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Thielemann JFB, Kasparik B, König J, Unterhitzenberger J, Rosner R. Stability of Treatment Effects and Caregiver-Reported Outcomes: A Meta-Analysis of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents. Child Maltreat 2024; 29:375-387. [PMID: 36959760 PMCID: PMC10981190 DOI: 10.1177/10775595231167383] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The efficacy of trauma-focused treatments for children and adolescents is well researched. However, less is known about the long-term and caregiver-reported effects. Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey. Treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) were computed at 12-month follow-up with posttraumatic stress symptoms (PTSS) as primary outcome and symptoms of depression, anxiety, and grief as secondary outcomes. Concordance between participant and caregiver ratings were investigated. TF-CBT showed large improvements across all outcomes from pre-treatment to 12-month follow-up (PTSS: g = 1.71, CI 1.27-2.15) and favorable results compared to active treatments and treatment as usual at 12-month follow-up (PTSS: g = .35, CI .13-.56). More pronounced effects were found in group settings. No significant differences were detected between participant and caregiver ratings with high reliability across almost all outcomes and assessment points. TF-CBT is a reliable treatment for pediatric PTSS and secondary symptoms with stable results at 12-month follow-up.
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Affiliation(s)
- Jonathan Felix Benjamin Thielemann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
- Alexianer Krefeld GmbH, Hospital Maria-Hilf, Clinic for Mental Health, Department of General Psychiatry, Krefeld, Germany
| | - Barbara Kasparik
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
| | - Julia König
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
| | - Johanna Unterhitzenberger
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
- Centre for Children and Adolescents Inn-Salzach e.V., Department of Child and Adolescent Psychiatry, Altoetting, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
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Dougherty GW, Ostrowski LE, Nöthe-Menchen T, Raidt J, Schramm A, Olbrich H, Yin W, Sears PR, Dang H, Smith AJ, Beule AG, Hjeij R, Rutjes N, Haarman EG, Maas SM, Ferkol TW, Noone PG, Olivier KN, Bracht DC, Barbry P, Zaragosi LE, Fierville M, Kliesch S, Wohlgemuth K, König J, George S, Loges NT, Ceppe A, Markovetz MR, Luo H, Guo T, Rizk H, Eldesoky T, Dahlke K, Boldt K, Ueffing M, Hill DB, Pang YP, Knowles MR, Zariwala MA, Omran H. Recessively Inherited Deficiency of Secreted WFDC2 (HE4) Causes Nasal Polyposis and Bronchiectasis. Am J Respir Crit Care Med 2024. [PMID: 38626355 DOI: 10.1164/rccm.202308-1370oc] [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: 08/07/2023] [Accepted: 04/16/2024] [Indexed: 04/18/2024] Open
Abstract
RATIONALE Bronchiectasis is a pathological dilatation of the bronchi in the respiratory airways associated with environmental or genetic causes (e.g., cystic fibrosis, primary ciliary dyskinesia and primary immunodeficiency disorders), but most cases remain idiopathic. OBJECTIVES To identify novel genetic defects in unsolved cases of bronchiectasis presenting with severe rhinosinusitis, nasal polyposis, and pulmonary Pseudomonas aeruginosa infection. METHODS DNA was analyzed by next-generation or targeted Sanger sequencing. RNA was analyzed by quantitative PCR and single-cell RNA sequencing. Patient-derived, cells, cell cultures and secretions (mucus, saliva, seminal fluid) were analyzed by Western blotting and immunofluorescence microscopy, and mucociliary activity was measured. Blood serum was analyzed by electrochemiluminescence immunoassay. Protein structure and proteomic analyses were used to assess the impact of a disease-causing founder variant. MEASUREMENTS AND MAIN RESULTS We identified bi-allelic pathogenic variants in WFDC2 in 11 individuals from 10 unrelated families originating from the United States, Europe, Asia, and Africa. Expression of WFDC2 was detected predominantly in secretory cells of control airway epithelium and also in submucosal glands. We demonstrate that WFDC2 is below the limit of detection in blood serum and hardly detectable in samples of saliva, seminal fluid, and airway surface liquid from WFDC2-deficient individuals. Computer simulations and deglycosylation assays indicate that the disease-causing founder variant p.Cys49Arg structurally hampers glycosylation and thus secretion of mature WFDC2. CONCLUSIONS WFDC2 dysfunction defines a novel molecular etiology of bronchiectasis characterized by the deficiency of a secreted component of the airways. A commercially available blood test combined with genetic testing allows its diagnosis. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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Affiliation(s)
| | - Lawrence E Ostrowski
- Universtiy of North Carolina at Chapel Hill, Marsico Lung Institute/ Cystic Fibrosis Center, Chapel Hill, North Carolina, United States
- United States
| | | | - Johanna Raidt
- University Hospital Muenster, Pediatrics, Muenster, Germany
| | - Andre Schramm
- University Hospital Muenster, General Pediatrics, Muenster, Germany
| | - Heike Olbrich
- University Hospital Muenster, General Pediatrics, Muenster, Germany
| | - Weining Yin
- University of North Carolina at Chapel Hill, 2331, Marsico Lung Institute/Cystic Fibrosis Research Center, Chapel Hill, North Carolina, United States
| | - Patrick R Sears
- Marsico Lung Institute/Cystic Fibrosis Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Hong Dang
- UNC, Marsico Lung Institute, Chapel Hill, North Carolina, United States
| | - Amanda J Smith
- Marsico Lung Institute/Cystic Fibrosis Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Achim G Beule
- University Clinic Münster, Dept. of ENT, Münster, Germany
| | - Rim Hjeij
- University Hospital Muenster, Pediatrics, Muenster, Germany
| | - Niels Rutjes
- Amsterdam UMC, Emma Children's Hospital, Department of Pediatric Pulmonology & Allergy, Amsterdam, Netherlands
| | - Eric G Haarman
- Amsterdam UMC, 522567, Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam, Noord-Holland, Netherlands
| | - Saskia M Maas
- Amsterdam UMC, Emma Children's Hospital, Department of Pediatric Pulmonology & Allergy, Amsterdam, Netherlands
| | - Thomas W Ferkol
- The University of North Carolina at Chapel Hill, 2331, Chapel Hill, North Carolina, United States
| | | | - Kenneth N Olivier
- The University of North Carolina at Chapel Hill, 2331, Medicine, Chapel Hill, North Carolina, United States
| | - Diana C Bracht
- University Children's Hospital Muenster, Department of General Pediatrics, Muenster, Germany
| | - Pascal Barbry
- Université Côte d'Azur, Institut de Pharmacologie Moléculaire et Cellulaire, Sophia Antipolis, France
- CNRS, 27051, Institut de Pharmacologie Moléculaire et Cellulaire, Sophia Antipolis, France
| | - Laure-Emmanuelle Zaragosi
- Université Côte d'Azur, 439710, Institut de Pharmacologie Moléculaire et Cellulaire, Sophia Antipolis, Provence-Alpes-Côte d'Azur, France
- CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, Sophia Antipolis, France
| | - Morgane Fierville
- Université Côte d'Azur and CNRS, 3IA Côte d'Azur & Institut de Pharmacologie Moléculaire et Cellulaire, Sophia Antipolis, France
| | - Sabine Kliesch
- Centre of Reproductive Medicine and Andrology, University Hospital Muenster, Department of Clinical and Surgical Andrology, Muenster, Germany
| | - Kai Wohlgemuth
- University Hospital Muenster, Department of General Pediatrics, Muenster, Germany
| | - Julia König
- University Children´s Hospital Muenster, Department of General Pediatrics, Muenster, Germany
| | - Sebastian George
- University Hospital Muenster, Department of General Pediatrics, Muenster, Germany
| | - Niki T Loges
- University Hospital Muenster, Pediatrics, Muenster, Germany
| | - Agathe Ceppe
- University of North Carolina at Chapel Hill, 2331, Chapel Hill, North Carolina, United States
| | - Matthew R Markovetz
- University of North Carolina at Chapel Hill, Marsico Lung Institute, Chapel Hill, North Carolina, United States
| | - Hong Luo
- Second Xiangya Hospital, 70566, Respiratory and Critical Care Medicine, Changsha, China
| | - Ting Guo
- Second Xiangya Hospital, Central South University, Department of Pulmonary and Critical Care Medicine, Changsha, Hunan, China
| | - Hoda Rizk
- Faculty of Medicine, University of Mansoura, Department of Pediatrics, Mansoura, Egypt
| | - Tarek Eldesoky
- Faculty of Medicine, University of Mansoura, Department of Pediatrics, Mansoura, Egypt
| | - Katrin Dahlke
- Institute for Ophthalmic Research and Core Facility for Medical Proteomics, Eberhard Karls University Tübingen, Tuebingen, Germany
| | - Karsten Boldt
- Institute for Ophthalmic Research and Core Facility for Medical Proteomics, Eberhard Karls University Tübingen, Tuebingen, Germany
| | - Marius Ueffing
- Institute for Ophthalmic Research and Core Facility for Medical Proteomics, Eberhard Karls University Tübingen, Tuebingen, Germany
| | - David B Hill
- University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina, United States
| | - Yuan-Ping Pang
- Mayo Clinic, Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, Minnesota, United States
| | - Michael R Knowles
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Maimoona A Zariwala
- UNC School of Medicine, Pathology/Lab Medicine, Chapel Hill, North Carolina, United States
| | - Heymut Omran
- University Hospital Münster, General Pediatrics, Münster, Germany;
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Trost K, Ertl V, König J, Rosner R, Comtesse H. Climate change-related concerns in psychotherapy: therapists' experiences and views on addressing this topic in therapy. BMC Psychol 2024; 12:192. [PMID: 38589939 PMCID: PMC11003001 DOI: 10.1186/s40359-024-01677-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND While adverse impacts of climate change on physical health are well-known, research on its effects on mental health is still scarce. Thus, it is unclear whether potential impacts have already reached treatment practice. Our study aimed to quantify psychotherapists' experiences with patients reporting climate change-related concerns and their views on dealing with this topic in psychotherapy. METHODS In a nationwide online survey, responses were collected from 573 psychotherapists from Germany. Therapists reported on the presence of such patients, their socio-demographic characteristics, and climate change-related reactions. Psychotherapists' views on dealing with this topic in psychotherapy were also assessed. Descriptive statistics were used to analyse the responses. RESULTS About 72% (410/573) of psychotherapists indicated having had patients expressing concerns about climate change during treatment. Out of these therapists, 41% (166/410) stated that at least one patient sought treatment deliberately because of such concerns. Patients were mainly young adults with higher education. Most frequent primary diagnoses were depression, adjustment disorder, and generalized anxiety disorder. Psychotherapists having encountered such patients differed from those without such encounters in their views on potential functional impairment and the necessity to target the concerns in treatment. Although 79% (326/415) of all respondents felt adequately prepared by their current therapeutic skills, 50% (209/414) reported a lack of information on how to deal with such concerns in therapy. CONCLUSIONS Results indicate that psychotherapists are frequently confronted with climate change-related concerns and regard the mental health impact of climate change on their patients as meaningful to psychotherapeutic care. Regular care could be improved by a continuous refinement of the conceptualization and knowledge of the mental health influences of climate change. This would allow providing tailored methods of assessing and addressing climate change-related concerns in practice.
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Affiliation(s)
- Katharina Trost
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany.
| | - Verena Ertl
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Julia König
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Rita Rosner
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Hannah Comtesse
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
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König J, Rahn A, Schätzel J, Frank M, Stahnke T, Witt M, Stachs A, Stachs O, Langner I, Lindner T, Beller E, Fischer DC, Streckenbach F. Effects of prenatal Doppler ultrasound on the retina of the chick embryo in ovo. Anat Histol Embryol 2023; 52:1003-1009. [PMID: 37668174 DOI: 10.1111/ahe.12960] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
Currently, the effect of prenatal ultrasound on foetal development is intensively discussed and the guidelines for prenatal diagnostics have been changed. However, data supporting these concerns are scarce. Therefore, we used an established in ovo model of the chicken embryo to investigate cell proliferation and apoptosis within the retina. A total of 21 chicken eggs were fenestrated on Day 5 and allocated to either the control (n = 8) or exposition group (n = 13). The exposition group was treated with pulsed-wave Doppler ultrasound (PWD) for 10 min while controls remained without treatment. After subsequent incubation (6-48 h), the eggs were sacrificed, and chicken embryos were examined morphologically (HE-staining) and immunohistochemically. Counting of apoptotic and proliferating cells per retina was performed using antibodies specific for phospho-histone-H3 and active caspase-3 in combination with a biotin-labelled secondary antibody and peroxidase conjugated avidin-biotin complex for chromogenic detection. Due to a rather low number of specimens at each time point after ultrasound exposition, we neglected the effects of incubation time and focused on treatment effects. This approach revealed that the median number of proliferating cells is reduced after 10 min of exposure to PWD (569 vs. 766), while the number of apoptotic cells is fairly comparable between groups (5 vs. 6). Our data contribute to a better understanding of prenatal US on foetal development by suggesting that PWD could have an impact on the number of proliferating cells in the developing chicken retina and therefore justify further investigations.
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Affiliation(s)
- Julia König
- Department of Anesthesia and Intensive Care, University Hospital Rostock, Rostock, Germany
| | - Anja Rahn
- Department of Pediatrics, Rostock University Medical Center, Rostock, Germany
| | - Jana Schätzel
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
| | - Marcus Frank
- Medical Biology and Electron Microscopy Centre, Rostock University Medical Center, Rostock, Germany
- Department of Life, Light and Matter, University of Rostock, Rostock, Germany
| | - Thomas Stahnke
- Institute for Implant Technology and Biomaterials-IIB e.V., Rostock, Germany
| | - Martin Witt
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany
- Department of Anatomy, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Angrit Stachs
- Department of Obstetrics and Gynecology, Rostock University Medical Center, Rostock, Germany
| | - Oliver Stachs
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
- Department of Life, Light and Matter, University of Rostock, Rostock, Germany
| | - Inga Langner
- Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Tobias Lindner
- Core Facility Multimodal Small Animal Imaging, Rostock University Medical Center, Rostock, Germany
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Ebba Beller
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Dagmar-C Fischer
- Department of Pediatrics, Rostock University Medical Center, Rostock, Germany
| | - Felix Streckenbach
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, Rostock, Germany
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Halkjær SI, Lo B, Cold F, Højer Christensen A, Holster S, König J, Brummer RJ, Aroniadis OC, Lahtinen P, Holvoet T, Gluud LL, Petersen AM. Fecal microbiota transplantation for the treatment of irritable bowel syndrome: A systematic review and meta-analysis. World J Gastroenterol 2023; 29:3185-3202. [PMID: 37346153 PMCID: PMC10280798 DOI: 10.3748/wjg.v29.i20.3185] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is the most prevalent gastrointestinal disorder in developed countries and reduces patients’ quality of life, hinders their ability to work, and increases health care costs. A growing number of trials have demonstrated an aberrant gut microbiota composition in IBS, also known as ‘gut dysbiosis’. Fecal microbiota transplantation (FMT) has been suggested as a treatment for IBS.
AIM To assess the efficacy and safety of FMT for the treatment of IBS.
METHODS We searched Cochrane Central, MEDLINE, EMBASE and Web of Science up to 24 October 2022 for randomised controlled trials (RCTs) investigating the effectiveness of FMT compared to placebo (including autologous FMT) in treating IBS. The primary outcome was the number of patients with improvements of symptoms measured using a validated, global IBS symptoms score. Secondary outcomes were changes in quality-of-life scores, non-serious and serious adverse events. Risk ratios (RR) and corresponding 95%CI were calculated for dichotomous outcomes, as were the mean differences (MD) and 95%CI for continuous outcomes. The Cochrane risk of bias tool was used to assess the quality of the trials. GRADE criteria were used to assess the overall quality of the evidence.
RESULTS Eight RCTs (484 participants) were included in the review. FMT resulted in no significant benefit in IBS symptoms three months after treatment compared to placebo (RR 1.19, 95%CI: 0.68-2.10). Adverse events were reported in 97 participants in the FMT group and in 45 participants in the placebo group (RR 1.17, 95%CI: 0.63-2.15). One serious adverse event occurred in the FMT group and two in the placebo group (RR 0.42, 95%CI: 0.07-2.60). Endoscopic FMT delivery resulted in a significant improvement in symptoms, while capsules did not. FMT did not improve the quality of life of IBS patients but, instead, appeared to reduce it, albeit non significantly (MD -6.30, 95%CI: -13.39-0.79). The overall quality of the evidence was low due to moderate-high inconsistency, the small number of patients in the studies, and imprecision.
CONCLUSION We found insufficient evidence to support or refute the use of FMT for IBS. Larger trials are needed.
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Affiliation(s)
- Sofie Ingdam Halkjær
- Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Copenhagen IBD Center, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
| | - Bobby Lo
- Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Copenhagen IBD Center, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
| | - Frederik Cold
- Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Copenhagen IBD Center, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
| | | | - Savanne Holster
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro 70362, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro 70362, Sweden
| | - Robert Jan Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro 70362, Sweden
| | - Olga C Aroniadis
- Department of Internal Medicine, Division of Gastroenterology, Renaissance School of Medicine, Stony Brook University Hospital, New York, NY 11794-8434, United States
| | - Perttu Lahtinen
- Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti 15850, Finland
- Department of Medicine, University of Helsinki, Helsinki 00014, Finland
| | - Tom Holvoet
- Department of Gastroenterology, University Hospital Ghent, Ghent 9000, Belgium
| | - Lise Lotte Gluud
- Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
| | - Andreas Munk Petersen
- Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Copenhagen IBD Center, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
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König J, Doering BK, Unterhitzenberger J. Effekte des psychologischen Gesellschaftsspiels „That’s me“ als Selbsterfahrungsangebot im (Psychologie)Studium. Zeitschrift für Klinische Psychologie und Psychotherapie 2023. [DOI: 10.1026/1616-3443/a000681] [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: 01/21/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das als Tutorium angebotene Gesellschaftsspiel That’s me kann bereits Psychologiestudierenden einen niederschwelligen Einstieg in die Selbsterfahrung bieten. Bisher ist nichts darüber bekannt, ob durch das Spiel messbare Veränderungen in Bereichen auftreten, in denen Selbsterfahrung wirken kann. Fragestellung: Wir erwarteten positive Veränderungen in den Bereichen Emotionale Kompetenz, Emotionsregulation, interpersonelle Probleme und motivationale Inkongruenz durch die Teilnahme am Tutorium. Methode: Wir verglichen die Werte vor und nach der Teilnahme an That’s me (EG) und mit einer unbehandelten Kontrollgruppe (KG). Ergebnisse: In der EG zeigten sich signifikante Verbesserungen in allen erhobenen Skalen mit kleinen Effektstärken. Die KG zeigte keine Veränderungen. Schlussfolgerungen: Mit Hilfe des niederschwelligen, ökonomischen Angebots That’s me konnten signifikante Veränderungen in Bereichen erzielt werden, in denen Selbsterfahrung wirken kann.
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Affiliation(s)
- Julia König
- Lehrstuhl für Klinische und Biologische Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland
| | - Bettina K. Doering
- Klinische Psychologie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland
| | - Johanna Unterhitzenberger
- Lehrstuhl für Klinische und Biologische Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland
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Streckenbach F, Jäschke M, Jahns N, Langner I, König J, Wree A, Stahnke T, Stachs O, Frank M, Langner S, Lindner T. MR
microscopy of the developing upper extremity of the chicken in ovo using 7 Tesla
MRI. Anat Histol Embryol 2022; 52:356-362. [PMID: 36461880 DOI: 10.1111/ahe.12894] [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] [Received: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/04/2022]
Abstract
MR microscopy (MRM) is known as ultra-high-field (UHF) magnetic resonance imaging with an in-plane spatial resolution of <100 μm, yields highly resolved non-invasive anatomical imaging and allows longitudinal assessment of embryonic avian development. The aim of the present study was to evaluate the feasibility of in vivo anatomical MRI assessment of the developing upper extremity of the chicken. Thirty-eight fertilized chicken eggs were examined at 7 Tesla acquiring high-resolution T2-weighted images with an in-plane resolution of 74 × 74 μm. To reduce motion artefacts, the eggs were moderately cooled before and during MRI. Development of the upper extremity was anatomically and quantitatively assessed. Chondrification and ossification on MRI were correlated with histological examination. MRM allowed the identification of the embryo from stage D5 onwards. First chondrification of the upper extremity was visible at stage D7, and the differentiation of the forearm was possible from stage D9 throughout the developmental period with excellent correlation to histology. MRM also allowed the differentiation between cortical and medullary bone as well as the detection of chondrified areas. UHF MRM allows the in vivo and in ovo evaluation of the upper limb during embryonic development and provides non-invasive longitudinal anatomical information. This technique allows longitudinal studies of the same embryo during the developmental period and may therefore provide further insights into the development of the upper extremity. With improved coil technique and increasing availability of UHF MR systems, there is great potential regarding several research topics in experimental musculoskeletal radiology.
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Affiliation(s)
- Felix Streckenbach
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology Rostock University Medical Center Rostock Germany
| | - Malte Jäschke
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology Rostock University Medical Center Rostock Germany
| | - Nora Jahns
- Institute for Diagnostic Radiology and Neuroradiology University Medicine Greifswald Greifswald Germany
| | - Inga Langner
- Department of Orthopedics and Orthopaedic Surgery University Medicine Greifswald Greifswald Germany
| | - Julia König
- Department of Anesthesia and Intensive Care University Hospital Rostock Rostock Germany
| | - Andreas Wree
- Institute of Anatomy, Rostock University Medical Center Rostock Germany
| | - Thomas Stahnke
- Department of Ophthalmology Rostock University Medical Center Rostock Germany
- Institute for Implant Technology and Biomaterials‐IIB E.V Associated Institute of the University of Rostock Warnemuende Germany
| | - Oliver Stachs
- Department of Ophthalmology Rostock University Medical Center Rostock Germany
| | - Marcus Frank
- Medical Biology and Electron Microscopy Center Rostock University Medical Center Rostock Germany
- Department Life, Light & Matter University of Rostock Rostock Germany
| | - Sönke Langner
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology Rostock University Medical Center Rostock Germany
| | - Tobias Lindner
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology Rostock University Medical Center Rostock Germany
- Core Facility Multimodal Small Animal Imaging Rostock University Medical Center Rostock Germany
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König J. Kommentar II zum Fall: „Alles, was in unserer Macht steht“. Ethik Med 2022. [DOI: 10.1007/s00481-022-00730-w] [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: 11/27/2022]
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Thielemann JFB, Kasparik B, König J, Unterhitzenberger J, Rosner R. A systematic review and meta-analysis of trauma-focused cognitive behavioral therapy for children and adolescents. Child Abuse Negl 2022; 134:105899. [PMID: 36155943 DOI: 10.1016/j.chiabu.2022.105899] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 05/13/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Among minors, posttraumatic stress symptoms (PTSS) are a common consequence of traumatic events requiring trauma-focused treatment. OBJECTIVE This meta-analysis quantified treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) with PTSS as primary outcome and symptoms of depression, anxiety, and grief as secondary outcomes. PARTICIPANTS AND SETTING Inclusion criteria for individual settings: (1) patients aged between 3 and 21, (2) at least one traumatic event, (3) minimum 8 sessions of (4) TF-CBT according to Cohen, Mannarino and Deblinger (2006, 2017), (5) a quantitative PTSS measure at pre- and post-treatment, (6) original research only. Inclusion criteria for group settings: had to involve (1) psychoeducation, (2) coping strategies, (3) exposure, (4) cognitive processing/restructuring, (5) contain some reference to the manual and no minimum session number was required. METHODS Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey. RESULTS 4523 participants from 28 RCTs and 33 uncontrolled studies were included. TF-CBT showed large improvements across all outcomes from pre- to post-treatment (PTSS: g = 1.14, CI 0.97-1.30) and favorable results compared to any control condition including wait-list, treatment as usual, and active treatment at post-treatment (PTSS: g = 0.52, CI 0.31-0.73). Effects were more pronounced for group settings. We give pooled estimates adjusted for risk of bias and publication bias, which initially limited the quality of the analyzed data. CONCLUSIONS TF-CBT is an effective treatment for pediatric PTSS as well as for depressive, anxiety, and grief symptoms. It is superior to control conditions, supporting international guidelines recommending it as a first-line treatment.
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Affiliation(s)
- J F B Thielemann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049 Ingolstadt, Germany.
| | - B Kasparik
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049 Ingolstadt, Germany
| | - J König
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049 Ingolstadt, Germany
| | - J Unterhitzenberger
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049 Ingolstadt, Germany; Centre for Children and Adolescents Inn-Salzach e.V., Department of Child and Adolescent Psychiatry, Vinzenz-von-Paul-Straße 14, 84503 Altoetting, Germany
| | - R Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049 Ingolstadt, Germany
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10
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Brunner M, Knasmüller F, König J. Psychoanalytische Erkundungen der Gesellschaft. Forum Psychoanal 2022. [PMCID: PMC9614755 DOI: 10.1007/s00451-022-00480-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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Die psychoanalytische Erkundung gesellschaftlicher Phänomene beginnt bereits mit Freuds kulturtheoretischen Schriften. In diesem Artikel zeichnen wir nach, wie an Freud anschließende kritische Denker:innen die Psychoanalyse für Gesellschaftsanalysen produktiv zu machen suchten, und entwickeln davon ausgehend Konturen einer psychoanalytisch orientierten Sozialforschung, die nicht nur psychoanalytische Erkenntnisse „anwendet“, sondern der gesellschaftlichen Hervorbringung innerpsychischer Konflikte nachspürt. Wir gehen dann auf Alfred Lorenzers Methodologie und Methode der Tiefenhermeneutischen Kulturanalyse ein und geben aus dieser theoretischen Perspektive einen Einblick in aktuelle Forschungen zu den Coronaprotesten.
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Affiliation(s)
- Markus Brunner
- grid.263618.80000 0004 0367 8888Sigmund Freud PrivatUniversität, Wien, Österreich
| | - Florian Knasmüller
- grid.263618.80000 0004 0367 8888Sigmund Freud PrivatUniversität, Wien, Österreich
| | - Julia König
- grid.5802.f0000 0001 1941 7111Institut für Erziehungswissenschaft, Johannes Gutenberg Universität, Mainz, Deutschland
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11
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Rode J, Edebol Carlman HMT, König J, Hutchinson AN, Thunberg P, Persson J, Brummer RJ. Multi-Strain Probiotic Mixture Affects Brain Morphology and Resting State Brain Function in Healthy Subjects: An RCT. Cells 2022; 11:cells11182922. [PMID: 36139496 PMCID: PMC9496704 DOI: 10.3390/cells11182922] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Probiotics can alter brain function via the gut–brain axis. We investigated the effect of a probiotic mixture containing Bifidobacterium longum, Lactobacillus helveticus and Lactiplantibacillus plantarum. In a randomized, placebo-controlled, double-blinded crossover design, 22 healthy subjects (6 m/16 f; 24.2 ± 3.4 years) underwent four-week intervention periods with probiotics and placebo, separated by a four-week washout period. Voxel-based morphometry indicated that the probiotic intervention affected the gray matter volume of a cluster covering the left supramarginal gyrus and superior parietal lobule (p < 0.0001), two regions that were also among those with an altered resting state functional connectivity. Probiotic intervention resulted in significant (FDR < 0.05) functional connectivity changes between regions within the default mode, salience, frontoparietal as well as the language network and several regions located outside these networks. Psychological symptoms trended towards improvement after probiotic intervention, i.e., the total score of the Hospital Anxiety and Depression Scale (p = 0.056) and its depression sub-score (p = 0.093), as well as sleep patterns (p = 0.058). The probiotic intervention evoked distinct changes in brain morphology and resting state brain function alongside slight improvements of psycho(bio)logical markers of the gut–brain axis. The combination of those parameters may provide new insights into the modes of action by which gut microbiota can affect gut–brain communication and hence brain function.
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Affiliation(s)
- Julia Rode
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
- Correspondence:
| | - Hanna M. T. Edebol Carlman
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Ashley N. Hutchinson
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Per Thunberg
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden
| | - Jonas Persson
- Center for Lifespan Developmental Research (LEADER), Faculty of Humanities and Social Sciences, School of Law, Psychology and Social Work, Örebro University, 70182 Örebro, Sweden
| | - Robert J. Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
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12
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Bayarjargal L, Spahr D, König J, Milman V, Winkler B. Polymerization of CO 4 groups in carbonates. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322095225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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13
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Benkö T, König J, Theysohn JM, Schotten C, Saner FH, Treckmann J, Radunz S. Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? Eur J Med Res 2022; 27:74. [PMID: 35619164 PMCID: PMC9134704 DOI: 10.1186/s40001-022-00708-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/06/2019] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In hepatocellular carcinoma (HCC) patients, intraarterial therapies are regularly employed as a bridge to liver transplantation to prevent tumor progression during waiting time. Objective of this study was to compare HCC recurrence after liver transplantation following TACE or radioembolization bridging treatment. METHODS We retrospectively analyzed prospectively collected data on 131 consecutive HCC patients who underwent liver transplantation between January 2007 and December 2017 at our liver transplant center (radioembolization n = 44, TACE n = 87). Multivariable logistic regression and cox proportional hazard regression models were used to evaluate factors associated with tumor recurrence and post-transplant survival. RESULTS Between groups, patients were comparable with regards to age and gender. In the radioembolization group, Milan criteria for HCC were met significantly less frequently (20.5% vs. 65.5%, p < 0.0001). Patients in the radioembolization group required significantly fewer intraarterial treatments (1 [1-2] vs. 1 [1-7], p = 0.0007). On explant specimen, tumor differentiation, microvascular invasion and tumor necrosis were comparable between the groups. HCC recurrence and overall survival were similar between the groups. Multivariable analysis detected increasing recipient age, male gender, complete tumor necrosis and absence of microvascular invasion being independently associated with decreased odds for HCC recurrence. Increasing model of end-stage liver disease (MELD) score and tumor recurrence were independently associated with increased odds of post-transplant death. CONCLUSIONS Intraarterial bridging treatment leading to tumor necrosis may not only prevent waitlist drop-out but also facilitate long-term successful liver transplantation in HCC patients. Both radioembolization and TACE represent potent treatment strategies.
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Affiliation(s)
- Tamás Benkö
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
| | - Julia König
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
| | - Jens M Theysohn
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Clemens Schotten
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
| | - Fuat H Saner
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
| | - Jürgen Treckmann
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
| | - Sonia Radunz
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany.
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14
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Rode J, Edebol Carlman HMT, König J, Repsilber D, Hutchinson AN, Thunberg P, Andersson P, Persson J, Kiselev A, Lathrop Stern L, Salomon B, Mohammed AA, Labus JS, Brummer RJ. Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses Toward an Emotional Task in Healthy Subjects: A Randomized Clinical Trial. Front Nutr 2022; 9:827182. [PMID: 35571902 PMCID: PMC9104811 DOI: 10.3389/fnut.2022.827182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/01/2021] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
Background Evidence from preclinical studies suggests that probiotics affect brain function via the microbiome-gut-brain axis, but evidence in humans remains limited. Objective The present proof-of-concept study investigated if a probiotic product containing a mixture of Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 (in total 3 × 109 CFU/day) affected functional brain responses in healthy subjects during an emotional attention task. Design In this double-blinded, randomized, placebo-controlled crossover study (Clinicaltrials.gov, NCT03615651), 22 healthy subjects (24.2 ± 3.4 years, 6 males/16 females) were exposed to a probiotic intervention and a placebo for 4 weeks each, separated by a 4-week washout period. Subjects underwent functional magnetic resonance imaging while performing an emotional attention task after each intervention period. Differential brain activity and functional connectivity were assessed. Results Altered brain responses were observed in brain regions implicated in emotional, cognitive and face processing. Increased activation in the orbitofrontal cortex, a region that receives extensive sensory input and in turn projects to regions implicated in emotional processing, was found after probiotic intervention compared to placebo using a cluster-based analysis of functionally defined areas. Significantly reduced task-related functional connectivity was observed after the probiotic intervention compared to placebo. Fecal microbiota composition was not majorly affected by probiotic intervention. Conclusion The probiotic intervention resulted in subtly altered brain activity and functional connectivity in healthy subjects performing an emotional task without major effects on the fecal microbiota composition. This indicates that the probiotic effects occurred via microbe-host interactions on other levels. Further analysis of signaling molecules could give possible insights into the modes of action of the probiotic intervention on the gut-brain axis in general and brain function specifically. The presented findings further support the growing consensus that probiotic supplementation influences brain function and emotional regulation, even in healthy subjects. Future studies including patients with altered emotional processing, such as anxiety or depression symptoms are of great interest. Clinical Trial Registration [http://clinicaltrials.gov/], identifier [NCT03615651].
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Affiliation(s)
- Julia Rode
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
- *Correspondence: Julia Rode,
| | - Hanna M. T. Edebol Carlman
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Dirk Repsilber
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ashley N. Hutchinson
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Per Thunberg
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Pernilla Andersson
- Center for Lifespan Developmental Research (LEADER), Faculty of Humanities and Social Sciences, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Jonas Persson
- Center for Lifespan Developmental Research (LEADER), Faculty of Humanities and Social Sciences, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Andrey Kiselev
- Center for Applied Autonomous Sensor Systems, Faculty for Business, Science and Engineering, School of Natural Science and Technology, Örebro University, Örebro, Sweden
| | - Lori Lathrop Stern
- Global Medical Innovation, Pfizer Consumer Healthcare, Madison, NJ, United States
| | - Benita Salomon
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ahmed Abdulilah Mohammed
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Jennifer S. Labus
- Integrative Bioinformatics and Biostatistics Core, Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Robert J. Brummer
- Nutrition-Gut-Brain Interactions Research Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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15
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Wicke FS, Ernst M, Otten D, Werner A, Dreier M, Brähler E, Tibubos AN, Reiner I, Michal M, Wiltink J, Münzel T, Lackner KJ, Pfeiffer N, König J, Wild PS, Beutel ME. The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Affiliation(s)
- F S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany.
| | - M Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - D Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - I Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
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Edebol Carlman HMT, Rode J, König J, Repsilber D, Hutchinson AN, Thunberg P, Persson J, Kiselev A, Pruessner JC, Brummer RJ. Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses to an Arithmetic Stress Task in Healthy Subjects: A Randomised Clinical Trial and Proof-of-Concept Study. Nutrients 2022; 14:nu14071329. [PMID: 35405944 PMCID: PMC9002567 DOI: 10.3390/nu14071329] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Probiotics are suggested to impact physiological and psychological stress responses by acting on the gut-brain axis. We investigated if a probiotic product containing Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 affected stress processing in a double-blinded, randomised, placebo-controlled, crossover proof-of-concept study (NCT03615651). Twenty-two healthy subjects (24.2 ± 3.4 years, 6 men/16 women) underwent a probiotic and placebo intervention for 4 weeks each, separated by a 4-week washout period. Subjects were examined by functional magnetic resonance imaging while performing the Montreal Imaging Stress Task (MIST) as well as an autonomic nervous system function assessment during the Stroop task. Reduced activation in regions of the lateral orbital and ventral cingulate gyri was observed after probiotic intervention compared to placebo. Significantly increased functional connectivity was found between the upper limbic region and medioventral area. Interestingly, probiotic intervention seemed to predominantly affect the initial stress response. Salivary cortisol secretion during the task was not altered. Probiotic intervention did not affect cognitive performance and autonomic nervous system function during Stroop. The probiotic intervention was able to subtly alter brain activity and functional connectivity in regions known to regulate emotion and stress responses. These findings support the potential of probiotics as a non-pharmaceutical treatment modality for stress-related disorders.
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Affiliation(s)
- Hanna M. T. Edebol Carlman
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
| | - Julia Rode
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
- Correspondence: ; Tel.: +46-1930-3817
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
| | - Dirk Repsilber
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
| | - Ashley N. Hutchinson
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
| | - Per Thunberg
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
| | - Jonas Persson
- Center for Lifespan Developmental Research (LEADER), Faculty of Humanities and Social Sciences, School of Law, Psychology and Social Work, Örebro University, 70182 Örebro, Sweden;
| | - Andrey Kiselev
- Center for Applied Autonomous Sensor Systems, Faculty for Business, Science and Engineering, School of Natural Science and Technology, Örebro University, 70182 Örebro, Sweden;
| | - Jens C. Pruessner
- Douglas Institute, McGill University, Montréal, QC H4H1R3, Canada;
- Department of Psychology, University of Konstanz, 78457 Konstanz, Germany
| | - Robert J. Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden; (H.M.T.E.C.); (J.K.); (D.R.); (A.N.H.); (R.J.B.)
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17
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Kleinherbers E, Stegmann P, Kurzmann A, Geller M, Lorke A, König J. Pushing the Limits in Real-Time Measurements of Quantum Dynamics. Phys Rev Lett 2022; 128:087701. [PMID: 35275653 DOI: 10.1103/physrevlett.128.087701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
Time-resolved studies of quantum systems are the key to understanding quantum dynamics at its core. The real-time measurement of individual quantum numbers as they switch between certain discrete values, well known as a "random telegraph signal," is expected to yield maximal physical insight. However, the signal suffers from both systematic errors, such as a limited time resolution and noise from the measurement apparatus, as well as statistical errors due to a limited amount of data. Here we demonstrate that an evaluation scheme based on factorial cumulants can reduce the influence of such errors by orders of magnitude. The error resilience is supported by a general theory for the detection errors as well as experimental data of single-electron tunneling through a self-assembled quantum dot. Thus, factorial cumulants push the limits in the analysis of random telegraph data, which represent a wide class of experiments in physics, chemistry, engineering, and life sciences.
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Affiliation(s)
- E Kleinherbers
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - P Stegmann
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Kurzmann
- 2nd Institute of Physics, RWTH Aachen University, 52074 Aachen, Germany
| | - M Geller
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - A Lorke
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - J König
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
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Siech C, Arnold H, Mattigk A, Bellut L, König J, Kluth L. Gender differences in Urologic training – results of the second GeSRU (Germany Society of Residents in Urology) training survey. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00187-7] [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: 11/04/2022]
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19
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Stahl L, Struck JP, König J, Braun M, Westphal J. [Implementation of the new collective agreement in 2021 in urological clinics : Expectations and reality]. Urologe A 2021; 61:407-410. [PMID: 34935996 DOI: 10.1007/s00120-021-01736-w] [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] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
The amendment to the collective agreement is intended to significantly improve the working conditions of physicians and includes longer-term duty scheduling, work on a maximum of two weekends per month, less overtime. Smaller hospitals often have problems implementing these requirements and have to make compromises. At least the overtime is now better paid-overall, an improvement in working conditions can only be achieved by increasing the number of staff, then better and more intensive training is also possible.
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Affiliation(s)
- L Stahl
- Klinik für Urologie, Klinikum Lippe Detmold, Detmold, Deutschland. .,Urologie, Klinikum Lippe GmbH, Röntgenstr. 18, 32756, Detmold, Deutschland.
| | - J P Struck
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - J König
- Abteilung für Urologie, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Deutschland
| | - M Braun
- Standort Spital Männedorf, Uroviva, Männedorf, Schweiz
| | - J Westphal
- Klinik für Urologie und Kinderurologie, Krankenhaus Maria Hilf der Alexianer Krefeld GmbH, Krefeld, Deutschland
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20
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Rode J, Yang L, König J, Hutchinson AN, Wall R, Venizelos N, Brummer RJ, Rangel I, Vumma R. Butyrate Rescues Oxidative Stress-Induced Transport Deficits of Tryptophan: Potential Implication in Affective or Gut-Brain Axis Disorders. Neuropsychobiology 2021; 80:253-263. [PMID: 33075780 DOI: 10.1159/000510886] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Butyrate is a short-chain fatty acid metabolite produced by microbiota in the colon. With its antioxidant properties, butyrate has also been shown to alter the neurological functions in affective disorder models, suggesting it as a key mediator in gut-brain interactions. OBJECTIVE Here, we evaluated the negative effect of oxidative stress on the transport of the serotonin precursor tryptophan as present in affective disorders. Butyrate was hypothesized to be able to rescue these deficits due to its antioxidative capacities and its effect on transmembrane transport of tryptophan. Human skin-derived fibroblasts were used as cellular models to address these objectives. METHODS Human fibroblasts were treated with hydrogen peroxide to induce oxidative stress. Stressed as well as control cells were treated with different concentrations of butyrate. Tryptophan (3H) was used as a tracer to measure the transport of tryptophan across the cell membranes (n = 6). Furthermore, gene expression profiles of different amino acid transporters were analyzed (n = 2). RESULTS As hypothesized,oxidative stress significantly decreased the uptake of tryptophan in fibroblast cells, while butyrate counteracted this effect. Oxidative stress did not alter the gene expression profile of amino acid transporters. However, treatment of stressed and control cells with different concentrations of butyrate differentially regulated the gene expression of large amino acid transporters 1 and 2, which are the major transporters of tryptophan. CONCLUSIONS Gut microbiota-derived butyrate may have therapeutic potential in affective disorders characterized by either aberrant serotonergic activity or neuroinflammation due to its role in rescuing the oxidative stress-induced perturbations of tryptophan transport.
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Affiliation(s)
- Julia Rode
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Lin Yang
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ashley Nicole Hutchinson
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Rebecca Wall
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Nikolaos Venizelos
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Robert-Jan Brummer
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ignacio Rangel
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ravi Vumma
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden,
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Schätzer M, Bhardwaj J, Sommer J, Miskovic R, König J, Hoppichler F. Catering situation at Austrian schools. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.525] [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
Due to the increase in all-day compulsory schools in Austria, it is important that students receive health-promoting meals throughout the day. The aim of the analysis was a nationwide evaluation of the current situation concerning catering at schools.
Methods
Using a nationwide representative sample of schools from the 5th grade upwards, a questionnaire was conducted as a telephone interview with 331 randomly chosen schools. In addition, 56 schools in Vienna from the 5th grade onwards were randomly selected in order to analyze the current offer at school cafeterias in detail.
Results
Lunch was offered at 72% of all schools, a school cafeteria was available at 81%, a cold drink vending machine at 66%, a hot drink vending machine at 41% and a snack vending machine at 23%. With regard to the health promoting composition of the catering offer, 18% of all schools already had a certified lunch menu, 22% a certified school cafeteria, 14% a certified cold drink vending machine and 5% a certified snack vending machine. In 79% of schools there is direct competition for school catering (93% supermarkets, 45% bakeries, 33% snack stands, 8% fast food restaurants). The results of the detailed analysis in Vienna showed that only 35% of all school cafeterias are certified. All of these locations are advised externally.
Conclusions
The majority of the schools offer catering during breaks and at lunchtime. Without external advice, the majority of the offers must be classified as not health promoting.
Key messages
The food offered at schools is an important component in the nutrition of students in Austria. Cafeteria operators in schools often need external advice in order to be able to offer a healthy selection of food and beverages.
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Affiliation(s)
- M Schätzer
- Special Institute for Preventive Cardiology and Nutrition, Elsbethen/Salzburg, Austria
| | - J Bhardwaj
- Special Institute for Preventive Cardiology and Nutrition, Elsbethen/Salzburg, Austria
| | - J Sommer
- Special Institute for Preventive Cardiology and Nutrition, Elsbethen/Salzburg, Austria
- Department for Nutritional Sciences, University of Vienna, Vienna, Austria
| | - R Miskovic
- Special Institute for Preventive Cardiology and Nutrition, Elsbethen/Salzburg, Austria
- Department for Nutritional Sciences, University of Vienna, Vienna, Austria
| | - J König
- Department for Nutritional Sciences, University of Vienna, Vienna, Austria
| | - F Hoppichler
- Special Institute for Preventive Cardiology and Nutrition, Elsbethen/Salzburg, Austria
- Department of Internal Medicine, Hospital of the Brothers of St. John of God Salzburg, Salzburg, Austria
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22
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König J, Chung S, Ertl V, Doering BK, Comtesse H, Unterhitzenberger J, Barke A. The German Translation of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) Scale: Results from Healthcare Workers during the Second Wave of COVID-19. Int J Environ Res Public Health 2021; 18:9377. [PMID: 34501967 PMCID: PMC8431413 DOI: 10.3390/ijerph18179377] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
Healthcare workers (HCW) are among those most directly affected by the COVID-19 pandemic. Most research with this group has used ad hoc measures, which limits comparability across samples. The Stress and Anxiety to Viral Epidemics-9 scale (SAVE-9) is a nine-item scale first developed in Korea, and has since been translated into several languages. We report on data collected from 484 German HCW between November 2020 and March 2021, during the "second wave" of coronavirus infections. We conducted item analysis, confirmatory factor analysis on the previously found factor solutions of the SAVE-9, examined correlations with established measures of depression, generalized anxiety, and insomnia, and compared scores between different groups of HCW. The psychometric properties of the German SAVE-9 were satisfactory and comparable to previous findings from Korea and Russia. Correlations with mental health measures were positive, as expected. We found some significant differences between groups of HCW on the SAVE-9 which were consistent with the literature but did not appear on the other mental health measures. This suggests that the SAVE-9 taps into specifically work-related stress, which may make it a helpful instrument in this research area.
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Affiliation(s)
- Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
| | - Verena Ertl
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Bettina K. Doering
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Hannah Comtesse
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Johanna Unterhitzenberger
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Antonia Barke
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
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König J, Kneuer C, Herrmann K. Using multiple in silico models to improve robustness of predictions for bacterial mutagenicity. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00440-9] [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: 10/20/2022]
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24
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Arnold H, Fassbach M, Mattigk A, Zehe V, Beck A, Wundrack F, Bellut L, König J, Siech C. [Training and work conditions of residents in urology in Germany : Results of the second German Society of Residents in Urology e. V. (GeSRU) residency survey from 2020]. Urologe A 2021; 60:1025-1034. [PMID: 34259878 PMCID: PMC8278189 DOI: 10.1007/s00120-021-01608-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Residency is the fundation for high-quality medical care and also for career development of young urologists. In 2015 the GeSRU (German Society of Residents in Urology) carried out the first nationwide survey among young physicians in urology and described the status quo of their residency. This revised follow-up examination draws an updated picture of the training and working conditions of residents in urology and assesses the development. METHODS In 2020 the GeSRU conducted an online-based survey of all residents in urology; therefore, the 2015 questionnaire was expanded. The model of the professional gratification crisis was used again. RESULTS A total of 332 questionnaires were analyzed. Major findings have not changed since 2015. The daily working routine is characterized by high pace and workload and economic considerations. Family- and research-friendly working conditions are largely lacking. 35% of the respondents draw professional consequences. The psychosocial strain remains very high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION These results demonstrate that there are still systemically immanent burdens for residents in urology, which require adjustments to the working and training conditions. A structured, transparent curriculum for urological residency, remuneration and time for training and models which enable work-life balance should be established.
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Affiliation(s)
- H Arnold
- Facharztpraxis, Urologie Dr. Hannah Arnold, Gesundheitszentrum Senden, Hauptstraße 11 c, 89250, Senden, Deutschland.
| | - M Fassbach
- Klinik für Urologie, urologische Onkologie und Kinderurologie, Helios Klinikum Duisburg, Duisburg, Deutschland
| | - A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - V Zehe
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - A Beck
- Klinik für Urologie, Katholisches Marienkrankenhaus Hamburg, Hamburg, Deutschland
| | - F Wundrack
- Klinik für Urologie, Helios Klinikum Berlin-Buch, Berlin-Buch, Deutschland
| | - L Bellut
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J König
- Klinik für Urologie, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Deutschland
| | - C Siech
- Klinik für Urologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
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Roca Rubio MF, Eriksson U, Brummer RJ, König J. Short intense psychological stress induced by skydiving does not impair intestinal barrier function. PLoS One 2021; 16:e0254280. [PMID: 34237102 PMCID: PMC8266057 DOI: 10.1371/journal.pone.0254280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 06/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background and aim Psychological stress has been shown to increase intestinal permeability and is associated with the development of gastrointestinal disorders. This study aimed to investigate skydiving as an alternative model to analyse the effect of acute psychological stress on intestinal barrier function. Materials and methods Twenty healthy subjects participated in a tandem skydive followed by a negative control visit, of which 19 (9 females and 10 males, 25.9 ± 3.7 years) were included in the study. Intestinal permeability was assessed by a multi-sugar urinary recovery test. Sucrose recovery and lactulose/rhamnose ratio in 0-5h urine indicated gastroduodenal and small intestinal permeability, respectively, and sucralose/erythritol ratio in 5-24h urine indicated colonic permeability. Blood samples were taken to assess markers associated with barrier function. This study has been registered at ClinicalTrials.gov (NCT03644979) on August 23, 2018. Results Skydiving resulted in a significant increase in salivary cortisol levels directly after skydiving compared to the control visit. Cortisol levels were still increased two hours after landing, while cortisol levels before skydiving were not significantly different from the baseline at the control visit. Skydiving did not induce a significant increase in gastroduodenal, small intestinal or colonic permeability. There was also no significant increase in plasma intestinal and liver fatty acid-binding proteins, suggesting no damage to the enterocytes. Discussion These results show that the acute intense psychological stress induced by skydiving does not affect intestinal permeability in healthy subjects. Future models aiming to investigate the effect of stress on human intestinal barrier function should consider a more sustained exposure to the psychological stressor.
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Affiliation(s)
- Maria Fernanda Roca Rubio
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
- * E-mail:
| | - Ulrika Eriksson
- Man-Technology-Environment Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden
| | - Robert J. Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Michel MS, Himmler M, Necknig U, Kriegmair M, Speck T, Fichtner J, Steffens J, Borgmann H, Bolenz C, Tuellmann M, Ruppin S, Petersilie F, Rebmann U, König J, Westphal J, Goebell P, Leyh H, Borchers H. [Certified residency curriculum for the specialization training in urology from the German Society of Urology according to the 2018 Training Regulations (version of 20. September 2019)]. Urologe A 2021; 59:135-140. [PMID: 33141266 PMCID: PMC7721681 DOI: 10.1007/s00120-020-01367-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M S Michel
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - M Himmler
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - U Necknig
- Abteilung für Urologie und Kinderurologie, Klinikum Garmisch-Partenkirchen, Auenstraße 6, 82467, Garmisch-Partenkirchen, Deutschland
| | - M Kriegmair
- Urologische Klinik München Planegg, Germeringer Str. 32, 82152, Planegg, Deutschland
| | - T Speck
- , Treskow Allee 103, 10318, Berlin, Deutschland
| | - J Fichtner
- Klinik für Urologie, Johanniter-Krankenhaus Oberhausen, Steinbrinkstraße 96a, 46245, Oberhausen, Deutschland
| | - J Steffens
- Klinik für Urologie und Kinderurologie, St.-Antonius Hospital, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Straße 8, 52249, Eschweiler, Deutschland
| | - H Borgmann
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - C Bolenz
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - M Tuellmann
- , Dr.-Henkel-Str. 2, 85435, Erding, Deutschland
| | - S Ruppin
- , Friedrichstr. 94, 10117, Berlin, Deutschland
| | - F Petersilie
- Deutsche Gesellschaft für Urologie, Martin-Buber-Str. 10, 14163, Berlin, Deutschland
| | - U Rebmann
- , Große Nikolaistr. 1, 06108, Halle, Deutschland
| | - J König
- Abteilung für Urologie, Asklepios Stadtklinik Bad Tölz, Schützenstraße 15, 83646, Bad Tölz, Deutschland
| | - J Westphal
- Klinik für Urologie und Kinderurologie, Krankenhaus Maria Hilf der Alexianer Krefeld GmbH, Dießemer Bruch 81, 47805, Krefeld, Deutschland
| | - P Goebell
- Urologische und Kinderurologische Universitätsklinik, Malteser Waldkrankenhaus St. Marien, Rathsberger Straße 57, 91054, Erlangen, Deutschland
| | - H Leyh
- Abteilung für Urologie und Kinderurologie, Klinikum Garmisch-Partenkirchen, Auenstraße 6, 82467, Garmisch-Partenkirchen, Deutschland
| | - H Borchers
- Deutsche Gesellschaft für Urologie, Martin-Buber-Str. 10, 14163, Berlin, Deutschland
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Ott N, Harland A, Scaal M, König J, Bredow J, Eysel P, Müller LP, Meyer C. The role of the transversal ligament on the atlantoaxial complex - Bending forces at C1/2 flexion limits in the elderly. Clin Biomech (Bristol, Avon) 2021; 84:105329. [PMID: 33765570 DOI: 10.1016/j.clinbiomech.2021.105329] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/16/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Biomechanical functionality as well as trauma mechanisms of the atlantoaxial complex are still an issue of controversy. The transverse atlantal ligament is the strongest stabilizator. The present study aimed to analyze the bending forces of the transverse atlantal ligament and of the base of the odontoid in elderly specimens. METHODS In this biomechanical study five cadaveric specimen with a mean age of 72 at death and bone mineral density measuring for 555.3 Hounsfield units on average were used. To analyze the strain of the transverse atlantal ligament and the dense base, strain gauges were used. A custom biomechanical setup was used to test each specimen at C1/2 flexion and the strain of the transverse atlantal ligament and the dens base (μm/m) were measured. FINDINGS In four out of five, a rupture of the transverse atlantal ligament was observed, the mean force required for the ligament to fall was 175 N (min. 99.8 N; 249.2 N; SD 64.7) by a mean strain of 2102.9 μm/m (min. 1953.5 μm/m; max. 2272.3 μm/m; SD 189.7). In one specimen with the lowest Hounsfield units (155), the dens base fractured before the transverse atlantal ligament ruptured and no strain could be measured at the transversal ligament during movement afterwards. INTERPRETATION The transverse atlantal ligament fails at an average of 175 N in the elderly, which is less than the value reported previously. In osteoporotic specimen the generated force to rupture the transverse atlantal ligament can fracture the dens itself.
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Affiliation(s)
- N Ott
- Department of Trauma and Orthopedic Surgery, University Hospital of Cologne, Cologne, Germany.
| | - A Harland
- Department of Trauma and Orthopedic Surgery, University Hospital of Cologne, Cologne, Germany
| | - Martin Scaal
- Department of Anatomy, University of Cologne, Cologne, Germany
| | - J König
- Department of Orthopedic Surgery, Division of Spine Surgery, Schön-Kliniken Düsseldorf, Düsseldorf, Germany
| | - J Bredow
- Department of Trauma and Orthopedic Surgery, University Hospital of Cologne, Cologne, Germany
| | - P Eysel
- Department of Trauma and Orthopedic Surgery, University Hospital of Cologne, Cologne, Germany
| | - L P Müller
- Department of Trauma and Orthopedic Surgery, University Hospital of Cologne, Cologne, Germany
| | - C Meyer
- Department of Orthopedic Surgery, Division of Spine Surgery, Schön-Kliniken Düsseldorf, Düsseldorf, Germany
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König J, Kopp B, Ziegelmeier A, Rimane E, Steil R, Renneberg B, Rosner R. Young people's trauma-related cognitions before and after cognitive processing therapy for post-traumatic stress disorder. Psychol Psychother 2021; 94:33-44. [PMID: 31833224 DOI: 10.1111/papt.12263] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/14/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Cognitive processing therapy (CPT) is a psychotherapy for post-traumatic stress disorder (PTSD) with a broad evidence base. Change in trauma-related cognitions is considered its primary working mechanism. When trying to integrate a traumatic event into existing cognitive schemas, the adaptive mechanism is changing the schema (accommodation). However, PTSD patients frequently either change their schemas too much (over-accommodation), or cognitively distort the event (assimilation). We aimed to test the hypothesized connections between the three types of cognition and symptom load. DESIGN This study adds to the literature using 'impact statements', essays on their trauma-related thoughts written by patients at the beginning and end of CPT, to investigate cognitive change and its relationship to symptomatic outcome. METHODS We analysed statements written by 31 adolescents and young adults who received developmentally adapted CPT (a longer treatment where CPT is the core component) in a randomized controlled trial. RESULTS As expected, post-CPT statements contained more accommodated and fewer over-accommodated and assimilated clauses than pre-CPT statements. Correlations between cognition frequencies and concurrent symptom load were as expected for assimilation, and, in part, over-accommodation and accommodation. Decreased PTSD and depressive symptoms were correlated with increased accommodated thoughts. For over-accommodation and assimilation, however, expected correlations could not be shown. CONCLUSIONS Our results support the notion that cognitive change is an important mechanism of change in CPT in a sample of younger, non-English-speaking clients.
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Affiliation(s)
- Julia König
- Catholic University of Eichstätt-Ingolstadt, Germany
| | - Brigitte Kopp
- Catholic University of Eichstätt-Ingolstadt, Germany
| | | | - Eline Rimane
- Catholic University of Eichstätt-Ingolstadt, Germany
| | | | | | - Rita Rosner
- Catholic University of Eichstätt-Ingolstadt, Germany
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Martin C, Jones C, Marshall CA, Huang C, Reeve J, Fleming MP, König J, Jomeen J. Fear of childbirth measurement: appraisal of the content overlap of four instruments. J Reprod Infant Psychol 2020; 40:329-341. [DOI: 10.1080/02646838.2020.1861226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Colin Martin
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Catriona Jones
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Claire A. Marshall
- East Yorkshire Perinatal Mental Health Liaison Team, Humber Teaching NHS Foundation Trust, Hull, UK
| | - Chao Huang
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Joanne Reeve
- Academy of Primary Care, Hull York Medical School, University of Hull, Hull, UK
| | - Mick P. Fleming
- Faculty of Wellbeing, University College Isle of Man, Isle of Man, UK
| | - Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Julie Jomeen
- Faculty of Health Sciences, Southern Cross University, Lismore, Australia
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Holster S, Repsilber D, Geng D, Hyötyläinen T, Salonen A, Lindqvist CM, Rajan SK, de Vos WM, Brummer RJ, König J. Correlations between microbiota and metabolites after faecal microbiota transfer in irritable bowel syndrome. Benef Microbes 2020; 12:17-30. [PMID: 33350360 DOI: 10.3920/bm2020.0010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Faecal microbiota transfer (FMT) consists of the infusion of donor faecal material into the intestine of a patient with the aim to restore a disturbed gut microbiota. In this study, it was investigated whether FMT has an effect on faecal microbial composition, its functional capacity, faecal metabolite profiles and their interactions in 16 irritable bowel syndrome (IBS) patients. Faecal samples from eight different time points before and until six months after allogenic FMT (faecal material from a healthy donor) as well as autologous FMT (own faecal material) were analysed by 16S RNA gene amplicon sequencing and gas chromatography coupled to mass spectrometry (GS-MS). The results showed that the allogenic FMT resulted in alterations in the microbial composition that were detectable up to six months, whereas after autologous FMT this was not the case. Similar results were found for the functional profiles, which were predicted from the phylogenetic sequencing data. While both allogenic FMT as well as autologous FMT did not have an effect on the faecal metabolites measured in this study, correlations between the microbial composition and the metabolites showed that the microbe-metabolite interactions seemed to be disrupted after allogenic FMT compared to autologous FMT. This shows that FMT can lead to altered interactions between the gut microbiota and its metabolites in IBS patients. Further research should investigate if and how this affects efficacy of FMT treatments.
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Affiliation(s)
- S Holster
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - D Repsilber
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - D Geng
- Man-Technology-Environmental Research Centre, Faculty of Business, Science and Engineering, School of Science and Technology, Örebro University, Örebro, Sweden
| | - T Hyötyläinen
- Man-Technology-Environmental Research Centre, Faculty of Business, Science and Engineering, School of Science and Technology, Örebro University, Örebro, Sweden
| | - A Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - C M Lindqvist
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - S K Rajan
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - W M de Vos
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - R J Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - J König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Holster S, Rode J, Bohr J, Kumawat AK, Veress G, Hultgren Hörnquist E, Brummer RJ, König J. Faecal microbiota transfer in patients with microscopic colitis - a pilot study in collagenous colitis. Scand J Gastroenterol 2020; 55:1454-1466. [PMID: 33142068 DOI: 10.1080/00365521.2020.1839544] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Faecal microbiota transfer (FMT) consists of the infusion of donor faecal material into the intestine of patients with the aim to restore a disturbed gut microbiota. METHODS In this pilot study (NCT03275467), the effect of three repeated FMTs (day 0, two weeks, four weeks) was studied and followed up for six months in nine collagenous colitis (CC) patients, using two stool donors. RESULTS Five patients had an active disease at the time of baseline sampling. The primary endpoint (remission at six weeks, defined as <3 stools whereof <1 watery stool per day) was achieved by two of these patients, and by one at eight weeks. Overall, in all nine patients, FMT did not result in a significant reduction of watery stools, assessed by daily diary. However, diarrhoea (assessed by gastrointestinal symptom rating scale) was significantly improved at four (p = .038) and eight weeks (p = .038), indigestion at eight (p = .045) and 12 weeks (p = .006), disease-related worries at four (p = .027) and eight weeks (p = .027), and quality of life at six months (p = .009). FMT resulted in an increased number of lamina propria lymphocytes, possibly indicating an initial mucosal immune activation. No serious adverse events, no systemic effects, and no changes in faecal calprotectin and psychological symptoms were observed. CONCLUSIONS FMT is able to improve symptoms in a yet undefined subset of CC patients. Further studies could help to characterise this subset and to understand if these results can be generalised to all microscopic colitis patients.
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Affiliation(s)
- Savanne Holster
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Julia Rode
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Johan Bohr
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden, Örebro University Hospital, Örebro, Sweden
| | - Ashok Kumar Kumawat
- Cardiovascular Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Gábor Veress
- Department of Laboratory Medicine, Faculty for Medicine and Health, Örebro University, Örebro, Sweden, Örebro University Hospital, Örebro, Sweden
| | - Elisabeth Hultgren Hörnquist
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Robert Jan Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Gkika E, Tanja S, Stephanie K, Schaefer-Schuler A, Mix M, Küsters A, Tosch M, Eschmann S, Bultel Y, Hass P, Fleckenstein J, Thieme A, Stockinger M, Dieckmann K, Miederer M, Holl G, Rischke C, Adebahr S, Lenz S, Broichhagen C, Binder H, König J, Grosu A, Nestle U. PD-0413: The role of different chemotherapy protocols for concurrent CRT in locally advanced NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00435-7] [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: 10/22/2022]
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Fazeli G, Beer KB, Geisenhof M, Tröger S, König J, Müller-Reichert T, Wehman AM. Loss of the Major Phosphatidylserine or Phosphatidylethanolamine Flippases Differentially Affect Phagocytosis. Front Cell Dev Biol 2020; 8:648. [PMID: 32793595 PMCID: PMC7385141 DOI: 10.3389/fcell.2020.00648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/16/2020] [Accepted: 06/29/2020] [Indexed: 12/31/2022] Open
Abstract
The lipids phosphatidylserine (PtdSer) and phosphatidylethanolamine (PtdEth) are normally asymmetrically localized to the cytosolic face of membrane bilayers, but can both be externalized during diverse biological processes, including cell division, cell fusion, and cell death. Externalized lipids in the plasma membrane are recognized by lipid-binding proteins to regulate the clearance of cell corpses and other cell debris. However, it is unclear whether PtdSer and PtdEth contribute in similar or distinct ways to these processes. We discovered that disruption of the lipid flippases that maintain PtdSer or PtdEth asymmetry in the plasma membrane have opposite effects on phagocytosis in Caenorhabditis elegans embryos. Constitutive PtdSer externalization caused by disruption of the major PtdSer flippase TAT-1 led to increased phagocytosis of cell debris, sometimes leading to two cells engulfing the same debris. In contrast, PtdEth externalization caused by depletion of the major PtdEth flippase TAT-5 or its activator PAD-1 disrupted phagocytosis. These data suggest that PtdSer and PtdEth externalization have opposite effects on phagocytosis. Furthermore, externalizing PtdEth is associated with increased extracellular vesicle release, and we present evidence that the extent of extracellular vesicle accumulation correlates with the extent of phagocytic defects. Thus, a general loss of lipid asymmetry can have opposing impacts through different lipid subtypes simultaneously exerting disparate effects.
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Affiliation(s)
- Gholamreza Fazeli
- Rudolf Virchow Center, University of Würzburg, Würzburg, Germany.,Imaging Core Facility, Biocenter, University of Würzburg, Würzburg, Germany
| | - Katharina B Beer
- Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | | | - Sarah Tröger
- Imaging Core Facility, Biocenter, University of Würzburg, Würzburg, Germany
| | - Julia König
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Ann M Wehman
- Rudolf Virchow Center, University of Würzburg, Würzburg, Germany.,Department of Biological Sciences, University of Denver, Denver, CO, United States
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König J, Unterhitzenberger J, Calmer C, Kohout P, Karl R, Rosner R, Butollo W. What was helpful in today's session? Responses of clients in two different psychotherapies for posttraumatic stress disorder. ACTA ACUST UNITED AC 2020; 57:437-443. [PMID: 32551724 DOI: 10.1037/pst0000295] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was to qualitatively analyze and compare the written responses clients in treatment for posttraumatic stress disorder (PTSD) gave when asked about helpful and negative aspects of the previous session. Data were collected during a randomized quantitative study comparing dialogical exposure therapy (DET, a gestalt-based integrative therapy, n = 58) and cognitive processing therapy (CPT, a cognitive-behavioral therapy, n = 52). We developed a coding manual using Mayring's (2015) qualitative content analysis approach and were able to code responses reliably. Five main categories emerged, unspecified and specific therapy elements, therapeutic relationship, client process, and general positive experience, with the first three containing subcategories. Each therapy had its own codes for specific therapy elements, while the other codes were identical for both treatments. The results for specific therapy elements were in accordance with the theories behind the two treatments, with CPT clients naming cognitive factors most frequently, whereas in DET, emotions were the most frequently mentioned. Results for therapeutic relationship were surprisingly similar given that DET therapists consider the therapeutic relationship to be an active ingredient, while CPT therapists consider it as the basis for the intervention rather than a working mechanism in itself. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Radermacher LK, Ponto K, Merkesdal S, Pomart V, Frommer L, Pfeiffer N, König J, Kahaly GJ. Type I Diabetes is the Main Cost Driver in Autoimmune Polyendocrinopathy. J Clin Endocrinol Metab 2020; 105:5570009. [PMID: 31529067 DOI: 10.1210/clinem/dgz021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/09/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Autoimmune polyendocrinopathy (AP), a chronic complex orphan disease, encompasses at least two autoimmune-induced endocrine diseases. OBJECTIVE To estimate for the first time total, indirect and direct costs for patients with AP, as well as cost drivers. DESIGN Cross-sectional cost of illness study. SETTING Academic tertiary referral center for AP. PATIENTS 146 consecutive, unselected AP patients. INTERVENTION Interviews pertaining to patients' socioeconomic situation covered a recall period of 12 months. Both the human capital (HCA) and the friction cost approaches (FCAs) were applied as estimation methods. MAIN OUTCOME MEASURES Direct and indirect annual costs, and sick leave and medication costs. RESULTS AP markedly impacts healthcare expenses. Mean overall costs of AP in Germany ranged from €5 971 090 to €29 848 187 per year (HCA). Mean indirect costs ranged from €3 388 284 to €16 937 298 per year (HCA) while mean direct costs ranged from €2 582 247 to €12 908 095/year. Mean direct costs per year were €1851 in AP patients with type 1 diabetes (T1D, 76%) and €671 without T1D, which amounts to additional direct costs of €1209 for T1D when adjusting for concomitant autoimmune disease (95% CI = €1026-1393, P < 0.0001). Sick leave cost estimates for AP patients with T1D exceeded those without T1D by 70% (FCA) and 43% (HCA), respectively. In multiple regression analyses, T1D predicted total and direct costs, medication costs and costs for diabetic devices (all P < 0.001). Overall, AP patients with T1D were 54% (FCA) more expensive than those without T1D. CONCLUSIONS Public health socioeconomic relevance of AP was demonstrated, with T1D as main cost driver.
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Affiliation(s)
| | - Katharina Ponto
- Department of Ophthalmology, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Sonja Merkesdal
- Department of Rheumatology, Hannover Medical School, Hannover, Germany
| | - Vanessa Pomart
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Frommer
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg University, Medical Center, Mainz, Germany
| | - George J Kahaly
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
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Klepzig K, Horn U, König J, Holtz K, Wendt J, Hamm A, Lotze M. Brain imaging of chill reactions to pleasant and unpleasant sounds. Behav Brain Res 2020; 380:112417. [DOI: 10.1016/j.bbr.2019.112417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
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König J, Aeishen S, Cebulla A, Bellut L, Fassbach M, Westphal J, Struck JP. Qualität statt Quantität verbessert die Weiterbildung. Urologe A 2019; 58:877-880. [DOI: 10.1007/s00120-019-0987-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Klepzig K, Horn U, Holtz K, König J, Wendt J, Hamm A, Lotze M. FV 14 Brain imaging of chill reactions to pleasant and unpleasant sounds. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.624] [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: 10/26/2022]
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39
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Buentzel J, Yao S, Elakad O, Lois AM, Brünies J, König J, Hinterthaner M, Danner BC, Ströbel P, Emmert A, Bohnenberger H. Expression and prognostic impact of alpha thalassemia/mental retardation X-linked and death domain-associated protein in human lung cancer. Medicine (Baltimore) 2019; 98:e16712. [PMID: 31374064 PMCID: PMC6708616 DOI: 10.1097/md.0000000000016712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Molecular characterization of lung cancer specimens after radical surgery offers additional prognostic information and may help to guide adjuvant therapeutic procedures. The transcriptional regulators alpha thalassemia/mental retardation X-linked (ATRX) and death domain-associated protein (DAXX) have recently been described in different cancer entities as a useful prognostic biomarker. This study was initiated to explore their protein expression patterns and prognostic value in patients with operable lung cancer disease.The protein abundance (in the following text also named protein expression) of ATRX and DAXX were analyzed by immunohistochemistry in 194 samples of squamous cell lung carcinoma (SQCLC), 111 samples of pulmonary adenocarcinoma (AC) and 40 samples of small cell lung cancer (SCLC). The protein levels of ATRX and DAXX were correlated with clinicopathological characteristics and patient outcome.ATRX showed strong protein expression in 16.2% of AC, 11.9% of SQCLC, and 42.5% of SCLC. DAXX was highly expressed in 54.9% of AC, 76.2% of SQCLC, and 82.5% of SCLC. Immunostaining of both ATRX and DAXX were seen in 14.4% of AC, 11.3% of SQCLC, and 42.5% of SCLC. High protein expression of ATRX was a favorable prognostic marker for patients with AC (hazard ratio 0.38, P = .02). Sub-group analyses showed a significant correlation between ATRX and the clinical stage of SQCLC and SCLC. Histological grading and ATRX were also significantly associated in cases of SQCLC.The presence of ATRX and DAXX are correlated with lung cancer histology. Strong ATRX protein expression is associated with a significantly longer overall survival in patients with AC.
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Affiliation(s)
| | | | | | | | | | - Julia König
- Department of Hematology and Medical Oncology
| | - Marc Hinterthaner
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Göttingen, Germany
| | - Bernhard C. Danner
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Göttingen, Germany
| | | | - Alexander Emmert
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Göttingen, Germany
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Kurzmann A, Stegmann P, Kerski J, Schott R, Ludwig A, Wieck AD, König J, Lorke A, Geller M. Optical Detection of Single-Electron Tunneling into a Semiconductor Quantum Dot. Phys Rev Lett 2019; 122:247403. [PMID: 31322370 DOI: 10.1103/physrevlett.122.247403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Indexed: 06/10/2023]
Abstract
The maximum information of a dynamic quantum system is given by real-time detection of every quantum event, where the ultimate challenge is a stable, sensitive detector with high bandwidth. All physical information can then be drawn from a statistical analysis of the time traces. We demonstrate here an optical detection scheme based on the time-resolved resonance fluorescence on a single quantum dot. Single-electron resolution with high signal-to-noise ratio (4σ confidence) and high bandwidth of 10 kHz make it possible to record the individual quantum events of the transport dynamics. Full counting statistics with factorial cumulants gives access to the nonequilibrium dynamics of spin relaxation of a singly charged dot (γ_{↑↓}=3 ms^{-1}), even in an equilibrium transport measurement.
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Affiliation(s)
- A Kurzmann
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
- Solid State Physics Laboratory, ETH Zurich, 8093 Zurich, Switzerland
| | - P Stegmann
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - J Kerski
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - R Schott
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - A Ludwig
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - A D Wieck
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - J König
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - A Lorke
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - M Geller
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
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Unterhitzenberger J, Wintersohl S, Lang M, König J, Rosner R. Providing manualized individual trauma-focused CBT to unaccompanied refugee minors with uncertain residence status: a pilot study. Child Adolesc Psychiatry Ment Health 2019; 13:22. [PMID: 31131021 PMCID: PMC6524217 DOI: 10.1186/s13034-019-0282-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/03/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Unaccompanied refugee minors (URMs) seeking asylum show high rates of posttraumatic stress disorder (PTSD), depression and anxiety. In addition, they experience post-migration stressors like an uncertain residence status. Therefore, psychotherapeutic interventions for URMs are urgently needed but have scarcely been investigated up to now. This study aimed to examine manualized individual trauma-focused cognitive behavioural therapy (TF-CBT) for URMs with PTSD involving their professional caregivers (i.e. social workers in child and adolescent welfare facilities). METHODS We conducted an uncontrolled pilot study with three follow-up assessments (post-intervention, 6 weeks, and 6 months). Participants who met the PTSD diagnostic criteria were treated in a university psychotherapeutic outpatient clinic in Germany with a mean of 15 sessions of TF-CBT. All participants (n = 26) were male UM (Mage = 17.1, SD = 1.0), predominately from Afghanistan (n = 19, 73.1%) and did not have a residence permit. The sample was severely traumatized according to the number of traumatic event types reported (M = 11.3, SD = 2.8). The primary outcome was PTSD measured with the Child and Adolescent Trauma Screen (CATS) and the Diagnostic Interview for Mental Disorders in Childhood and Adolescence (Kinder-DIPS). Secondary outcomes were depression, behavioural and somatic symptoms. All but the somatic symptoms were assessed in both self-report and proxy report. RESULTS At post-intervention the completer sample (n = 19) showed significantly decreased PTSD symptoms, F(1, 18) = 11.41, p = .003, with a large effect size (d = 1.08). Improvements remained stable after 6 weeks and 6 months. In addition to PTSD symptoms, their caregivers reported significantly decreased depressive and behavioural symptoms in participants. According to the clinical interview, 84% of PTSD cases recovered after TF-CBT treatment. After 6 months, youths whose asylum request had been rejected showed increased PTSD symptoms according to individual trajectories in the Kinder-DIPS. The effect was, however, non-significant. CONCLUSIONS Intervention studies are feasible with URMs. This pilot study presents preliminary evidence for the efficacy of an evidence-based intervention like TF-CBT in reducing PTSD symptoms in URMs. Stressors related to asylum proceedings after the end of therapy have the potential to negatively influence psychotherapy outcomes.
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Affiliation(s)
- Johanna Unterhitzenberger
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstrasse 25, 85072 Eichstätt, Germany
| | - Svenja Wintersohl
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstrasse 25, 85072 Eichstätt, Germany
| | - Margret Lang
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstrasse 25, 85072 Eichstätt, Germany
| | - Julia König
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstrasse 25, 85072 Eichstätt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstrasse 25, 85072 Eichstätt, Germany
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König J. The German W-DEQ version B—Factor structure and prediction of posttraumatic stress symptoms six weeks and one year after childbirth. Health Care Women Int 2019; 40:581-596. [DOI: 10.1080/07399332.2019.1583230] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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Hertel J, Frenzel S, König J, Wittfeld K, Füllen G, Pietzner M, Völzke H, Grabe H. MEASURING BIOLOGICAL AGE AS A TASK OF INDIVIDUALIZATION: A FRAMEWORK FOR PREDICTOR SELECTION AND MODEL VALIDATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Hertel
- University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - S Frenzel
- University Medicine Greifswald, Department of Psychiatry and Psychotherapy, Germany
| | - J König
- University Medicine Greifswald, Department of Psychiatry and Psychotherapy, Germany
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Greifswald/Rostock, Germany
| | - G Füllen
- Rostock University Medical Center, Institute for Biostatistics and Informatics in Medicine and Ageing Research, Germany
| | - M Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - H Grabe
- University Medicine Greifswald, Department of Psychiatry and Psychotherapy, Germany
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Lewis S, König J, Lawson C, Collinson L, Tsui J. Ischaemic Myotubes Stimulate Angiogenesis via Exosomes. Eur J Vasc Endovasc Surg 2018. [DOI: 10.1016/j.ejvs.2018.06.071] [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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Görig T, Eichinger M, Philippi H, König J, Urschitz M, De Bock F. Evaluation einer ICF-CY-basierten komplexen Versorgungsmaßnahme zur Verbesserung der partizipativen Entscheidungsfindung an Sozialpädiatrischen Zentren (SPZ) und der sozialen Teilhabe von Kindern mit chronischen Erkrankungen: Design der Studie PART-CHILD. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T Görig
- Universität Heidelberg, Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Mannheim, Deutschland
| | - M Eichinger
- Universität Heidelberg, Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Mannheim, Deutschland
| | - H Philippi
- SPZ Frankfurt-Mitte, Frankfurt am Main, Deutschland
| | - J König
- Universität Mainz, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Mainz, Deutschland
| | - M Urschitz
- Universität Mainz, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Mainz, Deutschland
| | - F De Bock
- Universität Heidelberg, Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Mannheim, Deutschland
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Schülein S, Schoffer O, Radde K, König J, Weyer V, Blettner M, Klug S. Probability of hysterectomy in Germany. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.387] [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: 10/28/2022] Open
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Affiliation(s)
- Julia König
- a Nutrition-Gut-Brain Interactions Research Centre, Faculty of Health and Medicine, School of Medical Sciences , Örebro University , Örebro , Sweden
| | - Robert J Brummer
- a Nutrition-Gut-Brain Interactions Research Centre, Faculty of Health and Medicine, School of Medical Sciences , Örebro University , Örebro , Sweden
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König J, Guerreiro MA, Peršoh D, Begerow D, Krauss J. Knowing your neighbourhood-the effects of Epichloë endophytes on foliar fungal assemblages in perennial ryegrass in dependence of season and land-use intensity. PeerJ 2018; 6:e4660. [PMID: 29780665 PMCID: PMC5958879 DOI: 10.7717/peerj.4660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/23/2017] [Accepted: 04/02/2018] [Indexed: 12/21/2022] Open
Abstract
Epichloë endophytes associated with cool-season grass species can protect their hosts from herbivory and can suppress mycorrhizal colonization of the hosts' roots. However, little is known about whether or not Epichloë endophyte infection can also change the foliar fungal assemblages of the host. We tested 52 grassland study sites along a land-use intensity gradient in three study regions over two seasons (spring vs. summer) to determine whether Epichloë infection of the host grass Lolium perenne changes the fungal community structure in leaves. Foliar fungal communities were assessed by Next Generation Sequencing of the ITS rRNA gene region. Fungal community structure was strongly affected by study region and season in our study, while land-use intensity and infection with Epichloë endophytes had no significant effects. We conclude that effects on non-systemic endophytes resulting from land use practices and Epichloë infection reported in other studies were masked by local and seasonal variability in this study's grassland sites.
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Affiliation(s)
- Julia König
- Department of Animal Ecology and Tropical Biology, Biocentre, University of Würzburg, Würzburg, Germany
| | | | - Derek Peršoh
- Department of Geobotany, Ruhr-Universität Bochum, Bochum, Germany
| | - Dominik Begerow
- Department of Geobotany, Ruhr-Universität Bochum, Bochum, Germany
| | - Jochen Krauss
- Department of Animal Ecology and Tropical Biology, Biocentre, University of Würzburg, Würzburg, Germany
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Gessner A, König J, Fromm MF. Contribution of multidrug and toxin extrusion protein 1 (MATE1) to renal secretion of trimethylamine-N-oxide (TMAO). Sci Rep 2018; 8:6659. [PMID: 29704007 PMCID: PMC5923289 DOI: 10.1038/s41598-018-25139-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/12/2018] [Indexed: 12/29/2022] Open
Abstract
Trimethylamine-N-oxide (TMAO) gained considerable attention because of its role as a cardiovascular risk biomarker. Organic cation transporter 2 (OCT2) mediates TMAO uptake into renal proximal tubular cells. Here we investigated the potential role of multidrug and toxin extrusion protein 1 (MATE1) for translocation of TMAO across the luminal membrane of proximal tubular cells. HEK293 cells stably expressing OCT2 (HEK-OCT2) or MATE1 (HEK-MATE1) were used for uptake studies. Transcellular transport of TMAO was investigated using monolayers of MDCK control cells (MDCK-Co) as well as single- (MDCK-OCT2, MDCK-MATE1) and double-transfected cells (MDCK-OCT2-MATE1). In line with previous studies, HEK-OCT2 cells revealed a 2.4-fold uptake of TMAO compared to control cells (p < 0.001), whereas no significant uptake was observed in HEK-MATE1. In monolayers of MDCK cells, polarised TMAO transcellular transport was not significantly different between MDCK-Co and MDCK-OCT2 cells, but significantly increased in MDCK-MATE1 (p < 0.05) and MDCK-OCT2-MATE1 cells (p < 0.001). The OCT/MATE inhibitor trimethoprim abolished TMAO translocation in MDCK-OCT2-MATE1 cells (p < 0.05). The present data suggest that MATE1 contributes to renal elimination of TMAO. For selected MATE substrates, such as TMAO, uptake studies using non-polarised MATE-expressing cells can reveal false negative results compared to studies using polarised monolayers.
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Affiliation(s)
- A Gessner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - J König
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M F Fromm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
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Abstract
Summary
Objectives:
Medical prognosis is commonly expressed in terms of ordered outcome categories. This paper provides simple statistical procedures to judge whether the predictor variables reflect this natural ordering.
Methods:
The concept of stochastic ordering in logistic regression and discrimination models is applied to naturally ordered outcome scales in medical prognosis.
Results:
The ordering stage is assessed by a data-generated choice between ordered, partially ordered, and unordered models. The ordinal structure of the outcome is particularly taken into consideration in the construction of allocation rules and in the assessment of their performance. The specialized models are compared to the unordered model with respect to the classification efficiency in a clinical prognostic study.
Conclusions:
It is concluded that our approach offers more flexibility than the widely used cumulative-odds model and more stability than the multinomial logistic model. The procedure described in this paper is strongly recommended for practical applications to support medical decision-making.
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