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Bufka J, Sýkora J, Vaňková L, Gutová V, Kačerová Š, Daum O, Schwarz J. Impact of autoimmune gastritis on chronic urticaria in paediatric patients - pathophysiological point of views. Eur J Pediatr 2024; 183:515-522. [PMID: 37947925 PMCID: PMC10912447 DOI: 10.1007/s00431-023-05324-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
We would like to provide an updated comprehensive perspective and identify the components linked to chronic spontaneous urticaria (CSU) without specific triggers in autoimmune atrophic gastritis (AAG). AAG is an organ-specific autoimmune disease that affects the corpus-fundus gastric mucosa. Although we lack a unified explanation of the underlying pathways, when considering all paediatric patients reported in the literature, alterations result in gastric neuroendocrine enterochromaffin-like (ECL) cell proliferation and paracrine release of histamine. Several mechanisms have been proposed for the pathogenesis of CSU, with much evidence pointing towards AAG and ECL cell responses, which may be implicated as potential factors contributing to CSU. The excessive production/release of histamine into the bloodstream could cause or trigger exacerbations of CSU in AAG, independent of Helicobacter pylori; thus, the release of histamine from ECL cells may be the primary modulator. CONCLUSION Considering the understanding of these interactions, recognising the respective roles of AAG in the pathogenesis of CSU may strongly impact the diagnostic workup and management of unexplained/refractory CSU and may inform future research and interventions in the paediatric population. WHAT IS KNOWN • Autoimmune atrophic gastritis is a chronic immune-mediated inflammatory disease characterised by the destruction of the oxyntic mucosa in the gastric body and fundus, mucosal atrophy, and metaplastic changes. • Autoimmune atrophic gastritis in paediatric patients is important because of the poor outcome and risk of malignancy and possibly underestimated entities primarily reported in single-case reports. WHAT IS NEW • Upper gastrointestinal inflammatory disorders, independent of H. pylori, have been implicated as potential inducing factors in the development of chronic spontaneous urticaria. • If a paediatric patient presents with symptoms such as anaemia, reduced vitamin B12 levels, recurrent urticaria with no other detectable aetiology, positive anti-parietal cell antibodies, and elevated gastrin levels, autoimmune atrophic gastritis should be considered a possible cause of chronic urticaria.
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Affiliation(s)
- J Bufka
- Department of Pediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Alej Svobody 80, Pilsen, 323 00, Czech Republic.
| | - J Sýkora
- Department of Pediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Alej Svobody 80, Pilsen, 323 00, Czech Republic
| | - L Vaňková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - V Gutová
- Department of Allergology and Immunology, Teaching Hospital in Pilsen, Pilsen, Czech Republic
| | - Š Kačerová
- Department of Allergology and Immunology, Teaching Hospital in Pilsen, Pilsen, Czech Republic
| | - O Daum
- Sikl's Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - J Schwarz
- Department of Pediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Alej Svobody 80, Pilsen, 323 00, Czech Republic
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Tosi U, Ramos A, Rampichini M, Alexiades G, Boddu S, Cisse B, Kacker A, Patsalides A, Tabaee A, Schwarz J, Schwartz TH, Ramakrishna R. Combined surgical repair and venous sinus stenting for patients with skull base encephaloceles secondary to dural venous sinus stenosis. Acta Neurochir (Wien) 2023; 165:2283-2292. [PMID: 37344735 DOI: 10.1007/s00701-023-05680-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Chronically elevated intracranial pressure (ICP) seen in idiopathic intracranial hypertension (IIH) can cause the development of skull base encephaloceles and cerebrospinal fluid (CSF) leaks. Surgical repair and ventriculoperitoneal shunt (VPS) placement are mainstays of treatment. Venous sinus stenting (VSS) is a newly accepted treatment modality. The goal of this study was thus to determine if VSS can be used to treat symptoms and prevent recurrence after surgical encephalocele repair. METHODS Retrospective chart review of patients that had surgical repair of encephaloceles followed by VSS for symptomatic stenosis with elevated pressure gradient. RESULTS A total of 13 patients underwent a combined encephalocele repair and VSS. Seventy-two percent were female; 46% had headaches, 69% pulsatile tinnitus, and 92% CSF rhinorrhea or otorrhea. One had seizures. Mean lumbar opening pressure was 23.3 ± 2.6 cm H2O; the average sagittal-to-jugular pressure gradient was 12.7 ± 1.8 cmH2O and was elevated in all patients. Four patients had middle fossa craniotomy for repair of tegmen defect (one bilateral); one had a retrosigmoid craniotomy for repair of a sigmoid plate defect. Eight had an endoscopic endonasal repair for sphenoid or cribriform plate encephalocele. There were no VSS procedural complications or complications associated with dual antiplatelet therapy. One patient had meningitis after endoscopic repair that was treated with antibiotics. One patient had recurrence of both CSF leak and venous stenosis adjacent to the stent requiring repeat repair and VSS. There was no further recurrence. CONCLUSION In patients with dural sinus stenosis and encephaloceles requiring repair, VSS can be performed safely within weeks of surgery for relief of symptoms, resolution of underlying pathology, and prevention of CSF leak recurrence.
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Affiliation(s)
- Umberto Tosi
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Alexander Ramos
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Margherita Rampichini
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - George Alexiades
- Department of Otolaryngology, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Srikanth Boddu
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Babacar Cisse
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Ashutosh Kacker
- Department of Otolaryngology, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Athos Patsalides
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Abtin Tabaee
- Department of Otolaryngology, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Justin Schwarz
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA
- Department of Otolaryngology, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Rohan Ramakrishna
- Department of Neurological Surgery, NewYork-Presbyterian, Weill Cornell Medicine, 525 E 68th St, Box 99, New York, NY, 10065, USA.
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Nagayama T, Schaeuble MA, Fein JR, Loisel GP, Wu M, Mayes DC, Hansen SB, Knapp PF, Webb TJ, Schwarz J, Vesey RA. A generalized approach to x-ray data modeling for high-energy-density plasma experiments. Rev Sci Instrum 2023; 94:2887772. [PMID: 37129462 DOI: 10.1063/5.0128811] [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] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
Accurate understanding of x-ray diagnostics is crucial for both interpreting high-energy-density experiments and testing simulations through quantitative comparisons. X-ray diagnostic models are complex. Past treatments of individual x-ray diagnostics on a case-by-case basis have hindered universal diagnostic understanding. Here, we derive a general formula for modeling the absolute response of non-focusing x-ray diagnostics, such as x-ray imagers, one-dimensional space-resolved spectrometers, and x-ray power diagnostics. The present model is useful for both data modeling and data processing. It naturally accounts for the x-ray crystal broadening. The new model verifies that standard approaches for a crystal response can be good approximations, but they can underestimate the total reflectivity and overestimate spectral resolving power by more than a factor of 2 in some cases near reflectivity edge features. We also find that a frequently used, simplified-crystal-response approximation for processing spectral data can introduce an absolute error of more than an order of magnitude and the relative spectral radiance error of a factor of 3. The present model is derived with straightforward geometric arguments. It is more general and is recommended for developing a unified picture and providing consistent treatment over multiple x-ray diagnostics. Such consistency is crucial for reliable multi-objective data analyses.
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Affiliation(s)
- T Nagayama
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - M A Schaeuble
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - J R Fein
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - G P Loisel
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - M Wu
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - D C Mayes
- University of Texas at Austin, Austin, Texas 78712, USA
| | - S B Hansen
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - P F Knapp
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - T J Webb
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - J Schwarz
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - R A Vesey
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
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Dotlacil V, Lerchova T, Coufal S, Kucerova B, Schwarz J, Hradsky O, Skaba R, Rygl M. Comparison of laparoscopic and open ileocecal resection for Crohn's disease in children. Pediatr Surg Int 2023; 39:140. [PMID: 36847848 PMCID: PMC9971069 DOI: 10.1007/s00383-023-05419-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Ileocecal resection (ICR) is the most frequently performed surgery in paediatric Crohn's disease (CD) patients. The aim of the study was to compare laparoscopic-assisted and open ICR. METHODS Retrospective review of consecutive CD patients undergoing ICR between March 2014 and December 2021 was performed. The patients were divided into open (OG) and laparoscopic (LG) groups. Compared parameters included patients' demographics, clinical characteristics, surgery, duration of hospitalisation and follow-up. Complications were classified according to the Clavien-Dindo classification (CDc). Risk factors were identified using multivariable analysis. RESULTS Sixty-two patients (29 females, 46.7%) were included in the analysis, forty-two patients in OG. The median duration of surgery was 130 in OG versus 148 in LG (p = 0.065) minutes. Postoperative complications were reported in 4 patients (12.1%). There was no significant difference in postoperative complications according to CDc (OG 7.14 vs LG 5%, p = 1). The median length of hospitalisation was 8 in OG and 7 days in LG (p = 0.0005). The median length of follow-up was 21.5 months. CONCLUSION The laparoscopic-assisted approach had shorter hospital stay and was not associated with increased risk of 30-day postoperative complications. Laparoscopic surgery should be considered the preferred surgical approach for primary ICR.
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Affiliation(s)
- V Dotlacil
- Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, Praha 5, 150 06, Prague, Czech Republic.
| | - T Lerchova
- Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - S Coufal
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - B Kucerova
- Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, Praha 5, 150 06, Prague, Czech Republic
| | - J Schwarz
- Department of Paediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Pilsen, Czech Republic
| | - O Hradsky
- Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - R Skaba
- Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, Praha 5, 150 06, Prague, Czech Republic
| | - M Rygl
- Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, Praha 5, 150 06, Prague, Czech Republic
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Ramos A, Carnevale JA, Majeed K, Kocharian G, Hussain I, Goldberg JL, Schwarz J, Kutler DI, Knopman J, Stieg P. Multidisciplinary management of carotid body tumors: a single-institution case series of 22 patients. J Neurosurg 2023; 138:95-103. [PMID: 35523262 DOI: 10.3171/2022.3.jns22136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/21/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Carotid body tumors (CBTs) are rare, slow-growing neoplasms derived from the parasympathetic paraganglia of the carotid bodies. Although inherently vascular lesions, the role of preoperative embolization prior to resection remains controversial. In this report, the authors describe an institutional series of patients with CBT successfully treated via resection following preoperative embolization and compare the results in this series to previously reported outcomes in the treatment of CBT. METHODS All CBTs resected between 2013 and 2019 at a single institution were retrospectively identified. All patients had undergone preoperative embolization performed by interventional neuroradiologists, and all had been operated on by a combined team of cerebrovascular neurosurgeons and otolaryngology-head and neck surgeons. The clinical, radiographic, endovascular, and perioperative data were collected. All procedural complications were recorded. RESULTS Among 22 patients with CBT, 63.6% were female and the median age was 55.5 years at the time of surgery. The most common presenting symptoms included a palpable neck mass (59.1%) and voice changes (22.7%). The average tumor volume was 15.01 ± 14.41 cm3. Most of the CBTs were Shamblin group 2 (95.5%). Blood was predominantly supplied from branches of the ascending pharyngeal artery, with an average of 2 vascular pedicles (range 1-4). Fifty percent of the tumors were embolized with more than one material: polyvinyl alcohol, 95.5%; Onyx, 50.0%; and N-butyl cyanoacrylate glue, 9.1%. The average reduction in tumor blush following embolization was 83% (range 40%-95%). No embolization procedural complications occurred. All resections were performed within 30 hours of embolization. The average operative time was 173.9 minutes, average estimated blood loss was 151.8 ml, and median length of hospital stay was 4 days. The rate of permanent postoperative complications was 0%; 2 patients experienced transient hoarseness, and 1 patient had medical complications related to alcohol withdrawal. CONCLUSIONS This series reveals that endovascular embolization of CBT is a safe and effective technique for tumor devascularization, making preoperative angiography and embolization an important consideration in the management of CBT. Moreover, the successful management of CBT at the authors' institution rests on a multidisciplinary approach whereby endovascular surgeons, neurosurgeons, and ear, nose, and throat-head and neck surgeons work together to optimally manage each patient with CBT.
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Affiliation(s)
- Alexander Ramos
- 1Departments of Neurological Surgery.,3Interventional Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
| | - Joseph A Carnevale
- 1Departments of Neurological Surgery.,3Interventional Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
| | | | - Gary Kocharian
- 1Departments of Neurological Surgery.,3Interventional Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
| | | | | | - Justin Schwarz
- 1Departments of Neurological Surgery.,3Interventional Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
| | | | - Jared Knopman
- 1Departments of Neurological Surgery.,3Interventional Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
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Mueller Y, Auderset D, Maeder M, Schwarz J, Masserey E. Sentinel monitoring of COVID-related daily activity in primary care practices of the canton of Vaud. Eur J Public Health 2022. [PMCID: PMC9594695 DOI: 10.1093/eurpub/ckac131.560] [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: 11/30/2022] Open
Abstract
Introduction During the COVID pandemic, COVID-related data collected in family medicine were scarce. We aimed to monitor cantonal trends of COVID-related activity in family medicine and paediatric practices during the year 2021. Methods Family physicians and paediatricians established in the canton of Vaud were invited to join an ad hoc sentinel surveillance system. Online data collection was based on daily activity reports and monthly questionnaires. In particular, participants categorized daily counts of consultations and phone calls into predefined COVID-related categories. Results Thirty-seven practices contributed regularly to the system between March 20th and December 31st 2021. Out of 81'407 medical consultations, 4'950 (6.1%) were related to new COVID suspicions as defined by the Federal Office of Public Health, and 5'252 (6.4%) otherwise related to COVID. Depending on the week and the practice, between 5.6% and 26.5% of face-to-face consultations were COVID-related. In paediatrics, COVID-related activity corresponded mostly to new COVID suspicions (11.2% of on-site consultations), whereas among family physicians other COVID topics predominated (9.8% of face-to-face consultations), mainly questions about vaccination. Consultations for persisting COVID-related symptoms were stable at a low level throughout the year, and constituted less than 1% of all consultations. Most practices swabbed patients for SARS-CoV-2 tests, and an increasing proportion performed rapid antigenic tests over the year. In paediatrics, COVID-suspicions were not systematically tested. Conclusions Throughout 2021, COVID-related consultations constituted an important part of family medicine and paediatric practices’ activity in the canton of Vaud. Monitoring COVID-related activity in primary care during a pandemic documents how physicians translate recommendations into practice and provides health authorities with valuable information to guide public health action. Key messages • Throughout 2021, COVID-related consultations constituted an important part of family medicine and paediatric practices’ activity in the canton of Vaud. • Monitoring COVID-related activity in primary care during a pandemic documents how physicians translate recommendations into daily practice.
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Affiliation(s)
- Y Mueller
- Department of Family Medicine, Center for Primary Care and Public Health , Lausanne, Switzerland
| | - D Auderset
- Department of Family Medicine, Center for Primary Care and Public Health , Lausanne, Switzerland
| | - M Maeder
- Department of Family Medicine, Center for Primary Care and Public Health , Lausanne, Switzerland
| | - J Schwarz
- Department of Family Medicine, Center for Primary Care and Public Health , Lausanne, Switzerland
| | - E Masserey
- Cantonal Health Directorate , Lausanne, Switzerland
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Carnevale JA, Goldberg JL, Kocharian G, Ramos A, Schwarz J. Fusiform Cerebral Aneurysm and Atrial Myxoma. World Neurosurg 2022; 168:244-245. [DOI: 10.1016/j.wneu.2022.09.124] [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] [Received: 07/09/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022]
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Carnevale JA, Goldberg JL, Kocharian G, Garton ALA, Ramos A, Schwarz J, Boddu SR, Gobin YP, Knopman J. Flow diversion for cerebral aneurysms. Neurosurg Focus Video 2022; 7:V2. [PMID: 36425268 PMCID: PMC9664494 DOI: 10.3171/2022.7.focvid2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/11/2022] [Indexed: 12/03/2022]
Abstract
The treatment of cerebral aneurysms includes open microsurgical options (e.g., clipping, trapping/bypass) and evolving endovascular techniques. Following the landmark trials that propelled endovascular treatment to the forefront, flow diversion has shown high aneurysm cure rates with minimal complications. Flow diversion stents are placed in the parent vessel, redirecting blood flow from the aneurysm, promoting reendothelization across the neck, and resulting in complete occlusion of the aneurysm. As a result, flow diversion has become increasingly used as the primary treatment for unruptured aneurysms; however, its applications are being pushed to new frontiers. Here, the authors present three cases showcasing the treatment of intracranial aneurysms with flow diversion. The video can be found here: https://stream.cadmore.media/r10.3171/2022.7.FOCVID2253.
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Carnevale JA, Goldberg JL, Schwarz J. Lumbar Herniated Disc. World Neurosurg 2022; 166:52-53. [PMID: 35863642 DOI: 10.1016/j.wneu.2022.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Joseph A Carnevale
- Department of Neurological Surgery, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York, USA.
| | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York, USA
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Kocharian G, Zappi KB, Carnevale J, Schwarz J, Knopman J. Recent Advances and Future Directions in Middle Meningeal Artery Embolization for Chronic Subdural Hematomas. Curr Pain Headache Rep 2022; 26:657-665. [PMID: 35802284 DOI: 10.1007/s11916-022-01068-0] [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: 05/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to present a brief background on chronic subdural hematomas (cSDH), middle meningeal artery (MMA) embolization, and its role in decreasing recurrence of cSDH. A review of the most up-to-date literature should demonstrate the efficacy of this procedure. RECENT FINDINGS The latest data shows that MMA embolization is a safe procedure, with low complication rates and low recurrence rates. While cSDH managed with surgical evacuation can have a recurrence rate upwards of 30%, MMA embolization alone or as an adjunct to surgery decreases recurrence to less than 5% in most studies. MMA embolization can be especially useful in high-risk populations such as the elderly, patients on anti-platelet medication, and those with coagulopathies. It can also be done awake, done without general anesthesia, and is significantly less invasive than traditional surgical techniques. In reviewing the literature on MMA embolization, it is clear that there are numerous retrospective studies and systematic reviews demonstrating its safety and efficacy, and some prospective dual-arm studies that present novel information. The numerous clinical trials that are currently underway should help to further establish MMA embolization as standard of care in the management of cSDH.
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Affiliation(s)
- Gary Kocharian
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68thSt., M-220, Box 99, New York, NY, 10065, USA.
| | - Kyle B Zappi
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68thSt., M-220, Box 99, New York, NY, 10065, USA
| | - Joseph Carnevale
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68thSt., M-220, Box 99, New York, NY, 10065, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68thSt., M-220, Box 99, New York, NY, 10065, USA
| | - Jared Knopman
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68thSt., M-220, Box 99, New York, NY, 10065, USA
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Goldberg JL, Wipplinger C, Kirnaz S, Xia J, Sommer F, Meng A, Schwarz J, Giantini-Larsen A, Meaden RM, Sugino R, Gadjradj P, Medary B, Carnevale JA, Navarro R, Tsiouris AJ, Hussain I, Härtl R. Clinical Significance of Redundant Nerve Roots in Patients with Lumbar Stenosis Undergoing Minimally Invasive Tubular Decompression. World Neurosurg 2022; 164:e868-e876. [PMID: 35598849 DOI: 10.1016/j.wneu.2022.05.061] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/14/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Symptomatic lumbar spinal stenosis (LSS) is a common indication for surgery in the elderly. Preoperative radiographic evaluation of patients with LSS often reveals redundant nerve roots (RNRs). The clinical significance of RNRs is uncertain. RNRs have not been studied in the setting of minimally invasive surgery. This study investigates the relationship between RNRs and clinical outcomes after minimally invasive tubular decompression. METHODS Chart review was performed for patients with degenerative LSS who underwent minimally invasive decompression. Preoperative magnetic resonance imaging parameters were assessed, and patient-reported outcomes were analyzed. RESULTS Fifty-four patients underwent surgery performed at an average of 1.8 ± 0.8 spinal levels. Thirty-one patients (57%) had RNRs. Patients with RNRs were older (median = 72 years vs. 66 years, P = 0.050), had longer median symptom duration (32 months vs. 15 months, P < 0.01), and had more levels operated on (2.1 vs. 1.4; P < 0.01). The median follow-up after surgery was 2 months (range = 1.3-12 months). Preoperative and postoperative patient-reported outcomes were similar based on RNR presence. Patients without RNRs had larger lumbar cross-sectional areas (CSAs) (median = 121 mm2 vs. 95 mm2, P = 0.014) and the index-level CSA (52 mm2 vs. 34 mm2, P = 0.007). The CSA was not correlated with RNR morphology or location. CONCLUSIONS Preoperative RNRs are associated with increased age, symptom duration, and lumbar stenosis severity. Patients improved after minimally invasive decompression regardless of RNR presence. RNR presence had no effect on short-term clinical outcomes. Further study is required to assess their long-term significance.
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Affiliation(s)
- Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA.
| | - Christoph Wipplinger
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Sertac Kirnaz
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Jimmy Xia
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Fabian Sommer
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Alicia Meng
- Department of Neuroradiology, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Alexandra Giantini-Larsen
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Ross M Meaden
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Rafael Sugino
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Pravesh Gadjradj
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Branden Medary
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Joseph A Carnevale
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Rodrigo Navarro
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - A John Tsiouris
- Department of Neuroradiology, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA
| | - Ibrahim Hussain
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Roger Härtl
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
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12
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Kreslová M, Sýkorová A, Bittenglová R, Schwarz J, Pomahačová R, Jehlička P, Kobr J, Trefil L, Sýkora J. Age-Related Progression of Microvascular Dysfunction in Cystic Fibrosis: New Detection Ways and Clinical Outcomes. Physiol Res 2021. [DOI: 10.33549//physiolres.934743] [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: 11/25/2022] Open
Abstract
There are concerns about altered vascular functions that could play an important role in the pathogenesis and influence the severity of chronic disease, however, increased cardiovascular risk in paediatric cystic fibrosis (CF) has not been yet fully understood. Aim was to analyse vascular disease risk and investigate changes over times in CF and controls. We prospectively enrolled 22 CF subjects (a median age of 16.07 years), and 22 healthy demographically matched controls (a median age of 17.28 years) and determined endothelial function. We utilised a combined diagnostic approach by measuring the plethysmographic Reactive Hyperemia Index (RHI) as the post-to preocclusive endothelium-dependent changes of vascular tone, and biomarkers that are known to be related to endothelial dysfunction (ED): asymmetric dimethyl arginine (ADMA), high-sensitive CRP (hsCRP), VCAM-1 and E-selectin. RHI values were significantly lower in CF young adults (p<0.005). HsCRP (p<0.005), E-selectin (p<0.001) and VCAM-1 (p<0.001) were significantly increased in CF patients since childhood. The findings have provided a detailed account of the ongoing process of microvascular dysfunction with gradual progression with the age of CF patients, making them further at risk of advanced vascular disease. Elevations of biomarkers in CF children with not yet demonstrated RHI changes but with significantly reduced RHI in adulthood and lipid profile changes indicate the possible occurrence of ED with CF-related specific risk factors over time and will enable us to provide the best possible support.
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Affiliation(s)
- M. Kreslová
- Department of Pediatrics, Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Pilsen, Czech Republic.
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13
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Schwarz J, Leiderer P, Palberg T. Salt-concentration-dependent nucleation rates in low-metastability colloidal charged sphere melts containing small amounts of doublets. Phys Rev E 2021; 104:064607. [PMID: 35030906 DOI: 10.1103/physreve.104.064607] [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: 07/07/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
We determined bulk crystal nucleation rates in aqueous suspensions of charged spheres at low metastability. Experiments were performed in dependence on electrolyte concentration and for two different particle number densities. The time-dependent nucleation rate shows a pronounced initial peak, while postsolidification crystal size distributions are skewed towards larger crystallite sizes. At each concentration, the nucleation rate density initially drops exponentially with increasing salt concentration. The full data set, however, shows an unexpected scaling of the nucleation rate densities with metastability times the number density of particles. Parameterization of our results in terms of classical nucleation theory reveals unusually low interfacial free energies of the nucleus surfaces and nucleation barriers well below the thermal energy. We tentatively attribute our observations to the presence of doublets introduced by the employed conditioning technique. We discuss the conditions under which such small seeds may induce nucleation.
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Affiliation(s)
- J Schwarz
- Institute of Physics, Johannes Gutenberg University, 55128 Mainz, Germany
| | - P Leiderer
- Fachbereicht Physik, University of Konstanz, 78457 Konstanz, Germany
| | - T Palberg
- Institute of Physics, Johannes Gutenberg University, 55128 Mainz, Germany
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14
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Schwarz J, Vecka M, Stožický F, Pomahačová R, Staňková B, Tvrzická E, Kreslová M, Zahálková R, Sýkora J. The assessment of plasma fatty acid profiles in newly diagnosed treatment-naive paediatric Crohn's disease. Physiol Res 2021; 70:799-808. [PMID: 34505533 DOI: 10.33549/physiolres.934665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Fatty acid (FA) profiles as potentially relevant components of Crohn's disease (CD) have been insufficiently analysed. We sought to explore the plasma profiles of n-3 and n-6 polyunsa-turated fatty acids (PUFAs) in newly diagnosed untreated active CD. We included 26 consecutive CD pediatric patients (<19 years) and 14 healthy controls (HCs). Disease characteristics, including inflammatory markers, dietary histories, and the Pediatric Crohn's Disease Activity Index (PCDAI), were obtained. The profiles of plasma FAs in plasma lipid classes were analysed by gas chromatography with FID detection of methyl esters. The erythrocyte sedimentation rate, C-reactive protein level and fecal calprotectin level (all p<0.001) were significantly higher in CD patients than in HCs. Most changes were observed in plasma phospholipids (PLs), such as a higher content of n-3 and changes in n-6 long-chain PUFAs in the CD group. The CD group had a lower ratio of n-6/n-3 PUFAs in PLs (p<0.001) and triacylglycerols (TAGs) (p<0.01). Correlations of the FA content in plasma PLs with disease activity scores of CD were also observed, which were positive for the sum of monounsaturated fatty acids (MUFAs) as well as oleic acid (18:1n-9) (both p<0.05). The metabolism of PUFAs is significantly altered even in treatment-naive newly diagnosed active pediatric CD, and the content of major FAs in PLs correlates with disease activity and inflammatory markers, thus probably contributing to the still unclear early disease pathogenesis.
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Affiliation(s)
- J Schwarz
- Division of Pediatric Gastroenterology, Department of Pediatrics, Faculty Hospital, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
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15
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Schwarz J, Schädler J, Albini S, Peter-Egli J, Probst S, Schüpbach-Regula G, Wiederkehr D. [Health, performance and use of medication in professional Swiss meat rabbit production]. SCHWEIZ ARCH TIERH 2021; 164:623-634. [PMID: 34758955 DOI: 10.17236/sat00317] [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] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Husbandry conditions for rabbits in Switzerland are at a high animal welfare level in international comparison. Wire mesh flooring is prohibited and group housing is mandatory up to the age of eight weeks. Despite these animal-friendly husbandry standards, animal losses seem to be a significant problem, although reliable data on professional Swiss meat rabbit production is lacking to date. A herd survey was carried out in 52 rabbit farms to address this situation. At the same time, each new litter and each fattening group was documented with a standardized form focusing on animal death and the use of medication by the farmer over a one year period. In the case of increased mortality or new health problems, dead rabbits were sent to the National Reference Center for Poultry and Rabbit Diseases (Zurich) for pathological examination including bacteriological and parasitological diagnostics. Data from 32 farms were evaluated. The average mortality of young animals (birth to weaning) was 14.9% (1.0-30.0%) and of fattening rabbits (weaning to slaughter) 17.3% (4.3-31.8%). Intestinal diseases, mainly dysentery, intestinal coccidiosis and mucoid enteropathies, were the primary cause of death (68.2%). Eimeria spp., Escherichia coli and Clostridium perfringens were identified as the most frequent pathogens. Respiratory diseases were found in 18.7% of the examined rabbits, with Pasteurella multocida identified as the most common pathogen. 60.0% of the farms used antibiotics during the study period and a third (34.7%) of all the fattening animals were medicated with at least one antibiotic. The present results confirm that despite high animal welfare standards infectious diseases and mortality rates represent a considerable problem in professional Swiss meat rabbit production. Risk factors of increased morbidity and mortality should be identified to improve rabbit health, to reduce the high mortality rate and the extensive use of antibiotics in professional Swiss meat rabbit production. Practicable management improvements with specific prevention strategies should be developed.
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Affiliation(s)
- J Schwarz
- Hochschule für Agrar-, Forst- und Lebensmittelwissenschaften, Berner Fachhochschule
| | - J Schädler
- Nationales Referenzzentrum für Geflügel- und Kaninchenkrankheiten, Institut für Lebensmittelsicherheit und -hygiene, Vetsuisse Fakultät, Universität Zürich
| | - S Albini
- Nationales Referenzzentrum für Geflügel- und Kaninchenkrankheiten, Institut für Lebensmittelsicherheit und -hygiene, Vetsuisse Fakultät, Universität Zürich
| | - J Peter-Egli
- Schweizerische Vereinigung für Schweinemedizin (SVSM)
| | - S Probst
- Hochschule für Agrar-, Forst- und Lebensmittelwissenschaften, Berner Fachhochschule
| | - G Schüpbach-Regula
- Veterinary Public Health Institut (VPHI), Vetsuisse-Fakultät, Universität Bern
| | - D Wiederkehr
- Hochschule für Agrar-, Forst- und Lebensmittelwissenschaften, Berner Fachhochschule
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16
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Kreslová M, Sýkorová A, Bittenglová R, Schwarz J, Pomahačová R, Jehlička P, Kobr J, Trefil L, Sýkora J. Age-Related Progression of Microvascular Dysfunction in Cystic Fibrosis: New Detection Ways and Clinical Outcomes. Physiol Res 2021; 70:893-903. [PMID: 34717066 DOI: 10.33549/physiolres.934743] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
There are concerns about altered vascular functions that could play an important role in the pathogenesis and influence the severity of chronic disease, however, increased cardiovascular risk in paediatric cystic fibrosis (CF) has not been yet fully understood. Aim was to analyse vascular disease risk and investigate changes over times in CF and controls. We prospectively enrolled 22 CF subjects (a median age of 16.07 years), and 22 healthy demographically matched controls (a median age of 17.28 years) and determined endothelial function. We utilised a combined diagnostic approach by measuring the plethysmographic Reactive Hyperemia Index (RHI) as the post-to preocclusive endothelium-dependent changes of vascular tone, and biomarkers that are known to be related to endothelial dysfunction (ED): asymmetric dimethyl arginine (ADMA), high-sensitive CRP (hsCRP), VCAM-1 and E-selectin. RHI values were significantly lower in CF young adults (p<0.005). HsCRP (p<0.005), E-selectin (p<0.001) and VCAM-1 (p<0.001) were significantly increased in CF patients since childhood. The findings have provided a detailed account of the ongoing process of microvascular dysfunction with gradual progression with the age of CF patients, making them further at risk of advanced vascular disease. Elevations of biomarkers in CF children with not yet demonstrated RHI changes but with significantly reduced RHI in adulthood and lipid profile changes indicate the possible occurrence of ED with CF-related specific risk factors over time and will enable us to provide the best possible support.
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Affiliation(s)
- M Kreslová
- Department of Pediatrics, Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Pilsen, Czech Republic.
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17
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Kim M, Lee M, Schwarz J, Kacker A, Schwartz TH. A Novel Negative Pressure, Face-Mounted Antechamber to Minimize Aerosolization of Particles During Endoscopic Skull Base Surgery. Oper Neurosurg (Hagerstown) 2021; 21:131-136. [PMID: 34017990 PMCID: PMC8194582 DOI: 10.1093/ons/opab173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/09/2020] [Accepted: 03/19/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has revealed deficiencies in the adequacy of personal protective equipment (PPE) for healthcare workers. Endoscopic endonasal skull base surgery is thought to be among the highest-risk aerosol-generating procedures for surgeons and operating room personnel. OBJECTIVE To validate the efficacy and clinical feasibility of a novel surgical device. METHODS A low-cost, modifiable, and easily producible negative pressure, face-mounted antechamber was developed utilizing 3D printing and silicone molding. Efficacy was evaluated using an optical particle sizer to quantify aerosols generated during both cadaver and intraoperative human use with high-speed drilling. RESULTS Particle counts in the cadaver showed that drilling led to a 2.49-fold increase in particles 0.3 to 5 μm (P = .001) and that the chamber was effective at reducing particles to levels not significantly different than baseline. In humans, drilling led to a 37-fold increase in particles 0.3 to 5 μm (P < .001), and the chamber was effective at reducing particles to a level not significantly different than baseline. Use of the antechamber in 6 complex cases did not interfere with the ability to perform surgery. Patients did not report any facial discomfort after surgery related to antechamber use. CONCLUSION The use of a negative pressure facial antechamber can effectively reduce aerosolization from endoscopic drilling without disturbing the flow of the operation. The antechamber, in conjunction with appropriate PPE, will be useful during the COVID-19 pandemic, as well as during flu season and any future viral outbreaks.
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Affiliation(s)
- Matthew Kim
- Department of Otolaryngology—Head and Neck Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York, USA
| | - Mark Lee
- Department of Otolaryngology—Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, USA
| | - Justin Schwarz
- Department of Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Ashutosh Kacker
- Department of Otolaryngology—Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, USA
| | - Theodore H Schwartz
- Department of Otolaryngology—Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, USA
- Department of Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA
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18
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Dahling V, May S, Peter SV, Schwarz J, Ignatyev Y, Scheibner H, Heinze M. [Expectations of patients and relatives for modern hospital care in geriatric psychiatry]. Z Gerontol Geriatr 2021; 55:476-481. [PMID: 34251463 DOI: 10.1007/s00391-021-01941-4] [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: 02/25/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In order to improve health care in geriatric psychiatry, users must be granted a larger role in shaping their treatment. To this aim we identify factors that are essential to psychiatric care from users' perspectives. METHODS Focus groups and interviews (n = 12) were conducted to identify the health care factors that were most essential to its users. In addition, patients (n = 72) and relatives (n = 62) evaluated the current health care in a questionnaire. RESULTS The most essential factors were longer consultations with doctors and treatment providers, comprehensive and comprehensible information, individualized procedures and therapies, having clearly defined scopes for each professional group, environmental factors and the integration of relatives into the therapy process. CONCLUSION The reported factors could help improve health services in geriatric psychiatry by pointing towards potential changes and room for optimization in health care on both structural and process levels.
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Affiliation(s)
- V Dahling
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland.
| | - S May
- Zentrum für Versorgungsforschung, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
| | - S V Peter
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
| | - J Schwarz
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
| | - Y Ignatyev
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
| | - H Scheibner
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
| | - M Heinze
- Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg Theodor Fontane, Rüdersdorf bei Berlin, Deutschland
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19
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Schwarz J, Carnevale JA, Goldberg JL, Ramos AD, Link TW, Knopman J. Perioperative prophylactic middle meningeal artery embolization for chronic subdural hematoma: a series of 44 cases. J Neurosurg 2021:1-9. [PMID: 34020417 DOI: 10.3171/2020.10.jns202856] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/12/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Chronic subdural hematoma (cSDH) is a common and challenging pathology to treat due to both the historically high recurrence rate following surgical evacuation and the medical comorbidities inherent in the aging patient population that it primarily affects. Middle meningeal artery (MMA) embolization has shown promise in the treatment of cSDHs, most convincingly to avoid surgical evacuation in relatively asymptomatic patients. Symptomatic patients requiring surgical evacuation may also benefit from perioperative MMA embolization to prevent cSDH recurrence. The goal of this study was to determine the utility of perioperative MMA embolization for symptomatic cSDH requiring surgical evacuation and to assess if there is a decrease in the cSDH recurrence rate compared to historical recurrence rates following surgical evacuation alone. METHODS Symptomatic cSDHs were evacuated using a subdural evacuating port system (SEPS) with 5-mm twist-drill craniostomy in an intensive care unit or by performing a craniotomy in the operating room, using either a small (silver dollar, < 4 cm) or large (≥ 4 cm) craniotomy. MMA embolization was performed perioperatively using angiography, selective catheterization of the MMA, and infusion of polyvinyl particles. Outcomes were assessed clinically and radiographically with interval head CT imaging. RESULTS There were 44 symptomatic cSDHs in 41 patients, with 3 patients presenting with bilateral symptomatic cSDH. All cSDHs were evacuated using an SEPS (n = 18), a silver-dollar craniotomy (n = 16), or a large craniotomy (n = 10). Prophylactic MMA embolization was performed successfully in all cSDHs soon after surgical evacuation. There were no deaths and no procedural complications. There was an overall reduction of greater than 50% or resolution of cSDH in 40/44 (90.9%) cases, regardless of the evacuation procedure used. Of the 44 prophylactic cases, there were 2 (4.5%) cases of cSDH recurrence that required repeat surgical evacuation at the 1-year follow-up. These 2 cSDHs were initially evacuated using an SEPS and subsequently required a craniotomy, thereby representing an overall 4.5% recurrence rate of treated cSDH requiring repeat evacuation. Most notably, of the 26 patients who underwent surgical evacuation with a craniotomy followed by MMA embolization, none had cSDH recurrence requiring repeat intervention. CONCLUSIONS Perioperative prophylactic MMA embolization in the setting of surgical evacuation, via either craniotomy or SEPS, may help to lower the recurrence rate of cSDH.
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20
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Tosi U, Chidambaram S, Schwarz J, Diaz SM, Singh S, Norman S, Radwanski R, Murthy S, Apuzzo M, Schwartz TH, Pannullo SC. The World of Neurosurgery Reimagined Post COVID-19: Crisis ↔ Opportunities. World Neurosurg 2021; 148:251-255. [PMID: 33770847 DOI: 10.1016/j.wneu.2020.11.167] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/10/2020] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has impacted neurosurgery in unforeseeable ways. Neurosurgical patient care, research, and education have undergone extraordinary modifications as medicine and mankind have adapted to overcome the challenges posed by this pandemic. Some changes will disappear as the situation slowly recovers to a prepandemic status quo. Others will remain: This pandemic has sparked some long-overdue systemic transformations across all levels of medicine, including in neurosurgery, that will be beneficial in the future. In this paper, we present some of the challenges faced across different levels of neurosurgical clinical care, research, and education, the changes that followed, and how some of these modifications have transformed into opportunities for improvement and growth in the future.
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Affiliation(s)
- Umberto Tosi
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Swathi Chidambaram
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Sunidhi Singh
- Weill Cornell Medical College, New York, New York, USA
| | - Sofya Norman
- Weill Cornell Medical College, New York, New York, USA
| | - Ryan Radwanski
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA
| | - Santosh Murthy
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Michael Apuzzo
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Susan C Pannullo
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
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21
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Schwarz J, Al Balushi A, Sundararajan S, Dinkin M, Oliveira C, Greenfield JP, Patsalides A. Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting. Interv Neuroradiol 2021; 27:257-265. [PMID: 33236688 PMCID: PMC8050535 DOI: 10.1177/1591019920976234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Venous sinus stenting (VSS) is an accepted and minimally invasive treatment for adult idiopathic intracranial hypertension (IIH) associated with lateral sinus stenosis (LSS). The efficacy and safety of venous sinus stenting (VSS) in children with IIH has not been established. METHODS This is a retrospective analysis of IIH patients 18 years of age or younger with LSS treated with VSS at our institution. Included patients have fulminant disease course or are refractory or intolerant to medical management. RESULTS Eight patients were identified; 4 males and 4 females. Mean age is 13.4 years (range 4-18). All patients had severe headaches, 5 had blurred vision, 3 had diplopia and 3 had pulsatile tinnitus. Papilledema was present in 4 patients. Three patients had prior surgical procedures. Four patients were intolerant to medical management, 3 were refractory and 1 had fulminant course. Cerebral venography demonstrated severe stenosis of the dominant sinus in 6 patients and of bilateral co-dominant sinuses in 2 patients. Six patients had intrinsic stenosis and 2 had extrinsic stenosis. Venous sinus stenting (VSS) resulted in improvement of symptoms, papilledema and normalization of CSF opening pressure in 7 patients. No immediate complications were observed. Mean follow-up period is 21 months (range 6-42). Two patients required re-stenting; one responded well and the other had persistent symptoms and underwent subsequent surgical procedures of CSF diversion, suboccipital decompression and duraplasty which were also ineffective. CONCLUSION VSS may provide a viable option for pediatric IIH patients who are intolerant to medication, have failed conservative management or prior surgical interventions, or present with fulminant disease.
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Affiliation(s)
- Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Ali Al Balushi
- Department of Neurological Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Sri Sundararajan
- Department of Neurological Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Marc Dinkin
- Department of Ophthalmology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Cristiano Oliveira
- Department of Ophthalmology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Jeffrey P Greenfield
- Department of Neurological Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Athos Patsalides
- Department of Neurological Surgery, North Shore University Hospital, Northwell Health, Manhasset, NY, USA
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22
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Martins M, Reinwardt S, Schunck JO, Schwarz J, Baev K, Müller A, Buhr T, Perry-Sassmannshausen A, Klumpp S, Schippers S. Disentangling the Photodissociation Dynamics of the HF + Molecular Radical via Kinetic-Energy-Release-Resolved F 1s Core Excitation and Ionization. J Phys Chem Lett 2021; 12:1390-1395. [PMID: 33508188 DOI: 10.1021/acs.jpclett.0c03356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The F 1s core level photoionization of the ionic molecular radical HF+ has been studied using the photon-ion merged-beams technique at a synchrotron radiation source. Upon analyzing kinetic energy release (KER) dependent photoion yield spectra, complex ultrafast dissociation dynamics of the F 1s core hole excited σ* state can be revealed. By means of configuration-interaction electronic structure calculations of the excited molecular potential energy curves, this complex process can be attributed to a spin-dependent dissociation of the excited σ* biradical state.
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Affiliation(s)
- M Martins
- Institut für Experimentalphysik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - S Reinwardt
- Institut für Experimentalphysik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - J O Schunck
- Institut für Experimentalphysik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - J Schwarz
- Institut für Experimentalphysik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - K Baev
- Institut für Experimentalphysik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - A Müller
- Institut für Atom- und Molekülphysik, Justus-Liebig-Universität Gießen, Leihgesterner Weg 217, 35392 Giessen, Germany
| | - T Buhr
- I. Physikalisches Institut, Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - A Perry-Sassmannshausen
- I. Physikalisches Institut, Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - S Klumpp
- Deutsches Elektronen-Synchrotron (DESY), Notkestrasse 85, 22607 Hamburg, Germany
| | - S Schippers
- I. Physikalisches Institut, Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
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Schoeb DS, Schwarz J, Hein S, Schlager D, Pohlmann PF, Frankenschmidt A, Gratzke C, Miernik A. Mixed reality for teaching catheter placement to medical students: a randomized single-blinded, prospective trial. BMC Med Educ 2020; 20:510. [PMID: 33327963 PMCID: PMC7745503 DOI: 10.1186/s12909-020-02450-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/26/2020] [Accepted: 12/11/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Cost-effective methods to facilitate practical medical education are in high demand and the "mixed-reality" (MR) technology seems suitable to provide students with instructions when learning a new practical task. To evaluate a step-by-step mixed reality (MR) guidance system for instructing a practical medical procedure, we conducted a randomized, single-blinded prospective trial on medical students learning bladder catheter placement. METHODS We enrolled 164 medical students. Students were randomized into 2 groups and received instructions on how to perform bladder catheter placement on a male catheterization training model. One group (107 students) were given their instructions by an instructor, while the other group (57 students) were instructed via an MR guidance system using a Microsoft HoloLens. Both groups did hands on training. A standardized questionnaire covering previous knowledge, interest in modern technologies and a self-evaluation was filled out. In addition, students were asked to evaluate the system's usability. We assessed both groups's learning outcome via a standardized OSCE (objective structured clinical examination). RESULTS Our evaluation of the learning outcome revealed an average point value of 19.96 ± 2,42 for the control group and 21.49 ± 2.27 for the MR group - the MR group's result was significantly better (p = 0.00). The self-evaluations revealed no difference between groups, however, the control group gave higher ratings when evaluating the quality of instructions. The MR system's assessment showed less usability, with a cumulative SUS (system usability scale) score of 56.6 (lower half) as well as a cumulative score of 24.2 ± 7.3 (n = 52) out of 100 in the NASA task load index. CONCLUSIONS MR is a promising tool for instructing practical skills, and has the potential to enable superior learning outcomes. Advances in MR technology are necessary to improve the usability of current systems. TRIAL REGISTRATION German Clinical Trial Register ID: DRKS00013186.
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Affiliation(s)
- D. S. Schoeb
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - J. Schwarz
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - S. Hein
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - D. Schlager
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - P. F. Pohlmann
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - A. Frankenschmidt
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - C. Gratzke
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - A. Miernik
- Department of Urology, Faculty of Medicine, Medical Center – University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
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Carnevale J, Schwarz J, Goldberg J, Link TW, Knopman J. Perioperative Prophylactic Middle Meningeal Artery Embolization for Chronic Subdural Hematoma. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Vecka M, Sýkora J, Stožický F, Pomahačová R, Staňková B, Tvrzická E, Schwarz J, Kreslová M, Zahálková R. The fatty acid profile in new-onset paediatric Crohn's disease. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Gerardo C, Keyler D, Rapp-Olsson A, Schwarz J, Dart R. 72 Post Hoc Analysis of the RCT Comparing F(ab’)2to Fab Antivenom: Control of Venom-induced Tissue Injury in Copperhead Snakebite Patients. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.082] [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: 10/23/2022]
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27
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Akerstedt T, Ghilotti F, Schwarz J, Theorell-Haglöw J, Lindberg E. 0460 Insomnia In 400 Women: Polysomnography, Immune Parameters, Depression and Anxiety. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Insomnia disorder has a very weak link to polysomnography (PSG) and so does sleep problems in the general population. The reason for this is not clear. One possibility is that the perception of disturbed sleep may be related to immune activation or anxiety/depression, without impairment of objective sleep.
Methods
400 women participated, constituting a representative sample of the city of Uppsala with oversampling of snorers. Insomniacs (N=41) were compared with normal sleepers in terms of polysomnography (PSG), immune parameters, anxiety and depression
Results
The results (after adjustment for age and BMI) show that C-reactive protein (CRP) reached a higher level (4.4±.5) in insomniacs (vs 2.3±.2 for normal sleepers) (p=.003) and lower subjective health (p=.000), while anxiety (p=.000) and depression (p=.000) (Hospital Anxiety and Depression Scale (HAD)) showed higher levels. PSG sleep continuity variables lacked association with insomnia, as did all sleep stage variables except for REM%, with a lower level in the insomnia group (p=.021). Interleukin 6 and Tumor Necrosis Factor alpha were not related to insomnia. CRP levels did not correlate significantly with anxiety or depression, but with subjective health (r=-.21, p=.000). A logistic regression analysis (excluding the variable subjective health) with insomnia as outcome (0/1) yielded as predictors CRP (OR=1.14, Ci= 1.05; 1.24, p=.000), depression (OR=1.21, Ci=1.06;1.38, p=.000) and anxiety (OR=1.15, Ci=1.02;1.30, p=.021).
Conclusion
It was concluded that increased CRP levels may be part of the subjective experience of insomnia.
Support
No external funding
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Affiliation(s)
| | | | - J Schwarz
- Stockholm University, Stockholm, SWEDEN
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Abstract
Venous sinus stenting is an accepted and minimally invasive treatment for idiopathic intracranial hypertension associated with significant venous sinus stenosis. There is inherent difficulty in navigating past the region of venous stenosis in order to safely deliver and deploy a stent. We have developed the "Cobra" technique, which allows for the safe and efficient navigation past regions of high-grade venous sinus stenosis.
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Affiliation(s)
- Justin Schwarz
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Alejandro Santillan
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Athos Patsalides
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
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29
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Aker M, Altenmüller K, Arenz M, Babutzka M, Barrett J, Bauer S, Beck M, Beglarian A, Behrens J, Bergmann T, Besserer U, Blaum K, Block F, Bobien S, Bokeloh K, Bonn J, Bornschein B, Bornschein L, Bouquet H, Brunst T, Caldwell TS, La Cascio L, Chilingaryan S, Choi W, Corona TJ, Debowski K, Deffert M, Descher M, Doe PJ, Dragoun O, Drexlin G, Dunmore JA, Dyba S, Edzards F, Eisenblätter L, Eitel K, Ellinger E, Engel R, Enomoto S, Erhard M, Eversheim D, Fedkevych M, Felden A, Fischer S, Flatt B, Formaggio JA, Fränkle FM, Franklin GB, Frankrone H, Friedel F, Fuchs D, Fulst A, Furse D, Gauda K, Gemmeke H, Gil W, Glück F, Görhardt S, Groh S, Grohmann S, Grössle R, Gumbsheimer R, Ha Minh M, Hackenjos M, Hannen V, Harms F, Hartmann J, Haußmann N, Heizmann F, Helbing K, Hickford S, Hilk D, Hillen B, Hillesheimer D, Hinz D, Höhn T, Holzapfel B, Holzmann S, Houdy T, Howe MA, Huber A, James TM, Jansen A, Kaboth A, Karl C, Kazachenko O, Kellerer J, Kernert N, Kippenbrock L, Kleesiek M, Klein M, Köhler C, Köllenberger L, Kopmann A, Korzeczek M, Kosmider A, Kovalík A, Krasch B, Kraus M, Krause H, Kuckert L, Kuffner B, Kunka N, Lasserre T, Le TL, Lebeda O, Leber M, Lehnert B, Letnev J, Leven F, Lichter S, Lobashev VM, Lokhov A, Machatschek M, Malcherek E, Müller K, Mark M, Marsteller A, Martin EL, Melzer C, Menshikov A, Mertens S, Minter LI, Mirz S, Monreal B, Morales Guzmán PI, Müller K, Naumann U, Ndeke W, Neumann H, Niemes S, Noe M, Oblath NS, Ortjohann HW, Osipowicz A, Ostrick B, Otten E, Parno DS, Phillips DG, Plischke P, Pollithy A, Poon AWP, Pouryamout J, Prall M, Priester F, Röllig M, Röttele C, Ranitzsch PCO, Rest O, Rinderspacher R, Robertson RGH, Rodenbeck C, Rohr P, Roll C, Rupp S, Ryšavý M, Sack R, Saenz A, Schäfer P, Schimpf L, Schlösser K, Schlösser M, Schlüter L, Schön H, Schönung K, Schrank M, Schulz B, Schwarz J, Seitz-Moskaliuk H, Seller W, Sibille V, Siegmann D, Skasyrskaya A, Slezák M, Špalek A, Spanier F, Steidl M, Steinbrink N, Sturm M, Suesser M, Sun M, Tcherniakhovski D, Telle HH, Thümmler T, Thorne LA, Titov N, Tkachev I, Trost N, Urban K, Vénos D, Valerius K, VanDevender BA, Vianden R, Vizcaya Hernández AP, Wall BL, Wüstling S, Weber M, Weinheimer C, Weiss C, Welte S, Wendel J, Wierman KJ, Wilkerson JF, Wolf J, Xu W, Yen YR, Zacher M, Zadorozhny S, Zbořil M, Zeller G. Improved Upper Limit on the Neutrino Mass from a Direct Kinematic Method by KATRIN. Phys Rev Lett 2019; 123:221802. [PMID: 31868426 DOI: 10.1103/physrevlett.123.221802] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 06/10/2023]
Abstract
We report on the neutrino mass measurement result from the first four-week science run of the Karlsruhe Tritium Neutrino experiment KATRIN in spring 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are energy analyzed by a high-resolution MAC-E filter. A fit of the integrated electron spectrum over a narrow interval around the kinematic end point at 18.57 keV gives an effective neutrino mass square value of (-1.0_{-1.1}^{+0.9}) eV^{2}. From this, we derive an upper limit of 1.1 eV (90% confidence level) on the absolute mass scale of neutrinos. This value coincides with the KATRIN sensitivity. It improves upon previous mass limits from kinematic measurements by almost a factor of 2 and provides model-independent input to cosmological studies of structure formation.
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Affiliation(s)
- M Aker
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Altenmüller
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- IRFU (DPhP & APC), CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M Arenz
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - M Babutzka
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J Barrett
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - S Bauer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - M Beck
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - A Beglarian
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - J Behrens
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - T Bergmann
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - U Besserer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Blaum
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - F Block
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Bobien
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Bokeloh
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - J Bonn
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - B Bornschein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Bornschein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H Bouquet
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Brunst
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - T S Caldwell
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - L La Cascio
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Chilingaryan
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - W Choi
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - T J Corona
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - K Debowski
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - M Deffert
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Descher
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - P J Doe
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - O Dragoun
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - G Drexlin
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J A Dunmore
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Dyba
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Edzards
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - L Eisenblätter
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Eitel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - E Ellinger
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - R Engel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Enomoto
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M Erhard
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - D Eversheim
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - M Fedkevych
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Felden
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Fischer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Flatt
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - J A Formaggio
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - F M Fränkle
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - G B Franklin
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - H Frankrone
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - F Friedel
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - D Fuchs
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A Fulst
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - D Furse
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - K Gauda
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - H Gemmeke
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - W Gil
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - F Glück
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Görhardt
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Groh
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Grohmann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R Grössle
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R Gumbsheimer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Ha Minh
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M Hackenjos
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - V Hannen
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Harms
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J Hartmann
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Haußmann
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - F Heizmann
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - K Helbing
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - S Hickford
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - D Hilk
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - B Hillen
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - D Hillesheimer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - D Hinz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Höhn
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Holzapfel
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Holzmann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Houdy
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M A Howe
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Huber
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - T M James
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Jansen
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kaboth
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - C Karl
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - O Kazachenko
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - J Kellerer
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - N Kernert
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Kippenbrock
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M Kleesiek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Klein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - C Köhler
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - L Köllenberger
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kopmann
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Korzeczek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - A Kosmider
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kovalík
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - B Krasch
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Kraus
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - H Krause
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Kuckert
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Kuffner
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Kunka
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Lasserre
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- IRFU (DPhP & APC), CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - T L Le
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - O Lebeda
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - M Leber
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - B Lehnert
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Letnev
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - F Leven
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Lichter
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V M Lobashev
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - A Lokhov
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Machatschek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - E Malcherek
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Müller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Mark
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Marsteller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - E L Martin
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - C Melzer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Menshikov
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Mertens
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L I Minter
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Mirz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Monreal
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - P I Morales Guzmán
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - K Müller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - U Naumann
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - W Ndeke
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - H Neumann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Niemes
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Noe
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N S Oblath
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - H-W Ortjohann
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Osipowicz
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - B Ostrick
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - E Otten
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - D S Parno
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - D G Phillips
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P Plischke
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Pollithy
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A W P Poon
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Pouryamout
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - M Prall
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Priester
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Röllig
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - C Röttele
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - P C-O Ranitzsch
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - O Rest
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - R Rinderspacher
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R G H Robertson
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - C Rodenbeck
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - P Rohr
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Ch Roll
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - S Rupp
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Ryšavý
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - R Sack
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Saenz
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - P Schäfer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Schimpf
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - K Schlösser
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Schlösser
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Schlüter
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - H Schön
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Schönung
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Schrank
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Schulz
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - J Schwarz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H Seitz-Moskaliuk
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - W Seller
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - V Sibille
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - D Siegmann
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A Skasyrskaya
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Slezák
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - A Špalek
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - F Spanier
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Steidl
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Steinbrink
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - M Sturm
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Suesser
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Sun
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - D Tcherniakhovski
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H H Telle
- Departamento de Química Física Aplicada, Universidad Autonoma de Madrid, Campus de Cantoblanco, 28049 Madrid, Spain
| | - T Thümmler
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - L A Thorne
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - N Titov
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - I Tkachev
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - N Trost
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Urban
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - D Vénos
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - K Valerius
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - B A VanDevender
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - R Vianden
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - A P Vizcaya Hernández
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - B L Wall
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Wüstling
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Weber
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - C Weinheimer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - C Weiss
- Project, Process, and Quality Management (PPQ), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Welte
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - J Wendel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K J Wierman
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J F Wilkerson
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Wolf
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - W Xu
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - Y-R Yen
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M Zacher
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - S Zadorozhny
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Zbořil
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - G Zeller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
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Santillan A, Hee Sur M, Schwarz J, Easthausen I, Behrman DA, Patsalides A. Endovascular preoperative embolization for temporomandibular joint replacement surgery. Interv Neuroradiol 2019; 26:99-104. [PMID: 31594444 DOI: 10.1177/1591019919880426] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND PURPOSE This retrospective study evaluates the safety and effectiveness of preoperative endovascular embolization in patients who underwent temporomandibular joint (TMJ) replacement surgery. MATERIAL AND METHODS We included all patients treated with preoperative embolization of the internal maxillary artery (IMAX) between June 2016 and January 2019. All patients were treated by the same surgeon using standard surgical approaches and procedures. Periprocedural adverse events, blood loss during surgery and clinical follow-up are reported. RESULTS Fourteen patients (12 females, median age 32.5) were treated with 21 embolizations of the IMAX (bilateral embolizations in seven patients) prior to TMJ replacement surgery with prosthetic joints (TMJ Concepts prostheses). Seven patients presented with TMJ ankylosis/degenerative joint disease/post-trauma deformity, four patients with Idiopathic Condylar Resorption and resultant mandibular displacement/hypoplasia, two patients with rheumatoid arthritis-associated condylar degeneration and resultant loss of mandibular position, and 1 patient being re-reconstructed following management of a prosthetic joint infection. Seven patients underwent bilateral prosthetic joint replacement. Four patients underwent additional facial skeletal surgery as part of their treatment. The mean blood volume loss during TMJ surgery was approximately 370 cc (range 100-800 cc). Joint space-specific blood loss was not recorded, but, as per the surgical team, was significantly decreased when compared to non-embolized patients. There were no intra-procedural complications. The median clinical follow-up was 3.5 months (range 1-24 months). The modified Rankin scale (mRS) was 0 before the procedure and at last clinical follow-up in all patients. After TMJ surgery, three patients reported paresthesia of the trigeminal nerve likely related to the residual condyle resection and two patients had mild facial nerve weakness (Temporal and/or Marginal Mandibular branch) related to the surgical exposures. CONCLUSION Endovascular preoperative embolization of the IMAX is feasible, safe and likely effective in reducing blood volume loss in complex TMJ replacement surgery.
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Affiliation(s)
- Alejandro Santillan
- Department of Neurological Surgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Min Hee Sur
- Department of Oral and Maxillofacial Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Imaani Easthausen
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - David A Behrman
- Department of Oral and Maxillofacial Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Athos Patsalides
- Department of Neurological Surgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
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von Peter S, Ignatyev Y, Indefrey S, Johne J, Schwarz J, Timm J, Heinze M. [Specific components for integrative and flexible care models according to § 64b SGB V]. Nervenarzt 2019; 89:559-564. [PMID: 29209751 DOI: 10.1007/s00115-017-0459-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a need for a theoretical model for evaluating integrative and flexible care models according to § 64b of the Social Security Statutes Book V (SGB V). MATERIAL AND METHODS An iterative process of data collection and analysis has been executed according to grounded theory methodology. RESULTS A total of 11 specific components have been identified and shown to be robust and practicable and compatible with the data from the literature. CONCLUSION These components can be used for implementation, quality management and evaluation of projects for treatment models according to § 64b SGB V.
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Affiliation(s)
- S von Peter
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland.
| | - Y Ignatyev
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
| | - S Indefrey
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland
| | - J Johne
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland
| | - J Schwarz
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
| | - J Timm
- Kompetenzzentrum für Klinische Studien Bremen, Universität Bremen, Bremen, Deutschland
| | - M Heinze
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
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Henke L, Green O, Curcuru A, Mutic S, Markovina S, Schwarz J, Grigsby P, Robinson C, Chundury A. EP-1510 Phase I Trial of Stereotactic MR-guided Online Adaptive Radiotherapy for Ovarian Oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31930-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Abstract P3-08-17: Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-17] [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: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. Numerous clinical utility studies have shown that acknowledging the RS impacts on clinical decision making, leading to a decrease in chemotherapy (CT) use. However, the cost of the assay limits it widespread use, especially in low and middle-income countries. Our objective was to determine the patterns of use of ODx, its results and the subsequent treatment choices in a large Latin American cohort.
Methods: We retrospectively reviewed the electronic medical records of patients with early-stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at 3 specialized Peruvian cancer centers between 2007 and 2017. Descriptive results for numeric variables were presented as means with standard deviation (SD) or medians with interquartile range (IQR), depending on their distributions; otherwise, we expressed the qualitative variables as numbers with percentages. We evaluated the association between ODx RS category and treatment using the Chi-squared test.
Results: A total of 551 patients were included. Patients had a mean age of 56.2 ± 11.9 (SD) (range: 26-89). 9.6% (n=53) of patients were ≤40 years old. The size of the tumors ranged from 0.1 cm to 7.2 cm (median = 1.5 cm; IQR 1.0-2.2cm). 36 (6.5%) patients had tumors ≤ 0.5cm and 7 (1%) had tumors > 5cm. A minority of patients had lymph node involvement (5.8%, n=32). ODx was ordered in 55 cases (10%) of lobular carcinoma and in 23 cases (4%) of favorable histology tumors (19 mucinous, 4 tubular). Most tumors exhibited an intermediate histological grade (71.6%, n=386). Ki67 was available in 58.8% patients (n= 324), with a median Ki67 of 20 (IQR 10-30). Using commercial cutoffs RS was distributed as follows: low (0–17) = 316 (57.4%), intermediate (18–30) = 177 (32.1%), and high (≥31) = 58 (10.5%). In general, 57.5% (n=317) of patients received endocrine therapy (ET) as their only systemic treatment and 42.5% (n=234), also received CT (ET + CT). In the low-risk category, 87.3% (n=276) of patients received ET and 12.7% (n=40), ET + CT. Within the intermediate-risk category, most patients received ET + CT (77.4%, n=137). Only one patient in the high-risk category did not receive CT. There was a significant association between the RS group and treatment choice (p<0.001).
Impact of ODx RS results on treatment recommendations Oncotype risk categories LowIntermediateHighp valueTreatmentn%n%n%<0.001Endocrine therapy27687.34022.611.7 Chemotherapy + Endocrine therapy4012.713777.45798.3
Conclusion: ODx significantly influenced treatment decisions in our cohort, however an overutilization of CT was found in low-risk patients. Further data analysis is needed to explain the higher than expected use of CT. Also, there is room for improvement in the selection of cases that undergo ODx testing.
Citation Format: Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-17.
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Affiliation(s)
- R Ruiz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - Z Morante
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - F Namuche
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - D Urrunaga
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - A Aguilar
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - J Schwarz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Leon
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - G Ziegler
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Chavez Mac Gregor
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - H Gomez
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
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Santillan A, Schwarz J, Patsalides A. Transvenous Embolization of Dural Arteriovenous Fistulas of the Hypoglossal Canal: Report of Three Cases and Review of the Literature. Interv Neurol 2018; 7:315-322. [PMID: 30410507 DOI: 10.1159/000488500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/16/2018] [Indexed: 11/19/2022]
Abstract
In this article, we report three cases of dural arteriovenous fistulas of the hypoglossal canal treated via transvenous approach. We also perform a review of the literature on the endovascular management of this type of lesions with particular attention to the dangerous extracranial-intracranial anastomoses that can occur at this level.
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Affiliation(s)
- Alejandro Santillan
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
| | - Justin Schwarz
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
| | - Athos Patsalides
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
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Lin C, Verma V, Ly Q, Schwarz J, Meza J, Sasson A, Are C, Kos B, Grem J. Phase I Trial of Concurrent Stereotactic Body Radiation Therapy and Nelfinavir for Locally Advanced Borderline or Unresectable Pancreatic Cancer-Final Results. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.332] [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: 11/28/2022]
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Armstrong DJ, Looker QM, Stahoviak JW, Smith IC, Shores JE, Rambo PK, Schwarz J, Speas CS, Porter JL. Phase modulation failsafe system for multi-kJ lasers based on optical heterodyne detection. Rev Sci Instrum 2018; 89:105106. [PMID: 30399920 DOI: 10.1063/1.5051125] [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] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 09/24/2018] [Indexed: 06/08/2023]
Abstract
Amplification of the transverse scattered component of stimulated Brillouin scattering (SBS) can contribute to optical damage in the large aperture optics of multi-kJ lasers. Because increased laser bandwidth from optical phase modulation (PM) can suppress SBS, high energy laser amplifiers are injected with PM light. Phase modulation distributes the single-frequency spectrum of a master oscillator laser among individual PM sidebands, so a sufficiently high modulation index β can maintain the fluence for all spectral components below the SBS threshold. To avoid injection of single frequency light in the event of a PM failure, a high-speed PM failsafe system (PMFS) must be employed. Because PM is easily converted to AM, essentially all PM failsafes detect AM, with the one described here employing a novel configuration where optical heterodyne detection converts PM to AM, followed by passive AM power detection. Although the PMFS is currently configured for continuous monitoring, it can also detect PM for pulse durations ≥2 ns and could be modified to accommodate shorter pulses. This PMFS was deployed on the Z-Beamlet Laser (ZBL) at Sandia National Laboratories, as required by an energy upgrade to support programs at Sandia's Z Facility such as magnetized liner inertial fusion. Depending on the origin of a PM failure, the PMFS responds in as little as 7 ns. In the event of an instantaneous failure during initiation of a laser shot, this response time translates to a 30-50 ns margin of safety by blocking a pulse from leaving ZBL's regenerative amplifier, which prevents injection of single frequency light into the main amplification chain. The performance of the PMFS, without the need for operator interaction, conforms to the principles of engineered safety.
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Affiliation(s)
- D J Armstrong
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - Q M Looker
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - J W Stahoviak
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - I C Smith
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - J E Shores
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - P K Rambo
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - J Schwarz
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - C S Speas
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - J L Porter
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
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Flores C, Aguilar A, Enriquez D, Mas Lopez L, Schwarz J, Vallejos C. P3.15-10 Survival Impact of Peripheral Blood Ratios in Lung Cancer According Clinical Stage. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1886] [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]
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Schollmeier M, Ao T, Field ES, Galloway BR, Kalita P, Kimmel MW, Morgan DV, Rambo PK, Schwarz J, Shores JE, Smith IC, Speas CS, Benage JF, Porter JL. Polycapillary x-ray lenses for single-shot, laser-driven powder diffraction. Rev Sci Instrum 2018; 89:10F102. [PMID: 30399823 DOI: 10.1063/1.5036569] [Citation(s) in RCA: 3] [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: 04/17/2018] [Accepted: 06/03/2018] [Indexed: 06/08/2023]
Abstract
X-ray diffraction measurements to characterize phase transitions of dynamically compressed high-Z matter at Mbar pressures require both sufficient photon energy and fluence to create data with high fidelity in a single shot. Large-scale laser systems can be used to generate x-ray sources above 10 keV utilizing line radiation of mid-Z elements. However, the laser-to-x-ray energy conversion efficiency at these energies is low, and thermal x-rays or hot electrons result in unwanted background. We employ polycapillary x-ray lenses in powder x-ray diffraction measurements using solid target x-ray emission from either the Z-Beamlet long-pulse or the Z-Petawatt (ZPW) short-pulse laser systems at Sandia National Laboratories. Polycapillary lenses allow for a 100-fold fluence increase compared to a conventional pinhole aperture while simultaneously reducing the background significantly. This enables diffraction measurements up to 16 keV at the few-photon signal level as well as diffraction experiments with ZPW at full intensity.
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Affiliation(s)
- M Schollmeier
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - T Ao
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - E S Field
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - B R Galloway
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - P Kalita
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - M W Kimmel
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - D V Morgan
- Mission Support and Test Services, NM Operations, 2900 East Road, Los Alamos, New Mexico 87544, USA
| | - P K Rambo
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - J Schwarz
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - J E Shores
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - I C Smith
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - C S Speas
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - J F Benage
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
| | - J L Porter
- Sandia National Laboratories, P.O. Box 5800, MS 1192, Albuquerque, New Mexico 87185, USA
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Santillan A, Schwarz J, Boddu S, Gobin YP, Knopman J, Patsalides A. Stent-assisted coil embolization of anterior communicating artery aneurysms using the LVIS Jr stent. Interv Neuroradiol 2018; 25:12-20. [PMID: 30180758 DOI: 10.1177/1591019918798144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/04/2023] Open
Abstract
BACKGROUND AND PURPOSE This retrospective study evaluates the safety and mid-term and long-term effectiveness of stent-assisted coil embolization of anterior communicating artery (Acomm) aneurysms treated with the LVIS Jr stent. MATERIALS AND METHODS All patients treated with the LVIS Jr stent for Acomm aneurysms between June 2015 and March 2018 were included in the analysis. Details of the procedure's periprocedural adverse events, immediate aneurysm occlusion rates, and clinical and angiographic follow-up assessment were collected. RESULTS A total of 25 patients with 25 aneurysms were included. Eighteen aneurysms were found incidentally. Seven patients presented with seven ruptured aneurysms: Six were remotely ruptured and one acutely ruptured. Twenty-four patients were treated successfully and one technical failure is reported. The parent arteries measured 1.4 mm to 2.9 mm in diameter (mean, 2.3 mm). Intraprocedural thromboembolic complications occurred in two patients (8%) and an intraoperative aneurysm rupture in one patient (4%). Immediate complete aneurysm occlusion was noted in 18 out of 25 patients (72%). Clinical follow-up ranged from three months to 36 months (mean, 15.8 months) and the imaging follow-up ranged from two to 35 months (mean, 14.2 months). Complete aneurysm occlusion was achieved in 14 out of 20 patients (70%) at last angiographic follow-up. Of the two patients with in-stent thrombosis, one patient had an acutely ruptured aneurysm and the other patient was treated with an LVIS Jr stent in a Y configuration. Neurological morbidity and mortality rate were 0%. CONCLUSIONS Complex, wide-necked Acomm aneurysms can be effectively treated with stent-assisted embolization using LVIS Jr stents.
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Affiliation(s)
- Alejandro Santillan
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Justin Schwarz
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Srikanth Boddu
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Y Pierre Gobin
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Jared Knopman
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Athos Patsalides
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
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Plaisancié P, Bruno J, Nicolas A, Pesenti S, Schwarz J, Simon JL, Léonil J. Letter to the Editor: A response to Chessa et al. (2018). J Dairy Sci 2018; 101:4706. [DOI: 10.3168/jds.2018-14426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/22/2018] [Indexed: 12/31/2022]
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Bruno J, Nicolas A, Pesenti S, Schwarz J, Simon JL, Léonil J, Plaisancié P. Corrigendum to “Variants of β-casofensin, a bioactive milk peptide, differently modulate the intestinal barrier: In vivo and ex vivo studies in rats” (J. Dairy Sci. 100:3360–3372). J Dairy Sci 2018; 101:5667. [DOI: 10.3168/jds.2018-101-6-5667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Schramm W, Benning NH, Bogusch J, Czekalla A, de Mey V, Fahn M, Fröhlich S, Hannß S, Hentschel S, Kellermann P, Klass M, Lochner D, Lüönd M, Schubert V, Schwarz J, Stein T, Trefz T, Wein M, Wettstein R. Validierung des PROSIT Typ 2 Diabetes Retinopathiemodells. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641953] [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)
- W Schramm
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - NH Benning
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - J Bogusch
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - A Czekalla
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - V de Mey
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Fahn
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Fröhlich
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Hannß
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Hentschel
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - P Kellermann
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Klass
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - D Lochner
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Lüönd
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - V Schubert
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - J Schwarz
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - T Stein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - T Trefz
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Wein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - R Wettstein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
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Santillan A, Boddu S, Schwarz J, Lin N, Gobin YP, Knopman J, Patsalides A. LVIS Jr. stent for treatment of intracranial aneurysms with parent vessel diameter of 2.5 mm or less. Interv Neuroradiol 2018; 24:246-253. [PMID: 29463145 DOI: 10.1177/1591019918759307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and purpose This retrospective study evaluates the safety, effectiveness, and long-term clinical and angiographic follow-up of intracranial aneurysms treated with the Low-Profile Visualized Intraluminal Support Junior (LVIS Jr.) stent and parent vessels of diameter equal to or less than 2.5 mm. Materials and methods We included all patients treated with the LVIS Jr. stent in aneurysms with small parent vessel diameter between March 2015 and July 2017. Periprocedural adverse events, immediate aneurysm occlusion rates, and clinical and angiographic follow-up are reported. Results A total of 35 patients with 35 aneurysms were included. Ten aneurysms were ruptured (28.6%) and 25 were unruptured (71.4%). The parent arteries measured 0.9 mm to 2.5 mm in diameter (mean, 2.2 mm). Intra-procedural thromboembolic complications occurred in four patients (11.4%) and there was an intraoperative aneurysm rupture in one patient (2.8%). Immediate complete aneurysm occlusion was noted in 21 out of 35 patients (60%). Clinical follow-up ranged between one and 25 months (mean, 10.5 months) and magnetic resonance angiography follow-up ranged between four and 24 months (mean, 10.4 months). Complete aneurysm occlusion was achieved in 21 out of 29 patients (72.4%) at last angiographic follow-up (mean, 9.4 months; range four to 23 months). In-stent stenosis occurred in one out of 29 patients (3.4%), who was asymptomatic. Of the four patients with in-stent thrombosis, three patients were treated with "Y configuration" (two patients with middle cerebral artery aneurysms and one patient with an anterior communicating artery aneurysm). Mortality rate was 0%. Neurological morbidity was 2.9%. Conclusions Stenting with the LVIS Jr. stent allowed us to treat complex intracranial aneurysms with parent vessel diameter of 2.5 mm or less with an acceptable safety profile.
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Affiliation(s)
- Alejandro Santillan
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Srikanth Boddu
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Justin Schwarz
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Ning Lin
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Y Pierre Gobin
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Jared Knopman
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
| | - Athos Patsalides
- Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA
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Nakatsutsumi M, Sentoku Y, Korzhimanov A, Chen SN, Buffechoux S, Kon A, Atherton B, Audebert P, Geissel M, Hurd L, Kimmel M, Rambo P, Schollmeier M, Schwarz J, Starodubtsev M, Gremillet L, Kodama R, Fuchs J. Self-generated surface magnetic fields inhibit laser-driven sheath acceleration of high-energy protons. Nat Commun 2018; 9:280. [PMID: 29348402 PMCID: PMC5773560 DOI: 10.1038/s41467-017-02436-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/29/2017] [Indexed: 11/27/2022] Open
Abstract
High-intensity lasers interacting with solid foils produce copious numbers of relativistic electrons, which in turn create strong sheath electric fields around the target. The proton beams accelerated in such fields have remarkable properties, enabling ultrafast radiography of plasma phenomena or isochoric heating of dense materials. In view of longer-term multidisciplinary purposes (e.g., spallation neutron sources or cancer therapy), the current challenge is to achieve proton energies well in excess of 100 MeV, which is commonly thought to be possible by raising the on-target laser intensity. Here we present experimental and numerical results demonstrating that magnetostatic fields self-generated on the target surface may pose a fundamental limit to sheath-driven ion acceleration for high enough laser intensities. Those fields can be strong enough (~105 T at laser intensities ~1021 W cm–2) to magnetize the sheath electrons and deflect protons off the accelerating region, hence degrading the maximum energy the latter can acquire. Laser-generated ion acceleration has received increasing attention due to recent progress in super-intense lasers. Here the authors demonstrate the role of the self-generated magnetic field on the ion acceleration and limitations on the energy scaling with laser intensity.
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Affiliation(s)
- M Nakatsutsumi
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France. .,European XFEL, GmbH, Holzkoppel 4, 22869, Schenefeld, Germany. .,Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, 565-0871, Japan.
| | - Y Sentoku
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565-0871, Japan.,Department of Physics, University of Nevada, Reno, Nevada, 89557, USA
| | - A Korzhimanov
- Institute of Applied Physics, 46 Ulyanov Street, 603950, Nizhny Novgorod, Russia
| | - S N Chen
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France.,Institute of Applied Physics, 46 Ulyanov Street, 603950, Nizhny Novgorod, Russia
| | - S Buffechoux
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France
| | - A Kon
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565-0871, Japan.,Graduate School of Engineering, Osaka University, Suita, Osaka, 565-0871, Japan.,Japan Synchrotron Radiation Research Institute, Sayo, Hyogo, 679-5198, Japan
| | - B Atherton
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - P Audebert
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France
| | - M Geissel
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - L Hurd
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France.,Department of Physics and Astronomy, Clemson University, Clemson, SC, 29634, USA
| | - M Kimmel
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - P Rambo
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - M Schollmeier
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - J Schwarz
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - M Starodubtsev
- Institute of Applied Physics, 46 Ulyanov Street, 603950, Nizhny Novgorod, Russia
| | | | - R Kodama
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565-0871, Japan.,Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, 565-0871, Japan.,Graduate School of Engineering, Osaka University, Suita, Osaka, 565-0871, Japan
| | - J Fuchs
- LULI-CNRS, École Polytechnique, CEA: Université Paris-Saclay; UPMC Univ Paris 06: Sorbonne Universités, Palaiseau cedex, F-91128, France. .,Institute of Applied Physics, 46 Ulyanov Street, 603950, Nizhny Novgorod, Russia.
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Gerhardsson A, Fischer H, Lekander M, Kecklund G, Axelsson J, Åkerstedt T, Schwarz J. Emotional working memory in older adults after total sleep deprivation. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Akerstedt T, Theorell-Haglöw J, Schwarz J, Lindberg E. The change in sleepiness across 10 years of aging and its relation to changes in polysomnographic variables. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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48
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Schwarz J, Scheckenbach V, Kugel H, Spring B, Pagel J, Härtel C, Pauluschke-Fröhlich J, Peter A, Poets CF, Gille C, Köstlin N. Granulocytic myeloid-derived suppressor cells (GR-MDSC) accumulate in cord blood of preterm infants and remain elevated during the neonatal period. Clin Exp Immunol 2017; 191:328-337. [PMID: 28963753 DOI: 10.1111/cei.13059] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 09/22/2017] [Indexed: 12/17/2022] Open
Abstract
Preterm delivery is the leading cause of perinatal morbidity and mortality. Among the most important complications in preterm infants are peri- or postnatal infections. Myeloid-derived suppressor cells (MDSC) are myeloid cells with suppressive activity on other immune cells. Emerging evidence suggests that granulocytic MDSC (GR-MDSC) play a pivotal role in mediating maternal-fetal tolerance. The role of MDSC for postnatal immune-regulation in neonates is incompletely understood. Until the present time, nothing was known about expression of MDSC in preterm infants. In the present pilot study, we quantified GR-MDSC counts in cord blood and peripheral blood of preterm infants born between 23 + 0 and 36 + 6 weeks of gestation (WOG) during the first 3 months of life and analysed the effect of perinatal infections. We show that GR-MDSC are increased in cord blood independent of gestational age and remain elevated in peripheral blood of preterm infants during the neonatal period. After day 28 they drop to nearly adult levels. In case of perinatal or postnatal infection, GR-MDSC accumulate further and correlate with inflammatory markers C-reactive protein (CRP) and white blood cell counts (WBC). Our results point towards a role of GR-MDSC for immune-regulation in preterm infants and render them as a potential target for cell-based therapy of infections in these patients.
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Affiliation(s)
- J Schwarz
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - V Scheckenbach
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - H Kugel
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - B Spring
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - J Pagel
- Department of Pediatrics, University Clinic Schleswig Holstein, Campus Lübeck, Lübeck, Germany
| | - C Härtel
- Department of Obstetrics and Gynecology, University Hospital Tuebingen, Germany
| | | | - A Peter
- German Centre for Diabetes Research (DZD), Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tuebingen, Tuebingen, Germany.,Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, Tuebingen University Hospital, Tuebingen, Germany
| | - C F Poets
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - C Gille
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - N Köstlin
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
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Elbashir S, Parveen S, Schwarz J, Rippen T, Jahncke M, DePaola A. Seafood pathogens and information on antimicrobial resistance: A review. Food Microbiol 2017; 70:85-93. [PMID: 29173644 DOI: 10.1016/j.fm.2017.09.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [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: 11/17/2016] [Revised: 09/11/2017] [Accepted: 09/14/2017] [Indexed: 01/22/2023]
Abstract
Seafood-borne diseases are a major public health hazard in the United States and worldwide. Per capita, seafood consumption has increased globally during recent decades. Seafood importation and domestic aquaculture farming has also increased. Moreover, several recent outbreaks of human gastroenteritis have been linked to the consumption of contaminated seafood. Investigation of seafood-borne illnesses caused by norovirus, and Vibrio, and other bacteria and viruses require a concrete knowledge about the pathogenicity and virulence properties of the etiologic agents. This review explores pathogens that have been associated with seafood and resulting outbreaks in the U.S. and other countries as well as the presence of antimicrobial resistance in the reviewed pathogens. The spectrum of such resistance is widening due to the overuse, misuse, and sub-therapeutic application of antimicrobials in humans and animals.
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Affiliation(s)
- S Elbashir
- Food Science and Technology Ph.D. Program, Department of Agriculture, Food and Resource Sciences, University of Maryland Eastern Shore, 2116 Center for Food Science and Technology, Princess Anne, MD 21853, USA
| | - S Parveen
- Food Science and Technology Ph.D. Program, Department of Agriculture, Food and Resource Sciences, University of Maryland Eastern Shore, 2116 Center for Food Science and Technology, Princess Anne, MD 21853, USA.
| | - J Schwarz
- Food Science and Technology Ph.D. Program, Department of Agriculture, Food and Resource Sciences, University of Maryland Eastern Shore, 2116 Center for Food Science and Technology, Princess Anne, MD 21853, USA
| | - T Rippen
- Food Science and Technology Ph.D. Program, Department of Agriculture, Food and Resource Sciences, University of Maryland Eastern Shore, 2116 Center for Food Science and Technology, Princess Anne, MD 21853, USA
| | - M Jahncke
- Virginia Tech., Virginia Seafood Agricultural Research and Extension Center, 102 South King Street, Hampton, VA 23669, USA
| | - A DePaola
- Angelo DePaola Consulting, 12719 Dauphin Island Pkwy, Coden, AL 36523, USA
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50
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Nilsonne G, Tamm S, Schwarz J, Almeida R, Fischer H, Kecklund G, Lekander M, Fransson P, Åkerstedt T. 0107 INCREASED GLOBAL FMRI SIGNAL VARIABILITY AFTER PARTIAL SLEEP DEPRIVATION: FINDINGS FROM THE STOCKHOLM SLEEPY BRAIN STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.106] [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: 11/13/2022] Open
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