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Abstract Background Dyslipidemia has been associated with reduced bone mineral density and osteoporotic fractures, but the relation between lipid and bone metabolism remains poorly understood. Analysing the effects of lipoprotein subclasses on bone turnover may provide valuable insights into this association. We therefore examined whether lipoprotein subclasses, measured by proton nuclear magnetic resonance (1H-NMR) spectroscopy, are associated with bone turnover markers (BTMs) and with the ultrasound-based bone stiffness index. Methods Data from 1.349 men and 1.123 women, who participated in the population-based Study of Health in Pomerania-TREND were analysed. Serum intact amino-terminal propeptide of type I procollagen (P1NP, bone formation) and carboxy-terminal telopeptide of type I collagen (CTX, bone resorption) concentrations were measured. Associations between the lipoprotein data and the BTMs or the stiffness index were investigated using linear regression models. Results The triglyceride or cholesterol content in very-low-density lipoprotein and intermediate-density lipoprotein particles was inversely associated with both BTMs, with effect estimates being slightly higher for CTX than for P1NP. The triglyceride content in low-density lipoprotein and high-density lipoprotein particles and the Apo-A2 content in high-density lipoprotein particles was further inversely associated with the BTMs. Associations with the ultrasound-based bone stiffness index were absent. Conclusions Consistent inverse associations of triglycerides with bone turnover were observed, which argue for a protective effect on bone health, at least in the normal range. Yet, the presented associations did not translate into effects on the ultrasound-based bone stiffness. Further, there was no relevant gain of information by assessing the lipoprotein subclasses. Nevertheless, our study highlights the close relations between lipid and bone metabolism in the general population.

Background: Vulnerability to infectious diseases in refugees is dependent on country of origin, flight routes, and conditions. Information on specific medical needs of different groups of refugees is lacking. We assessed the prevalence of infectious diseases, immunity to vaccine-preventable diseases, and chronic medical conditions in children, adolescents, and adult refugees from Ukraine who arrived in Germany in 2022. Methods: Using different media, we recruited Ukrainian refugees at 13 sites between 9–12/2022. An antigen test for acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, serologies for a range of vaccine-preventable diseases, as well as interferon gamma release assays (IGRAs) for tuberculosis (TB), and SARS-CoV-2 were performed. We assessed personal and family history of chronic medical conditions, infectious diseases, vaccination status, and conditions during migration. Results: Overall, 1793 refugees (1401 adults and 392 children/adolescents) were included. Most participants were females (n = 1307; 72·3%) and from Eastern or Southern Ukraine. TB IGRA was positive in 13% (n = 184) of the adults and in 2% (n = 7) of the children.Serology-based immunological response was insufficient in approximately 21% (360/1793) of the participants for measles, 32% (572/1793) for diphtheria, and 74% (1289/1793) for hepatitis B. Conclusions: We show evidence of low serological response to vaccine-preventable infections and increased LTBI prevalence in Ukrainian refugees. These findings should be integrated into guidelines for screening and treatment of infectious diseases in migrants and refugees in Germany and Europe. Furthermore, low immunity for vaccine-preventable diseases in Ukrainians independent of their refugee status, calls for tailor-made communication efforts.

This contribution to the Symposium on Ecosystem Restoration and EU Law assesses the underground protection schemes suggested by the European Green Deal (EGD) for the European Union (EU). By addressing the overground bias that environmental laws and policies have traditionally suffered from, the analysis engages with the EU Soil Strategy for 2030, its ‘Mission “A Soil Deal for Europe”’, and the proposed 2023 Soil Monitoring Directive. The Article explores how and to what extent this agenda for the preservation and restoration of soils is legally reordering the European ground and, simultaneously, how and to what extent it is regrounding the European legal order.

The programme of the German Congress for Laboratory Medicine 2022 was essentially designed by the divisions of the German Society for Clinical Chemistry and Laboratory Medicine (DGKL). Almost all chairpersons of the divisions organised a 90-min symposium on current topics, i.e. conceptualised the symposia and invited speakers. For this article all chairpersons summarised the lectures that were given within the symposia. The DGKL’s work is structured into 5 areas of expertise: Molecular Diagnostics, Learning & Teaching, Quality & Management, Laboratory & Diagnostics and Biobanks & Informatics. The areas of expertise are in turn subdivided into divisions. About the history of the establishment of this new structure within the DGKL you can find information in the editorial of this issue.

Objectives: Throughout the SARS-CoV-2 pandemic, Germany like other countries lacked adaptive population-based panels to monitor the spread of epidemic diseases. Methods: To fill a gap in population-based estimates needed for winter 2022/23 we resampled in the German SARS-CoV-2 cohort study MuSPAD in mid-2022, including characterization of systemic cellular and humoral immune responses by interferon-γ-release assay (IGRA) and CLIA/IVN assay. We were able to confirm categorization of our study population into four groups with differing protection levels against severe COVID-19 courses based on literature synthesis. Using these estimates, we assessed potential healthcare burden for winter 2022/23 in different scenarios with varying assumptions on transmissibility, pathogenicity, new variants, and vaccine booster campaigns in ordinary differential equation models. Results: We included 9921 participants from eight German regions. While 85% of individuals were located in one of the two highest protection categories, hospitalization estimates from scenario modeling were highly dependent on viral variant characteristics ranging from 30-300% compared to the 02/2021 peak. Our results were openly communicated and published to an epidemic panel network and a newly established modeling network. Conclusions: We demonstrate feasibility of a rapid epidemic panel to provide complex immune protection levels for inclusion in dynamic disease burden modeling scenarios.

Even though reliable glucose concentration measurements are essential in diagnosis and monitoring of diabetes mellitus, external quality assurance based on mandatory reference method values can only be conducted to a limited extent for measurements in whole blood. The reason is the lack of stabilized whole blood materials suitable for the application in glucose measurement devices used in near-patient testing.

BackgroundElevated cardiac troponin levels in blood are associated with increased risk of cardiovascular diseases and mortality. Cardiac troponin levels are heritable, but their genetic architecture remains elusive.MethodsWe conducted a transethnic genome-wide association analysis on high-sensitivity cTnT (cardiac troponin T; hs-cTnT) and high-sensitivity cTnI (cardiac troponin I; hs-cTnI) levels in 24 617 and 14 336 participants free of coronary heart disease and heart failure from 6 population-based cohorts, followed by a series of bioinformatic analyses to decipher the genetic architecture of hs-cTnT and hs-cTnI.ResultsWe identified 4 genome-wide significant loci for hs-cTnT including a novel locus rs3737882 in PPFIA4 and 3 previously reported loci at NCOA2, TRAM1, and BCL2. One known locus at VCL was replicated for hs-cTnI. One copy of C allele for rs3737882 was associated with a 6% increase in hs-cTnT levels (minor allele frequency, 0.18; P=2.80×10-9). We observed pleiotropic loci located at BAG3 and ANO5. The proportions of variances explained by single-nucleotide polymorphisms were 10.15% and 7.74% for hs-cTnT and hs-cTnI, respectively. Single-nucleotide polymorphisms were colocalized with BCL2 expression in heart tissues and hs-cTnT and with ANO5 expression in artery, heart tissues, and whole blood and both troponins. Mendelian randomization analyses showed that genetically increased hs-cTnT and hs-cTnI levels were associated with higher odds of atrial fibrillation (odds ratio, 1.38 [95% CI, 1.25-1.54] for hs-cTnT and 1.21 [95% CI, 1.06-1.37] for hs-cTnI).ConclusionsWe identified a novel genetic locus associated with hs-cTnT in a multiethnic population and found that genetically regulated troponin levels were associated with atrial fibrillation.

Abstract Introduction Immunological alterations associated with increased susceptibility to infection are an essential aspect of stroke pathophysiology. Several immunological functions of adipose tissue are altered by obesity and are accompanied by chronic immune activation. The purpose of this study was to examine immune function (monocytes, granulocytes, cytokines) as a function of body mass index (BMI: 1st group: 25; 2nd group: 25 BMI 30; 3rd group: 30) and changes in body weight post stroke. Method Fat status was assessed using standardized weight measurements on days 1, 2, 3, 4, 5, and 7 after ischemic stroke in a cohort of 40 stroke patients and 16 control patients. Liver fat and visceral fat were assessed by MRI on day 1 or 2 [I] and on day 5 or 7 [II]. Leukocyte subpopulations in peripheral blood, cytokines, chemokines, and adipokine concentrations in sera were quantified. In a second cohort (stroke and control group, n = 17), multiple regression analysis was used to identify correlations between BMI and monocyte and granulocyte subpopulations. Results Weight and fat loss occurred from the day of admission to day 1 after stroke without further reduction in the postischemic course. No significant changes in liver or visceral fat were observed between MRI I and MRI II. BMI was inversely associated with IL-6 levels, while proinflammatory cytokines such as eotaxin, IFN-β, IFN -γ and TNF-α were upregulated when BMI increased. The numbers of anti-inflammatory CD14+CD16+ monocytes and CD16+CD62L− granulocytes were reduced in patients with higher BMI values, while that of proinflammatory CD16dimCD62L+ granulocytes was increased. Conclusion A small weight loss in stroke patients was detectable. The data demonstrate a positive correlation between BMI and a proinflammatory poststroke immune response. This provides a potential link to how obesity may affect the clinical outcome of stroke patients.

Fused filament fabrication (FFF) is one of the most widely used additive manufacturing processes and allows the production of complex parts. FFF can manufacture lightweight and strong structural components when processing high-performance carbon-fiber-reinforced thermoplastics. Although the process feasibility for printing 20% short-carbon-fiber reinforced PEEK was already demonstrated in the literature, a systematic study addressing the influence of printing parameters on different loading conditions is still lacking. Therefore, the present study investigates the influence of selected FFF parameters – i.e., layer height (LH), printing temperature (PT) and printing speed (PS) – on three mechanical properties: tensile (UTS), bending (UBS), and impact (UIS) ultimate strengths. The analyzed samples were printed and tested according to a central composite design of experiments, and each parameter's individual and combined effects were assessed by analysis of variance (ANOVA). Different regression models were obtained for each test, allowing the optimization of the parameters for each condition and resulting in three distinct optimized parameter sets. The relationship between parameters and microstructure was also assessed via fractography analyses, showing that lower LH and PS reduce the number and size of volumetric defects observed within the printed parts, as lower values improve interlayer cohesion. Contrarily, PT showed that average values (around 385 °C) benefit the microstructure the most, as higher temperatures result in larger defects and low temperatures reduce interlayer cohesion. Finally, the contour plots of the three produced models were overlaid to identify a universal parameter set capable of simultaneously correlating and maximizing all three performances. This procedure allowed the identification of the following optimized values: LH of 0.1 mm, PT of 385 °C and PS of 17.5 mm/s, resulting in the experimental UTS, UBS and UIS values of 116.7 ± 5 MPa, 167.2 ± 11 MPa and 28.2 ± 3 kJ/m2.

Polyetheretherketone (PEEK) is considered a ‘gold-standard’ material choice for cranial bone reconstruction. The introduction of additive manufacturing (AM) into the pipeline for patient specific cranial implant (PSCI) fabrication could accelerate supply chain needs and improve patient outcomes. Fused filament fabrication (FFF), a material extrusion-based technology, is a much-researched process due to its accessibility and ease of use. However, the quality of PEEK processed by FFF is highly affected by the applied printing profile. Therefore, in this study, the effects of printing parameters such as build orientation and air flow temperature on mechanical performance (cyclic and impact tests) and implant quality (characterisation of surface topography, discoloration and crystallinity) were analysed and compared with a commercial milled PEEK implant. It has been found that horizontally printed implants show higher mechanical integrity compared to implants printed upright or tilted by 45°, but obtain lower surface quality. In addition, lower air flow temperatures lead to strong implant discolorations due to high amounts of amorphousness, which further result in high absorbed energies during impact as well as large deformations until complete failure. The best results from a mechanical point of view were achieved with PSCIs printed at a build orientation of 180°, an air flow temperature of 210 °C, a shell number of 3, a layer height of 0.15 mm, a printing speed of 50 mm/min, a rectilinear ±45° infill pattern and an implant thickness of 5 mm. However, the surface quality of implants produced this way is not completely satisfactory, and the arrangement of the support structures must be further improved.

PurposeStatic stretch training (SST) with long stretching durations seems to be sufficient to increase flexibility, maximum strength (MSt) and muscle thickness (MTh). However, changes in contraction properties and effects on muscle damage remain unclear. Consequently, the objective of the study was to investigate the effects of a 6-week self-performed SST on MSt, MTh, contractile properties, flexibility, and acute response of creatine kinase (CK) 3 days after SST.MethodsForty-four participants were divided into a control (CG, n = 22) and an intervention group (IG, n = 22), who performed a daily SST for 5 min for the lower limb muscle group. While isometric MSt was measured in leg press, MTh was examined via sonography and flexibility by functional tests. Muscle stiffness and contraction time were measured by tensiomyography on the rectus femoris. Additionally, capillary blood samples were taken in the pretest and in the first 3 days after starting SST to measure CK.ResultsA significant increase was found for MSt (p 0.310). Scheffé post hoc test did not show significant differences between the rectus femoris muscle inter- and intragroup comparisons for MTh nor for muscle stiffness and contraction time (p > 0.05, η2 0.05, η2 = 0.032.DiscussionIn conclusion, the increase in MSt cannot be exclusively explained by muscular hypertrophy or the increased CK-related repair mechanism after acute stretching. Rather, neuronal adaptations have to be considered. Furthermore, daily 5-min SST over 6 weeks does not seem sufficient to change muscle stiffness or contraction time. Increases in flexibility tests could be attributed to a stretch-induced change in the muscle–tendon complex.

Nonhuman interests are today routinely articulated in a register of 'rights'. 'Rights of nature' and 'animal rights' have expanded the vernacular of liberal rights beyond the human subject, thereby arguably entering the realm of 'post-human rights'. For such rights to be enforced, however, they must be recognised within a legal order and mediated by human subjects speaking on behalf of nonhuman 'right-holders'. This article focuses on the modes of representation and subjectification of nonhumans – whether natural entities, animals, or ecosystems – that underpin this reconfiguration. While granting rights to nonhumans de-centres the human figure at the heart of liberal legal orders, it remains focused on the category of the subject. Taking on the questions of the symposium on 'After Rights? Politics, Ethics, Aesthetics', I argue that granting rights to nonhumans might well enable a move beyond or 'after human rights', but not 'after human rights'. To think the possibility of an 'after rights', I turn to practices of sociality as articulated in works of critical Black studies that refuse the category of the subject as such. What emerges are modes of living in escape from violent subjections to racialised, colonial, and liberal inscriptions of worlding through 'rights', whether humans or nonhumans. [ABSTRACT FROM AUTHOR]