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Perera MNMN, Schmidt D, Gibbs WEK, Juodkazis S, Stoddart PR. Influence of the dielectric substrate on the effective optical constants of silver plasmonic films. APPLIED OPTICS 2019; 58:6038-6044. [PMID: 31503924 DOI: 10.1364/ao.58.006038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
The effective optical properties of plasmonic thin films can be used to model the far-field response of nanostructured materials to an incident electromagnetic field. In the present work, optically thin nanostructured silver (Ag) plasmonic films were fabricated on transparent dielectric substrates of soda-lime glass, sapphire, and fused silica using oblique angle deposition. The influence of the underlying dielectric substrate on the effective optical properties of the nanostructured layer was investigated by an ellipsometric-optical model based on Mueller matrix ellipsometry. The wavelength-dependent uniaxial optical responses of the nanostructured Ag films fabricated on sapphire were modeled with three Gaussian and one Tanguy oscillator, representing key optical phenomena over the range from 300 to 1000 nm. In comparison with the same Ag films on glass, the results confirm that the effective optical properties cannot be considered in isolation from the substrate. As expected, the extinction peak associated with the localized surface plasmon resonance was redshifted by approximately 220 nm per unit of the substrate refractive index. Importantly, it was found that the direction of incidence also influences the film behavior, with a substantial redshift in the extinction peak for light directed through the dielectric compared to free-space illumination. This property can have a significant effect on the far-field performance of these films.
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Zaccara G, Schmidt D. Antiepileptic Drugs in Clinical Development: Differentiate or Die? Curr Pharm Des 2019; 23:5593-5605. [PMID: 28799516 DOI: 10.2174/1381612823666170809100524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/02/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Animal models when carefully selected, designed and conducted, are important parts of any translational drug development strategy. However, research of new compounds for patients with drugresistant epilepsies is still based on animal experiments, mostly in rodents, which are far from being a model of chronic human epilepsy and have failed to differentiate the efficacy of new compounds versus standard drug treatment. OBJECTIVE The objective was identification and description of compounds in clinical development in 2016. METHOD Search was conducted from the website of the U.S. National Institutes of Health and from literature. RESULTS Identified compounds have been divided in two groups: 1) compounds initially developed for the treatment of diseases other than epilepsy: biperiden, bumetanide, everolimus, fenfluramine, melatonin, minocycline, verapamil. 2) Compounds specifically developed for the treatment of epilepsy: allopregnanolone, cannabidiol, cannabidivarin, ganaxolone, nalutozan, PF-06372865, UCB0942, and cenobamate. Everolimus, and perhaps, fenfluramine are effective in specific epileptic diseases and may be considered as true disease modifying antiepileptic drugs. These are tuberous sclerosis complex for everolimus and Dravet syndrome for fenfluramine. With the exception of a few other compounds such as cannabinidiol, cannabidivarin and minocycline, the vast majority of other compounds had mechanisms of action which are similar to the mechanism of action of the anti-seizure drugs already in the market. CONCLUSION Substantial improvements in the efficacy, specifically as pharmacological treatment of drug-resistant epilepsy is regarded, are not expected. New drugs should be developed to specifically target the biochemical alteration which characterizes the underlying disease and also include targets that contribute to epileptogenesis in relevant epilepsy models.
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Hunziker L, Radovanovic D, Jeger R, Pedrazzini G, Cuculi F, Urban P, Erne P, Rickli H, Pilgrim T, Hess F, Simon R, Hangartner P, Hufschmid U, Hornig B, Altwegg L, Trummler S, Windecker S, Rueff T, Loretan P, Roethlisberger C, Evéquoz D, Mang G, Ryser D, Müller P, Jecker R, Kistler W, Hongler T, Stäuble S, Freiwald G, Schmid H, Stauffer J, Cook S, Bietenhard K, Roffi M, Wojtyna W, Schönenberger R, Simonin C, Waldburger R, Schmidli M, Federspiel B, Weiss E, Marty H, Weber K, Zender H, Poepping I, Hugi A, Koltai E, Iglesias J, Erne P, Heimes T, Jordan B, Pagnamenta A, Feraud P, Beretta E, Stettler C, Repond F, Widmer F, Heimgartner C, Polikar R, Bassetti S, Iselin H, Giger M, Egger P, Kaeslin T, Fischer A, Herren T, Eichhorn P, Neumeier C, Flury G, Girod G, Vogel R, Niggli B, Yoon S, Nossen J, Stoller U, Veragut U, Bächli E, Weber A, Schmidt D, Hellermann J, Eriksson U, Fischer T, Peter M, Gasser S, Fatio R, Vogt M, Ramsay D, Wyss C, Bertel O, Maggiorini M, Eberli F, Christen S. Twenty-Year Trends in the Incidence and Outcome of Cardiogenic Shock in AMIS Plus Registry. Circ Cardiovasc Interv 2019; 12:e007293. [DOI: 10.1161/circinterventions.118.007293] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Semrau S, Agaimy A, Pavel M, Lubgan D, Schmidt D, Cavallaro A, Golcher H, Grützmann R, Fietkau R. Long-term control with chemoradiation of initially metastatic mixed adenoneuroendocrine carcinoma of the rectum: a case report. J Med Case Rep 2019; 13:82. [PMID: 30902067 PMCID: PMC6431024 DOI: 10.1186/s13256-019-1995-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Mixed adenoneuroendocrine carcinomas are highly malignant tumors with both adenocarcinomatous and neuroendocrine components. They can originate in any organ but are more common in the rectum. Due to their rarity, current treatment recommendations for mixed adenoneuroendocrine carcinoma are based on limited data and follow general guidelines for the management of adenocarcinomas and neuroendocrine neoplasms. Uncertainty regarding the efficacy of the available local and systemic treatment strategies is a compounding issue. Even those patients with locally limited disease have a relatively short life expectancy. In this report, we describe a case of deep rectal mixed adenoneuroendocrine carcinoma with long survival after chemoradiation. CASE PRESENTATION A 48-year-old Caucasian woman was diagnosed with a grade 3 rectal adenocarcinoma combined with a poorly differentiated large cell neuroendocrine carcinoma component and synchronous metastases (cT3cN1cM1) in both lobes of the liver in 2012. She received concomitant chemoradiotherapy followed by four additional cycles of cisplatin plus irinotecan. Initial treatment induced complete remission of the rectal tumor and liver metastases. Consequently, it was not necessary to surgically resect the primary tumor or any of the metastases. Three months after the end of treatment, one metastasis in the first segment of the liver showed regrowth, and stereotactic body radiotherapy of the metastasis and chemotherapy resulted in a clinical complete response. The patient has been recurrence-free for more than 5 years. CONCLUSIONS Extended long-term control of a poorly differentiated metastatic (stage IV) mixed adenoneuroendocrine carcinoma is rare. The multimodal first- and second-line regimens of radiotherapy and chemotherapy described in this case report represent a new therapeutic approach. Encouraged by the results in this case, we compiled a review of the literature on mixed adenoneuroendocrine carcinoma.
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LaPara K, Chan JY, Zdechlik A, Ljunggren K, Schmidt D, Hackel B, Yee D. Abstract P1-05-03: Isoform specific targeting of insulin receptor. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-05-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The insulin receptor (InsR) exists in both an A and B isoform. InsR-B differs from InsR-A by the inclusion of exon 11, which encodes 12 amino acid residues at the C-terminus of the InsR alpha-subunit. Increased InsR-A expression is associated with mitogenic signaling pathways while InsR-B is linked to insulin-mediated metabolic functions. Predominant InsR-A expression may therefore be important in growth and fetal development of embryos, whereas predominant InsR-B expression has a role in metabolic insulin action in adult life. Increased InsR-A expression is seen in breast cancer. In endocrine resistant breast cancer, InsR-A is expressed at high levels (Gradishar, et al. Clin Cancer Res 22:301 2016 PMID: 26324738). Thus, developing InsR-A specific inhibitors could be a useful therapy for breast cancer. We have previously published InsR specific binders using a T7 phage gene 2 protein (Gp2), a small protein scaffold (Chan, et al. Mol Cancer Ther 16:1324 2017 PMID: 28468775), with the long-term goal of creating effective InsR inhibitors and diagnostics. Using yeast display and directed evolution, we identified three Gp2 variants (Gp2 #1, #5, and #10) with low nanomolar affinity and specific binding to cell surface InsR. We have shown that these Gp2 variants inhibited insulin-mediated monolayer proliferation in both endocrine-sensitive and resistant breast cancer, but did not downregulate InsR expression. To further characterize the specificity of Gp2 variants, we used two techniques. HEK293T cells were infected with lentiviral vectors expressing either InsR-A tagged with mCherry or InsR-B tagged with eGFP. Using these cells, we performed “mock panning” and showed the Gp2 #5 variant bound both InsR-A and InsR-B, but had higher affinity for InsR-B. We also incorporated Gp2 #5 into the capsid of a tropism-null adeno-associated virus (AAV). Using this Gp2-AAV, we infected HEK293T-InsR-A or InsR-B cells at a number of different multiplicities of infection. These data were consistent with panning data and showed specific Gp2-AAV infection of cells expressing high levels of InsR-B, but not InsR-A. Thus, our data show that Gp2 variants we created have a higher affinity for InsR-B than InsR-A. Despite this preferred affinity, these Gp2 binders have sufficient binding to InsR-A to disrupt the biological effects of insulin in breast cancer cells. Thus, even relatively low affinity binding to InsR-A can disrupt its function. Further development of InsR-A Gp2 binders may be developed and provide more specific targeting of the breast cancer specific isoform of InsR.
Citation Format: LaPara K, Chan JY, Zdechlik A, Ljunggren K, Schmidt D, Hackel B, Yee D. Isoform specific targeting of insulin receptor [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-05-03.
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Schmidt D, Berger B, Kahlert M, Bayer M, Schneider C, Höfling S, Sedov ES, Kavokin AV, Aßmann M. Tracking Dark Excitons with Exciton Polaritons in Semiconductor Microcavities. PHYSICAL REVIEW LETTERS 2019; 122:047403. [PMID: 30768323 DOI: 10.1103/physrevlett.122.047403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/30/2018] [Indexed: 05/13/2023]
Abstract
Dark excitons are of fundamental importance for a wide variety of processes in semiconductors but are difficult to investigate using optical techniques due to their weak interaction with light fields. We reveal and characterize dark excitons nonresonantly injected into a semiconductor microcavity structure containing InGaAs/GaAs quantum wells by a gated train of eight 100 fs pulses separated by 13 ns by monitoring their interactions with the bright lower polariton mode. We find a surprisingly long dark exciton lifetime of more than 20 ns, which is longer than the time delay between two consecutive pulses. This creates a memory effect that we clearly observe through the variation of the time-resolved transmission signal. We propose a rate equation model that provides a quantitative agreement with the experimental data.
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Fallon SJ, McDougall AJ, Espinoza T, Roberts DT, Brooks S, Kind PK, Kennard MJ, Bond N, Marshall SM, Schmidt D, Hughes J. Age structure of the Australian lungfish (Neoceratodus forsteri). PLoS One 2019; 14:e0210168. [PMID: 30673738 PMCID: PMC6343868 DOI: 10.1371/journal.pone.0210168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022] Open
Abstract
The Australian lungfish has been studied for more than a century without any knowledge of the longevity of the species. Traditional methods for ageing fish, such as analysis of otolith (ear stone) rings is complicated in that lungfish otoliths differ from teleost fish in composition. As otolith sampling is also lethal, this is not appropriate for a protected species listed under Australian legislation. Lungfish scales were removed from 500 fish from the Brisbane, Burnett and Mary rivers. A sub–sample of scales (85) were aged using bomb radiocarbon techniques and validated using scales marked previously with oxytetracycline. Lungfish ages ranged from 2.5–77 years of age. Estimated population age structures derived using an Age Length Key revealed different recruitment patterns between river systems. There were statistically significant von Bertalanffy growth model parameters estimated for each of the three rivers based on limited sample sizes. In addition, length frequency distributions between river systems were also significantly different. Further studies will be conducted to review drivers that may explain these inter-river differences.
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Yörüker U, Valeske K, Müller M, Schmidt D, Thul J, Jux C, Schranz D, Akintürk H. Aortic Valve Repair for Pediatric and Grown-Up Congenital Heart Disease Patients: 16 Years Single-Center Experience with 106 Cases. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schrittenlocher S, Bachmann B, Tiurbe AM, Tuac O, Velten K, Schmidt D, Cursiefen C. Impact of preoperative visual acuity on Descemet Membrane Endothelial Keratoplasty (DMEK) outcome. Graefes Arch Clin Exp Ophthalmol 2018; 257:321-329. [DOI: 10.1007/s00417-018-4193-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022] Open
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Schuster SC, Wolf P, Schmidt D, Slama S, Zimmermann C. Pinning Transition of Bose-Einstein Condensates in Optical Ring Resonators. PHYSICAL REVIEW LETTERS 2018; 121:223601. [PMID: 30547603 DOI: 10.1103/physrevlett.121.223601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Indexed: 06/09/2023]
Abstract
We experimentally investigate the dynamic instability of Bose-Einstein condensates in an optical ring resonator that is asymmetrically pumped in both directions. We find that, beyond a critical resonator-pump detuning, the system becomes stable regardless of the pump strength. Phase diagrams and quenching curves are presented and described by numerical simulations. We discuss a physical explanation based on a geometric interpretation of the underlying nonlinear equations of motion.
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Wolf P, Schuster SC, Schmidt D, Slama S, Zimmermann C. Observation of Subradiant Atomic Momentum States with Bose-Einstein Condensates in a Recoil Resolving Optical Ring Resonator. PHYSICAL REVIEW LETTERS 2018; 121:173602. [PMID: 30411934 DOI: 10.1103/physrevlett.121.173602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Indexed: 06/08/2023]
Abstract
We experimentally investigate the formation of subradiant atomic momentum states in Bose-Einstein condensates inside a recoil resolving optical ring resonator according to the theoretical proposal of Cola, Bigerni, and Piovella. The atoms are pumped from the side with laser light that contains two frequency components. They resonantly drive cavity assisted Raman transitions between three discreet atomic momentum states. Within a few hundred microseconds, the system evolves into a stationary subradiant state. In this state, the condensate develops two density gratings suitable to diffract the two frequency components of the pump field into the resonator. Both components destructively interfere such that scattering is efficiently suppressed. A series of subradiant states for various amplitude ratios of the two pump components between 0 and 2.1 have been observed. The results are well explained with a three state quantum model in mean field approximation.
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Keul J, Kommoss F, Karnezis AN, Wang Y, Pasternak J, Hartkopf A, Oberlechner E, Taran A, Staebler A, Schmidt D, Gilks CB, Huntsman DG, Brucker SY, Kommoss S. Sertoli-Leydigzelltumoren (SLCT) des Ovars: Dicer1- und Foxl2-Mutationsstatus als Beitrag zur Etablierung einer neuartigen, klinisch und histopathologisch relevanten Klassifikation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Kleinsteuber A, Halleck F, Khadzhynov D, Staeck A, Lehner L, Duerr M, Glander P, Schmidt D, Budde K, Staeck O. Impact of Pre-existing Comorbidities on Long-term Outcomes in Kidney Transplant Recipients. Transplant Proc 2018; 50:3232-3241. [PMID: 30577191 DOI: 10.1016/j.transproceed.2018.08.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Outcomes of patients with end-stage renal disease are mainly affected by their comorbidities. Detailed data evaluating the impact of pre-transplant comorbidities on long-term outcome after kidney transplantation are largely missing. METHODS In a long-term retrospective analysis, we investigated 839 deceased donor kidney transplant recipients (KTRs) who received transplants between 1999 and 2014. The prevalence and impact of the most relevant comorbidities were studied in detail. RESULTS At the time of transplantation, 25% of KTRs had coronary artery disease (CAD), 16% had diabetes mellitus (DM), 11% had peripheral arterial disease (PAD), 8% had chronic heart failure (CHF), and 7% had cerebrovascular disease (CVD). KTRs with pre-existing CAD, DM, PAD, and CHF showed a significantly inferior patient survival. Multivariate analysis adjusting for all relevant factors and comorbidities confirmed CAD as most hazardous independent risk factor for premature death (hazard ratio [HR] 1.70; P = .002). A multivariate analysis revealed CHF and PAD as independent risk factors for death censored graft loss (HR 2.20; P = .003 and HR 1.80; P = .013). Diabetes was independently and significantly associated with T-cell- (HR 1.46; P = .020) and antibody-mediated rejections (HR 2.27; P = .030). CONCLUSIONS Detailed quantification of the impact of pre-transplant comorbidities may facilitate the evaluation of transplant candidates, guide post-transplant follow-up, and may help to further refine prediction algorithms and allocation systems.
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Schmidt D. [Meeting of the Working Group on Cytopathology of the German Society of Pathology, 2018]. DER PATHOLOGE 2018; 39:346-347. [PMID: 30120510 DOI: 10.1007/s00292-018-0483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kuchler K, Prifling B, Schmidt D, Markötter H, Manke I, Bernthaler T, Knoblauch V, Schmidt V. Analysis of the 3D microstructure of experimental cathode films for lithium-ion batteries under increasing compaction. J Microsc 2018; 272:96-110. [PMID: 30088276 DOI: 10.1111/jmi.12749] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/22/2018] [Indexed: 11/28/2022]
Abstract
It is well known that the microstructure of electrodes in lithium-ion batteries has an immense impact on their overall performance. The compaction load during the calendering process mainly determines the resulting morphology of the electrode. Therefore, NCM-based cathode films from uncompacted (0 MPa) to most highly compacted (1000 MPa) were manufactured, which corresponds to global porosities ranging from about 50% to 18%. All samples have been imaged using synchrotron tomography. These image data allow an extensive analysis of the 3D cathode microstructure with respect to increasing compaction. In addition, the numerous microstructural changes can be quantified using several characteristics describing the morphology of cathode samples. Three characteristics, namely global porosity, global volume fraction of active material and mean cathode thickness, are compared to experimental results. In addition, the microstructural analysis by means of 3D image data and image processing techniques allows the investigation of characteristics which are hard or impossible to ascertain by experiments, for example the continuous pore size distribution and the sphericity distribution of NCM-particles. Finally, the dependency of microstructural characteristics on compaction load is described by the help of parametric probability distributions. This approach can be used, for example, to predict the distribution of a certain characteristic for an 'unknown' compaction load, which is a valuable information with regard to the optimization and development process of NCM-cathodes in lithium-ion batteries. LAY DESCRIPTION It is well known that the microstructure of electrodes in lithium-ion batteries has an immense impact on their overall performance. The manufacturing of the batteries includes the so-called calendering, where the electrodes are compressed with a certain pressure, which is called compaction load. This process step mainly determines the resulting morphology of the electrode and thus the properties of the battery. Therefore, eight cathodes with different compaction loads were manufactured and imaged by synchrotron tomography, which leads to 3D images containing detailed information about the inner structure of the cathode. This image data allows an extensive analysis of the 3D cathode microstructure with respect to increasing compaction. In order to quantify the microstructural changes we use several characteristics describing diverse properties of the morphology. Furthermore, the 3D image data can be used for the computation of characteristics which can not be determined by experiments. Therefore, 3D image data allows us to understand how the microstructure of cathodes is influenced by the compaction load. Finally, we are able to predict the distribution of a certain characteristic for arbitrary compaction loads. This information is valuable with regard to the development of improved lithium-ion batteries.
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Haghikia A, Liman T, Li XS, Schmidt D, Zimmermann F, Kraenkel N, Fraccarollo D, Widera C, Sonnenschein K, Haghikia A, Bauersachs J, Bavendiek U, Hazen S, Endres M, Landmesser U. P2467Gut microbiota-dependent TMAO and risk of cardiovascular events in patients with stroke: relation to pro-inflammatory monocytes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmidt D. [The new S3 guideline "Prevention of cervical carcinoma" : What is important for pathology?]. DER PATHOLOGE 2018; 39:269-279. [PMID: 29700570 DOI: 10.1007/s00292-018-0441-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Of the numerous aspects involved in the diagnosis, treatment, and follow-up of cervical uterine precursor lesions, epidemiology, virology, cytology, human papillomavirus (HPV) testing, and diagnostic algorithms for equivocal and HPV-positive findings are important for pathologists. Cytology will continue to be used as a preventive medical check-up in young women, while HPV-based screening is suggested for older women. HPV screening has yielded a significant reduction in cancer precursors and invasive cervical carcinoma in numerous studies. In contrast to the sensitivity, the specificity of the HPV test is inferior to that of cytology and the morphological biomarker p16/Ki-67, so that they are suitable as methods in the triage of HPV-positive findings. Cytological abnormalities and mildly dysplastic changes could be further clarified by an HPV test or the p16/Ki-67 test. The HPV test should also be used in the follow-up of patients after conization.
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Battegay E, Cheetham M, Holzer BM, Nowak A, Schmidt D, Rampini S. [Multimorbidity management and the physician's daily clinical dilemma]. Internist (Berl) 2018; 58:344-353. [PMID: 28246687 DOI: 10.1007/s00108-017-0200-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
About 20-25% of all persons and about 90% of all patients who are acutely hospitalized in internal medicine departments have multiple acute or chronic diseases. They are multimorbid. The encounter with multimorbid patients has become the most common situation in the health care system. Theoretically, multimorbidity results in an innumerable potential disease constellations. In addition, the likelihood of interactions between diseases (disease-disease interactions, DDI) and the complexity increases overproportionately with each additional disease. However, multimorbidity often occurs in typical diadic, triadic, or higher characteristic combinations, in "disease clusters", e. g., vascular risk factors, heart and lung diseases, Frailty and dementia, psychiatric and somatic disorders. Such combinations lead to a worsening of the overall prognosis. In addition, DDIs are often difficult to treat or are life-threatening. Examples of DDIs include the following: anticoagulation and simultaneous severe bleeding, pain treatment and hypertension or renal insufficiency, depression and reduced medication adherence, chronic obstructive pulmonary disease and depression, Frailty and neurodepressant drugs and frequent falls, and combined psychiatric and somatic disorders. Such DDIs are common. Nevertheless, there are few studies and clinical guidelines that address these issues. The care of multimorbid patients is, therefore, heavily reliant upon guidelines developed mostly for single diseases. However, multimorbidity and serious DDIs are usually not addressed in these. Clinical guidelines can thus inadvertently jeopardize the safety of persons suffering from multiple diseases. In addition, stressful dilemmas arise for physicians encountering DDIs because of difficult treatment decisions.
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Knaup P, Schmidt D, Jaspers MWM. Section 2: Patient Records: The Computerized Patient Record: Where Do We Stand? Yearb Med Inform 2018. [DOI: 10.1055/s-0038-1638464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
SummaryTo provide an overview of trends in research, developments and implementations of the computerized patient record (CPR) of the last two years.We surveyed the medical informatics literature, spanning the years 2004-2005, focusing on publications on CPRs.The main trends revealed were: 1) the development of technologies to realize privacy and security goals or remote data entry and access to CPRs; 2) investigations into how to enhance the quality and reuse of CPR data; 3) the development and evaluation of decision support functions to be integrated with CPRs; 4) evaluations of the impact of CPRs on clinicians, patients, clinical work settings and patient outcomes; and 5) the further development and use of standards to move towards shared electronic health records (EHRs).The CPR is playing a growing part in medical informatics research and evaluation studies, but the goal of establishing a comprehensive lifelong EHR is still a long way off. In moving forward to EHRs, convergence of EHR standards seems required to realize true interoperability of health care applications. User acceptance of present-day CPRs (for all categories of users) and compatibility with work patterns has not been achieved yet, and can only be realized by giving these goals high priority. This will require substantial resources for in-depth work flow analysis, development and evaluation of CPRs. Besides this, the implementation of effective CPRs asks for health care organizations that are willing to invest in new developments and to contribute to evaluation studies, to further improve CPRs’ functionalities and enhance their use in practice.Haux R, Kulikowski C, editors. IMIA Yearbook of Medical Informatics 2006.
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Held M, Schmidt D, Gött F, Hübner G, Joa F, Jany B. Detektionsrate von persistierender Belastungsintoleranz CTEPH, Non-CTEPH-PH, und residuellen Perfusionsstörungen ohne PH und Charaktersisierung einer CTED nach akuter Lungenembolie – Ergebnisse aus dem Würzburger PHNLE-Register. Pneumologie 2018. [DOI: 10.1055/s-0037-1619319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gardner RM, Gatewood LC, Haux R, Schmidt D, Wetter T, Jaspers MWM. The International Partnership for Health Informatics Education. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
To inform the medical and health informatics community on the rational, goals, and the achievements of the International Partnership for Health Informatics Education – IPHIE, (IΦE), that was established at six universities in 1999.
Methods:
We elaborate on the overall goals of IΦE and describe the current state of affairs: the activities undertaken and faculty and student experience related to these activities. In addition we outline the lessons we have learned over these past six years and our plans for the future.
Results:
IΦE members first started to collaborate by supporting and encouraging the exchange of talented students and faculty and by establishing joint master classes for honors students. Following the success of these activities, new initiatives were undertaken such as the organization of student workshops at medical informatics conferences and a joint course on strategic information management in hospitals in Europe.
Conclusions:
International partnerships such as IΦE take time to establish, and, if they are to be successful, maintaining leadership continuity is critically important. We are convinced that IΦE promotes professionalism of future medical informatics specialists. There will be a continuing growth of globalization in higher education. It will therefore become increasingly important to offer educational programs with international components.
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Krause BJ, Schmidt D, Hautzel H, Herzog H, Shah NJ, Halsband U, Müller-Gärtner HW, Mottaghy FM. Comparison of PET and fMRI activation patterns during declarative memory processes. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: In this study neuronal correlates of encoding and retrieval in paired association learning were compared using two different neuroimaging methods: positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Methods: 6 right-handed normal male volunteers took part in the study. Each subject underwent six 0-15-butanol PET scans and an fMRI study comprising four single epochs on a different day. The subjects had to learn and retrieve 12 word pairs which were visually presented (highly imaginable words, not semantically related). Results: Mean recall accuracy was 93% in the PET as well as in the fMRI experiment. During encoding and retrieval we found anterior cingulate cortex activation, and bilateral prefrontal cortex activation in both imaging modalities. Furthermore, we demonstrate the importance of the precuneus in episodic memory. With PET the results demonstrate frontopolar activations whereas fMRI fails to show activations in this area probably due to susceptibility artifacts. In fMRI we found additionally parahippocampal activation and due to the whole-brain coverage cerebellar activation during encoding. The distance between the center-of-mass activations in both modalities was 7.2 ± 6.5 mm. Conclusion: There is a preponderance of commonalities in the activation patterns yielded with fMRI and PET. However, there are also important differences. The decision to choose one or the other neuroimaging modality should among other aspects depend on the study design (single subject vs. group study) and the task of interest.
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Schmidt D, Matheja P, Coenen HH, Langen KJ, Weckesser M. The role of L-3-1-123-iodine-α-methyl tyrosine-SPECT in cerebral gliomas. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryL-3-1-123-iodine-a-methyltyrosine (IMT) is a 1-123-labelled amino acid which has been used for single photon emission computed tomography (SPECT) of cerebral gliomas for more than a decade. IMT-SPECT is able to detect tumor infiltration independent of disruptions of the blood-brain barrier which is often difficult with computed tomography or magnetic resonance tomography. The method is useful to detect tumor recurrences and helps to distinguish gliomas from non-neoplastic brain masses. IMT-SPECT is thus a valuable tool in the diagnostic evaluation and in therapy planning of patients with cerebral gliomas.
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Wilsdorf M, Schmidt D, Bartetzko MP, Dallabernardina P, Schuhmacher F, Seeberger PH, Pfrengle F. A traceless photocleavable linker for the automated glycan assembly of carbohydrates with free reducing ends. Chem Commun (Camb) 2018; 52:10187-9. [PMID: 27463261 DOI: 10.1039/c6cc04954k] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report a traceless photocleavable linker for the automated glycan assembly of carbohydrates with free reducing ends. The reductive-labile functionality in the linker tolerates all commonly used reagents and protocols for automated glycan assembly, as demonstrated with the successful preparation of nine plant cell wall-related oligosaccharides, and is cleaved by hydrogenolysis.
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Cupisti K, Antke C, Schmidt D, Knoefel WT, Müller HW, Schommartz B. Lokalisation von Nebenschilddrüsenadenomen mit planarer 99mTc-Sestamibi-Szintigraphie. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungZiel: Im Rahmen der präoperativen Lokalisationsdiagnostik beim primären Hyperparathyreoidismus (pHPT) wurden die Subtraktions- und die 2-Phasen-Technik der 99mTc-Sestamibi- Szintigraphie untereinander und mit den Operationsergebnissen verglichen. Patienten, Methoden: Prospektiv wurden 126 Patienten mit pHPT präoperativ untersucht. Die Darstellung der Schilddrüse (99mTc-Pertechnetat) wurde von dem Perfusionsbild (99mTc-Sestamibi) subtrahiert, eine weitere Aufnahme 2 h p. i. diente zur Feststellung einer Aktivitätsretention. Die zeitnahe Befunderstellung erfolgte unter Berücksichtigung beider Techniken. Retrospektiv wurden die Auswertungen getrennt vier erfahrenen Fachärzten vorgelegt. Ergebnisse: In der klinischen Routine wurden bei 109 Patienten präoperativ korrekte Befunde erhoben (87%). Von 129 resezierten Nebenschilddrüsenadenomen wurden 118 richtig lokalisiert (Sensitivität 91%, pos. Vorhersagewert 94%). Bei der retrospektiven Analyse führten in 75% der Fälle beide Techniken zum richtigen Ergebnis, bei 14% war nur die 2-Phasen-Technik zielführend, bei 7% nur die Subtraktionstechnik. Mit der 2-Phasen-Technik wurden signifikant mehr Untersuchungen richtig beurteilt als mit der Subtraktionstechnik (88,7 ± 3,2% versus 81,6 ± 1,2%, p <0,01, zweiseitiger t-Test). Schlussfolgerung: Die präoperative szintigraphische Lokalisationsdiagnostik hyperaktiver Nebenschilddrüsen bei pHPT unterstützt das minimal-invasive operative Vorgehen durch eine hohe Rate an richtigen Befunden. Die 2-Phasen- erscheint sensitiver als die Subtraktionstechnik. In einigen Fällen kann die richtige Lokalisation nur mit Hilfe der Subtraktionstechnik angegeben werden. Für eine optimale Vorbereitung der Operation empfiehlt sich die vorgestellte Kombination beider Techniken.
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