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Fabricius D, Knieling T, Zurmuehl N, Makedon L, Freihorst J, Schmidt H, Bode S. Changes in vitamins and trace elements after initiation of highly effective CFTR modulator therapy in children and adults with cystic fibrosis - a real-life insight. Mol Cell Pediatr 2024; 11:4. [PMID: 38717689 PMCID: PMC11078909 DOI: 10.1186/s40348-024-00178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Highly-effective CFTR-modulator therapy with elexa-/teza-/ivacaftor (ETI) has led to improvements in pulmonary outcomes, sweat chloride, body mass index (BMI) and quality of life in people with cystic fibrosis (CF). Improved uptake of fat-soluble vitamins and micronutrients has been reported for CFTR-modulators but data regarding ETI therapy is lacking. METHODS This single-center retrospective study evaluated forced expiratory volume in one second (FEV-1), sweat chloride, BMI, transaminases (AST, ALT), bilirubin, vitamins A, D, E, zinc and selenium in children and adults eligible for ETI. Parameters were assessed before and up to one year after initiation of ETI. RESULTS 58 patients (median age m = 28 years, SD ± 11.6 years, 51.7% female14 < 18 years old) were included. FEV-1 and sweat chloride improved significantly after ETI. There were no changes in BMI or AST. ALT was increased significantly after 4 weeks of ETI but returned to normal levels in further course. Bilirubin levels remained elevated after ETI. Vitamin A was significantly higher 12 months after ETI. No changes were found for vitamins D, E, zinc and selenium. CONCLUSIONS This study adds to the evidence that improvements of some fat-soluble vitamin levels can be found after ETI. No changes regarding micronutrients were noted. Individualized follow-up and supplementation are recommended.
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Affiliation(s)
- Dorit Fabricius
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Tina Knieling
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Noelle Zurmuehl
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Leandra Makedon
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Joachim Freihorst
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Hanna Schmidt
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany
| | - Sebastian Bode
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Eythstrasse 24, 89075, Ulm, Germany.
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2
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Nedospasov IA, Pupyrev PD, Sotnikov A, Schmidt H, Weihnacht M, Mayer AP. Generation of time-independent torque by ultrasonic guided waves. Ultrasonics 2024; 138:107250. [PMID: 38306760 DOI: 10.1016/j.ultras.2024.107250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
The excitation of acoustic waves by a unidirectional transducer, integrated in a piezoelectric cylindrical tube or disk, can lead to a time-independent torque. This phenomenon, demonstrated earlier in experiments and analyzed with coupling-of mode theory, is explained in detail, starting on the level of lattice dynamics of a piezoelectric crystal. Expressions are derived for the stationary torque in the form of integrals over the volume or surface of the piezoelectric, involving the electric potential and displacement field associated with the acoustic waves generated by the transducer. Simulations have been carried out with the help of the finite element method for a tube made of PZT for two cases: A pre-defined potential on the surface of the tube and metal electrodes buried in the piezoelectric. The displacement field and electric potential of the high-frequency acoustic waves (between 200 and 300 kHz) were computed and used in the evaluation of the integrals. The attenuation due to various loss channels of the acoustic waves in the system has been analyzed in detail, as this plays a crucial role for the efficiency of torque generation. It is conjectured that time-reversal symmetry, present in the absence of attenuation, prohibits the generation of a static torque at least in the linear limit. A qualitative comparison is made between the simulations and earlier experiments. Discrepancies are attributed to lack of knowledge of the relevant material constants of the piezoelectric and to a simplified modeling of the electrode geometry in the cylindrical tube, which was necessary for reasons of numerical accuracy.
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Affiliation(s)
- I A Nedospasov
- Kotelnikov Institute of Radio Engineering and Electronics, Russian Academy of Sciences, Mokhovaya str. 11-7 125009, Moscow, Russia
| | - P D Pupyrev
- HS Offenburg - University of Applied Sciences, Klosterstr. 14 77723, Gengenbach, Germany
| | - A Sotnikov
- Leibniz Institute for Solid State and Materials Research, Helmholtzstraße 20 01069, Dresden, Germany
| | - H Schmidt
- Leibniz Institute for Solid State and Materials Research, Helmholtzstraße 20 01069, Dresden, Germany
| | - M Weihnacht
- INNOXACS - Innovations in Crystal Acoustics, Am Muehlfeld 34 01744, Dippoldiswalde, Germany
| | - A P Mayer
- HS Offenburg - University of Applied Sciences, Klosterstr. 14 77723, Gengenbach, Germany.
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Stüben BO, Hoyer DP, Radunz S, Saner F, Schmidt H, Baba HA, Treckmann JW, Mazilescu LI. Idiosyncratic Drug-Induced Liver Injury in a Healthy Patient following PCSK9-Inhibitor Injection. Case Reports Hepatol 2024; 2024:5556907. [PMID: 38249623 PMCID: PMC10796182 DOI: 10.1155/2024/5556907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Background Acute liver injury is a life-threatening condition with disparate aetiology. Swift and adequate interdisciplinary treatment is essential to assure the best possible outcomes in these patients. Investigations to identify the cause of the condition and the implementation of quick and appropriate treatment can be lifesaving. Case Presentation. In October 2022, an otherwise healthy 66-year-old male presented at the University Hospital Essen with acute liver injury following an inclisiran injection for hypercholesterinaemia. Four weeks following admission, the patient fully recovered after initially receiving short-term cortisol therapy and open albumin (OPAL) dialysis, and the indices of liver, kidney, and coagulation function were normal at discharge. Conclusion This is to our knowledge the first reported acute liver injury due to an inclisiran injection. Cortisol in combination with OPAL dialysis is an effective method for the treatment of acute liver injury caused by inclisiran injury, and in this case, it led to a near-complete reversal of the acute liver injury at the time of discharge.
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Affiliation(s)
- B.-O. Stüben
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - D. P. Hoyer
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - S. Radunz
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - F. Saner
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - H. Schmidt
- Department of Internal Medicine, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - H. A. Baba
- Institute of Pathology, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - J. W. Treckmann
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
| | - L. I. Mazilescu
- Department of General, Visceral and Transplant Surgery, Medical Center University Duisburg-Essen, Essen 45147, Germany
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Zurloh M, Goetz M, Herold T, Treckmann J, Markus P, Schumacher B, Albers D, Rink A, Rosery V, Zaun G, Kostbade K, Pogorzelski M, Ting S, Schmidt H, Stiens R, Wiesweg M, Schuler M, Kasper S, Virchow I. Impact of encorafenib on survival of patients with BRAF V600E-mutant metastatic colorectal cancer in a real-world setting. J Cancer Res Clin Oncol 2023; 149:12903-12912. [PMID: 37466791 PMCID: PMC10587317 DOI: 10.1007/s00432-023-05141-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Patients with BRAFV600E-mutant metastatic colorectal cancer (mCRC) have a dismal prognosis. The best strategies in these patients remain elusive. Against this background, we report the clinical course of patients with BRAFV600E-mutant mCRC to retrieve the best treatment strategy. PATIENTS AND METHODS Clinico-pathological data were extracted from the electronic health records. Kaplan-Meier method was used to estimate overall (OS) and progression-free survival (PFS). Objective response rate (ORR) was assessed according to RECIST 1.1. RESULTS In total, 51 patients were enrolled. FOLFOXIRI was administered to 12 patients; 29 patients received FOLFOX or FOLFIRI as first-line treatment. Median OS was 17.6 months. Median PFS with FOLFOXIRI (13.0 months) was significantly prolonged (HR 0.325) as compared to FOLFOX/FOLFIRI (4.3 months). However, this failed to translate into an OS benefit (p = 0.433). Interestingly, addition of a monoclonal antibody to chemotherapy associated with superior OS (HR 0.523). A total of 64.7% patients received further-line therapy, which included a BRAF inhibitor in 17 patients. Targeted therapy associated with very favourable OS (25.1 months). CONCLUSION Patients with BRAFV600E-mutated mCRC benefit from the addition of an antibody to first-line chemotherapy. Further-line treatment including a BRAF inhibitor has a dramatic impact on survival.
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Affiliation(s)
- M Zurloh
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Goetz
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
| | - T Herold
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - J Treckmann
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - P Markus
- Department of General Surgery and Traumatology, Elisabeth Hospital, Essen, Germany
| | - B Schumacher
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - D Albers
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - A Rink
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - V Rosery
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - G Zaun
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - K Kostbade
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - S Ting
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- Institute of Pathology Nordhessen, Kassel, Germany
| | - H Schmidt
- Department of Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - R Stiens
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
- Medical Faculty, University Duisburg-Essen, Essen, Germany.
| | - I Virchow
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
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Schmidt H, Höpfer LM, Wohlgemuth L, Knapp CL, Mohamed AOK, Stukan L, Münnich F, Hüsken D, Koller AS, Stratmann AEP, Müller P, Braun CK, Fabricius D, Bode SFN, Huber-Lang M, Messerer DAC. Multimodal analysis of granulocytes, monocytes, and platelets in patients with cystic fibrosis before and after Elexacaftor-Tezacaftor-Ivacaftor treatment. Front Immunol 2023; 14:1180282. [PMID: 37457734 PMCID: PMC10347380 DOI: 10.3389/fimmu.2023.1180282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
Cystic fibrosis (CF) is a monogenetic disease caused by an impairment of the cystic fibrosis transmembrane conductance regulator (CFTR). CF affects multiple organs and is associated with acute and chronic inflammation. In 2020, Elexacaftor-Tezacaftor-Ivacaftor (ETI) was approved to enhance and restore the remaining CFTR functionality. This study investigates cellular innate immunity, with a focus on neutrophil activation and phenotype, comparing healthy volunteers with patients with CF before (T1, n = 13) and after six months (T2, n = 11) of ETI treatment. ETI treatment reduced sweat chloride (T1: 95 mmol/l (83|108) vs. T2: 32 mmol/l (25|62), p < 0.01, median, first|third quartile) and significantly improved pulmonal function (FEV1 T1: 2.66 l (1.92|3.04) vs. T2: 3.69 l (3.00|4.03), p < 0.01). Moreover, there was a significant decrease in the biomarker human epididymis protein 4 (T1: 6.2 ng/ml (4.6|6.3) vs. T2: 3.0 ng/ml (2.2|3.7), p < 0.01) and a small but significant decrease in matrix metallopeptidase 9 (T1: 45.5 ng/ml (32.5|140.1) vs. T2: 28.2 ng/ml (18.2|33.6), p < 0.05). Neutrophil phenotype (CD10, CD11b, CD62L, and CD66b) and function (radical oxygen species generation, chemotactic and phagocytic activity) remained largely unaffected by ETI treatment. Likewise, monocyte phenotype and markers of platelet activation were similar at T1 and T2. In summary, the present study confirmed a positive impact on patients with CF after ETI treatment. However, neither beneficial nor harmful effects of ETI treatment on cellular innate immunity could be detected, possibly due to the study population consisting of patients with well-controlled CF.
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Affiliation(s)
- Hanna Schmidt
- Department of Pediatric and Adolescent Medicine, University Hospital Ulm, Ulm, Germany
| | - Larissa Melina Höpfer
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Lisa Wohlgemuth
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Christiane Leonie Knapp
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | | | - Laura Stukan
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Frederik Münnich
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Dominik Hüsken
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | | | | | - Paul Müller
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Christian Karl Braun
- Department of Pediatric and Adolescent Medicine, University Hospital Ulm, Ulm, Germany
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital Ulm, Ulm, Germany
| | - Dorit Fabricius
- Department of Pediatric and Adolescent Medicine, University Hospital Ulm, Ulm, Germany
| | | | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
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Schurr T, Loth F, Lidington E, Piccinin C, Arraras JI, Groenvold M, Holzner B, van Leeuwen M, Petersen MA, Schmidt H, Young T, Giesinger JM. Patient-reported outcome measures for physical function in cancer patients: content comparison of the EORTC CAT Core, EORTC QLQ-C30, SF-36, FACT-G, and PROMIS measures using the International Classification of Functioning, Disability and Health. BMC Med Res Methodol 2023; 23:21. [PMID: 36681808 PMCID: PMC9862545 DOI: 10.1186/s12874-022-01826-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patient-reported physical function (PF) is a key endpoint in cancer clinical trials. Using complex statistical methods, common metrics have been developed to compare scores from different patient-reported outcome (PRO) measures, but such methods do not account for possible differences in questionnaire content. Therefore, the aim of our study was a content comparison of frequently used PRO measures for PF in cancer patients. METHODS Relying on the framework of the International Classification of Functioning, Disability and Health (ICF) we categorized the item content of the physical domains of the following measures: EORTC CAT Core, EORTC QLQ-C30, SF-36, PROMIS Cancer Item Bank for Physical Function, PROMIS Short Form for Physical Function 20a, and the FACT-G. Item content was linked to ICF categories by two independent reviewers. RESULTS The 118 items investigated were assigned to 3 components ('d - Activities and Participation', 'b - Body Functions', and 'e - Environmental Factors') and 11 first-level ICF categories. All PF items of the EORTC measures but one were assigned to the first-level ICF categories 'd4 - Mobility' and 'd5 - Self-care', all within the component 'd - Activities and Participation'. The SF-36 additionally included item content related to 'd9 - Community, social and civic life' and the PROMIS Short Form for Physical Function 20a also included content related to 'd6 - domestic life'. The PROMIS Cancer Item Bank (v1.1) covered, in addition, two first-level categories within the component 'b - Body Functions'. The FACT-G Physical Well-being scale was found to be the most diverse scale with item content partly not covered by the ICF framework. DISCUSSION Our results provide information about conceptual differences between common PRO measures for the assessment of PF in cancer patients. Our results complement quantitative information on psychometric characteristics of these measures and provide a better understanding of the possibilities of establishing common metrics.
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Affiliation(s)
- T Schurr
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Hospital of Psychiatry I, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
| | - F Loth
- Professorship for Psychological Diagnostics and Intervention Psychology, Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072 Eichstätt, Germany
| | - E Lidington
- Cancer Behavioural Science Unit, King’s College London, Guy’s Hospital, St Thomas Street, London, SE1 9RT UK
| | - C Piccinin
- Quality of Life Department, EORTC, Avenue E. Mounier, 83/11, 1200 Brussels, Belgium
| | - JI Arraras
- Medical Oncology Department, Hospital Universitario de Navarra, C/Irunlarrea 3, S31008 Pamplona, Spain
| | - M Groenvold
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - B Holzner
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
| | - M van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - MA Petersen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H Schmidt
- University Clinic and Outpatient Clinic for Radiotherapy and Institute of Health and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - T Young
- Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Rickmansworth Rd, GB- HA6 2RN Halle (Saale), UK
| | - JM Giesinger
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
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Leavitt VM, Kever AM, Weinstein SM, Shinohara RT, Schmidt H, Aoun SM, Solari A, Solomon AJ. Diagnosis concealment is prevalent in MS, and associated with diagnosis experience. Mult Scler Relat Disord 2022; 68:104373. [PMID: 36544320 DOI: 10.1016/j.msard.2022.104373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Receiving a diagnosis of multiple sclerosis (MS) can be stressful; later, patients may conceal their diagnosis. Here, we aimed to (1) assess prevalence of disclosure and concealment behaviors, and (2) explore whether diagnosis experience is associated with later concealment and if MS provider engagement on this topic modifies concealment. METHODS In a survey-based study, MS patients completed DISCO-MS assessing disclosure and concealment and responded to questions about diagnosis experience and practitioner attention to disclosure. Frequency analysis and Pearson's correlations were used in exploratory analyses. RESULTS 428 adults with MS participated. 49% (N = 201) conceal their diagnosis. Higher education [t(405) = 3.66, p < 0.001], younger age (r = -0.15, p = 0.002), and shorter disease duration (r = -0.18, p = 0.010) were associated with higher concealment. 39% (N = 159) anticipate negative consequences of disclosure. Individuals reporting positive diagnosis experience (26%, N = 102) were less likely to conceal later in disease course compared to those with negative experience (34%, N = 136) [t(233) = 2.483, p = 0.014]. Patients whose MS providers discussed disclosure (23%, N = 73) anticipated less negative consequences of disclosure [t(323) = 2.475, p = 0.014]. CONCLUSIONS Diagnosis concealment is common in MS. Favorable diagnosis experience and provider attention to the topic of disclosure throughout the MS disease course may influence diagnosis concealment.
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Affiliation(s)
- V M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, Box 16, New York, NY 10032, USA.
| | - A M Kever
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, Box 16, New York, NY 10032, USA
| | - S M Weinstein
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, PA, USA
| | - R T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, PA, USA
| | - H Schmidt
- Accelerated Cure Project, Waltham, MA, USA
| | - S M Aoun
- Perron Institute for Neurological and Translational Science, University of Western Australia, La Trobe University, Australia
| | - A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A J Solomon
- Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, University Health Center - Arnold 2, 1 South Prospect Street, Burlington, VT, USA
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Linde L, Moerk SR, Gregers E, Andreasen JB, Lassen JF, Ravn HB, Schmidt H, Riber LP, Laugesen H, Terkelsen CJ, Moeller-Soerensen PH, Holmvang L, Kjaergaard J, Hassager C, Moeller JE. Selection of patients for mechanical circulatory support for refractory out-of-hospital cardiac arrest: a Danish nationwide multicenter study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential salvage therapy for selected patients with refractory out-of-hospital cardiac arrest (OHCA).
Purpose
The objective of this study was to describe the characteristics of potential ECPR patients.
Methods
This retrospective, observational cohort study included 579 patients admitted with refractory OHCA for possible ECPR at all tertiary cardiac arrest centers in Denmark between 2015 and 2020. Presenting characteristics, reasons for refraining from ECPR, and survival to hospital discharge were recorded.
Results
After initial evaluation, 221 patients (38%) proceeded to ECPR, and 358 (62%) were considered futile. Median prehospital low-flow time was 70 minutes [interquartile range 56–85] in ECPR patients and 62 minutes [48–81] in no-ECPR patients, p<0.001. Intra arrest transport was more than 50 km in 92 (42%) ECPR patients and 135 in no-ECPR patients (38%), p=0.25. Treatment decision was taken by a team of three specialists in 513 cases (97%). The leading cause for not initiating ECPR was duration of low flow time (39%). Severe metabolic derangement and low end-tidal CO2 (ETCO2) were contributing factors in 35% and 31%, respectively, Figure 1. 83% of the patients had two or more contributing factors recorded as reasons for not initiating ECPR, Figure 2. The most prevailing combination of contributing factors were non-shockable rhythm, low ETCO2, and metabolic derangement or duration of prehospital low flow time combined with low ETCO2. Survival to discharge was achieved in six patients (1.7%) in the no-ECPR group and 50 (23%) in the ECPR group.
Conclusions
In this large nationwide study of patients admitted for possible ECPR, 62% were not treated with ECPR. The most frequent reasons to abstain from ECPR were duration of prehospital low flow time, metabolic derangement, and low ETCO2.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation
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Affiliation(s)
- L Linde
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - S R Moerk
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - E Gregers
- Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J B Andreasen
- Aalborg University Hospital, Department of Anesthesiology and Intensive Care , Aalborg , Denmark
| | - J F Lassen
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - H B Ravn
- Odense University Hospital, Department of Anaesthesiology and Intensive Care , Odense , Denmark
| | - H Schmidt
- Odense University Hospital, Department of Anaesthesiology and Intensive Care , Odense , Denmark
| | - L P Riber
- Odense University Hospital, Department of Thoracic and Vascular Surgery , Odense , Denmark
| | - H Laugesen
- Aalborg University Hospital, Department of Anesthesiology and Intensive Care , Aalborg , Denmark
| | - C J Terkelsen
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - P H Moeller-Soerensen
- Copenhagen University Hospital, Cardiothoracic Anesthesiology , Copenhagen , Denmark
| | - L Holmvang
- Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Kjaergaard
- Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - C Hassager
- Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J E Moeller
- Odense University Hospital, Department of Cardiology , Odense , Denmark
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Pilleron S, Sun V, Hannan M, Haase K, Kenis C, Arthur E, Krok-Schoen J, Monginot S, Navarrete E, Nikita N, Roggendorf S, Schmidt H, Trevino K, Ayala A, Puts M. Loneliness in older adults with cancer: A scoping review. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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10
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Schmidt H, Toth M, Kappler‐Schorn C, Siebeneich U, Bode SFN, Fabricius D. Short‐term effects of a novel bronchial drainage device: A pilot cohort study in subjects with cystic fibrosis. Health Sci Rep 2022; 5:e812. [PMID: 36110342 PMCID: PMC9466653 DOI: 10.1002/hsr2.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/28/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Methods Results Conclusion
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Affiliation(s)
- Hanna Schmidt
- Department of Pediatric and Adolescent Medicine Ulm University Hospital Ulm Germany
- Institute of General Physiology Ulm University Ulm Germany
| | - Monika Toth
- Department of Pediatric and Adolescent Medicine Ulm University Hospital Ulm Germany
| | | | - Ute Siebeneich
- Department of Pediatric and Adolescent Medicine Ulm University Hospital Ulm Germany
| | - Sebastian F. N. Bode
- Department of Pediatric and Adolescent Medicine Ulm University Hospital Ulm Germany
| | - Dorit Fabricius
- Department of Pediatric and Adolescent Medicine Ulm University Hospital Ulm Germany
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11
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Weichenthal M, Svane IM, Kandolf Sekulovic L, Mangana J, Lugowska I, Mohr P, Espinosa E, Gogas H, Bender M, Ellebæk E, Gavrilova I, Herceg D, Muñoz Couselo E, Schmidt H, Stulhofer Buzina D, Rutkowski P, Ascierto P, Dummer R, Schadendorf D, Bastholt L. 836P Outcome of PD-1 inhibitor therapy of advanced melanoma patients according to demographic factors in a real-world setting across Europe. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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12
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Petersen S, Schmidt H, Ellebæk E, Haslund C, Hansen C, Bastholt L. 852P Does sex affect the efficacy of immune checkpoint inhibitors? A national Danish melanoma study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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13
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Ubels S, Verstegen M, Klarenbeek B, Bouwense S, van Berge Henegouwen M, Daams F, van Det MJ, Griffiths EA, Haveman JW, Heisterkamp J, Koshy R, Nieuwenhuijzen G, Polat F, Siersema PD, Singh P, Wijnhoven B, Hannink G, van Workum F, Rosman C, Matthée E, Slootmans CAM, Ultee G, Schouten J, Gisbertz SS, Eshuis WJ, Kalff MC, Feenstra ML, van der Peet DL, Stam WT, van Etten B, Poelmann F, Vuurberg N, van den Berg JW, Martijnse IS, Matthijsen RM, Luyer M, Curvers W, Nieuwenhuijzen T, Taselaar AE, Kouwenhoven EA, Lubbers M, Sosef M, Lecot F, Geraedts TCM, van Esser S, Dekker JWT, van den Wildenberg F, Kelder W, Lubbers M, Baas PC, de Haas JWA, Hartgrink HH, Bahadoer RR, van Sandick JW, Hartemink KJ, Veenhof X, Stockmann H, Gorgec B, Weeder P, Wiezer MJ, Genders CMS, Belt E, Blomberg B, van Duijvendijk P, Claassen L, Reetz D, Steenvoorde P, Mastboom W, Klein Ganseij HJ, van Dalsen AD, Joldersma A, Zwakman M, Groenendijk RPR, Montazeri M, Mercer S, Knight B, van Boxel G, McGregor RJ, Skipworth RJE, Frattini C, Bradley A, Nilsson M, Hayami M, Huang B, Bundred J, Evans R, Grimminger PP, van der Sluis PC, Eren U, Saunders J, Theophilidou E, Khanzada Z, Elliott JA, Ponten J, King S, Reynolds JV, Sgromo B, Akbari K, Shalaby S, Gutschow CA, Schmidt H, Vetter D, Moorthy K, Ibrahim MAH, Christodoulidis G, Räsänen JV, Kauppi J, Söderström H, Manatakis DK, Korkolis DP, Balalis D, Rompu A, Alkhaffaf B, Alasmar M, Arebi M, Piessen G, Nuytens F, Degisors S, Ahmed A, Boddy A, Gandhi S, Fashina O, Van Daele E, Pattyn P, Robb WB, Arumugasamy M, Al Azzawi M, Whooley J, Colak E, Aybar E, Sari AC, Uyanik MS, Ciftci AB, Sayyed R, Ayub B, Murtaza G, Saeed A, Ramesh P, Charalabopoulos A, Liakakos T, Schizas D, Baili E, Kapelouzou A, Valmasoni M, Pierobon ES, Capovilla G, Merigliano S, Silviu C, Rodica B, Florin A, Cristian Gelu R, Petre H, Guevara Castro R, Salcedo AF, Negoi I, Negoita VM, Ciubotaru C, Stoica B, Hostiuc S, Colucci N, Mönig SP, Wassmer CH, Meyer J, Takeda FR, Aissar Sallum RA, Ribeiro U, Cecconello I, Toledo E, Trugeda MS, Fernández MJ, Gil C, Castanedo S, Isik A, Kurnaz E, Videira JF, Peyroteo M, Canotilho R, Weindelmayer J, Giacopuzzi S, De Pasqual CA, Bruna M, Mingol F, Vaque J, Pérez C, Phillips AW, Chmelo J, Brown J, Han LE, Gossage JA, Davies AR, Baker CR, Kelly M, Saad M, Bernardi D, Bonavina L, Asti E, Riva C, Scaramuzzo R, Elhadi M, Abdelkarem Ahmed H, Elhadi A, Elnagar FA, Msherghi AAA, Wills V, Campbell C, Perez Cerdeira M, Whiting S, Merrett N, Das A, Apostolou C, Lorenzo A, Sousa F, Adelino Barbosa J, Devezas V, Barbosa E, Fernandes C, Smith G, Li EY, Bhimani N, Chan P, Kotecha K, Hii MW, Ward SM, Johnson M, Read M, Chong L, Hollands MJ, Allaway M, Richardson A, Johnston E, Chen AZL, Kanhere H, Prasad S, McQuillan P, Surman T, Trochsler MI, Schofield WA, Ahmed SK, Reid JL, Harris MC, Gananadha S, Farrant J, Rodrigues N, Fergusson J, Hindmarsh A, Afzal Z, Safranek P, Sujendran V, Rooney S, Loureiro C, Leturio Fernández S, Díez del Val I, Jaunoo S, Kennedy L, Hussain A, Theodorou D, Triantafyllou T, Theodoropoulos C, Palyvou T, Elhadi M, Abdullah Ben Taher F, Ekheel M, Msherghi AAA. Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score. Br J Surg 2022. [DOI: https://doi.org/10.1093/bjs/znac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Background
Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.
Methods
This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.
Results
Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.
Conclusion
The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.
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Affiliation(s)
- Sander Ubels
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Moniek Verstegen
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Bastiaan Klarenbeek
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Stefan Bouwense
- Department of Surgery, Maastricht University Medical Centre+ , Maastricht , the Netherlands
| | - Mark van Berge Henegouwen
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Freek Daams
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Marc J van Det
- Department of Surgery, ZGT hospital group , Almelo , the Netherlands
| | - Ewen A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham , Birmingham , UK
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham , Birmingham , UK
| | - Jan W Haveman
- Department of Surgery, University Medical Centre Groningen, University of Groningen , Groningen , the Netherlands
| | - Joos Heisterkamp
- Department of Surgery, Elisabeth-TweeSteden Hospital , Tilburg , the Netherlands
| | - Renol Koshy
- Department of Surgery, Newcastle upon Tyne Hospital NHS Trust , Newcastle upon Tyne , UK
- Department of Surgery, University Hospitals of Coventry and Warwickshire NHS Trust , Coventry , UK
| | | | - Fatih Polat
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Pritam Singh
- Department of Surgery, Nottingham University Hospitals NHS Trust , Nottingham , UK
- Department of Surgery, Regional Oesophago-Gastric Unit, Royal Surrey County Hospital , Guildford , UK
| | - Bas Wijnhoven
- Department of Surgery, Erasmus University Medical Centre , Rotterdam , the Netherlands
| | - Gerjon Hannink
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Frans van Workum
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
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Rasmussen A, Møller D, Hoffmann L, Knap M, Schmidt H, Ehmsen M, Ravkilde T, Worm E, Andersen M. PD-0653 Reproducibility of deep inspiration breath hold during RT for lung cancer patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Schmidt H, Gutjahr L, Sauter A, Zech F, Nchioua R, Stenger S, Frick M, Kirchhoff F, Dietl P, Wittekindt OH. Serially passaged, conditionally reprogrammed nasal epithelial cells as a model to study epithelial functions and SARS-CoV-2 infection. Am J Physiol Cell Physiol 2022; 322:C591-C604. [PMID: 35196166 PMCID: PMC8977148 DOI: 10.1152/ajpcell.00363.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary airway epithelial cells (pAECs) cultivated at air-liquid interface (ALI) conditions are widely used as surrogates for human in vivo epithelia. To extend the proliferative capacity and to enable serially passaging of pAECs, conditional reprogramming (cr) has been employed in recent years. However, ALI epithelia derived from cr cells often display functional changes with increasing passages. This highlights the need for thorough validation of the ALI cultures for the respective application. In our study, we evaluated the use of serially passaged cr nasal epithelial cells (crNECs) as a model to study SARS-CoV-2 infection and effects on ion and water transport. NECs were obtained from healthy individuals and cultivated as ALI epithelia derived from passages 1, 2, 3, and 5. We compared epithelial differentiation, ion and water transport, and infection with SARS-CoV-2 between passages. Our results show that epithelia maintained major differentiation characteristics and physiological ion and water transport properties through all passages. However, the frequency of ciliated cells, short circuit currents reflecting epithelial Na+ channel (ENaC) and cystic fibrosis transmembrane conductance regulator (CFTR) activity and expression of aquaporin 3 and 5 decreased gradually over passages. crNECs also expressed SARS-CoV-2 receptors angiotensin converting enzyme 2 (ACE2) and transmembrane serin2 protease 2 (TMPRSS2) across all passages and allowed SARS-CoV-2 replication in all passages. In summary, we provide evidence that passaged crNECs provide an appropriate model to study SARS-CoV-2 infection and also epithelial transport function when considering some limitations that we defined herein.
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Affiliation(s)
- Hanna Schmidt
- Department of Pediatric and Adolescent Medicine, Ulm University Medical Cente, Ulm, Germany.,Institute of General Physiology, Ulm University, Ulm, Germany
| | - Lara Gutjahr
- Institute of General Physiology, Ulm University, Ulm, Germany
| | | | - Fabian Zech
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Rayhane Nchioua
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Steffen Stenger
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Manfred Frick
- Institute of General Physiology, Ulm University, Ulm, Germany
| | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Paul Dietl
- Institute of General Physiology, Ulm University, Ulm, Germany
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Meena GG, Stambaugh AM, Ganjalizadeh V, Stott MA, Hawkins AR, Schmidt H. Ultrasensitive detection of SARS-CoV-2 RNA and antigen using single-molecule optofluidic chip. APL Photonics 2021; 6:066101. [PMID: 35693725 PMCID: PMC9186413 DOI: 10.1063/5.0049735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Nucleic acids and proteins are the two most important target types used in molecular diagnostics. In many instances, simultaneous sensitive and accurate detection of both biomarkers from the same sample would be desirable, but standard detection methods are highly optimized for one type and not cross-compatible. Here, we report the simultaneous multiplexed detection of SARS-CoV-2 RNAs and antigens with single molecule sensitivity. Both analytes are isolated and labeled using a single bead-based solid-phase extraction protocol, followed by fluorescence detection on a multi-channel optofluidic waveguide chip. Direct amplification-free detection of both biomarkers from nasopharyngeal swab samples is demonstrated with single molecule detection sensitivity, opening the door for ultrasensitive dual-target analysis in infectious disease diagnosis, oncology, and other applications.
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Affiliation(s)
- G. G. Meena
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - A. M. Stambaugh
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - V. Ganjalizadeh
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - M. A. Stott
- Electrical and Computer Engineering Department, Brigham Young University, Provo, Utah 84602, USA
| | - A. R. Hawkins
- Electrical and Computer Engineering Department, Brigham Young University, Provo, Utah 84602, USA
| | - H. Schmidt
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
- Author to whom correspondence should be addressed:. Telephone: 831-459-1482
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Brunelli M, Schwaar M, Isensee C, Goth S, Schmidt H, Heitmann A. Very (70W) vs. LSI guided (5-6) high power short duration ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein vs. pulmonary vein and posterior wall isolation. Europace 2021. [DOI: 10.1093/europace/euab116.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
high power short duration (HPSD) ablation is at least as safe while reducing procedure time than radiofrequency (RF) ablation with lower power in pts undergoing pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF). Purpose: to compare safety and efficacy of 2 different: 1) RF energy set up (FlexAbility: 70W, 41°, 6-10s, 11ml/h vs. TactiCath: 50W, 41°, LSI 5-6, 17ml/h, both Abbott), and 2) ablation strategies (posterior wall isolation (PWI) in addition to PVI vs. PVI) in pts undergoing their first ablation for paroxysmal AF. Methods: since June 2020 pts are prospectively assigned to alternatively undergo their RF catheter ablation with the FlexAbility (v-HPSD) or the TactiCath (LSI-HPSD) catheters (aim 200 pts). In addition, pts were alternatively assigned to PVI + PWI vs. PVI. All procedures were done using a 3D-mapping system (Ensite Precision), the ablation catheter was stabilized with a long sheath (Agilis) and a continuous series of lesions (4mm) were plotted around the PV, at the roof and between the 2 inferior PVs. On the PW, RF lesions were limited to 6s and 5 LSI for the v-HPSD and LSI-HPSD groups. Endoscopy was performed shortly after ablation in all pts and thermal esophageal lesion (TEL) characterized with the Kansas classification. Results: since June 2020 56 pts [61 ± 13 years old, 17 (30%) female, CHA2DS2-Vasc 2.3 ± 1.5, 55 ± 77 left ventricular ejection fraction] underwent v-HPSD (#28) and LSI-HPSD (#28) ablation. In 2/14 (14%) and in 3/15 (20%) pts (v-HPSD and LSI-HPSD groups, respectively) initially assigned to undergo simple PVI, PWI was added due to PW dependent flutter or evidence of pro-arrhythmic slow conduction on the PW. A shorter RF time to achieve PVI (17 ± 3 vs. 25 ± 6 min; P<.0001) was found for the v-HPSD group, although acute reconnection were numerically higher (9 vs. 4) and procedural time did not differ (32 ± 8 vs. 35 ± 9 min). Whenever attempted, PWI (#16 for each v-HPSD and LSI-HPSD group) was always successful. When v-HPSD and LSI-HPSD group were compared, no differences were found in RF and procedure time both at the roof (2.3 ± 0.9 vs. 2.7 ± 1.1 min and 3 ± 1.4 vs. 3.4 ± 1 min, respectively) and between the 2 inferior PVs (2.6 ± 0.6 vs. 2.9 ± 0.7 min and 4.3 ± 1.9 vs. 3.8 ± 1.2 min, respectively). Total RF (19.7 ± 4.5 vs. 28.5 ± 6.6 min, P<.0001) was shorted in the v-HPSD, but X-Ray (1.4 ± 0.7 vs. 1.2 ± 0.8 min) and total procedural time (102 ± 17 vs. 110 ± 20 min) did not differ. Rate of TELs was not different and found in 18% (#5: 4 I, 1 IIA) and 14% (all IIA) pts assigned to v-HPSD and LSI-HPSD respectively. A numerically higher number of TELs (6 vs. 3) was seen when PWI was pursued, although this did not prolong total RF and procedure time. Conclusion: a shorter RF time is associated with v-HPSD vs. LSI-HPSD strategy, although procedural time did not differ. TELs are a relative rare finding, and only numerically higher when isolation of the PW is pursued in addition to PV isolation.
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Affiliation(s)
- M Brunelli
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - M Schwaar
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - C Isensee
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - S Goth
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - H Schmidt
- Hospital Magdeburg, Division of Cardiology, Magdeburg, Germany
| | - A Heitmann
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
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Kragh P, Schmidt H. Einsatz des Simplexverfahrens zur Auswertung von Filmdosimetern / Application of the simplex method for the evaluation of film dosimeters. KERNTECHNIK 2021. [DOI: 10.1515/kern-1994-590309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bilbao L, Bortolotti A, Kilic H, Linhart JG, Nardi V, Schmidt H. Dynamics of thin liners driven by a quasi-cylindrical Z-pinch / Dynamik dünner „Liner“ in quasi-zylindrischen Z-Pinch-Experimenten. KERNTECHNIK 2021. [DOI: 10.1515/kern-1992-570520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cordes F, Ellermann C, Dechering DG, Frommeyer G, Kochhäuser S, Lange PS, Pott C, Lenze F, Kabar I, Schmidt H, Ullerich H, Eckardt L. Pre-procedural proton pump inhibition is associated with fewer peri-oesophageal lesions after cryoballoon pulmonary vein isolation. Sci Rep 2021; 11:4728. [PMID: 33633186 PMCID: PMC7907235 DOI: 10.1038/s41598-021-83928-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/08/2021] [Indexed: 11/09/2022] Open
Abstract
Pulmonary vein isolation (PVI) using cryoenergy is safe and efficient for treatment of atrial fibrillation (AF). Pre-existing upper gastrointestinal (GI) pathologies have been shown to increase the risk for AF. Therefore, this study aimed at assessing incidental pathologies of the upper GI tract in patients scheduled for PVI and to analyse the impact of patients’ characteristics on PVI safety outcome. In 71 AF patients, who participated in the MADE-PVI trial, oesophagogastroduodenoscopy and endosonography were prospectively performed directly before and the day after PVI to assess pre-existing upper GI pathologies and post-interventional occurrence of PVI-associated lesions. Subgroup analysis of the MADE-PVI trial identified clinically relevant incidental findings in 53 patients (74.6%) with age > 50 years being a significant risk factor. Pre-existing reflux oesophagitis increased risk for PVI-associated mediastinal oedema, while patients already treated with proton pump inhibitors (PPI) had significantly fewer mediastinal oedema. Our results suggest that AF patients with pre-existing reflux oesophagitis are at higher risk for PVI-associated mediastinal lesions, which is decreased in patients with constant PPI-treatment prior to PVI. Since PVI-associated mediastinal lesions are regarded as surrogate parameter for an increased risk of the fatal complication of an oesophago-atrial fistula, our findings hint at a beneficial effect of pre-interventional prophylactic PPI-treatment to reduce risk for PVI-associated complications. German Clinical Trials Register (DRKS00016006; date of registration: 17/12/2018).
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Affiliation(s)
- F Cordes
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - C Ellermann
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany.
| | - D G Dechering
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany
| | - G Frommeyer
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany
| | - S Kochhäuser
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany
| | - P S Lange
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany
| | - C Pott
- Department of Cardiology, Schuechtermann-Klinik, Bad Rothenfelde, Germany
| | - F Lenze
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - I Kabar
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - H Schmidt
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - H Ullerich
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - L Eckardt
- Department of Cardiology II (Electrophysiology), University Hospital Muenster, Albert-Schweitzer Campus 1, 48149, Münster, Germany
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22
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Messerer DAC, Schmidt H, Frick M, Huber-Lang M. Ion and Water Transport in Neutrophil Granulocytes and Its Impairment during Sepsis. Int J Mol Sci 2021; 22:1699. [PMID: 33567720 PMCID: PMC7914618 DOI: 10.3390/ijms22041699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
Neutrophil granulocytes are the vanguard of innate immunity in response to numerous pathogens. Their activity drives the clearance of microbe- and damage-associated molecular patterns, thereby contributing substantially to the resolution of inflammation. However, excessive stimulation during sepsis leads to cellular unresponsiveness, immunological dysfunction, bacterial expansion, and subsequent multiple organ dysfunction. During the short lifespan of neutrophils, they can become significantly activated by complement factors, cytokines, and other inflammatory mediators. Following stimulation, the cells respond with a defined (electro-)physiological pattern, including depolarization, calcium influx, and alkalization as well as with increased metabolic activity and polarization of the actin cytoskeleton. Activity of ion transport proteins and aquaporins is critical for multiple cellular functions of innate immune cells, including chemotaxis, generation of reactive oxygen species, and phagocytosis of both pathogens and tissue debris. In this review, we first describe the ion transport proteins and aquaporins involved in the neutrophil ion-water fluxes in response to chemoattractants. We then relate ion and water flux to cellular functions with a focus on danger sensing, chemotaxis, phagocytosis, and oxidative burst and approach the role of altered ion transport protein expression and activity in impaired cellular functions and cell death during systemic inflammation as in sepsis.
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Affiliation(s)
- David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, 89081 Ulm, Germany;
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ulm, 89081 Ulm, Germany
| | - Hanna Schmidt
- Institute of General Physiology, Ulm University, 89081 Ulm, Germany; (H.S.); (M.F.)
- Department of Pediatrics and Adolescent Medicine, University Hospital of Ulm, 89081 Ulm, Germany
| | - Manfred Frick
- Institute of General Physiology, Ulm University, 89081 Ulm, Germany; (H.S.); (M.F.)
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, 89081 Ulm, Germany;
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23
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Scherner M, Weber C, Schmidt H, Kuhr K, Hamacher S, Sabashnikov A, Eghbalzadeh K, Mader N, Wahlers T, Wippermann J. Impact of urgent coronary artery bypass grafting on acute kidney injury : A matched cohort study. Med Klin Intensivmed Notfmed 2021; 117:152-158. [PMID: 33471151 DOI: 10.1007/s00063-020-00769-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/26/2020] [Accepted: 10/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES There is limited knowledge regarding the specific interrelationships between urgent coronary artery bypass graft (U-CABG) surgery and postoperative acute kidney injury (AKI). We aimed to (1) analyze the impact of urgent CABG (U-CABG) on the incidence and severity of postoperative AKI, (2) estimate the influence of AKI after U‑CABG or elective CABG (E-CABG) on mortality and (3) identify risk factors for AKI depending on the urgency of operation. RESULTS U‑CABG patients showed a higher incidence of AKI (49.8% vs. E‑CABG: 39.7%; p = 0.026), especially for higher AKI stages 2 + 3. In-hospital mortality was higher in U‑CABG patients (12.6%) compared to E‑CABG patients (2.3%; p < 0.001). The impact of AKI on mortality did not differ, but showed a strong coherency between higher AKI stages (2 + 3) and mortality (stage 1: OR 2.409, 95% CI 1.017-5.706; p = 0.046 vs. stage 2 + 3: OR 5.577; 95% CI 2.033-15.3; p = 0.001). Univariate logistic regression analysis revealed that preoperative renal impairment, peripheral vascular disease and transfusion of more than two red blood cell concentrates were predictors for postoperative AKI in both groups. CONCLUSIONS U‑CABG is a risk factor for postoperative AKI and even "mild" AKI leads to a significantly higher mortality. Hence, the prevention of modifiable risk factors might reduce the incidence of postoperative AKI and thus improve outcome.
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Affiliation(s)
- M Scherner
- Dept. of Cardiothoracic Surgery, University of Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany. .,Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
| | - C Weber
- Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
| | - H Schmidt
- Departement of Cardiology, Klinikum Magdeburg, Magdeburg, Germany.,Faculty of Medicine, University of Halle, Halle, Germany
| | - K Kuhr
- Faculty of Medicine, University of Halle, Halle, Germany
| | - S Hamacher
- Faculty of Medicine, University of Halle, Halle, Germany
| | - A Sabashnikov
- Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
| | - K Eghbalzadeh
- Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
| | - N Mader
- Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
| | - T Wahlers
- Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
| | - J Wippermann
- Dept. of Cardiothoracic Surgery, University of Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
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24
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Chen R, Schmidt H. Model-based convolutional neural network approach to underwater source-range estimation. J Acoust Soc Am 2021; 149:405. [PMID: 33514155 DOI: 10.1121/10.0003329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
This paper is part of a special issue on machine learning in acoustics. A model-based convolutional neural network (CNN) approach is presented to test the viability of this method as an alternative to conventional matched-field processing (MFP) for underwater source-range estimation. The networks are trained with simulated data generated under a particular model of the environment. When tested with data simulated in environments that deviate slightly from the training environment, this approach shows improved prediction accuracy and lower mean-absolute-error (MAE) compared to MFP. The performance of this model-based approach also transfers to real data, as demonstrated separately with field data collected in the Beaufort Sea and off the coast of Southern California. For the former, the CNN predictions are consistent with expected source range while for the latter, the CNN estimates have lower MAE compared to MFP. Examination of the trained CNNs' intermediate outputs suggests that the approach is more constrained than MFP from outputting very inaccurate predictions when there is a slight environmental mismatch. This improvement appears to be at the expense of decreased certainty in the correct source range prediction when the environment is precisely modeled.
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Affiliation(s)
- R Chen
- Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H Schmidt
- Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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25
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Chen R, Schmidt H. Temporal and spatial characteristics of the Beaufort Sea ambient noise environment. J Acoust Soc Am 2020; 148:3928. [PMID: 33379872 DOI: 10.1121/10.0002955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
Underwater ambient noise from the Beaufort Sea, collected in March 2016, is analyzed to investigate the effect that environmental changes in the region have on the spatial and temporal characteristics of the ice-generated ambient noise. In particular, the influx of warm Pacific water, so called the Beaufort Lens, has dramatically altered the level and vertical directionality of ambient noise, creating a low noise zone in the ∼75-250 m depth interval with a noise notch at low grazing angles. It is also demonstrated how the observed noise vertical directionality is consistent with ice-mechanical activity along an active pressure ridge ∼30-50 km from the recording array, as shown by satellite imagery. The discrete ranges to this ice activity explain the peak arrival angles between -10 to -15 degrees in noise vertical directionality, as well as the horizontal noise notch. Transient noise events associated with the ice activity are analyzed using an image processing approach with hierarchical clustering applied to the recorded spectrograms. The observed events are grouped into three categories-short-time-broadband, long-time-narrowband, and long-time-broadband-each likely generated through a different mechanism by the ice cover. The spectral and temporal distribution of these transients are discussed.
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Affiliation(s)
- R Chen
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H Schmidt
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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26
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Meena GG, Wall TA, Stott MA, Brown O, Robison R, Hawkins AR, Schmidt H. 7X multiplexed, optofluidic detection of nucleic acids for antibiotic-resistance bacterial screening. Opt Express 2020; 28:33019-33027. [PMID: 33114971 PMCID: PMC7679188 DOI: 10.1364/oe.402311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Rapid and accurate diagnosis of bacterial infections resistant to multiple antibiotics requires development of new bio-sensors for differentiated detection of multiple targets. This work demonstrates 7x multiplexed detection for antibiotic-resistance bacterial screening on an optofluidic platform. We utilize spectrally multiplexed multi-spot excitation for simultaneous detection of nucleic acid strands corresponding to bacterial targets and resistance genes. This is enabled by multi-mode interference (MMI) waveguides integrated in an optofluidic device. We employ a combinatorial three-color labeling scheme for the nucleic acid assays to scale up their multiplexing capability to seven different nucleic acids, representing three species and four resistance genes.
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Affiliation(s)
- G. G. Meena
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - T. A. Wall
- Electrical and Computer Engineering Department, Brigham Young University, Provo, Utah 84602, USA
| | - M. A. Stott
- Electrical and Computer Engineering Department, Brigham Young University, Provo, Utah 84602, USA
| | - O. Brown
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah 84602, USA
| | - R. Robison
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah 84602, USA
| | - A. R. Hawkins
- Electrical and Computer Engineering Department, Brigham Young University, Provo, Utah 84602, USA
| | - H. Schmidt
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
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27
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Meena GG, Hanson RL, Wood RL, Brown OT, Stott MA, Robison RA, Pitt WG, Woolley AT, Hawkins AR, Schmidt H. 3× multiplexed detection of antibiotic resistant plasmids with single molecule sensitivity. Lab Chip 2020; 20:3763-3771. [PMID: 33048071 PMCID: PMC7574402 DOI: 10.1039/d0lc00640h] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Bacterial pathogens resistant to antibiotics have become a serious health threat. Those species which have developed resistance against multiple drugs such as the carbapenems, are more lethal as these are last line therapy antibiotics. Current diagnostic tests for these resistance traits are based on singleplex target amplification techniques which can be time consuming and prone to errors. Here, we demonstrate a chip based optofluidic system with single molecule sensitivity for amplification-free, multiplexed detection of plasmids with genes corresponding to antibiotic resistance, within one hour. Rotating disks and microfluidic chips with functionalized polymer monoliths provided the upstream sample preparation steps to selectively extract these plasmids from blood spiked with E. coli DH5α cells. Waveguide-based spatial multiplexing using a multi-mode interference waveguide on an optofluidic chip was used for parallel detection of three different carbapenem resistance genes. These results point the way towards rapid, amplification-free, multiplex analysis of antibiotic-resistant pathogens.
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Affiliation(s)
- G G Meena
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, USA.
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28
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Richtig G, Cerroni L, Schmidt H, Beham-Schmid C, Deinlein T, Vallant C, Richtig E. Talimogene laherparepvec can initiate plasma cell invasion into infiltrated melanoma lesions - a case series. J Eur Acad Dermatol Venereol 2020; 35:e209-e211. [PMID: 32885517 DOI: 10.1111/jdv.16922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- G Richtig
- Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Otto Loewi Research Center, Pharmacology Section, Medical University of Graz, Graz, Austria
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - H Schmidt
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - C Beham-Schmid
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - T Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C Vallant
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - E Richtig
- Department of Dermatology, Medical University of Graz, Graz, Austria
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29
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Fraeulin L, Holzgreve F, Haenel J, Filmann N, Schmidt H, Bader A, Frei M, Groneberg DA, van Mark A, Ohlendorf D. A device-based stretch training for office workers resulted in increased range of motion especially at limited baseline flexibility. Work 2020; 68:353-364. [PMID: 32925158 DOI: 10.3233/wor-203273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is unclear whether and under which conditions stretch training programs lead to gains in flexibility when applied in work health promotion for office workers in order to reduce musculoskeletal disorders (MSD). OBJECTIVE The aim of this study was to analyze whether the stretch training "five-Business" leads to gains in range of motion (ROM). Furthermore, the influence of baseline flexibility and socio-demographic factors (sex, age, weight, height and body mass index (BMI)) on trainability was assessed. METHODS 161 office workers (n = 45 female; n = 116 male) without major MSD were recruited. Over three months, a standardized static stretch training ("five-Business") was executed on a device, supervised twice per week for 10 min. ROM was assessed using a digital inclinometer (shoulder, hip and trunk extension) and a tape measure (fingertip-to-floor and lateral inclination). RESULTS ROM gains (p≤0.001) were present in all tests, except for the hip extension. ROM changes correlated moderately (0.24-0.62) with the baseline flexibility (p≤0.001). Subjects with limited flexibility reached the largest gains (1.41-25.33%). Regarding the socio-demographic factors only one low correlation occurred (weight - retroflexion; -0.177). CONCLUSION The "five-Business" stretch training effectively increases ROM in office workers, especially when baseline flexibility is limited.
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Affiliation(s)
- L Fraeulin
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - F Holzgreve
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - J Haenel
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - N Filmann
- Institute for Biostatistics and Mathematical Modelling, Center for Health Sciences, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - H Schmidt
- Health & Safety, Daimler AG, Stuttgart, Germany
| | - A Bader
- Health & Safety, Daimler AG, Stuttgart, Germany
| | - M Frei
- Works Medical Service, Mercedes-Benz AG, Rastatt, Germany
| | - D A Groneberg
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - A van Mark
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - D Ohlendorf
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
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30
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Schliemann C, Gerwing M, Heinzow H, Harrach S, Schwöppe C, Wildgruber M, Hansmeier A, Angenendt L, Berdel A, Kessler T, Wilms C, Hartmann W, Wardelmann E, Kraehling T, Heindel W, Gerss J, Schmidt H, Lenz G, Mesters R, Berdel W. 563P First-in-class CD13-targeted tissue factor tTF-NGR in patients with recurrent or refractory malignant tumours: Safety and pharmacokinetic results of a phase I study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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31
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Weser R, Darinskii AN, Weihnacht M, Schmidt H. Experimental and numerical investigations of mechanical displacements in surface acoustic wave bounded beams. Ultrasonics 2020; 106:106077. [PMID: 32305680 DOI: 10.1016/j.ultras.2020.106077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/18/2019] [Accepted: 01/01/2020] [Indexed: 06/11/2023]
Abstract
The present paper studies experimentally and numerically the surface acoustic wave (SAW) field on a piezoelectric substrate generated by interdigital transducers (IDT). On the one hand, mechanical displacements produced by the SAW are measured with the help of a laser Doppler vibrometer. On the other hand, mechanical displacements are computed by the two-dimensional finite element method in frequency domain followed by the spatial Fourier transform. Combining these two steps of computations results in the intended two-dimensional distribution of mechanical displacements on the substrate surface. The comparison of experimental and numerical data obtained for a series of different IDTs reveals that it is possible to estimate the shape of the SAW beam and the absolute value of mechanical displacement amplitude using only the basic parameters of the IDT and its electrical admittance measured by a network analyzer.
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Affiliation(s)
- R Weser
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany.
| | - A N Darinskii
- Shubnikov Institute of Crystallography FSRC "Crystallography and Photonics", Russian Academy of Sciences, Leninskii pr. 59, Moscow 119333, Russia
| | - M Weihnacht
- InnoXacs, Am Muehlfeld 34, 01744 Dippoldiswalde, Germany
| | - H Schmidt
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany
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32
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Weser R, Winkler A, Weihnacht M, Menzel S, Schmidt H. The complexity of surface acoustic wave fields used for microfluidic applications. Ultrasonics 2020; 106:106160. [PMID: 32334142 DOI: 10.1016/j.ultras.2020.106160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 01/27/2020] [Accepted: 02/13/2020] [Indexed: 05/08/2023]
Abstract
Using surface acoustic waves (SAW) for the agitation and manipulation of fluids and immersed particles or cells in lab-on-a-chip systems has been state of the art for several years. Basic tasks comprise fluid mixing, atomization of liquids as well as sorting and separation (or trapping) of particles and cells, e.g. in so-called acoustic tweezers. Even though the fundamental principles governing SAW excitation and propagation on anisotropic, piezoelectric substrates are well-investigated, the complexity of wave field effects including SAW diffraction, refraction and interference cannot be comprehensively simulated at this point of time with sufficient accuracy. However, the design of microfluidic actuators relies on a profound knowledge of SAW propagation, including superposition of multiple SAWs, to achieve the predestined functionality of the devices. Here, we present extensive experimental results of high-resolution analysis of the lateral distribution of the complex displacement amplitude, i.e. the wave field, alongside with the electrical S-parameters of the generating transducers. These measurements were carried out and are compared in setups utilizing travelling SAW (tSAW) excited by single interdigital transducer (IDT), standing SAW generated between two IDTs (1DsSAW, 1D acoustic tweezers) and between two pairs of IDTs (2DsSAW, 2D acoustic tweezers) with different angular alignment in respect to pure Rayleigh mode propagation directions and other practically relevant orientations. For these basic configurations, typically used to drive SAW-based microfluidics, the influence of common SAW phenomena including beam steering, coupling coefficient dispersion and diffraction on the resultant wave field is investigated. The results show how tailoring of the acoustic conditions, based on profound knowledge of the physical effects, can be achieved to finally realize a desired behavior of a SAW-based microacoustic-fluidic system.
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Affiliation(s)
- R Weser
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany.
| | - A Winkler
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany
| | - M Weihnacht
- InnoXacs GmbH, Am Muehlfeld 34, 01744 Dippoldiswalde, Germany
| | - S Menzel
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany
| | - H Schmidt
- Leibniz Institute for Solid State and Materials Research Dresden, SAWLab Saxony, Helmholtzstr. 20, 01069 Dresden, Germany
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33
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Sørensen AS, Nørgaard Andersen M, Juul-Madsen K, Skejø C, Schmidt H, Vorup-Jensen T, Kragstrup TW. OP0130 IN VITRO CHARACTERIZATION OF INFLAMMATORY ARTHRITIS ASSOCIATED WITH IMMUNE CHECK POINT INHIBITION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:During cancer treatment with immune checkpoint inhibitors (ICI) such as the anti-PD-1 antibody pembrolizumab, 2-4% of patients develop inflammatory arthritis as an immune related adverse event and half of patients with pre-existing inflammatory arthritis have disease flares. This type of adverse events shows striking similarities with traditional immune mediated inflammatory arthritis. However, the underlying immunological mechanisms of inflammatory arthritis associated with ICI are not fully understood.Objectives:We aimed to develop an in vitro model of inflammatory arthritis associated with ICI, and to use this model to investigate monocyte differentiation and activation following treatment with pembrolizumab.Methods:First, synovial fluid mononuclear cells (SFMCs) and peripheral blood mononuclear cells (PBMCs) from patients with immune mediated inflammatory arthritis (rheumatoid arthritis and peripheral spondyloarthritis, n=22) and PBMCs from healthy controls were incubated with pembrolizumab and assessed for monocyte chemoattractant protein 1 (MCP-1) secretion by ELISA. Then, cytokine production in SFMCs was studied in more detail by the multiplex V-PLEX proinflammatory panel and by intracellular flow cytometry. Finally, pembrolizumab treated SFMCs were incubated with the different disease modifying anti-rheumatic drugs adalimumab, tocilizumab, tofacitinib, and baricitinib.Results:Pembrolizumab significantly increased MCP-1 production in the SFMCcultures (P=0.0031). In contrast, pembrolizumab did not change MCP-1 production by PBMCs from neither patients nor healthy controls (P=0.77 and P=0.43). Pembrolizumab also increased the production of TNFα (P=0.049), IFNγ (P=0.047), and IL-12p70 (P=0.031), but did not change the production of IL-6 (P=0.98). Among SFMCs treated with pembrolizumab there was an increased frequency of intermediate monocytes (P=0.044). Interestingly, pembrolizumab also increased the MCP-1 production within the intermediate monocytes only (P=0.028). In contrast, among SFMCs treated with LPS, only the classical monocyte subset was increased (P=0.0045) and MCP-1 production increased in both intermediate and classical monocyte subsets. Lastly, the TNFα inhibitor adalimumab and the Janus kinase inhibitors baricitinib and tofacitinib attenuated the pembrolizumab-induced MCP-1 production (P=0.0004, P=0.033, and P=0.025, respectively) while this was not seen with the IL-6 inhibitor tocilizumab (P=0.75).Conclusion:We have developed a very simple in vitro model of inflammatory arthritis associated with ICI. Using this model, we found that pembrolizumab specifically activated intermediate monocytes and induced TNFα, IFNγ, and IL-12p70 production, whereas IL-6 was unchanged. These findings were supported by effectful reduction of MCP-1 secretion with TNFα inhibition but not with IL-6 inhibition. This model could potentially be used to further study the effects of ICIs and the underlying immunological mechanisms of inflammatory arthritis associated with ICI.References:None.Disclosure of Interests:Anne Sofie Sørensen: None declared, Morten Nørgaard Andersen: None declared, Kristian Juul-Madsen: None declared, Cæcilie Skejø: None declared, Henrik Schmidt: None declared, Thomas Vorup-Jensen: None declared, Tue Wenzel Kragstrup Shareholder of: iBio Tech ApS, Consultant of: Bristol-Myers Squibb, Speakers bureau: TWK has engaged in educational activities talking about immunology in rheumatic diseases receiving speaking fees from Pfizer, Bristol-Myers Squibb, Eli Lilly, Novartis, and UCB.
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Brunelli M, Schwaar M, Isensee C, Opara W, Michael T, Heitmann A, Schmidt H. 1249Acute efficacy and safety of pulmonary vein isolation for atrial fibrillation in patients alternatively assigned to high power short duration (70W, 8s) vs lesion index guided (35W) ablation. Europace 2020. [DOI: 10.1093/europace/euaa162.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
permanent trans-mural lesions not affecting surrounding anatomical structures is the goal of safe and effective wide antral pulmonary vein (PV) isolation in patients with paroxysmal and persistent atrial fibrillation (AF) undergoing catheter ablation (CA). Time, energy and contact force are parameters related to lesion goodness and incorporated in a complex formula (i.e. the lesion index, LSI™, Abbott). This parameter is emerging as the gold standard for PV isolation. Recently, the shallower but wider lesions created by high power short duration (HPSD) ablation has came to attention.
Purpose
to compare acute reconnection rate, procedural parameters, and complication rates in patients with paroxysmal or persistent AF undergoing CA.
Methods
one-hundred patients with paroxysmal and 100 with persistent AF will be alternatively assigned to undergo PV isolation with the FlexAbility™ (HPSD group, 70W, 41°, 8 seconds) or the TactiCath™ (LSI-group: 35W, 41°, LSI: 5-5.5 posterior wall, up to ≥6 anywhere else) catheter. A 3-D mapping system (Ensite Precision™) and a steerable sheath (Agilis™, both Abbott) were always used. Adenosine (30mg) is given after PV isolation and ≥ 20 minutes waiting time. Posterior wall isolation was added in all, and patients with persistent AF were additionally treated with mitral and cavotricuspid isthmus ablation. Results: between June and October 2019, 71 patients (68 ± 10 years old, 32 (45%) female, 44 (60%) paroxysmal AF, AF duration 58 ± 81 months) were alternatively assigned to HPSD (36, 51%) or LSI-guided (35, 49%) ablation. No difference in clinical characteristics was found between groups. After 44 ± 18 and 30 ± 14min of procedural and RF time, all PVs were isolated, and all 17 (24%) reconnections treated with an additional 4 ± 3 and 3 ± 2min, respectively. In 8 ± 3 and 7 ± 3 min of procedural and RF time, the PW was successfully isolated in all. PV isolation (34 ± 12min vs. 56 ± 16min; P<.0001), RF (18 ± 5min vs. 41 ± 9min; P<.0001), and total procedural (138 ± 34min vs. 162 ± 34min; P=.0026) time were shorter in the HPSD group. X-Ray time and effective dose did not differ. A similar rate of acute reconnections (9, 25% vs. 8 23%) was found when HPSD and LSI were compared. A higher, although statistically not significant, number of steam pops was observed in the HPSD (14, 39%) vs. LSI (8, 23%) group, possibly related to the higher incidence of moderate pericardial effusion (>0.5mm, <20mm) found the day following the ablation (10, 28% vs. 2, 6%; P=.0238). No further complications related to CA were detected.
Conclusions
in patients with paroxysmal and persistent AF undergoing their first CA, HPSD ablation is faster than an LSI-guided approach. Acute efficacy (reconnection rate) is similar. Although a higher rate of haemodynamically non-relevant pericardial effusions were seen in the HPSD group, these were all treated medically and the general safety profile of this approach is excellent and comparable to LSI ablation.
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Affiliation(s)
- M Brunelli
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - M Schwaar
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - C Isensee
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - W Opara
- Hospital Magdeburg, Division of Cardiology, Magdeburg, Germany
| | | | | | - H Schmidt
- Hospital Magdeburg, Division of Cardiology, Magdeburg, Germany
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Brunelli M, Opara W, Schwaar M, John N, Isensee C, Lutze G, Adler J, Heitmann A, Michael T, Gottstein T, Schmidt H. 1247Similar rate of thermal esophageal lesions are found in patients alternatively assigned to high power short duration (70W, 8s) vs. lesion index guided (35W) ablation for atrial fibrillation. Europace 2020. [DOI: 10.1093/europace/euaa162.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
wide antral pulmonary vein (PV) catheter ablation (CA) in patients with atrial fibrillation (AF) is safe and effective when permanent trans-mural lesions are achieved without causing harm to surrounding anatomical structures. Atrio-esophageal fistula, due to its high mortality, is the most dreadful complication related to CA for AF, therefore alternative radiofrequency (RF) approaches to reduce or eliminate this complication are currently studied. The shallower but wider lesions of high power short duration (HPSD) ablation might represent a safe alternative.
Purpose
to compare the rate of thermal esophageal lesions in patients with paroxysmal and persistent AF undergoing CA assigned to the 2 different RF modality.
Methods
one-hundred patients with paroxysmal and 100 with persistent AF will be alternatively assigned to undergo CA with the FlexAbility™ (HPSD group: 70W, 41°, 8 seconds) or the TactiCath™ (LSI-group: 35W, 41°, LSI: 5-5.5 posterior wall, up to 6 anywhere else) catheter. A 3-D mapping system, a steerable sheath and adenosine-test (30mg) were used in all patients. Posterior wall (PW) isolation in addition to PV isolation was performed in all, and patients with persistent AF were additionally treated with mitral and cavotricuspid isthmus ablation. Insertion of an esophageal probe was always attempted, and all patients underwent upper endoscopy 24 to 48 hours after CA.
Results
between June and October 2019, 71 patients (68 ± 10 years old, 32 (45%) female, 44 (60%) paroxysmal AF, AF duration 58 ± 81 months) were alternatively assigned to HPSD (36, 51%) or LSI-guided (35, 49%) ablation. No differences in clinical characteristics were found between groups. After 45 ± 18min and 30 ± 14 min of procedural and RF time, all PVs were isolated, and all spontaneous and adenosine-induced reconnections treated. Successful PW isolation was achieved with an additional 8 ± 3 and 7 ± 3 min of procedural and RF time. When HPSD and LSI-guided groups are compared, a similar rate of clinically non-relevant and self-healing thermal lesions at endoscopy was found (10, 27.8% vs. 10, 28.6%). Independent of the treatment group, a higher peak temperature identified patients with esophageal lesions (43.2° vs. 42°; P=.0065). A peak temperature value of 43.1° best identify patients most likely to develop thermal lesions (AUC 0.71, SE 84%, SP 39%). Interestingly, none of the 11 patients in whom esophageal probe insertion was not possible or attempted developed thermal lesions in comparison to 20 (33%) patients who underwent esophageal temperature monitoring (P=.0046). Conclusions: no difference in thermal induced esophageal lesions were found when the two different RF approach (HPSD vs. LSI guided) were compared. Interestingly, lack of temperature monitoring with an esophageal probe is associated with no thermal lesions at endoscopy.
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Affiliation(s)
- M Brunelli
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - W Opara
- Hospital Magdeburg, Division of Cardiology, Magdeburg, Germany
| | - M Schwaar
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - N John
- Clinic Magdeburg, Department of Gastroenterology, Magdeburg, Germany
| | - C Isensee
- Hospital Magdeburg, Electrophysiology Section, Department of Cardiology and Diabetology, Magdeburg, Germany
| | - G Lutze
- Clinic Magdeburg, Department of Gastroenterology, Magdeburg, Germany
| | - J Adler
- Clinic Magdeburg, Department of Gastroenterology, Magdeburg, Germany
| | | | | | - T Gottstein
- Clinic Magdeburg, Department of Gastroenterology, Magdeburg, Germany
| | - H Schmidt
- Hospital Magdeburg, Division of Cardiology, Magdeburg, Germany
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Udesen N, Helgestad O, Banke A, Frederiksen P, Jossiasen J, Jensen L, Schmidt H, Ravn H, Møller J. Impact of Concomitant Vasoactive Treatment in Mechanical Left Ventricular Unloading in Profound Cardiogenic Shock. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kampmeier S, Rennebaum F, Schmidt H, Riegel A, Herrmann M, Schaumburg F. Peripancreatic abscess supported by Bordetella hinzii. New Microbes New Infect 2020; 34:100650. [PMID: 32025312 PMCID: PMC6997295 DOI: 10.1016/j.nmni.2020.100650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/30/2019] [Accepted: 01/03/2020] [Indexed: 11/18/2022] Open
Abstract
We report a novel case of an infection with Bordetella hinzii, a pathogen usually detected in poultry, supporting a peripancreatic abscess formation as a complication of an acute necrotizing pancreatitis.
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Affiliation(s)
- S. Kampmeier
- Institute of Hygiene, University Hospital Münster, Germany
- Institute of Medical Microbiology, University Hospital Münster, Germany
- Corresponding author: S. Kampmeier, Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149, Münster, Germany.
| | - F. Rennebaum
- Department of Gastroenterology and Hepatology, University Hospital Münster, Germany
| | - H. Schmidt
- Department of Gastroenterology and Hepatology, University Hospital Münster, Germany
| | - A. Riegel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - M. Herrmann
- Institute of Medical Microbiology, University Hospital Münster, Germany
- Section of Medical and Geographical Infectiology, University Hospital Münster, Germany
| | - F. Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Germany
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Kooymann J, Witte S, Medenwald D, Golla A, Stangl G, Steckelberg A, Vordermark D, Schmidt H. INFLUENCING FACTORS ON THE DEVELOPMENT OF PHYSICAL FUNCTIONING OF OLDER CANCER PATIENTS DURING AND 12 MONTHS AFTER CANCER THERAPY: RESULTS OF A PROSPECTIVE OBSERVATIONAL STUDY. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Witte S, Medenwald D, Golla A, Shehu E, Vordermark D, Michl P, Binder M, Ruessel J, Steckelberg A, Schmidt H. TRAINING PROGRAMS PROMOTING DAILY ACTIVITY AND PHYSICAL FUNCTION OF OLDER PATIENTS WITH CANCER: A QUESTIONNAIRE-BASED SURVEY REGARDING INDIVIDUAL NEEDS AND PREFERENCES. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31240-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shehu E, Roggendorf S, Golla A, Hübner G, Stangl G, Lau A, Diestelhorst A, Vordermark D, Steckelberg A, Schmidt H. DEVELOPMENT OF A COMPLEX SUPPORTIVE INTERVENTION TO PROMOTE PHYSICAL FUNCTIONING OF OLDER CANCER PATIENTS, CONSIDERING INDIVIDUAL PLASTICITY (SIDEKICK). J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Willumsen N, Bager C, Jensen C, Karsdal M, Madsen D, Hansen M, Schmidt H, Svane I. Extracellular matrix and tissue derived metabolites in a liquid biopsy identifies endotypes of metastatic melanoma patients with differential response to immune checkpoint inhibitor treatment. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bol K, Ellebaek E, Donia M, Schmidt H, Bastholt L, Kiilgaard J, Svane IM. Real-world impact of immune checkpoint inhibitors in metastatic uveal melanoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tammemagi M, Nguyen K, Mcgarry C, Schmidt H, Leung Y, Darling G. P2.10-04 Predicting Non-Compliance in Routine Lung Cancer Screening for High-Risk Adults. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Josiassen J, Helgestad OKL, Moeller JE, Kjaergaard J, Schmidt H, Jensen LO, Holmvang L, Ravn HB, Hassager C. P1728Cardiogenic shock patients: those with and those without out-of-hospital cardiac arrest are different clinical entities. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Cardiogenic shock (CS) due to myocardial infarction (MI) carries 30-day mortality rates as high as 50%. The vast majority of study cohorts assessing mortality in CS comprise both patients presenting with and without out-of-hospital cardiac arrest (OHCA). Patients with and without OHCA are likely to represent two distinctive entities, which may be problematic to combine in an intervention trial.
Purpose
The aim of the study was to compare CS due to MI patients presenting with and without OHCA in terms of patient characteristics and outcome.
Methods
In the period from 2010–2017 all patients admitted at two tertiary heart centres in Denmark with CS following MI were individually identified and validated through patient records. The two centres have a catchment area of 3.9 million citizens corresponding to two-thirds of the Danish population.
Results
A total of 1716 CS patients were identified, of which 42% presented with OHCA. OHCA patients were younger (mean 63 vs 67 years), more frequently male (85 vs 67%), had higher lactate concentration (median 6.2 vs 5.0 mmol/L) on admission and higher left ventricular ejection fraction (median 30 vs 25%) compared to patients without OHCA (p<0.0001 for all). Patients presenting with OHCA had lower 30-day mortality compared to patients without OHCA (49% vs. 57%, respectively, plogrank<0.0001, Figure). Cause of in hospital death differed markedly between the two groups. Not surprisingly, anoxic brain damage was the leading cause of in hospital death in the OHCA group (56%) and only seen in 4% of patients without OHCA. In contrast, cardiac failure was the main cause of death in hospital death among patients without OHCA (60%), compared to 27% in patients with OHCA (p<0.0001).
Figure 1
Conclusion
Among patients with CS due to MI, overall 30-day mortality was significantly lower in patients presenting with OHCA. Anoxic brain damage was the main cause of in hospital death among OHCA patients, whereas fatal heart failure prevailed in patients without OHCA. Combining these two groups in a single trial with one specific intervention seems inappropriate and likely to cause an imbalance in the signal-to-noise ratio.
Acknowledgement/Funding
The Danish Heart Foundation and a research grant from Abiomed
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Affiliation(s)
- J Josiassen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - O K L Helgestad
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - J E Moeller
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - J Kjaergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - H Schmidt
- Odense University Hospital, Department of Cardiothoracic Anaesthesia, Odense, Denmark
| | - L O Jensen
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - L Holmvang
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - H B Ravn
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiothoracic Anaesthesia, Copenhagen, Denmark
| | - C Hassager
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
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Ellermann C, Cordes F, Dechering DG, Frommeyer G, Kochhaeuser S, Lange PS, Pott C, Lenze F, Schmidt H, Ullerich H, Eckardt L. P342Time-to-isolation-guided cryoballoon pulmonary vein isolation reduces esophageal and mediastinal alterations detected by endoscopic ultrasound. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) is recommended for treatment of symptomatic atrial fibrillation. Cryoballoon ablation is an emerging safe and efficient technique for achieving PVI. Nevertheless, structural alterations of the mediastinum and/or the oesophagus, which seem to be associated with an increased risk of the lethal complication of an atrio-oesophageal fistula, have been described.
Purpose
MADE-PVI (Mediastino-oesophageal Alterations Detected by Endosonography after PVI) aimed at evaluating safety of cryoballoon PVI in relation to two different freeze protocols. As a time-to-isolation (TTI)-guided protocol has been reported to be as effective as a conventional “two freeze protocol”, we hypothesized that a TTI-guided protocol causes less peri-atrial and -oesophageal lesions.
Methods
70 consecutive patients were scheduled for de novo cryoballoon (2nd generation) PVI employing either a conventional freeze protocol (Group A: n=35: 2x180s per vein) or a TTI-guided approach (Group B: n=35; freeze time: TTI+120s per vein or 1x180s in case TTI could not be measured). Structural oesophageal and mediastinal alterations (e.g. ulceration, oedema) were assessed by endoscopy and endosonography blinded prior and post ablation.
Results
Irrespective of used freeze protocol, ablation significantly increased atrio-oesophageal distances, including distance to left and right inferior pulmonary vein ostia as well as to the posterior wall of the left atrium (all p<0.001). In general, postinterventional mediastinal oedematous alterations were detected in 47 patients (70%) with a mean size of 14mm (± 0.9 mm), while only 10 patients (15%) revealed a large mediastinal oedema >20mm. Oesophageal thermal lesions occurred in 3 patients (4%) including 1 deep ulceration, which coincided with a large mediastinal oedema. The two freeze protocols had a distinct impact on mediastinal lesions as mean size of oedematous alterations and occurrence of large mediastinal oedema were significantly increased in Group A vs. Group B (17 mm vs. 11 mm, p<0.001; 26% vs. 6%, p=0.029). Furthermore, every oesophageal lesion was detected in patients in group A. Nonetheless, no major complication occurred in either group.
Conclusions
The present prospective study clearly demonstrates a significant impact of freeze protocol on post-interventional mediastino-oesophageal alterations. A TTI-guided protocol employing 2nd generation cryoballoon reduces mediastino-oesophageal lesions and may reduce complications.
Acknowledgement/Funding
This study was supported by Medtronic by an unrestricted grant (A 1351459).
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Affiliation(s)
- C Ellermann
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - F Cordes
- University Hospital of Munster, Department of Medicine B, Gastroenterology and Hepatology, Munster, Germany
| | - D G Dechering
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - G Frommeyer
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - S Kochhaeuser
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - P S Lange
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - C Pott
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
| | - F Lenze
- University Hospital of Munster, Department of Medicine B, Gastroenterology and Hepatology, Munster, Germany
| | - H Schmidt
- University Hospital of Munster, Department of Medicine B, Gastroenterology and Hepatology, Munster, Germany
| | - H Ullerich
- University Hospital of Munster, Department of Medicine B, Gastroenterology and Hepatology, Munster, Germany
| | - L Eckardt
- University Hospital of Munster, Department of Cardiology II - Electrophysiology, Munster, Germany
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Rahman M, Harrington M, Stott MA, Li Y, Sampad MJN, Yuzvinsky TD, Hawkins AR, Schmidt H. Optical trapping assisted detection rate enhancement of single molecules on a nanopore optofluidic chip. Optica 2019; 6:1130-1131. [PMID: 33598506 PMCID: PMC7885897 DOI: 10.1364/optica.6.001130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/17/2019] [Indexed: 05/25/2023]
Abstract
We use optical trapping to deliver molecular targets to the vicinity of a nanopore for high-throughput single molecule analysis on an optofluidic chip. DNA detection rates increase over 80× to enable detection at attomolar concentrations.
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Affiliation(s)
- M. Rahman
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - M. Harrington
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - M. A. Stott
- ECEn Department, Brigham Young University, 450 Engineering Building, Provo, Utah 84602, USA
| | - Y. Li
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - M. J. N. Sampad
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - T. D. Yuzvinsky
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
| | - A. R. Hawkins
- ECEn Department, Brigham Young University, 450 Engineering Building, Provo, Utah 84602, USA
| | - H. Schmidt
- School of Engineering, University of California, Santa Cruz, 1156 High Street, Santa Cruz, California 95064, USA
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Rahman M, Stott MA, Harrington M, Li Y, Sampad MJN, Lancaster L, Yuzvinsky TD, Noller HF, Hawkins AR, Schmidt H. On demand delivery and analysis of single molecules on a programmable nanopore-optofluidic device. Nat Commun 2019; 10:3712. [PMID: 31420559 PMCID: PMC6697697 DOI: 10.1038/s41467-019-11723-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 07/19/2019] [Indexed: 12/29/2022] Open
Abstract
Nanopore-based single nanoparticle detection has recently emerged as a vibrant research field with numerous high-impact applications. Here, we introduce a programmable optofluidic chip for nanopore-based particle analysis: feedback-controlled selective delivery of a desired number of biomolecules and integration of optical detection techniques on nanopore-selected particles. We demonstrate the feedback-controlled introduction of individual biomolecules, including 70S ribosomes, DNAs and proteins into a fluidic channel where the voltage across the nanopore is turned off after a user-defined number of single molecular insertions. Delivery rates of hundreds/min with programmable off-times of the pore are demonstrated using individual 70S ribosomes. We then use real-time analysis of the translocation signal for selective voltage gating of specific particles from a mixture, enabling selection of DNAs from a DNA-ribosome mixture. Furthermore, we report optical detection of nanopore-selected DNA molecules. These capabilities point the way towards a powerful research tool for high-throughput single-molecule analysis on a chip.
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Affiliation(s)
- M Rahman
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - M A Stott
- ECEn Department, Brigham Young University, 459 Clyde Building, Provo, UT, 84602, USA
| | - M Harrington
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - Y Li
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - M J N Sampad
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - L Lancaster
- Department of Molecular, Cell and Developmental Biology and Center for Molecular Biology of RNA, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - T D Yuzvinsky
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - H F Noller
- Department of Molecular, Cell and Developmental Biology and Center for Molecular Biology of RNA, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - A R Hawkins
- ECEn Department, Brigham Young University, 459 Clyde Building, Provo, UT, 84602, USA
| | - H Schmidt
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA.
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Furmanik G, Chatrou M, Willems B, van Gorp R, Schmidt H, van Eys G, Bochaton-Piallat M, Proudfoot D, Biessen E, Hedin U, Matic LP, Mees B, Shanahan C, Reutelingsperger C, Schurgers L. Nox5 Regulates Vascular Smooth Muscle Cell Phenotype. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Schmidt H, Kappelhof J. Review of the management of the Asian elephantElephas maximusEEP: current challenges and future solutions. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/izy.12233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Schmidt
- Studbook keeper Asian Elephant EEP Royal Rotterdam Zoological & Botanical Gardens Postbus 532 3000 AM Rotterdam The Netherlands
| | - J. Kappelhof
- Wageningen University & Research Droevendaalsesteeg 4 6708 PB Wageningen The Netherlands
- Royal Rotterdam Zoological & Botanical Gardens Postbus 532 3000 AM Rotterdam The Netherlands
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