal justice system, and tackle high recidivism rates.