Einthoven dissertation prizes 2014

For the 26th time in a row the Interuniversity Cardiology Institute of the Netherlands (ICIN-Netherlands Heart Institute) and the Netherlands Society of Cardiology (NVVC) have supported the competition for the best three cardiovascular PhD theses, published in the year 2014 [1–3]. The dissertation prize carries the name of one of the greatest Dutchmen in the history of cardiovascular medicine, Willem Einthoven, who in 1902 for the first time recorded the human ECG, for which he received the Nobel Prize in 1924 [4].This time the jury received a total of 28 PhD dissertations published in 2014. The jury members were very much impressed by the high scientific quality of the PhD fellows. The ultimate selection was based on a combination of several parameters: the curriculum vitae of the candidate, the scientific originality of the PhD thesis and its relevance for the cardiovascular field. In addition, several objective bibliometric parameters were used: (1) the number of articles in first-rate journals both in PubMed and the Web of Science (WOS), (2) the number of citations in WOS, (3) the Hirsch index and (4) the contribution as a first author (or shared first author).Based on a combination of these results, the jury finally selected three nominees: K.Y. van Spaendonck-Zwarts (University Medical Centre Groningen), N.M. van Mieghem (Erasmus Medical Centre, Rotterdam) and W.J. Dewilde (Sint Antonius Hospital, Nieuwegein).The members of the jury were: J.W. Deckers (Director CVOI), S. Heymans (ICIN professor), A. Mosterd (Chairman WCN), M.J. Schalij (Chairman Concilium NVVC) and V.A. Umans (President NVVC).The three candidates presented their Ph.D. theses at the annual spring meeting of the NVVC, held at the Congress Centre “De Leeuwenhorst” in Noordwijkerhout, 9–10 April 2015. Based on the quality of the presentation, the audience determined the ranking of the laureates. Mrs. dr. K.Y. van Speandonck-Zwarts received the third prize, dr. N.M. van Mieghem the second prize, and dr. W.J. Dewilde the first prize. We like to congratulate the three winners with their excellent PhD Theses. Summaries of the three nominated PhD theses are given below.     

A comparison of four pair-wise sequence alignment methods

Protein sequence alignment has become an essential task in modern molecular biology research. A number of alignment techniques have been documented in literature and their corresponding tools are made available as freeware and commercial software. The choice and use of these tools for sequence alignment through the complete interpretation of alignment results is often considered non-trivial by end-users with limited skill in Bioinformatics algorithm development. Here, we discuss the comparison of sequence alignment techniques based on dynamic programming (N-W, S-W) and heuristics (LFASTA, BL2SEQ) for four sets of sequence data towards an educational purpose. The analysis suggests that heuristics based methods are faster than dynamic programming methods in alignment speed.     

Native-unlike Long-lived Intermediates along the Folding Pathway of the Amyloidogenic Protein ��2-Microglobulin Revealed by Real-time Two-dimensional NMR

β2-microglobulin (β2m), the light chain of class I major histocompatibility complex, is responsible for the dialysis-related amyloidosis and, in patients undergoing long term dialysis, the full-length and chemically unmodified β2m converts into amyloid fibrils. The protein, belonging to the immunoglobulin superfamily, in common to other members of this family, experiences during its folding a long-lived intermediate associated to the trans-to-cis isomerization of Pro-32 that has been addressed as the precursor of the amyloid fibril formation. In this respect, previous studies on the W60G β2m mutant, showing that the lack of Trp-60 prevents fibril formation in mild aggregating condition, prompted us to reinvestigate the refolding kinetics of wild type and W60G β2m at atomic resolution by real-time NMR. The analysis, conducted at ambient temperature by the band selective flip angle short transient real-time two-dimensional NMR techniques and probing the β2m states every 15 s, revealed a more complex folding energy landscape than previously reported for wild type β2m, involving more than a single intermediate species, and shedding new light into the fibrillogenic pathway. Moreover, a significant difference in the kinetic scheme previously characterized by optical spectroscopic methods was discovered for the W60G β2m mutant.     

Standardised pre-hospital care of acute myocardial infarction patients: MISSION! guidelines applied in practice

Background. To improve acute myocardial infarction (AMI) care in the region ‘Hollands-Midden’ (the Netherlands), a standardised guideline-based care program was developed (MISSION!). This study aimed to evaluate the outcome of the pre-hospital part of the MISSION! program and to study potential differences in pre-hospital care between four areas of residency. Methods. Time-to-treatment delays, AMI risk profile, cardiac enzymes, hospital stay, in-hospital mortality, and pre-AMI medication was evaluated in consecutive AMI patients (n=863, 61±13years, 75% male) transferred to the Leiden University Medical Center for primary percutaneous coronary intervention (PCI). Results. Median time interval between onset of symptoms and arrival at the catheterisation laboratory was 150 (interquartile range [IQR] 101-280) minutes. The alert of emergency services to arrival at the hospital time was 48 (IQR 40-60) minutes and the door-to-catheterisation laboratory time was 23 (IQR 13-42) minutes. Despite significant regional differences in ambulance transportation times no difference in total time from onset of symptoms to arrival at the catheterisation room was found. Peak troponin T was 3.33 (IQR 1.23-7.04) µg/l, hospital stay was 2 (IQR 2-3) days and in-hospital mortality was 2.3%. Twelve percent had 0 known risk factors, 30% had one risk factor, 45% two to three risk factors and 13% had four or more risk factors. No significant differences were observed for AMI risk profiles and medication pre-AMI. Conclusions. This study shows that a standardised regional AMI treatment protocol achieved optimal and uniformly distributed pre-hospital performance in the region ‘Hollands-Midden’, resulting in minimal time delays regardless of area of residence. Hospital stay was short and in-hospital mortality low. Of the patients, 88% had ≥1 modifiable risk factor. (Neth Heart J 2010;18:408-15.)     

Ovariectomy and 17β-estradiol replacement in rats and mice: a visual demonstration

Estrogens are a family of female sexual hormones with an exceptionally wide spectrum of effects. When rats and mice are used in estrogen research they are commonly ovariectomized in order to ablate the rapidly cycling hormone production, replacing the 17β-estradiol exogenously. There is, however, lack of consensus regarding how the hormone should be administered to obtain physiological serum concentrations. This is crucial since the 17β-estradiol level/administration method profoundly influences the experimental results. We have in a series of studies characterized the different modes of 17β-estradiol administration, finding that subcutaneous silastic capsules and per-oral nut-cream Nutella are superior to commercially available slow-release pellets (produced by the company Innovative Research of America) and daily injections in terms of producing physiological serum concentrations of 17β-estradiol. Amongst the advantages of the nut-cream method, that previously has been used for buprenorphine administration, is that when used for estrogen administration it resembles peroral hormone replacement therapy and is non-invasive. The subcutaneous silastic capsules are convenient and produce the most stable serum concentrations. This video article contains step-by-step demonstrations of ovariectomy and 17β-estradiol hormone replacement by silastic capsules and peroral Nutella in rats and mice, followed by a discussion of important aspects of the administration procedures.     

全球双特异性抗体药物研发格局分析*

过去十年,全球双特异性抗体研发取得了突破性进展,4款产品获批上市,多个产品进入临床及临床前研究。双抗具有区别于单抗的独特生物学机制,有望成为针对癌症、自身免疫和传染病的下一代生物疗法,但双抗药物的开发更具复杂性,有着更高的技术壁垒。通过对全球双抗总体研发进展、企业研发格局、产品研发进展等角度分析,以期为相关企业的双抗研发方向选择及地区产业决策提供参考。     

聚果榕小蜂种内竞争的化学信息调节机制初探

昆虫种内普遍存在着对于交配机会、产卵场所以及食物资源的竞争, 而具信息交流作用的化学物质在调节种内竞争中起着重要的作用。聚果榕(Ficus racemosa)的传粉榕小蜂Ceratosolen fusciceps存在着种内竞争, 我们通过控制榕小蜂在果内能否互相接触(同时、间隔放蜂)的方法进行放蜂实验, 同时用瘿花比例、种子比例、败育花数量和榕小蜂子代数量作为榕小蜂种内竞争的指标, 并用顶空固相微萃取装置和气相色谱–质谱联用仪鉴定分析榕小蜂在雌花期进果前后, 榕果和榕小蜂中的差异性挥发性成分, 重点探讨这些物质在调节榕小蜂种内竞争中的作用。研究结果表明, 同时放蜂所产生的瘿花比例、种子比例和榕小蜂子代数量相较于间隔放蜂显著偏低, 而败育花数量则显著偏多; 化学鉴定结果表明榕小蜂进果前后榕树的挥发性物质的种类存在差异, 在鉴定出来的22种差异物质中, 部分物质对其他种昆虫有抑制产卵的作用。因此, 信息化学物质对榕小蜂的行为可能起着重要的调节作用, 这种作用对于榕小蜂子代和寄主榕树适合度可能都具有重要影响。     

An economic perspective on personalized medicine

The concept of personalized medicine not only promises to enhance the life of patients and increase the quality of clinical practice and targeted care pathways, but also to lower overall healthcare costs through early-detection, prevention, accurate risk assessments and efficiencies in care delivery. Current inefficiencies are widely regarded as substantial enough to have a significant impact on the economies of major nations like the US and China, and, therefore the world economy. A recent OECD report estimates healthcare expenditure for some of the developed western and eastern nations to be anywhere from 10% to 18%, and growing (with the US at the highest). Personalized medicine aims to use state-of-the-art genomic technologies, rich medical record data, tissue and blood banks and clinical knowledge that will allow clinicians and payors to tailor treatments to individuals, thereby greatly reducing the costs of ineffective therapies incurred through the current trial and error clinical paradigm. Pivotal to the field are drugs that have been designed to target a specific molecular pathway that has gone wrong and results in a diseased condition and the diagnostic tests that allow clinicians to separate responders from non-responders. However, the truly personalized approach in medicine faces two major problems: complex biology and complex economics; the pathways involved in diseases are quite often not well understood, and most targeted drugs are very expensive. As a result of all current efforts to translate the concepts of personalized healthcare into the clinic, personalized medicine becomes participatory and this implies patient decisions about their own health. Such a new paradigm requires powerful tools to handle significant amounts of personal information with the approach to be known as “P4 medicine”, that is predictive, preventive, personalized and participatory. P4 medicine promises to increase the quality of clinical care and treatments and will ultimately save costs. The greatest challenges are economic, not scientific.     

Archetype, adaptation and the mammalian heart

Forty years ago, we started our quest for ‘The Holy Grail’ of understanding ventricular rate control and rhythm in atrial fibrillation (AF). We therefore studied the morphology and function of a wide range of mammalian hearts. From mouse to whale, we found that all hearts show similar structural and functional characteristics. This suggests that the mammalian heart remained well conserved during evolution and in this aspect it differs from other organs and parts of the mammalian body. The archetype of the mammalian heart was apparently so successful that adaptation by natural selection (evolution) caused by varying habitat demands, as occurred in other organs and many other aspects of mammalian anatomy, bypassed the heart. The structure and function of the heart of placental mammals have thus been strikingly conserved throughout evolution. The changes in the mammalian heart that did take place were mostly adjustments (scaling), to compensate for variations in body size and shape. A remarkable scaling effect is, for instance, the difference in atrioventricular (AV) conduction time, which is vital for optimal cardiac function in all mammals, small and large. Scaling of AV conduction takes place in the AV node (AVN), but its substrate is unknown. This sheds new light on the vital role of the AVN in health and disease. The AVN is master and servant of the heart at the same time and is of salient importance for our understanding of supraventricular arrhythmias in humans, especially AF. In Information Technology a software infra-structure called ‘enterprise service bus’ (ESB) may provide understanding of the mammalian heart’s conservation during evolution. The ESB is quite unspecific (and thus general) when compared with the specialised components it has to support. For instance, one of the functions of an ESB is the routing of messages between system nodes. This routing is independent and unaware of the content of the messages. The function of the heart is likewise independent and unaware of the routing of blood (oxygen) and of the specialised components of the mammalian body it has to support. Conclusions Evolution seems to have bypassed the heart, which is in contrast to the sometimes similarly looking, but yet quite differently functioning of the other organs of the mammalian body.     

Plans of mice and men: from bench science to science policy

The transition from bench science to science policy is not always a smooth one, and my journey stretched as far as the unemployment line to the hallowed halls of the U.S. Capitol. While earning my doctorate in microbiology, I found myself more interested in my political activities than my experiments. Thus, my science policy career aspirations were born from merging my love of science with my interest in policy and politics. After receiving my doctorate, I accepted the Henry Luce Scholarship, which allowed me to live in South Korea for 1 year and delve into the field of science policy research. This introduction into science policy occurred at the South Korean think tank called the Science and Technology Policy Institute (STEPI). During that year, I used textbooks, colleagues, and hands-on research projects as my educational introduction into the social science of science and technology decision-making. However, upon returning to the United States during one of the worst job markets in nearly 80 years, securing a position in science policy proved to be very difficult, and I was unemployed for five months. Ultimately, it took more than a year from the end of the Luce Scholarship to obtain my next science policy position with the American Society for Microbiology Congressional Fellowship. This fellowship gave me the opportunity to work as the science and public health advisor to U.S. Senator Harry Reid. While there were significant challenges during my transition from the laboratory to science policy, those challenges made me tougher, more appreciative, and more prepared to move from working at the bench to working in the field of science policy.