Is There a Need for Vitamin D Supplements During Summer Time in Northern Germany? A Study of Hospitalised Fracture Patients.

Background/objectives: Vitamin D is a key factor in bone metabolism, especially in patients who have suffered fractures, a group in need of a healthy bone metabolism. In Germany, a 70-year-old person requires 20 min of sun exposure daily for sufficient endogenous production in April. While this appears to be a sufficient period on paper, it raises the question of whether sufficient synthesis is achieved, given the time and the implementation of skin cancer prevention.

[Comparative evaluation of trabecular bone density in Hounsfield units in the lumbar native CT cross-section for osteoporosis diagnosis and fracture risk determination by different examiners].

Background: An increasing loss of bone mineral density (BMD) in the axial skeleton leads to osteoporosis and fractures, with an increase found in the thoracic and thoracolumbar regions.

Research Question: The extent to which an examiner-independent assessment of the extent of osteoporosis and fracture risk determination is possible by determining the trabecular density in Hounsfield units (HU) in the spine should be examined. The next question was whether quantitative BMD values can be calculated from the HU values.

Biomechanical Analysis of Diffuse Idiopathic Skeletal Hyperostosis and Osteoporosis: Vertebral Fracture Risk Evaluation Using Finite Element Modeling with Clinical and Micro-CT Data in an Elderly Donor.

Biomechanical analysis of spinal structures is crucial in the evaluation of injuries, the risk of fracture, and age-related changes. Osteoporotic vertebrae are very fragile and therefore constitute a serious risk, especially in the elderly. At present, clinically relevant decision making in fracture risk assessment is predicated upon finite element analysis (FEA), which utilizes high-resolution computed tomography (CT) scans from clinical practice alongside micro-CT scans from laboratory settings.

[Impact of legal documentation requirements on physician practice using a regional specialty hospital as an example: an inventory].

Background:  Doctors in German hospitals are critical of their working conditions. They complain about long working hours, inadequate remuneration for their work, poor training and development opportunities, and increasing time spent on administrative tasks. As these points of criticism are largely based on subjective perception, in the present study we documented in detail the workflows of physicians in a major regional hospital, determined the time taken for the workflows, and performed a statistical evaluation of the data.

Outcomes of the EMDataResource cryo-EM Ligand Modeling Challenge.

The EMDataResource Ligand Model Challenge aimed to assess the reliability and reproducibility of modeling ligands bound to protein and protein-nucleic acid complexes in cryogenic electron microscopy (cryo-EM) maps determined at near-atomic (1.9-2.5 Å) resolution.

Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture.

Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches.

Vaccination with structurally adapted fungal protein fibrils induces immunity to Parkinson's disease.

The pathological misfolding and aggregation of soluble α-synuclein into toxic oligomers and insoluble amyloid fibrils causes Parkinson's disease, a progressive age-related neurodegenerative disease for which there is no cure. HET-s is a soluble fungal protein that can form assembled amyloid fibrils in its prion state. We engineered HET-s(218-298) to form four different fibrillar vaccine candidates, each displaying a specific conformational epitope present on the surface of α-synuclein fibrils.

Cryo-EM structures of lipidic fibrils of amyloid-β (1-40).

Alzheimer's disease (AD) is a progressive and incurable neurodegenerative disease characterized by the extracellular deposition of amyloid plaques. Investigation into the composition of these plaques revealed a high amount of amyloid-β (Aβ) fibrils and a high concentration of lipids, suggesting that fibril-lipid interactions may also be relevant for the pathogenesis of AD. Therefore, we grew Aβ40 fibrils in the presence of lipid vesicles and determined their structure by cryo-electron microscopy (cryo-EM) to high resolution.

Outcomes of the EMDataResource Cryo-EM Ligand Modeling Challenge.

The EMDataResource Ligand Model Challenge aimed to assess the reliability and reproducibility of modeling ligands bound to protein and protein/nucleic-acid complexes in cryogenic electron microscopy (cryo-EM) maps determined at near-atomic (1.9-2.5 Å) resolution.

Interobserver variability in the determination of bone mineral density in Hounsfield units from differently configured fields of measurement in the cancellous bone of vertebral bodies from elderly body donors.

Background: Due to the absence of suitable diagnostic procedures, osteoporosis (OP) is frequently detected late or not at all. Many elderly persons undergo computed tomographies (CT). The routine determination of Hounsfield units (HU) in bone as a part of these examinations could close a gap here.

Cryo-EM of Aβ fibrils from mouse models find tg-APP fibrils resemble those found in patients with sporadic Alzheimer's disease.

The use of transgenic mice displaying amyloid-β (Aβ) brain pathology has been essential for the preclinical assessment of new treatment strategies for Alzheimer's disease. However, the properties of Aβ in such mice have not been systematically compared to Aβ in the brains of patients with Alzheimer's disease. Here, we determined the structures of nine ex vivo Aβ fibrils from six different mouse models by cryogenic-electron microscopy.

A quality improvement initiative to increase adult ECMO decision-making abilities in a perfusion education program: The use of 3D ECMO simulation.

Introduction: Adult and pediatric ECMO procedures have been increasingly established as conventional life-saving modalities in critical care services across the world. Since 2017, a multidisciplinary team of program advisors for our perfusion education program have aimed to increase cardiovascular perfusion (CVP) student ECMO exposure and improve clinical decision-making. In this QI intervention, the use of 3D computer-based simulation was assessed in establishing a standardized process to improve the diagnosis and treatment of adult ECMO complications among first year CVP students.

Evaluation of bone density and hand grip strength in the course of drug treatment for osteoporosis : A real-world study.

Background: The aim of this clinical investigation was to assess the physical performance in osteoporotic patients undergoing drug treatment (DT) for years by measuring hand grip strength (HGS) and bone mineral density (BMD). A further aim was to detect the time until the occurrence of vertebral fractures (VF) and influencing factors.

Material And Methods: The investigation comprised 346 persons (276 women, 70 men) aged on average 66.

In silico cancer immunotherapy trials uncover the consequences of therapy-specific response patterns for clinical trial design and outcome.

Late-stage cancer immunotherapy trials often lead to unusual survival curve shapes, like delayed curve separation or a plateauing curve in the treatment arm. It is critical for trial success to anticipate such effects in advance and adjust the design accordingly. Here, we use in silico cancer immunotherapy trials - simulated trials based on three different mathematical models - to assemble virtual patient cohorts undergoing late-stage immunotherapy, chemotherapy, or combination therapies.

Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton.

Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae).

Facet Distraction and Dysphagia: A Prospective Evaluation of This Common Postoperative Issue Following Anterior Cervical Spine Surgery.

Study Design: Prospective cohort study.

Objective: Our primary study was to investigate whether the degree of postoperative facet and disk space distraction following anterior cervical discectomy and fusion (ACDF) affects the rate of postoperative dysphagia.

Summary Of Background Data: Although ACDF is safe and well tolerated, postoperative dysphagia remains a common complication.

Comparative outcome of different treatment options for fragility fractures of the sacrum.

Background: Fragility fractures of the sacrum (FFS) have been detected more and more frequently in recent times, and the incidence will continue to increase due to increasing life expectancy. The aim of this study was to compare the clinical outcome of conservative, interventional and surgical treatment of FFS.

Methods: Retrospectively, 292 patients (276 women, 16 men) with confirmed FFS were followed up over a period of 2 years.

Capture of activated dioxygen intermediates at the copper-active site of a lytic polysaccharide monooxygenase.

Metalloproteins perform a diverse array of redox-related reactions facilitated by the increased chemical functionality afforded by their metallocofactors. Lytic polysaccharide monooxygenases (LPMOs) are a class of copper-dependent enzymes that are responsible for the breakdown of recalcitrant polysaccharides oxidative cleavage at the glycosidic bond. The activated copper-oxygen intermediates and their mechanism of formation remains to be established.

[Impact of osteoporosis on physical performance parameters of middle-aged and elderly individuals-a cross-sectional study].

Background: Osteoporosis (OP) in the elderly is accompanied by reduced muscle mass and reduced muscle strength, also known as sarcopenia. This results in functional limitations and a high risk of falls and injuries. The determination of physical performance parameters such as grip strength and trunk strength on the one hand, and balance abilities on the other, provide information about the individual's general neuromuscular condition and serve as an indicator of physical performance in the elderly.

Histomorphometric analysis of osteocyte density and trabecular structure of 92 vertebral bodies of different ages and genders.

Background: Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density - a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies.

Methods: Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072).

The 3D structure of lipidic fibrils of α-synuclein.

α-synuclein misfolding and aggregation into fibrils is a common feature of α-synucleinopathies, such as Parkinson's disease, in which α-synuclein fibrils are a characteristic hallmark of neuronal inclusions called Lewy bodies. Studies on the composition of Lewy bodies extracted postmortem from brain tissue of Parkinson's patients revealed that lipids and membranous organelles are also a significant component. Interactions between α-synuclein and lipids have been previously identified as relevant for Parkinson's disease pathology, however molecular insights into their interactions have remained elusive.

[Sacral fragility fractures: risk factors and outcomes after cement sacroplasty].

Background: The objective of the present study on patients with fragility fractures of the sacrum (FFS) was to assess existing risk factors and clinical outcomes after cement sacroplasty (CSP).

Patients And Methods: 68 patients (64 women, 4 men) with previous FFS were followed up retrospectively. CT and MRI images were used to classify fractures according to Denis et al.

Quaternary structure of patient-homogenate amplified α-synuclein fibrils modulates seeding of endogenous α-synuclein.

Parkinson's disease (PD) and Multiple System Atrophy (MSA) are progressive and unremitting neurological diseases that are neuropathologically characterized by α-synuclein inclusions. Increasing evidence supports the aggregation of α-synuclein in specific brain areas early in the disease course, followed by the spreading of α-synuclein pathology to multiple brain regions. However, little is known about how the structure of α-synuclein fibrils influence its ability to seed endogenous α-synuclein in recipient cells.