Systematics, phylogeny and biogeography of Cousinia (Asteraceae)

Die Systematik, Phylogenie und Biogeographie der Gattung Cousinia (Asteraceae, Cardueae) als größter Gattung der Tribus Cardueae mit mehr als 600 Arten wurde untersucht. Diese Dissertation umfasst drei Hauptteile: Im ersten Teil wurde die Phylogenie und Evolution des Arctium-Cousinia-Komplexes Untersucht. Dieser Gattungskomplex enthält Arctium, Cousinia, Hypacanthium und Schmalhausenia und zeigt die höchste Diversität in der Irano-Turanischen Region und in den Gebirgen Zentralasiens. Es wurden ITS und rpS4-trnT-trnL-Sequenzen für insgesamt 138 Arten generiert, darunter von 129 (von ca. 600) Arten von Cousinia. Wie in früheren Analysen bereits gefunden, ist Cousinia nicht monophyletisch. Stattdessen sind Cousinia subg. Cynaroides und subg. Hypacanthodes mit insgesamt ca. 30 Arten enger mit Arctium, Hypacanthium und Schmalhausenia (Arctioid Clade) als mit subg. Cousinia (Cousinioid Clade) verwandt. Die Arctioid und Cousiniod clades werden auch durch Pollenmorphologie und Chromosomenzahl unterstützt, wie bereits früher bekannt war. In dem Arctioid Clade entsprechen morphologische Gattungsgrenzen, basierend auf Blattform, Blattbedornung und Morphologie der Involukralblätter, nicht den in der molekularen analyse gefundenen clades. Es kann keine taxonomische Lösung für diesen Konflikt gefunden werden, und die gennanten Merkmale wurden als homoplastisch betrachtet. Obwohl die phylogenetische Auflösung in dem Cousinioid Clade schlecht ist, enthalten die ITS und rpS4-trnT-trnL-Sequenzen phylogenetische Information. So gruppierten z.B. die sechs annuellen Arten in zwei Gruppen. Schlechte phylogenetische Auflösung resultiert wahrscheinlich aus dem Mangel an Merkmalen und der großen Artenzahl in dieser artenreichen und vergleichsweise jungen (ca. 8,7 mya) Linie. Artbildung in dem Cousinioid Clade scheint hauptsächlich allopatrisch zu sein. Der zweite Teil der Dissertation untersucht die Rolle der Hybridisierung in der Evolution von Cousinia s.s. Die in der Vergangenheit publizierteten 28 Hybrid-Kombinationen und 11 Zwischenformen wurden kritisch geprüft, und zwei Hybridindividuen wurden morphologisch und molekular untersucht. Die vermutlichen oder nachgewiesenen Eltern der Hybriden und Zwischenformen wurden auf die aus einer Bayesischen Analyse der ITS-Sequenzen von 216 Arten von Cousinia und verwandten Gattungen resultierenden Phylogenie aufgetragen. Weder Hybriden zwischen dem Cousinioid Clade und anderen Haupt-Claden des Arctium-Cousinia-Komplexes noch zwischen annuellen und perennirenden Arten von Cousinia s.s. wurden beobachtet. Die Ergebnisse zeigen eindeutig, dass Hybridisierung in Cousinia möglich is, und dass ca. 10,7% der Arten an interspezifischer Hybridisierung beteiligt sind. Obwohl Hybridisierung in Cousinia s.s. stattfindet und zu den Schwierigkeiten bei der Rekonstruktion ihrer phylogenetischen Geschichte beitragen könnte, war ihre Rolle für die Entwicklung und Diversität der Gruppe offenbar gering. Im dritten Teil wird eine taxonomische Revision der C. sect. Cynaroideae präsentiert. Cousinia sect. Cynaroideae, die größte Sektion der Gattung mit 110 veröffentlichten Arten, zeichnet sich durch eine Chromosomenzahl von 2n = 24 und durch ± herablaufende Blätter und Hüllblätter mit Anhängseln aus. Sie kommt im Iran, Irak, dem Kaukasus, der Türkei, Turkmenistan, Afghanistan, Pakistan, dem Libanon und Anti-Libanon vor und hat ihre Hauptzentren der Artdiversität im westlichen und nordwestlichen Iran, im Irak und in der südöstlichen Türkei. Die Revision dieser Gruppe, hauptsächlich basierend auf der Untersuchung von ca. 2250 Herbarbögen, führte zu einer Verringerung der Artenzahl auf 31 Arten mit acht Unterarten. Alle Arten werden typifiziert und ausgeschlüsselt, und Beschreibungen, Abbildungen und Verbreitungskarten werden für jede Art angegeben.

External drivers of biogeochemical cycles in a tropical montane forest in Ecuador

Successful conservation of tropical montane forest, one of the most threatened ecosystems on earth, requires detailed knowledge of its biogeochemistry. Of particular interest is the response of the biogeochemical element cycles to external influences such as element deposition or climate change. Therefore the overall objective of my study was to contribute to improved understanding of role and functioning of the Andean tropical montane forest. In detail, my objectives were to determine (1) the role of long-range transported aerosols and their transport mechanisms, and (2) the role of short-term extreme climatic events for the element budget of Andean tropical forest. In a whole-catchment approach including three 8-13 ha microcatchments under tropical montane forest on the east-exposed slope of the eastern cordillera in the south Ecuadorian Andes at 1850-2200 m above sea level I monitored at least in weekly resolution the concentrations and fluxes of Ca, Mg, Na, K, NO3-N, NH4-N, DON, P, S, TOC, Mn, and Al in bulk deposition, throughfall, litter leachate, soil solution at the 0.15 and 0.3 m depths, and runoff between May 1998 and April 2003. I also used meteorological data from my study area collected by cooperating researchers and the Brazilian meteorological service (INPE), as well as remote sensing products of the North American and European space agencies NASA and ESA. My results show that (1) there was a strong interannual variation in deposition of Ca [4.4-29 kg ha-1 a-1], Mg [1.6-12], and K [9.8-30]) between 1998 and 2003. High deposition changed the Ca and Mg budgets of the catchments from loss to retention, suggesting that the additionally available Ca and Mg was used by the ecosystem. Increased base metal deposition was related to dust outbursts of the Sahara and an Amazonian precipitation pattern with trans-regional dry spells allowing for dust transport to the Andes. The increased base metal deposition coincided with a strong La Niña event in 1999/2000. There were also significantly elevated H+, N, and Mn depositions during the annual biomass burning period in the Amazon basin. Elevated H+ deposition during the biomass burning period caused elevated base metal loss from the canopy and the organic horizon and deteriorated already low base metal supply of the vegetation. Nitrogen was only retained during biomass burning but not during non-fire conditions when deposition was much smaller. Therefore biomass burning-related aerosol emissions in Amazonia seem large enough to substantially increase element deposition at the western rim of Amazonia. Particularly the related increase of acid deposition impoverishes already base-metal scarce ecosystems. As biomass burning is most intense during El Niño situations, a shortened ENSO cycle because of global warming likely enhances the acid deposition at my study forest. (2) Storm events causing near-surface water flow through C- and nutrient-rich topsoil during rainstorms were the major export pathway for C, N, Al, and Mn (contributing >50% to the total export of these elements). Near-surface flow also accounted for one third of total base metal export. This demonstrates that storm-event related near-surface flow markedly affects the cycling of many nutrients in steep tropical montane forests. Changes in the rainfall regime possibly associated with global climate change will therefore also change element export from the study forest. Element budgets of Andean tropical montane rain forest proved to be markedly affected by long-range transport of Saharan dust, biomass burning-related aerosols, or strong rainfalls during storm events. Thus, increased acid and nutrient deposition and the global climate change probably drive the tropical montane forest to another state with unknown consequences for its functions and biological diversity.

Computational Modeling of Cardiac Excitation-Contraction Coupling in Physiological and Pathological Conditions

The cardiomyocyte is a complex biological system where many mechanisms interact non-linearly to regulate the coupling between electrical excitation and mechanical contraction. For this reason, the development of mathematical models is fundamental in the field of cardiac electrophysiology, where the use of computational tools has become complementary to the classical experimentation. My doctoral research has been focusing on the development of such models for investigating the regulation of ventricular excitation-contraction coupling at the single cell level. In particular, the following researches are presented in this thesis: 1) Study of the unexpected deleterious effect of a Na channel blocker on a long QT syndrome type 3 patient. Experimental results were used to tune a Na current model that recapitulates the effect of the mutation and the treatment, in order to investigate how these influence the human action potential. Our research suggested that the analysis of the clinical phenotype is not sufficient for recommending drugs to patients carrying mutations with undefined electrophysiological properties. 2) Development of a model of L-type Ca channel inactivation in rabbit myocytes to faithfully reproduce the relative roles of voltage- and Ca-dependent inactivation. The model was applied to the analysis of Ca current inactivation kinetics during normal and abnormal repolarization, and predicts arrhythmogenic activity when inhibiting Ca-dependent inactivation, which is the predominant mechanism in physiological conditions. 3) Analysis of the arrhythmogenic consequences of the crosstalk between β-adrenergic and Ca-calmodulin dependent protein kinase signaling pathways. The descriptions of the two regulatory mechanisms, both enhanced in heart failure, were integrated into a novel murine action potential model to investigate how they concur to the development of cardiac arrhythmias. These studies show how mathematical modeling is suitable to provide new insights into the mechanisms underlying cardiac excitation-contraction coupling and arrhythmogenesis.

Propter adhorantium auctoritatem voluntate. Legittimazione, patronage e propaganda nelle Gesta Regum Anglorum di Guglielmo di Malmesbury

L’oggetto di ricerca della presente tesi di dottorato è costituito dall’analisi dell’opera Gesta Regum Anglorum, del monaco benedettino Guglielmo di Malmesbury, all’interno della quale sono stati esplorati e verificati i temi di legittimazione, di patronage e di propaganda. L’opera, infatti, rimane senza un manifesto committente, ad eccezione di una primissima versione. Il titolo della tesi rivela fin da subito questo aspetto, giacché estrae un passaggio del prologo al I libro: «propter adhorantium auctoritatem voluntate», traducibile con «per le autorevoli esortazioni che ricevetti». Dopo un’analisi delle lettere dedicatorie premesse all’opera, si è ipotizzata la volontà dell’autore di dedicare le Gesta Regum Anglorum, nella loro versione definitiva, a Roberto conte di Gloucester, approfondendo in tal senso l’aspetto legittimatorio dell’opera e la possibilità che essa potesse servire come strumento per ottenere un patronage dal conte nei confronti dell’abbazia di Malmesbury. La seconda parte della tesi è incentrata sulla comparazione tra le due principali redazioni dell’opera – quella conclusa intorno al 1126/27 e quella rivista tra 1135 e 1140 – per analizzarne le modifiche, ipotizzandone la funzione come volta mitigare aspetti relativi ai principali antenati di Roberto di Gloucester (Guglielmo I e Guglielmo II). La terza parte della tesi si è concentrata sull’aspetto propagandistico dell’opera in favore del monastero di appartenenza di Guglielmo (Malmesbury) e soprattutto in favore del clero regolare, nella dicotomia che caratterizzò questo e il clero secolare durante gli anni in cui l’autore viveva. Nell’ultima parte della tesi, è stato ripreso l’aspetto legittimatorio delle Gesta Regum, tentando di fornire un’analisi delle tre raffigurazioni dei sovrani normanni d’Inghilterra, che punteggiano i tre libri finali dell’opera.

Identification and dissolution behavior of the secondary uranium minerals in the corrosion products of Depleted Uranium (DU) ammunition formed in soils

In der vorliegenden Studie wurden verschiedene Techniken eingesetzt um drei Proben (4, 7, and 8) die aus denrnKorrosionsprodukten von aus dem Kosovo Krieg stammenden Munitionskugeln, bestehend aus abgereichertem Uranrn(Depleted Uranium - DU), zu untersuchen. Als erstes Verfahren wurde die Raman-Spektroskopie eingesetzt. Hierbeirnzeigte sichin den Proben, charakterisiert durch einen Doppelpeak, die Anwesenheit von Schoepitrn(UO2)8O2(OH)12(H2O)12. Der erste und zweite Peakzeigte sich im Spektralbereich von 840,3-842,5 cm-1rnbeziehungsweise 853,6-855,8 cm-1. Diese Werte stimmen mit den Literaturwerten für Raman-Peaks für Schoepitrnüberein. Des Weiteren wurde bei dieser Untersuchungsmethode Becquerelite Ca(UO2)6O4(OH)6(H2O)8 mit einemrnPeak im Bereich zwischen 829 to 836 cm-1 gefunden. Aufgrund des Fehlens des Becquerelitespektrums in derrnSpektralbibliothek wurde eine in der Natur vorkommende Variante analysiert und deren Peak bei 829 cm-1 bestimmt,rnwas mit den Ergebnissen in den Proben korrespondiert. Mittels Röntgenbeugung (X-Ray Diffraction, XRD) zeigtenrnsich in allen Proben ähnliche Spektren. Das lässt darauf schließen, dass das pulverisierte Material in allen Probenrndas gleiche ist. Hierbei zeigte sich eine sehr gute Übereinstimmung mit Schoepit und/oder meta-rnSchoepit(UO2)8O2(OH)12(H2O)10, sowie Becquerelite. Weiterhin war weder Autunit, Sabugalit noch Uranylphosphatrnanwesend, was die Ergebnisse einer anderen Studie, durchgeführt an denselben Proben, wiederlegt. DiernAnwesenheit von P, C oder Ca im Probenmaterial konnte ausgeschlossen werden. Im Falle von Calciumkann diesrnmit der Anwesenheit von Uran erklärt werden, welches aufgrund seines Atomradius bevorzugt in Becquerelite (1:6)rneingebaut wird. Die beiden Hauptpeaks für Uran lagen im Falle von U 4f 7/2 bei 382.0 eV und im Falle von U 4f 5/2rnbei 392 eV. Diese Werte mit den Literaturwerten für Schoepit und meta-Schoepitüberein. Die Ergebnissernelektronenmikroskopischen Untersuchung zeigen U, O, Ca, Ti als dominante Komponenten in allen Messungen.rnElemente wie Si, Al, Fe, S, Na, und C wurden ebenfalls detektiert; allerdings kann nicht ausgeschlossen werden,rndass diese Elemente aus dem Boden in der unmittelbaren Umgebung der Munitionsgeschosse stammen. Gold wurdernebenfalls gemessen, was aber auf die Goldarmierung in den Probenaufbereitungsbehältern zurückgeführt werdenrnkann. Die Elektronenmikroskopie zeigte außerdem einige Stellen in denen elementares Uran und Bodenmineralernsowie sekundäre Uranminerale auftraten. Die Elementübersicht zeigt einen direkten Zusammenhang zwischen U andrnCa und gleichzeitig keine Korrelation zwischen U und Si, oder Mg. Auf der anderen Seite zeigte sich aber einrnZusammenhang zwischen Si und Al da beide Konstituenten von Bodenmineralen darstellen. Eine mit Hilfe derrnElektronenstrahlmikroanalyse durchgeführte quantitative Analyse zeigte den Massenanteil von Uran bei ca. 78 - 80%,rnwas mit den 78,2% and 79,47% für Becquerelite beziehungsweise Schoepit aufgrund ihrer Summenformelrnkorrespondiert. Zusätzlich zeigt sich für Calcium ein Massenanteil von 2% was mit dem Wert in Becquerelite (2.19%)rnrecht gut übereinstimmt. Der Massenanteil von Ti lag in einigen Fällen bei 0,77%, was auf eine noch nicht korrodierternDU-Legierung zurückzuführen ist. Ein Lösungsexperiment wurde weiterhin durchgeführt, wobei eine 0,01 M NaClO4-rnLösung zum Einsatz kam in der die verbliebene Probensubstanz der Korrosionsprodukte gelöst wurde;rnNatriumperchlorate wurde hierbei genutzt um die Ionenstärke bei 0,01 zu halten. Um Verunreinigungen durchrnatmosphärisches CO2 zu vermeiden wurden die im Versuch für die drei Hauptproben genutzten 15 Probenbehälterrnmit Stickstoffgas gespült. Eine Modelkalkulation für den beschriebenen Versuchsaufbau wurde mit Visual MINTEQrnv.3.0 für die mittels vorgenannten Analysemethoden beschriebenen Mineralphasen im pH-Bereich von 6 – 10 imrnFalle von Becquerelite, und Schoepit berechnet. Die modellierten Lösungskurven wurden unter An- und Abwesenheitrnvon atmosphärischem CO2 kalkuliert. Nach dem Ende des Lösungsexperiments (Dauer ca. 6 Monate) zeigten diernKonzentrationen des gelösten Urans, gemessen mittels ICP-OES, gute Übereinstimmung mit den modelliertenrnSchoepit und Becquerelite Kurven. Auf Grund des ähnlichen Löslichkeitverhaltens war es nicht möglich zwichen denrnbeiden Mineralen zu unterscheiden. Schoepit kontrolliert im sauren Bereich die Löslichkeit des Urans, währendrnbecquerelit im basichen am wenigsten gelöst wird. Des Weiteren bleibt festzuhalten, dass ein Anteil an CO2 in diernverschlossenen Probenbehälter eingedrungen ist, was sich mit der Vorhersage der Modeldaten deckt. Die Löslichkeitrnvon Uran in der Lösung als Funktion des pH-Wertes zeigte die niedrigsten Konzentrationen im Falle einer Zunahmerndes pH-Wertes von 5 auf 7 (ungefähr 5,1 x 10-6 mol/l) und einer Zunahme des pH-Wertes auf 8 (ungefähr 1,5 x 10-6rnmol/l bei). Oberhalb dieses Bereichs resultiert jeder weitere Anstieg des pH-Wertes in einer Zunahme gelösten Uransrnin der Lösung. Der ph-Wert der Lösung wie auch deren pCO2-Wert kontrollieren hier die Menge des gelösten Urans.rnAuf der anderen Seite zeigten im Falle von Becquerelite die Ca-Konzentrationen höhere Werte als erwartet, wobeirnwahrscheinlich auf eine Vermischung der Proben mit Bodensubstanz zurückgeführt werden kann. Abschließendrnwurde, unter Berücksichtigung der oben genannten Ergebnisse, eine Fallstudie aus Basrah (Irak) diskutiert, wo inrnzwei militärischen Konflikten Uranmunition in zwei Regionen unter verschiedenen Umweltbedingungen eingesetztrnwurden.

3D-ultrastructure, functions and stress responses of rhogocytes from the freshwater gastropods Biomphalaria glabrata and Lymnaea stagnalis

Rhogocytes, also termed ‘pore cells’, exist free in the hemolymph or embedded in the connective tissue of different body parts of molluscs, notably gastropods. These unique cells can be round, elongated or irregularly shaped, and up to 30 μm in diameter. Their hallmark is the so-called slit apparatus: i.e. pocket-like invaginations of the plasma membrane creating extracellular lacunae, bridged by cytoplasmic bars. These bars form distinctive slits of ca. 20 nm width. A slit diaphragm composed of proteins establishes a molecular sieve with holes of 20 x 20 nm. Different functions have been assigned to this special molluscan cell type, notably biosynthesis of the hemolymph respiratory protein hemocyanin. It has further been proposed, but not proven, that in the case of red-blooded snail species rhogocytes might synthesize the hemoglobin. However, the secretion pathway of these hemolymph proteins, and the functional role of the enigmatic slit apparatus remained unclear. Additionally proposed functions of rhogocytes, such as heavy metal detoxification or hemolymph protein degradation, are also not well studied. This work provides more detailed electron microscopical, histological and immunobiochemical information on the structure and function of rhogocytes of the freshwater snails Biomphalaria glabrata and Lymnaea stagnalis. By in situ hybridization on mantle tissues, it proves that B. glabrata rhogocytes synthesize hemoglobin and L. stagnalis rhogocytes synthesize hemocyanin. Hemocyanin is present, in endoplasmic reticulum lacunae and in vesicles, as individual molecules or pseudo-crystalline arrays. The first 3D reconstructions of rhogocytes are provided by means of electron tomography and show unprecedented details of the slit apparatus. A highly dense material in the cytoplasmic bars close to the diaphragmatic slits was shown, by immunogold labeling, to contain actin. By immunofluorescence microscopy, the protein nephrin was localized at the periphery of rhogocytes. The presence of both proteins in the slit apparatus supports the previous hypothesis, hitherto solely based on similarities of the ultrastructure, that the molluscan rhogocytes are phylogenetically related to mammalian podocytes and insect nephrocytes. A possible secretion pathway of respiratory proteins that includes a transfer mechanism of vesicles through the diaphragmatic slits is proposed and discussed. We also studied, by electron microscopy, the reaction of rhogocytes in situ to two forms of animal stress: deprivation of food and cadmium contamination of the tank water. Significant cellular reactions to both stressors were observed and documented. Notably, the slit apparatus surface and the number of electron-dense cytoplasmic vesicles increased in response to cadmium stress. Food deprivation led to an increase in hemocyanin production. These observations are also discussed in the framework of using such animals as potential environmental biomarkers.

In vivo and in vitro effects of antioxidant compounds and PPAR γ modulators on rainbow trout oxidative stress and lipid metabolism.

The aquafeed use of raw plant materials, as protein and lipid sources, has been considered and approved as a sustainable alternative to fish products (fish meal and oils) because the current trend to use high-lipid diets has been shown to induce undesirable increase in fat depots or further physiological alterations, such as induction of oxidative stress. In the aquaculture perspective, the addition of natural substances with antioxidant properties is an emerging strategy for protecting biological systems and foodstuffs from oxidative damage. Among natural substances, hydroxytyrosol (HT) and caffeic acid (CA) have attracted considerable attention as food antioxidant additives and modulators of physiological and molecular pathways involved in energy metabolism and adiposity. The aim of this study was to evaluate the effects of CA and HT on lipid metabolism and oxidative stress of rainbow trout (Oncorhynchus mykiss). In vitro results showed the potential anti-obesogenic effects of the compounds CA and HT on the adipose tissue of the rainbow trout. To support these data, in vitro assays performed (MTT, ORO, immunofluorescence) resulted in accordance among them; only results from proliferating cell nuclear antigen (PCNA) assay were not significant. In vivo results showed a possible anti-obesogenic effect of CA in liver and HT in adipose tissue. Regarding oxidative stress, we could hypothesize a possible anti-oxidant role of CA in liver.

Role of complement and perspectives for intervention in ischemia-reperfusion damage

Reperfusion of an organ following prolonged ischemia instigates the pro-inflammatory and pro-coagulant response of ischemia / reperfusion (IR) injury. IR injury is a wide-spread pathology, observed in many clinically relevant situations, including myocardial infarction, stroke, organ transplantation, sepsis and shock, and cardiovascular surgery on cardiopulmonary bypass. Activation of the classical, alternative, and lectin complement pathways and the generation of the anaphylatoxins C3a and C5a lead to recruitment of polymorphonuclear leukocytes, generation of radical oxygen species, up-regulation of adhesion molecules on the endothelium and platelets, and induction of cytokine release. Generalized or pathway-specific complement inhibition using protein-based drugs or low-molecular-weight inhibitors has been shown to significantly reduce tissue injury and improve outcome in numerous in-vitro, ex-vivo, and in-vivo models. Despite the obvious benefits in experimental research, only few complement inhibitors, including C1-esterase inhibitor, anti-C5 antibody, and soluble complement receptor 1, have made it into clinical trials of IR injury. The results are mixed, and the next objectives should be to combine knowledge and experience obtained in the past from animal models and channel future work to translate this into clinical trials in surgical and interventional reperfusion therapy as well as organ transplantation.

Inhibition of direct and indirect TLR-mediated activation of human NK cells by low molecular weight dextran sulfate

NK cells express toll-like receptors (TLR) that recognize conserved pathogen or damage associated molecular patterns and play a fundamental role in innate immunity. Low molecular weight dextran sulfate (DXS), known to inhibit the complement system, has recently been reported by us to inhibit TLR4-induced maturation of human monocyte-derived dendritic cells (MoDC). In this study, we investigated the capability of DXS to interfere with human NK cell activation triggered directly by TLR2 agonists or indirectly by supernatants of TLR4-activated MoDC. Both TLR2 agonists and supernatants of TLR4-activated MoDC activated NK cells phenotypically, as demonstrated by the analysis of NK cell activation markers (CD56, CD25, CD69, NKp30, NKp44, NKp46, DNAM-1 and NKG2D), and functionally as shown by increased NK cell degranulation (CD107a surface expression) and IFN-gamma secretion. DXS prevented the up-regulation of NK cell activation markers triggered by TLR2 ligands or supernatants of TLR4-activated MoDC and dose-dependently abrogated NK cell degranulation and IFN-gamma secretion. In summary our results suggest that DXS may be a useful reagent to inhibit the direct and indirect TLR-mediated activation of NK cells.

Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic stable heart failure. The present position paper aims to provide the practical recommendations on the core components and goals of CR intervention in different cardiovascular conditions, to assist in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all patients eligible. Thus a novel, disease-oriented document has been generated, where all components of CR for cardiovascular conditions have been revised, presenting both well-established and controversial aspects. A general table applicable to all cardiovascular conditions and specific tables for each clinical disease have been created and commented.

A mathematical model of regional citrate anticoagulation in hemodialysis

Regional citrate anticoagulation (RCA) during hemodialysis (HD) has several advantages over heparin anticoagulation, but calcium (Ca) derangements are a major concern necessitating repeated monitoring of systemic ionized Ca (Ca(2+)). We developed a mathematical model of Ca and citrate (Ci) kinetics during RCA.

The targeting of plasmalemmal ceramide to mitochondria during apoptosis

Ceramide is a key lipid mediator of cellular processes such as differentiation, proliferation, growth arrest and apoptosis. During apoptosis, ceramide is produced within the plasma membrane. Although recent data suggest that the generation of intracellular ceramide increases mitochondrial permeability, the source of mitochondrial ceramide remains unknown. Here, we determine whether a stress-mediated plasmalemmal pool of ceramide might become available to the mitochondria of apoptotic cells. We have previously established annexin A1--a member of a family of Ca(2+) and membrane-binding proteins--to be a marker of ceramide platforms. Using fluorescently tagged annexin A1, we show that, upon its generation within the plasma membrane, ceramide self-associates into platforms that subsequently invaginate and fuse with mitochondria. An accumulation of ceramide within the mitochondria of apoptotic cells was also confirmed using a ceramide-specific antibody. Electron microscopic tomography confirmed that upon the formation of ceramide platforms, the invaginated regions of the plasma membrane extend deep into the cytoplasm forming direct physical contacts with mitochondrial outer membranes. Ceramide might thus be directly transferred from the plasma membrane to the mitochondrial outer membrane. It is conceivable that this "kiss-of-death" increases the permeability of the mitochondrial outer membrane thereby triggering apoptosis.

The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge

Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, followed by biennial refresher courses. Currently, both standardized ERC advanced life support (ALS) provider courses and conventional refresher courses are offered. This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005.

Performance of the pediatric-sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children

This prospective, randomized, controlled trial compares the performance of the pediatric i-gel (Intersurgical Ltd., Wokingham, United Kingdom) with the Ambu AuraOnce laryngeal mask (Ambu A/S, Ballerup, Denmark) in anesthetized and ventilated children.