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Hausteiner-Wiehle C, Schmidt R. [Transdisciplinary treatment of functional movement disorders: integration instead of dissociation]. Nervenarzt 2024:10.1007/s00115-023-01596-z. [PMID: 38315181 DOI: 10.1007/s00115-023-01596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 02/07/2024]
Abstract
Successful treatment of patients with functional motor disorders is integrative in several ways: the primary treatment goal is the (re)integration of sensorimotor, cognitive and social functioning. The prerequisites for this are an integrated biopsychosocial model of everyone involved as well as close transdisciplinary cooperation. Instead of a simple addition of treatment components, all care providers and patients act in concert.
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Affiliation(s)
- Constanze Hausteiner-Wiehle
- Psychosomatischer Konsil- und Liaisondienst der Abteilung für Neurologie, Klinische Neurophysiologie und Stroke Unit, BG Unfallklinik Murnau, Prof. Küntscher-Str. 8, 82418, Murnau, Deutschland.
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der TU München, Klinikum rechts der Isar, München, Deutschland.
- Arbeitsgemeinschaft Funktionelle Neurologische Störungen e. V., .
| | - Roger Schmidt
- Klinik für Psychosomatik und Konsiliarpsychiatrie, Kantonsspital St. Gallen, St. Gallen, Schweiz
- Lurija Institut für Rehabilitationswissenschaften und Gesundheitsforschung, Kliniken Schmieder, Allensbach, Deutschland
- Arbeitsgemeinschaft Funktionelle Neurologische Störungen e. V
- Fachbereich Psychologie, Universität Konstanz, Konstanz, Deutschland
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Patterson C, Schmidt R, Goncin U, Walker ME, Hedlin P. A comparison of sevoflurane waste anesthetic gas concentration across three Saskatoon health care facilities. Can J Anaesth 2023; 70:1860-1862. [PMID: 37715045 DOI: 10.1007/s12630-023-02580-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 09/17/2023] Open
Affiliation(s)
- C Patterson
- Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - R Schmidt
- Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - U Goncin
- Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - M E Walker
- Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - P Hedlin
- Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
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Webster RW, Nicolli C, Allen TW, Bish MD, Bissonnette K, Check JC, Chilvers MI, Duffeck MR, Kleczewski N, Luis JM, Mueller BD, Paul PA, Price PP, Robertson AE, Ross TJ, Schmidt C, Schmidt R, Schmidt T, Shim S, Telenko DEP, Wise K, Smith DL. Uncovering the environmental conditions required for Phyllachora maydis infection and tar spot development on corn in the United States for use as predictive models for future epidemics. Sci Rep 2023; 13:17064. [PMID: 37816924 PMCID: PMC10564858 DOI: 10.1038/s41598-023-44338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 10/06/2023] [Indexed: 10/12/2023] Open
Abstract
Phyllachora maydis is a fungal pathogen causing tar spot of corn (Zea mays L.), a new and emerging, yield-limiting disease in the United States. Since being first reported in Illinois and Indiana in 2015, P. maydis can now be found across much of the corn growing regions of the United States. Knowledge of the epidemiology of P. maydis is limited but could be useful in developing tar spot prediction tools. The research presented here aims to elucidate the environmental conditions necessary for the development of tar spot in the field and the creation of predictive models to anticipate future tar spot epidemics. Extended periods (30-day windowpanes) of moderate mean ambient temperature (18-23 °C) were most significant for explaining the development of tar spot. Shorter periods (14- to 21-day windowpanes) of moisture (relative humidity, dew point, number of hours with predicted leaf wetness) were negatively correlated with tar spot development. These weather variables were used to develop multiple logistic regression models, an ensembled model, and two machine learning models for the prediction of tar spot development. This work has improved the understanding of P. maydis epidemiology and provided the foundation for the development of a predictive tool for anticipating future tar spot epidemics.
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Affiliation(s)
- Richard W Webster
- Department of Plant Pathology, North Dakota State University, Fargo, ND, 58108, USA
| | - Camila Nicolli
- Department of Plant Pathology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Tom W Allen
- Delta Research and Extension Center, Mississippi State University, Stoneville, MS, 38776, USA
| | - Mandy D Bish
- Division of Plant Science and Technology, University of Missouri, Columbia, MO, 65211, USA
| | - Kaitlyn Bissonnette
- Division of Plant Science and Technology, University of Missouri, Columbia, MO, 65211, USA
| | - Jill C Check
- Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Martin I Chilvers
- Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Maíra R Duffeck
- Department of Plant Pathology, The Ohio State University, Wooster, OH, 44691, USA
| | - Nathan Kleczewski
- Department of Crop Sciences, University of Illinois, Urbana, IL, 61801, USA
| | - Jane Marian Luis
- Department of Plant Pathology, The Ohio State University, Wooster, OH, 44691, USA
| | - Brian D Mueller
- Department of Plant Pathology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Pierce A Paul
- Department of Plant Pathology, The Ohio State University, Wooster, OH, 44691, USA
| | - Paul P Price
- Macon Ridge Research Station, LSU AgCenter, Winnsboro, LA, 71295, USA
| | - Alison E Robertson
- Department of Plant Pathology, Entomology, and Microbiology, Iowa State University, Ames, IA, 50011, USA
| | - Tiffanna J Ross
- Department of Botany and Plant Pathology, Purdue University, West Lafayette, IN, 47907, USA
| | - Clarice Schmidt
- Department of Plant Pathology, Entomology, and Microbiology, Iowa State University, Ames, IA, 50011, USA
| | - Roger Schmidt
- Nutrient and Pest Management Program, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Teryl Schmidt
- Department of Plant Pathology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Sujoung Shim
- Department of Botany and Plant Pathology, Purdue University, West Lafayette, IN, 47907, USA
| | - Darcy E P Telenko
- Department of Botany and Plant Pathology, Purdue University, West Lafayette, IN, 47907, USA
| | - Kiersten Wise
- Department of Plant Pathology, University of Kentucky, Princeton, KY, 42445, USA
| | - Damon L Smith
- Department of Plant Pathology, University of Wisconsin-Madison, Madison, WI, 53706, USA.
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Hausteiner-Wiehle C, Schmidt R, Henningsen P. Treating in concert: Integrated biopsychosocial care - Not only for functional disorders. J Psychosom Res 2023:111376. [PMID: 37230843 DOI: 10.1016/j.jpsychores.2023.111376] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Constanze Hausteiner-Wiehle
- Consultation and Liaison Psychosomatic Medicine, Department of Neurology, BG Trauma Center Murnau, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Germany.
| | - Roger Schmidt
- Department of Psychosomatic Medicine and Consultation Psychiatry, Kantonsspital St. Gallen, Switzerland; Lurija Institute for Rehabilitation Sciences and Health Research, University of Konstanz - Kliniken Schmieder, Allensbach, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Germany
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Krolak M, Hämmerli Keller K, Schmidt R, Nobel G, Germann N, Schmid D, Hornung R. Prevalence of medically induced psychological trauma and its influence on women's health. Int J Gynaecol Obstet 2023; 161:568-573. [PMID: 36700371 DOI: 10.1002/ijgo.14691] [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: 10/26/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of the present study was three-fold. One, to assess the prevalence of medical traumatization in outpatients of a gynecologic department; two, to analyze the relationship of medical traumatization with adverse childhood events; and three, to investigate the extent to which medical traumatization affects the health outcomes of woman. METHODS Between January and September 2022, a prospective cross-sectional study recruited patients of a gynecologic outpatient clinic at St. Gallen Cantonal Hospital in Switzerland. Medical trauma was a self-reported item. The presence of adverse childhood events was assessed using the Childhood Trauma Questionnaire. The severity of post-traumatic stress was evaluated using the Impact of Event Scale Revised questionnaire. RESULTS In total, 227 patients were recruited. Medical trauma was reported by 20% of the interviewees and it was strongly associated with obesity (A = 0.005). Undergoing surgery was most commonly the source of psychological distress (5.7%) followed by delivery (4.8%), pregnancy loss (4.8%), and cancer diagnosis (4.0%). Yet, fewer than 1% of the patients reached the threshold suggesting post-traumatic stress disorder. CONCLUSIONS We found no relationship between the medical trauma, adverse childhood events, cardiovascular disease, or substance abuse. The presence of medical trauma was associated with the patient's body mass index (calculated as weight in kilograms divided by the square of height in meters).
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Affiliation(s)
- Monika Krolak
- Department of Obstetrics and Gynecology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Katja Hämmerli Keller
- Department of Psychosomatic Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Roger Schmidt
- Department of Psychosomatic Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Gloria Nobel
- Department of Psychosomatic Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Nicolas Germann
- Department of Psychosomatic Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Dagmar Schmid
- Department of Psychosomatic Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - René Hornung
- Department of Obstetrics and Gynecology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
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Piliavska K, Dantlgraber M, Dettmers C, Jöbges M, Liepert J, Schmidt R. Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis. Front Neurol 2023; 14:1077838. [PMID: 37114221 PMCID: PMC10126263 DOI: 10.3389/fneur.2023.1077838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Functional neurological symptoms (FNS) in multiple sclerosis (MS) have shown to be underinvestigated even though neurological diseases such as MS represent a risk factor for developing FNS. Comorbidity of FNS and MS can produce high personal and social costs since FNS patients have high healthcare utilization costs and a quality of life at least as impaired as in patients with disorders with underlying structural pathology. This study aims to assess comorbid FNS in patients with MS (pwMS) and investigate whether FNS in pwMS are associated with poorer health-related quality of life and work ability. Methods Newly admitted patients (234) with MS were studied during their stay at Kliniken Schmieder, a neurological rehabilitation clinic in Konstanz, Germany. The degree to which the overall clinical picture was explained by MS pathology was rated by neurologists and allied health practitioners on a five-point Likert scale. Additionally, neurologists rated each symptom reported by the patients. Health-related quality of life was assessed using a self-report questionnaire and work ability was assessed using the mean number of hours worked per day and information regarding disability pension as reported by patients. Results In 55.1% of cases, the clinical picture was completely explained by structural pathology due to MS. 17.1% of pwMS presented an overall clinical picture half or less of which could be explained by underlying structural pathology. PwMS with a higher comorbid FNS burden had a lower health-related quality of life and reported fewer working hours per day than pwMS with symptoms explained by structural pathology. Furthermore, pwMS with a full disability pension had a higher comorbid FNS burden than pwMS with no or partial disability pension. Discussion These results show that FNS should be addressed diagnostically and therapeutically since such symptoms are an important comorbidity in MS that is related to poorer health-related quality of life and lower work ability.
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Affiliation(s)
- Katya Piliavska
- Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, Germany
- *Correspondence: Katya Piliavska,
| | | | - Christian Dettmers
- Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, Germany
- Kliniken Schmieder Konstanz, Konstanz, Germany
| | - Michael Jöbges
- Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, Germany
- Kliniken Schmieder Konstanz, Konstanz, Germany
| | - Joachim Liepert
- Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, Germany
- Kliniken Schmieder Allensbach, Allensbach, Germany
| | - Roger Schmidt
- Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, Germany
- Klinik für Psychosomatik und Konsiliarpsychiatrie, Kantonsspital, St. Gallen, Switzerland
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Taylor M, Cook C, Liu Y, Schmidt R, Hailer A, North J, Wang H, Kashem S, Purdom E, Marson A, Ramos S, Cho R, Cheng J. 509 A single-cell transcriptional gradient in human cutaneous memory T cells suppresses pathogenic Th17 inflammation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.518] [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: 10/17/2022]
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Frid P, Xu H, Mitchell BD, Drake M, Wasselius J, Gaynor B, Ryan K, Giese AK, Schirmer M, Donahue KL, Irie R, Bouts MJRJ, McIntosh EC, Mocking SJT, Dalca AV, Giralt-Steinhauer E, Holmegaard L, Jood K, Roquer J, Cole JW, McArdle PF, Broderick JP, Jimenez-Conde J, Jern C, Kissela BM, Kleindorfer DO, Lemmens R, Meschia JF, Rosand J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Thijs V, Woo D, Worrall BB, Kittner SJ, Petersson J, Golland P, Wu O, Rost NS, Lindgren A. Migraine-Associated Common Genetic Variants Confer Greater Risk of Posterior vs. Anterior Circulation Ischemic Stroke☆. J Stroke Cerebrovasc Dis 2022; 31:106546. [PMID: 35576861 PMCID: PMC10601407 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/01/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To examine potential genetic relationships between migraine and the two distinct phenotypes posterior circulation ischemic stroke (PCiS) and anterior circulation ischemic stroke (ACiS), we generated migraine polygenic risk scores (PRSs) and compared these between PCiS and ACiS, and separately vs. non-stroke control subjects. METHODS Acute ischemic stroke cases were classified as PCiS or ACiS based on lesion location on diffusion-weighted MRI. Exclusion criteria were lesions in both vascular territories or uncertain territory; supratentorial PCiS with ipsilateral fetal posterior cerebral artery; and cases with atrial fibrillation. We generated migraine PRS for three migraine phenotypes (any migraine; migraine without aura; migraine with aura) using publicly available GWAS data and compared mean PRSs separately for PCiS and ACiS vs. non-stroke control subjects, and between each stroke phenotype. RESULTS Our primary analyses included 464 PCiS and 1079 ACiS patients with genetic European ancestry. Compared to non-stroke control subjects (n=15396), PRSs of any migraine were associated with increased risk of PCiS (p=0.01-0.03) and decreased risk of ACiS (p=0.010-0.039). Migraine without aura PRSs were significantly associated with PCiS (p=0.008-0.028), but not with ACiS. When comparing PCiS vs. ACiS directly, migraine PRSs were higher in PCiS vs. ACiS for any migraine (p=0.001-0.010) and migraine without aura (p=0.032-0.048). Migraine with aura PRS did not show a differential association in our analyses. CONCLUSIONS Our results suggest a stronger genetic overlap between unspecified migraine and migraine without aura with PCiS compared to ACiS. Possible shared mechanisms include dysregulation of cerebral vessel endothelial function.
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Affiliation(s)
- P Frid
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden; Section of Neurology, Skåne University Hospital, Malmö, Sweden.
| | - H Xu
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - B D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USA
| | - M Drake
- Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden; Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden
| | - J Wasselius
- Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden; Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden
| | - B Gaynor
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - K Ryan
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A K Giese
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - M Schirmer
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - K L Donahue
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R Irie
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - M J R J Bouts
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - E C McIntosh
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - S J T Mocking
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - A V Dalca
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
| | - E Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Spain
| | - L Holmegaard
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - K Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J Roquer
- Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Spain
| | - J W Cole
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA
| | - P F McArdle
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J P Broderick
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - J Jimenez-Conde
- Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Spain
| | - C Jern
- Department of Laboratory Medicine, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - B M Kissela
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - D O Kleindorfer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - R Lemmens
- Department of Neurosciences, Experimental Neurology, VIB Center for Brain & Disease Research, Department of Neurology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
| | - J F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - J Rosand
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital, Boston, USA
| | - T Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, The Evelyn F. McKnight Brain Institute, FL, USA
| | - R L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, The Evelyn F. McKnight Brain Institute, FL, USA
| | - R Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Austria
| | - P Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, United Kingdom
| | - A Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - V Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, and Department of Neurology, Austin Health, Heidelberg, Australia
| | - D Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - B B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - S J Kittner
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA
| | - J Petersson
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
| | - P Golland
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
| | - O Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - N S Rost
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden; Section of Neurology, Skåne University Hospital, Lund, Sweden
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Heijnen-Kohl SMJ, Hitzert B, Schmidt R, Geurts HM, van Alphen SPJ. Features and Needs of Autistic Older Adults: A Delphi Study of Clinical Experiences. Clin Gerontol 2022:1-11. [PMID: 35426768 DOI: 10.1080/07317115.2022.2060157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES In geriatric psychiatry Autism Spectrum Disorders (ASD) are increasingly recognized. This study explores what clinicians know about diagnostic and/or therapeutic aspects of autistic older adults and how aging plays a role in the course of ASD. METHODS A Delphi study outlines the point of view of 11 clinical experts in the Netherlands and Belgium (Flanders). RESULTS Regarding diagnostics, age-specific aspects need to be considered. Age-related characteristics (cognitive differences, life events, co-occurring conditions) influence detecting autistic features in older adults. Regarding treatment, counseling methods need to be adapted. Psychoeducation, family therapy, couples therapy, behavioral counseling and psychopharmaca can be helpful in meeting the needs of autistic older adults. There was no consensus on the effects of aging on autistic older adults. CONCLUSIONS Diagnosis and treatment of ASD need adaptation for autistic older adults. Further research is needed on the validation of measurement tools, recorded treatment, therapy, psychoeducation, and the effects of aging among people on the autism spectrum. CLINICAL IMPLICATIONS Available knowledge helps clinicians to detect ASD in older adults and adapt to the specific features and needs of autistic older adults. The effects of aging on the course of ASD are unclear yet.
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Affiliation(s)
- S M J Heijnen-Kohl
- Clinical psychologist/psychotherapist and director at Mondriaan geriatric mental health care in Heerlen-Maastricht, The Netherlands
| | - B Hitzert
- Psychiatrist, BuurtzorgT, The Netherlands
| | - R Schmidt
- Geriatric Psychiatrist, The Netherlands
| | - H M Geurts
- Psychology Department, University of Amsterdam; and senior researcher at the Dr. Leo Kannerhuis national autism expertise centre, The Netherlands
| | - S P J van Alphen
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; and health care psychologist and manager at Mondriaan geriatric mental health care in Heerlen-Maastricht, The Netherlands
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Waller H, Schmidt R. Fault detection and localization by vibration monitoring with observers. Struct Dyn 2022. [DOI: 10.1201/9780203738085-53] [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: 11/11/2022] Open
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Zia H, Von Ah U, Meng Y, Schmidt R, Kerler J, Fuchsmann P. Biotechnological formation of dairy flavor inducing δ-lactones from vegetable oil. Food Chem X 2022; 13:100220. [PMID: 35498959 PMCID: PMC9039933 DOI: 10.1016/j.fochx.2022.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/05/2021] [Accepted: 01/14/2022] [Indexed: 10/25/2022] Open
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Vieira M, Souza C, Nobrega L, Reis R, Andrade C, Schmidt R, Carvalho L. Robotic-Assisted Uterus Retrieval from Living Donor for Uterine Transplantation: First Case in Brazil. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Haubensak R, Jackson M, Schmidt R, Wells J, Timmerman M, Hanson C. The Association Between Serum Vitamin D Levels and Bone-Related Outcomes in Patients 100 Days Post-Bone Marrow Transplant. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Lange C, Machad. Weber A, Schmidt R, Schroeder C, Strowitzki T, Germeyer A. P–284 Changes in protein expression due to metformin treatment and hyperinsulinemia in a human endometrial cancer cell line. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
The aim of the study was to identify new target proteins/pathways that are affected by metformin treatment in endometrial cancer cells in a proteomic approach.
Summary answer
The expression of 1,300 different proteins were investigated, of which 80 proteins with the most prominent changes were presented and some discussed in detail.
What is known already
The incidence of endometrial cancer (EC) has increased over the past years. Metabolic diseases such as obesity, type II diabetes mellitus (T2DM), and associated conditions (i.e. polycystic ovary syndrome (PCOS), insulin resistance) lead to elevated levels of circulating estrogens, which promote EC development and progression. Metformin, an insulin-sensitizing biguanide drug, commonly used in the treatment of T2DM, especially in obese patients, displayed anti-cancer effects in various cancer types, including EC. Different proteins and pathways have been suggested as potential targets, but the underlying mechanism of action of metformin’s anti-cancer activity is still not completely understood.
Study design, size, duration
In the present in vitro study, EC cells were cultured in 5.5 mmol/L glucose medium (supplemented with 10 nmol/L ß-estradiol (E2)) and treated with metformin (0.5 mmol/L), insulin (100 ng/mL), or remained untreated for 7 d. The expression of 1,300 different proteins was detected in cellular extracts in an affinity proteomic approach and compared between the treatment groups in order to identify potential target proteins and pathways that contribute to the anti-cancer effects of metformin.
Participants/materials, setting, methods
The study was carried out with the EC cell line HEC–1A that represents a postmenopausal model with low E2 sensitivity. Proteins were extracted, quantified with the BCA assay, and protein expression was analyzed using the scioDiscover antibody microarray. Differences in protein abundance between samples were presented as log2-fold changes (log2FC) with significance for samples that displayed |log2FC| ≥ 0.5 and adjusted p ≤ 0.05. Pathway analysis was carried out with the STRING and DAVID databases.
Main results and the role of chance
The data revealed that metformin and insulin targeted similar pathways in the present study and mostly acted on proteins related to proliferation, migration and tumor immune response. These pathways may be affected in a tumor-promoting as well as a tumor-suppressing way by either metformin treatment or insulin supplementation. Results for the 80 most affected proteins were presented and the consequences for the cells resulting from the detected expression changes were discussed in detail for several proteins. The presented data helps identify potential target proteins and pathways affected by metformin treatment in EC and allows for a better understanding of the mechanism of action of the biguanide drug’s anti-cancer activity. However, further investigations are necessary to confirm the observations and conclusions drawn from the presented data after metformin administration, especially for proteins that were regulated in a favorable way, i.e. AKT3, CCND2, CD63, CD81, GFAP, IL5, IL17A, IRF4, PI3, and VTCN1. Further proteins might be of interest, where metformin counteracted unfavorable effects that have been induced by hyperinsulinemia.
Limitations, reasons for caution
The results were obtained from an in vitro study with human cancer cell lines, and thus cannot be easily extrapolated to patients.
Wider implications of the findings: In the context of a hyperinsulinemic environment, further proteins might be of interest, i.e. AMFR, CCND2, CD63, ERBB3, EZR, GFAP, IRF4, PI3, PLCG2, SORL1, VEGFA, VTCN1, SPP1, and TM9SF2. Here, a metformin-induced insulin-sensitization might be able to counteract unfavorable effects on protein expression profile that have been induced by hyperinsulinemia.
Trial registration number
Not applicable
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Affiliation(s)
- C Lange
- University Women’s Hospital Heidelberg, Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg, Germany
| | - A Machad. Weber
- University Women’s Hospital Heidelberg, Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg, Germany
| | - R Schmidt
- Sciomics GmbH, Contract Research, Heidelberg, Germany
| | - C Schroeder
- Sciomics GmbH, Contract Research, Heidelberg, Germany
| | - T Strowitzki
- University Women’s Hospital Heidelberg, Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg, Germany
| | - A Germeyer
- University Women’s Hospital Heidelberg, Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg, Germany
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15
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Cook C, Liu Y, Schmidt R, Ramos S, Marson A, Cho R, Cheng J. 181 Tristetraprolin family members repress early T cell cytokine production and are recurrently downregulated in diverse human rashes. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.201] [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: 10/21/2022]
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16
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Pust GEA, Randerath J, Goetzmann L, Weierstall R, Korzinski M, Gold SM, Dettmers C, Ruettner B, Schmidt R. Association of Fatigue Severity With Maladaptive Coping in Multiple Sclerosis: A Data-Driven Psychodynamic Perspective. Front Neurol 2021; 12:652177. [PMID: 33897606 PMCID: PMC8058358 DOI: 10.3389/fneur.2021.652177] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/08/2021] [Indexed: 11/15/2022] Open
Abstract
Fatigue in persons with multiple sclerosis (PwMS) is severely disabling. However, the underlying mechanisms remain incompletely understood. Recent research suggests a link to early childhood adversities and psychological trait variables. In line with these studies, this paper took a psychodynamic perspective on MS-fatigue. It was hypothesized that fatigue could represent a manifestation of maladaptive coping with intense emotions. The schema therapeutic mode model served as a theoretical and empirically validated framework, linking psychodynamic theory and empirical research methods. The study was based on a data set of N = 571 PwMS that has also served as the basis for another publication. Data was collected online. The Schema Mode Inventory was used to quantify regulatory strategies to cope with emotionally stressful experiences. In addition, depressive symptoms (Beck's Depression Inventory - FastScreen), physical disability (Patient Determined Disease Steps), alexithymia (Toronto Alexithymia Scale-26), adverse childhood experiences (Childhood Trauma Questionnaire), and self-reported fatigue (Fatigue Scale for Motor and Cognitive Functions) were assessed. Latent profile analysis revealed three distinct groups of PwMS, based on their coping mode profiles: (1) PwMS with low maladaptive coping, (2) PwMS with avoidant/submissive coping styles, and (3) PwMS with avoidant/overcompensatory coping styles. Multivariate comparisons showed no significant difference in physical disability across the three groups. However, heightened levels of self-reported fatigue and depression symptoms occurred in PwMS with maladaptive coping styles. A path model uncovered that self-reported fatigue was robustly related to physical disability (β = 0.33) and detached/avoidant coping (Detached Protector; β = 0.34). There was no specific relation between any of the maladaptive coping modes and depression symptoms. Detached/avoidant coping was in turn predicted by childhood emotional abuse and neglect. The results indicate that childhood adversity and detached/avoidant coping styles may be associated with variability in MS-fatigue severity: PwMS that resort to detached/avoidant coping in response to negative emotions also tend to report heightened levels of fatigue, although they do not differ in their perceived disability from PwMS with low levels of fatigue and maladaptive coping. A link between MS-fatigue and the psychodynamic traumatic conversion model is discussed. The implications of these findings for therapeutic interventions require further study.
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Affiliation(s)
- Gesa E A Pust
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Institut für Neuroimmunologie und Multiple Sklerose, Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer Randerath
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany
| | - Lutz Goetzmann
- Institute of Philosophy, Psychoanalysis and Cultural Studies, Berlin, Germany
| | | | | | - Stefan M Gold
- Institut für Neuroimmunologie und Multiple Sklerose, Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Med. Klinik m.S. Psychosomatik, Campus Benjamin Franklin, Berlin, Germany
| | - Christian Dettmers
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany
| | | | - Roger Schmidt
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany.,Klinik für Psychosomatik und Konsiliarpsychiatrie, Departement Innere Medizin, Kantonsspital St. Gallen, St. Gallen, Switzerland
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17
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Devarajan N, McGarvey JA, Scow K, Jones MS, Lee S, Samaddar S, Schmidt R, Tran TD, Karp DS. Cascading effects of composts and cover crops on soil chemistry, bacterial communities and the survival of foodborne pathogens. J Appl Microbiol 2021; 131:1564-1577. [PMID: 33825272 PMCID: PMC8519115 DOI: 10.1111/jam.15054] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/05/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023]
Abstract
AIMS Recent foodborne disease outbreaks have caused farmers to re-evaluate their practices. In particular, concern that soil amendments could introduce foodborne pathogens onto farms and promote their survival in soils has led farmers to reduce or eliminate the application of animal-based composts. However, organic amendments (such as composts and cover crops) could bolster food safety by increasing soil microbial diversity and activity, which can act as competitors or antagonists and reduce pathogen survival. METHODS AND RESULTS Leveraging a study of a 27-year experiment comparing organic and conventional soil management, we evaluate the impacts of composted poultry litter and cover crops on soil chemistry, bacterial communities and survival of Salmonella enterica and Listeria monocytogenes. We found that bacterial community composition strongly affected pathogen survival in soils. Specifically, organic soils managed with cover crops and composts hosted more macronutrients and bacterial communities that were better able to suppress Salmonella and Listeria. For example, after incubating soils for 10 days at 20°C, soils without composts retained fourfold to fivefold more Salmonella compared to compost-amended soils. However, treatment effects dissipated as bacterial communities converged over the growing season. CONCLUSIONS Our results suggest that composts and cover crops may be used to build healthy soils without increasing foodborne pathogen survival. SIGNIFICANCE AND IMPACT OF THE STUDY Our work suggests that animal-based composts do not promote pathogen survival and may even promote bacterial communities that suppress pathogens. Critically, proper composting techniques are known to reduce pathogen populations in biological soil amendments of animal origin, which can reduce the risks of introducing pathogens to farm fields in soil amendments. Thus, animal-based composts and cover crops may be a safe alternative to conventional fertilizers, both because of the known benefits of composts for soil health and because it may be possible to apply amendments in such a way that food-safety risks are mitigated rather than exacerbated.
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Affiliation(s)
- N Devarajan
- Department of Wildlife, Fish, and Conservation Biology, University of California, Davis, Davis, CA, USA
| | - J A McGarvey
- Agricultural Research Service, U.S. Department of Agriculture, Albany, CA, USA
| | - K Scow
- Department of Land, Air and Water Resources, University of California, Davis, Davis, CA, USA
| | - M S Jones
- Department of Entomology, Washington State University, Pullman, WA, USA.,Tree Fruit Research and Extension Center, Washington State University, Wenatchee, WA, USA
| | - S Lee
- Agricultural Research Service, U.S. Department of Agriculture, Albany, CA, USA
| | - S Samaddar
- Department of Land, Air and Water Resources, University of California, Davis, Davis, CA, USA
| | - R Schmidt
- Department of Land, Air and Water Resources, University of California, Davis, Davis, CA, USA
| | - T D Tran
- Department of Wildlife, Fish, and Conservation Biology, University of California, Davis, Davis, CA, USA
| | - D S Karp
- Department of Wildlife, Fish, and Conservation Biology, University of California, Davis, Davis, CA, USA
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18
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Colonna I, Koini M, Pirpamer L, Damulina A, Hofer E, Schwingenschuh P, Enzinger C, Schmidt R, Ropele S. Microstructural Tissue Changes in Alzheimer Disease Brains: Insights from Magnetization Transfer Imaging. AJNR Am J Neuroradiol 2021; 42:688-693. [PMID: 33509922 DOI: 10.3174/ajnr.a6975] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Reductions in magnetization transfer ratio have been associated with brain microstructural damage. We aim to compare magnetization transfer ratio in global and regional GM and WM between individuals with Alzheimer disease and healthy control participants to analyze the relationship between magnetization transfer ratio and cognitive functioning in Alzheimer disease. MATERIALS AND METHODS In this prospective study, participants with Alzheimer disease and a group of age-matched healthy control participants underwent clinical examinations and 3T MR imaging. Magnetization transfer ratios were determined in the cortex, AD-signature regions, normal-appearing WM, and WM hyperintensities. RESULTS Seventy-seven study participants (mean age ± SD, 72 ± 8 years; 47 female) and 77 age-matched healthy control participants (mean age ± SD, 72 ± 8 years; 44 female) were evaluated. Magnetization transfer ratio values were lower in patients with Alzheimer disease than in healthy control participants in all investigated regions. When adjusting for atrophy and extent of WM hyperintensities, significant differences were seen in the global cortex (OR = 0.47; 95% CI: 0.22, 0.97; P = .04), in Alzheimer disease-signature regions (OR = 0.31; 95% CI: 0.14, 0.67; P = .003), in normal-appearing WM (OR = 0.59; 95% CI: 0.39, 0.88; P = .01), and in WM hyperintensities (OR = 0.18; 95% CI: 0.09, 0.33; P ≤ .001). The magnetization transfer ratio in these regions was an independent determinant of AD. When correcting for atrophy and WM hyperintensity extent, lower GM magnetization transfer ratios were associated with poorer global cognition, language function, and constructional praxis. CONCLUSIONS Alzheimer disease is associated with magnetization transfer ratio reductions in GM and WM regions of the brain. Lower magnetization transfer ratios in the entire cortex and AD-signature regions contribute to cognitive impairment independent of brain atrophy and WM damage.
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Affiliation(s)
- I Colonna
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - M Koini
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - L Pirpamer
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - A Damulina
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - E Hofer
- Institute for Medical Informatics, Statistics and Documentation (E.H.)
| | - P Schwingenschuh
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - C Enzinger
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.).,Division of Neuroradiology, Vascular & Interventional Radiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria
| | - R Schmidt
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
| | - S Ropele
- From the Department of Neurology (I.C., M.K., L.P., A.D., P.S., C.E., R.S., S.R.)
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19
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Hassa T, Spiteri S, Schmidt R, Merkel C, Schoenfeld MA. Increased Amygdala Activity Associated With Cognitive Reappraisal Strategy in Functional Neurologic Disorder. Front Psychiatry 2021; 12:613156. [PMID: 33841199 PMCID: PMC8032865 DOI: 10.3389/fpsyt.2021.613156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/18/2021] [Indexed: 01/12/2023] Open
Abstract
Cognitive reappraisal is an emotion regulation strategy to reduce the impact of affective stimuli. This regulation could be incomplete in patients with functional neurologic disorder (FND) resulting in an overflowing emotional stimulation perpetuating symptoms in FND patients. Here we employed functional MRI to study cognitive reappraisal in FND. A total of 24 FND patients and 24 healthy controls employed cognitive reappraisal while seeing emotional visual stimuli in the scanner. The Symptom Checklist-90-R (SCL-90-R) was used to evaluate concomitant psychopathologies of the patients. During cognitive reappraisal of negative IAPS images FND patients show an increased activation of the right amygdala compared to normal controls. We found no evidence of downregulation in the amygdala during reappraisal neither in the patients nor in the control group. The valence and arousal ratings of the IAPS images were similar across groups. However, a subgroup of patients showed a significant higher account of extreme low ratings for arousal for negative images. These low ratings correlated inversely with the item "anxiety" of the SCL-90-R. The increased activation of the amygdala during cognitive reappraisal suggests altered processing of emotional stimuli in this region in FND patients.
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Affiliation(s)
- Thomas Hassa
- Lurija Institute for Rehabilitation and Health Sciences, University of Konstanz, Konstanz, Germany.,Neurological Rehabilitation Center Kliniken Schmieder, Allensbach, Germany
| | - Stefan Spiteri
- Lurija Institute for Rehabilitation and Health Sciences, University of Konstanz, Konstanz, Germany.,Neurological Rehabilitation Center Kliniken Schmieder, Allensbach, Germany
| | - Roger Schmidt
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Department of Psychotherapeutic Neurology, Neurological Rehabilitation Center Kliniken Schmieder, Konstanz, Germany
| | - Christian Merkel
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Mircea Ariel Schoenfeld
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Leibniz-Institute for Neurobiology, Magdeburg, Germany.,Neurological Rehabilitation Center Kliniken Schmieder, Heidelberg, Germany
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20
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Dettmers C, Schmidt R, Jöbges M. Fatigue und Fatigability bei Multipler Sklerose –
Leistungsbeurteilung. REHABILITATION 2020; 59:327-329. [PMID: 33285611 DOI: 10.1055/a-1199-2594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Fatigue ist eines der häufigsten Symptome bei Patienten mit Multipler
Sklerose (MS) 1
2. Fatigue kann das Symptom sein, das die berufliche
Leistungsfähigkeit am gravierendsten beeinträchtigt 3
4. Der
Großteil der MS-Patienten ist im erwerbsfähigen Alter. Für
die sozialmedizinische Leistungsbeurteilung ist besonders problematisch, dass es
sich bei der Fatigue um ein subjektives Phänomen handelt, dass nicht
objektiv messbar ist.
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21
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Stielow T, Schmidt R, Peltz C, Fennel T, Scheel S. Fast reconstruction of single-shot wide-angle diffraction images through deep learning. Mach Learn : Sci Technol 2020. [DOI: 10.1088/2632-2153/abb213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Single-shot x-ray imaging of short-lived nanostructures such as clusters and nanoparticles near a phase transition or non-crystalizing objects such as large proteins and viruses is currently the most elegant method for characterizing their structure. Using hard x-ray radiation provides scattering images that encode two-dimensional projections, which can be combined to identify the full three-dimensional object structure from multiple identical samples. Wide-angle scattering using XUV or soft x-rays, despite yielding lower resolution, provides three-dimensional structural information in a single shot and has opened routes towards the characterization of non-reproducible objects in the gas phase. The retrieval of the structural information contained in wide-angle scattering images is highly non-trivial, and currently no efficient rigorous algorithm is known. Here we show that deep learning networks, trained with simulated scattering data, allow for fast and accurate reconstruction of shape and orientation of nanoparticles from experimental images. The gain in speed compared to conventional retrieval techniques opens the route for automated structure reconstruction algorithms capable of real-time discrimination and pre-identification of nanostructures in scattering experiments with high repetition rate—thus representing the enabling technology for fast femtosecond nanocrystallography.
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22
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Fruhwirth V, Enzinger C, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Schmidt R, Gattringer T, Pinter D. Baseline white matter hyperintensities affect the course of cognitive function after small vessel disease-related stroke: a prospective observational study. Eur J Neurol 2020; 28:401-410. [PMID: 33065757 PMCID: PMC7839458 DOI: 10.1111/ene.14593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023]
Abstract
Background and purpose Cognitive impairment is a common sequel of recent small subcortical infarction (RSSI) and might be negatively affected by preexisting cerebral small vessel disease (SVD). We investigated whether the course of cognitive function in patients with RSSI is influenced by the severity of white matter hyperintensities (WMH), an important imaging feature of SVD. Methods Patients with magnetic resonance imaging (MRI)‐proven single RSSI were tested neuropsychologically concerning global cognition, processing speed, attention, and set‐shifting. Deep and periventricular WMH severity was assessed using the Fazekas scale, and total WMH lesion volume was calculated from T1‐weighted MRI images. We compared baseline function and course of cognition 15 months after the acute event in patients with absent, mild, and moderate‐to‐severe WMH. Results The study cohort comprised 82 RSSI patients (mean age: 61 ± 10 years, 23% female). At baseline, 40% had cognitive impairment (1.5 standard deviations below standardized mean), and deficits persisted in one‐third of the sample after 15 months. After age correction, there were no significant differences in set‐shifting between WMH groups at baseline. However, although patients without WMH (deep: p < 0.001, periventricular: p = 0.067) or only mild WMH (deep: p = 0.098, periventricular: p = 0.001) improved in set‐shifting after 15 months, there was no improvement in patients with moderate‐to‐severe WMH (deep: p = 0.980, periventricular: p = 0.816). Baseline total WMH volume (p = 0.002) was the only significant predictor for attention 15 months poststroke. Conclusions This longitudinal study demonstrates that preexisting moderate‐to‐severe WMH negatively affect the restoration of cognitive function after RSSI, suggesting limited functional reserve in patients with preexisting SVD.
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Affiliation(s)
- V Fruhwirth
- Department of Neurology, Medical University of Graz, Graz, Austria.,Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria.,Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria.,Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - S Fandler-Höfler
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - M Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - S Eppinger
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - S Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - R Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - T Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria.,Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - D Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria.,Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria
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23
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Frederiksen KS, Cooper C, Frisoni GB, Frölich L, Georges J, Kramberger MG, Nilsson C, Passmore P, Mantoan Ritter L, Religa D, Schmidt R, Stefanova E, Verdelho A, Vandenbulcke M, Winblad B, Waldemar G. A European Academy of Neurology guideline on medical management issues in dementia. Eur J Neurol 2020; 27:1805-1820. [PMID: 32713125 PMCID: PMC7540303 DOI: 10.1111/ene.14412] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Dementia is one of the most common disorders and is associated with increased morbidity, mortality and decreased quality of life. The present guideline addresses important medical management issues including systematic medical follow-up, vascular risk factors in dementia, pain in dementia, use of antipsychotics in dementia and epilepsy in dementia. METHODS A systematic review of the literature was carried out. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework, we developed a guideline. Where recommendations based on GRADE were not possible, a good practice statement was formulated. RESULTS Systematic management of vascular risk factors should be performed in patients with mild to moderate dementia as prevention of cerebrovascular pathology may impact on the progression of dementia (Good Practice statement). Individuals with dementia (without previous stroke) and atrial fibrillation should be treated with anticoagulants (weak recommendation). Discontinuation of opioids should be considered in certain individuals with dementia (e.g. for whom there are no signs or symptoms of pain or no clear indication, or suspicion of side effects; Good Practice statement). Behavioral symptoms in persons with dementia should not be treated with mild analgesics (weak recommendation). In all patients with dementia treated with opioids, assessment of the individual risk-benefit ratio should be performed at regular intervals. Regular, preplanned medical follow-up should be offered to all patients with dementia. The setting will depend on the organization of local health services and should, as a minimum, include general practitioners with easy access to dementia specialists (Good Practice statement). Individuals with dementia and agitation and/or aggression should be treated with atypical antipsychotics only after all non-pharmacological measures have been proven to be without benefit or in the case of severe self-harm or harm to others (weak recommendation). Antipsychotics should be discontinued after cessation of behavioral disturbances and in patients in whom there are side effects (Good Practice statement). For treatment of epilepsy in individuals with dementia, newer anticonvulsants should be considered as first-line therapy (Good Practice statement). CONCLUSION This GRADE-based guideline offers recommendations on several important medical issues in patients with dementia, and thus adds important guidance for clinicians. For some issues, very little or no evidence was identified, highlighting the importance of further studies within these areas.
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Affiliation(s)
- K. S. Frederiksen
- Department of NeurologyDanish Dementia Research CenterRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - C. Cooper
- Department of Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - G. B. Frisoni
- Memory ClinicUniversity Hospital of GenevaUniversity of GenevaGenevaSwitzerland
| | - L. Frölich
- Department of Geriatric PsychiatryZentralinstitut für Seelische Gesundheit MannheimMedical Faculty MannheimUniversity of HeidelbergMannheimGermany
| | | | - M. G. Kramberger
- Department of NeurologyCenter for Cognitive ImpairmentsUniversity Medical Center Ljubljana, and Medical facultyUniversity of LjubljanaLjubljanaSlovenia
| | - C. Nilsson
- Department of Neurology and Rehabilitation MedicineSkåne University HospitalLundSweden
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
| | | | - L. Mantoan Ritter
- Epilepsy CentreKing's College NHS Foundation TrustKing´s College LondonLondonUK
| | - D. Religa
- Division of Clinical GeriatricsDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetNeo, StockholmSweden
- Karolinska University HospitalTheme AgingHuddingeSweden
| | - R. Schmidt
- University Clinic for NeurologyMedical University of GrazGrazAustria
| | - E. Stefanova
- Medical FacultyNeurology clinic CCSUniversity of BelgradeBelgradeSerbia
| | - A. Verdelho
- Department of Neurosciences and Mental HealthCHLNorte‐Hospital de Santa MariaIMMISAMBFaculty of MedicineUniversity of LisbonLisbonPortugal
| | - M. Vandenbulcke
- Department of NeurosciencesKU LeuvenGeriatric PsychiatryUniversity Hospitals LeuvenLeuvenBelgium
| | - B. Winblad
- Karolinska University HospitalTheme AgingHuddingeSweden
- Division of NeurogeriatricsDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetBioClinicumSolnaSweden
| | - G. Waldemar
- Department of NeurologyDanish Dementia Research CenterRigshospitaletUniversity of CopenhagenCopenhagenDenmark
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Sogkas G, Hirsch S, Olsson K, Schmidt R, Witte T, Jabonka A, Ernst D. THU0263 LUNG INVOLVEMENT IN PRIMARY SJÖGREN SYNDROME – AN UNDER-DIAGNOSED ENTITY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Interstitial lung disease (ILD) represents a frequent extra-glandular manifestation of primary Sjögren’s Syndrome (pSS). Limited published data regarding phenotyping and treatment exists. Advances in managing specific ILD phenotypes have not been comprehensively explored in patients with coexisting pSS.Objectives:This retrospective study aimed to phenotype lung diseases occurring in a well-described pSS cohort and describe treatment course and outcomes.Methods:Between April 2018 and September 2019, all pSS patients attending our Outpatient clinic were screened for possible lung involvement. Clinical, laboratory and computer tomography (CT) findings were analysed. Patients were classified according to CT findings into 5 groups: usual interstitial pneumonia (UIP), non-specific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP), combined pulmonary fibrosis and emphysema (CPFE) and unspecific-ILD.Results:Lung involvement was confirmed in 24/240 patients (10%). Clinically manifest pSS occurred later in patients with ILD vs. non-ILD (53.2 [42.0-61.7]vs.62.3 [55.6-68.8] years; p=0.0016). The commonest phenotype was UIP n=10 (41%), followed by NSIP n=7 (29%), DIP n=2 (8%), CPFE n=2 (8%) and unspecific-ILD n=3 (13%). Forced vital capacity (FVC) and carbon monoxide diffusion capacity (DLCO) appeared lower in UIP and DIP, without reaching a significant difference. Treatment focused universally on intensified immunosuppression, with 12/24 patients (50%) receiving cyclophosphamide. No anti-fibrotic treatments were used. Follow-up was median 13.2 [7.9-72.3] months, during which 6/24 (25%) patients exhibited a further decline in FVC. No deaths occurred.Conclusion:Lung involvement in pSS is heterogeneous. Better phenotyping and tailored treatment may improve outcomes and requires further evaluation in larger prospective studies.Disclosure of Interests:None declared
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Ferretti MT, Martinkova J, Biskup E, Benke T, Gialdini G, Nedelska Z, Rauen K, Mantua V, Religa D, Hort J, Santuccione Chadha A, Schmidt R. Sex and gender differences in Alzheimer's disease: current challenges and implications for clinical practice: Position paper of the Dementia and Cognitive Disorders Panel of the European Academy of Neurology. Eur J Neurol 2020; 27:928-943. [PMID: 32056347 DOI: 10.1111/ene.14174] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [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: 08/08/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
Alzheimer's disease (AD) is characterized by high heterogeneity in disease manifestation, progression and risk factors. High phenotypic variability is currently regarded as one of the largest hurdles in early diagnosis and in the design of clinical trials; there is therefore great interest in identifying factors driving variability that can be used for patient stratification. In addition to genetic and lifestyle factors, the individual's sex and gender are emerging as crucial drivers of phenotypic variability. Evidence exists on sex and gender differences in the rate of cognitive deterioration and brain atrophy, and in the effect of risk factors as well as in the patterns of diagnostic biomarkers. Such evidence might be of high relevance and requires attention in clinical practice and clinical trials. However, sex and gender differences are currently seldom appreciated; importantly, consideration of sex and gender differences is not currently a focus in the design and analysis of clinical trials for AD. The objective of this position paper is (i) to provide an overview of known sex and gender differences that might have implications for clinical practice, (ii) to identify the most important knowledge gaps in the field (with a special regard to clinical trials) and (iii) to provide conclusions for future studies. This scientific statement is endorsed by the European Academy of Neurology.
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Affiliation(s)
- M T Ferretti
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland
| | - J Martinkova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - E Biskup
- College of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland
| | - T Benke
- Neurology Clinic, Medical University Innsbruck, Innsbruck, Austria
| | - G Gialdini
- Neurology - Private Practice, Lucca, Italy
| | - Z Nedelska
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - K Rauen
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland.,Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - V Mantua
- Italian Medicines Agency, Rome, Italy
| | - D Religa
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - J Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - A Santuccione Chadha
- Women's Brain Project, Guntershausen, Switzerland.,Global Medical and Scientific Affairs, Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - R Schmidt
- Department of Neurogeriatrics, University Clinic of Neurology, Medical University Graz, Graz, Austria
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26
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Wattenburger K, Schmidt R, Placheta L, Middleton JR, Adkins PRF. Evaluation of 4 different teat disinfection methods prior to collection of milk samples for bacterial culture in dairy cattle. J Dairy Sci 2020; 103:4579-4587. [PMID: 32147259 DOI: 10.3168/jds.2019-17338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/20/2019] [Indexed: 11/19/2022]
Abstract
The first objective of this study was to determine whether differences would occur among teat end preparation techniques with regard to potential contamination of milk samples collected for bacterial culture. The second objective was to determine whether differences would be detected in genus or species of bacteria isolated from samples collected using the various methods as well as from contaminated or uncontaminated samples. Mammary quarter foremilk samples were collected from lactating dairy cattle at the University of Missouri Foremost Research Dairy Farm (Columbia). Four different teat end preparation methods were used to compare contamination rates in milk samples. Sampling techniques used before milk collection included (1) no preparation, (2) pre-milking disinfection and single-use towel drying of teats only, (3) scrubbing of the teat end with alcohol only, and (4) pre-milking disinfection, single-use towel drying, and scrubbing of the teat end with alcohol. Milk was plated on Columbia blood agar. Cultures were read at 48 h, with the number of morphologically different bacterial colony types quantified and isolated. Isolates were identified using MALDI-TOF mass spectrometry. Median numbers of colony types were compared among groups using Kruskal-Wallis ANOVA with post-hoc pairwise comparisons, and proportional data were compared using the chi-squared test. A total of 168 cows, including 665 quarters, were sampled, and 1,614 isolates resulted. Analysis with MALDI-TOF identified 29 unique genera and 81 unique species among the samples. More contaminated samples occurred in groups 1 and 2 compared with groups 3 and 4. Group 3 had more contaminated samples than group 4. The majority of Pseudomonas spp. isolates were identified within group 2. When applying previously described niches to Staphylococcus spp., environmental species were more likely to be identified among contaminated samples, whereas host-adapted species were more likely to be identified among uncontaminated samples. These data confirm that scrubbing the teat end with alcohol after pre-milking disinfection with an iodine-based teat disinfectant and drying of the teat minimizes contamination of the milk sample.
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Affiliation(s)
- K Wattenburger
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia 65211
| | - R Schmidt
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia 65211
| | - L Placheta
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia 65211
| | - J R Middleton
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia 65211
| | - P R F Adkins
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia 65211.
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27
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Frid P, Drake M, Giese AK, Wasselius J, Schirmer MD, Donahue KL, Cloonan L, Irie R, Bouts MJRJ, McIntosh EC, Mocking SJT, Dalca AV, Sridharan R, Xu H, Giralt-Steinhauer E, Holmegaard L, Jood K, Roquer J, Cole JW, McArdle PF, Broderick JP, Jimenez-Conde J, Jern C, Kissela BM, Kleindorfer DO, Lemmens R, Meschia JF, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Thijs V, Woo D, Worrall BB, Kittner SJ, Mitchell BD, Petersson J, Rosand J, Golland P, Wu O, Rost NS, Lindgren A. Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study. J Neurol 2020; 267:649-658. [PMID: 31709475 PMCID: PMC7035231 DOI: 10.1007/s00415-019-09613-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Posterior circulation ischemic stroke (PCiS) constitutes 20-30% of ischemic stroke cases. Detailed information about differences between PCiS and anterior circulation ischemic stroke (ACiS) remains scarce. Such information might guide clinical decision making and prevention strategies. We studied risk factors and ischemic stroke subtypes in PCiS vs. ACiS and lesion location on magnetic resonance imaging (MRI) in PCiS. METHODS Out of 3,301 MRIs from 12 sites in the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Genetics Network (SiGN), we included 2,381 cases with acute DWI lesions. The definition of ACiS or PCiS was based on lesion location. We compared the groups using Chi-squared and logistic regression. RESULTS PCiS occurred in 718 (30%) patients and ACiS in 1663 (70%). Diabetes and male sex were more common in PCiS vs. ACiS (diabetes 27% vs. 23%, p < 0.05; male sex 68% vs. 58%, p < 0.001). Both were independently associated with PCiS (diabetes, OR = 1.29; 95% CI 1.04-1.61; male sex, OR = 1.46; 95% CI 1.21-1.78). ACiS more commonly had large artery atherosclerosis (25% vs. 20%, p < 0.01) and cardioembolic mechanisms (17% vs. 11%, p < 0.001) compared to PCiS. Small artery occlusion was more common in PCiS vs. ACiS (20% vs. 14%, p < 0.001). Small artery occlusion accounted for 47% of solitary brainstem infarctions. CONCLUSION Ischemic stroke subtypes differ between the two phenotypes. Diabetes and male sex have a stronger association with PCiS than ACiS. Definitive MRI-based PCiS diagnosis aids etiological investigation and contributes additional insights into specific risk factors and mechanisms of injury in PCiS.
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Affiliation(s)
- Petrea Frid
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.
- Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Malmö, Sweden.
- Department of Neurology, Skåne University Hospital, Jan Waldenströms gata 19, 205 02, Malmö, Sweden.
| | - Mattias Drake
- Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden
- Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden
| | - A K Giese
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - J Wasselius
- Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden
- Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden
| | - M D Schirmer
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
- Department of Population Health Sciences, German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - K L Donahue
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - L Cloonan
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R Irie
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - M J R J Bouts
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - E C McIntosh
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - S J T Mocking
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - A V Dalca
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - R Sridharan
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
| | - H Xu
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - E Giralt-Steinhauer
- Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - L Holmegaard
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - K Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J Roquer
- Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J W Cole
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA
| | - P F McArdle
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J P Broderick
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - J Jimenez-Conde
- Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - C Jern
- Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - B M Kissela
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - D O Kleindorfer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - R Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Louvain, Belgium
- VIB Center for Brain and Disease Research, Louvain, Belgium
- Department of Neurology, University Hospitals Leuven, Louvain, Belgium
| | - J F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - T Rundek
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - R L Sacco
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - R Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria
| | - P Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, UK
- Ashford and St Peter's Hospital, Ashford, UK
| | - A Slowik
- Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - V Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
- Department of Neurology, Austin Health, Heidelberg, Australia
| | - D Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - B B Worrall
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - S J Kittner
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA
| | - B D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USA
| | - J Petersson
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Malmö, Sweden
| | - J Rosand
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
- Center for Genomic Research, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - P Golland
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA
| | - O Wu
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA
| | - N S Rost
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Lund, Sweden
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28
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Bartram U, Schmidt R. [Transdermal intoxication through broken opioid ampules : Accidental intoxication in a paramedic]. Anaesthesist 2020; 69:122-125. [PMID: 32002562 DOI: 10.1007/s00101-020-00732-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/30/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
This article presents the case of an accidental transdermal opioid intoxication in a paramedic. During an ambulance flight mission for patient repatriation several ampules containing opioids were broken unnoticed inside the ampule kit in the outside pocket of the work trousers of the paramedic. He developed the typical clinical picture of opioid intoxication with clouding of consciousness, miosis, and respiratory depression. This necessitated continuous monitoring of vital signs as well as repetitive administration of naloxone under the improvised circumstances of a mission abroad.
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Affiliation(s)
- U Bartram
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerzmedizin, Marienhospital Stuttgart, Böheimstr. 37, 70199, Stuttgart, Deutschland.
| | - R Schmidt
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerzmedizin, Marienhospital Stuttgart, Böheimstr. 37, 70199, Stuttgart, Deutschland
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29
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Berthold F, Faldum A, Ernst A, Boos J, Dilloo D, Eggert A, Fischer M, Frühwald M, Henze G, Klingebiel T, Kratz C, Kremens B, Krug B, Leuschner I, Schmidt M, Schmidt R, Schumacher-Kuckelkorn R, von Schweinitz D, Schilling FH, Theissen J, Volland R, Hero B, Simon T. Extended induction chemotherapy does not improve the outcome for high-risk neuroblastoma patients: results of the randomized open-label GPOH trial NB2004-HR. Ann Oncol 2020; 31:422-429. [PMID: 32067684 DOI: 10.1016/j.annonc.2019.11.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 10/04/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Long-term survival of high-risk neuroblastoma patients is still below 50% despite intensive multimodal treatment. This trial aimed to address whether the addition of two topotecan-containing chemotherapy courses compared to standard induction therapy improves event-free survival (EFS) of these patients. PATIENTS AND METHODS An open-label, multicenter, prospective randomized controlled trial was carried out at 58 hospitals in Germany and Switzerland. Patients aged 1-21 years with stage 4 neuroblastoma and patients aged 6 months to 21 years with MYCN-amplified tumors were eligible. The primary endpoint was EFS. Patients were randomly assigned to standard induction therapy with six chemotherapy courses or to experimental induction chemotherapy starting with two additional courses of topotecan, cyclophosphamide, and etoposide followed by standard induction chemotherapy (eight courses in total). After induction chemotherapy, all patients received high-dose chemotherapy with autologous hematopoietic stem cell rescue and isotretinoin for consolidation. Radiotherapy was applied to patients with active tumors at the end of induction chemotherapy. RESULTS Of 536 patients enrolled in the trial, 422 were randomly assigned to the control arm (n = 211) and the experimental arm (n = 211); the median follow-up time was 3.32 years (interquartile range 1.65-5.92). At data lock, the 3-year EFS of experimental and control patients was 34% and 32% [95% confidence Interval (CI) 28% to 40% and 26% to 38%; P = 0.258], respectively. Similarly, the 3-year overall survival of the patients did not differ [54% and 48% (95% CI 46% to 62% and 40% to 56%), respectively; P = 0.558]. The response to induction chemotherapy was not different between the arms. The median number of non-fatal toxicities per patient was higher in the experimental group while the median number of toxicities per chemotherapy course was not different. CONCLUSION While the burden for the patients was increased by prolonging the induction chemotherapy and the toxicity, the addition of two topotecan-containing chemotherapy courses did not improve the EFS of high-risk neuroblastoma patients and thus cannot be recommended. CLINICAL TRIALS. GOV NUMBER NCT number 03042429.
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Affiliation(s)
- F Berthold
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany.
| | - A Faldum
- Institute of Medical Statistics and Clinical Research, University of Muenster, Muenster, Germany
| | - A Ernst
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany
| | - J Boos
- Department of Pediatric Oncology and Hematology, University of Muenster, Muenster, Germany
| | - D Dilloo
- Department of Pediatric Oncology and Hematology, University of Bonn, Bonn, Germany
| | - A Eggert
- Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - M Fischer
- Department of Experimental Pediatric Oncology and Center for Molecular Medicine, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Frühwald
- Swabian Children's Cancer Center, Children's Hospital, University Hospital Augsburg, Augsburg, Germany
| | - G Henze
- Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T Klingebiel
- Department of Children and Adolescents, University Hospital, Goethe University Frankfurt (Main), Frankfurt am Main, Germany
| | - C Kratz
- Department of Pediatric Oncology and Hematology, Medicinal University, Hannover, Germany
| | - B Kremens
- Department of Pediatric Oncology and Hematology, University of Essen, Essen, Germany
| | - B Krug
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - I Leuschner
- Children's Tumor Registry, Institute of Pathology, University of Kiel, Kiel, Germany
| | - M Schmidt
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - R Schmidt
- Institute of Medical Statistics and Clinical Research, University of Muenster, Muenster, Germany
| | | | - D von Schweinitz
- Department of Pediatric Surgery, University of Munich, Munich, Germany
| | - F H Schilling
- Department of Pediatric Oncology and Hematology, Olgahospital Stuttgart, Stuttgart, Germany
| | - J Theissen
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - R Volland
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - B Hero
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - T Simon
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
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30
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Pust GEA, Dettmers C, Randerath J, Rahn AC, Heesen C, Schmidt R, Gold SM. Fatigue in Multiple Sclerosis Is Associated With Childhood Adversities. Front Psychiatry 2020; 11:811. [PMID: 33005150 PMCID: PMC7485280 DOI: 10.3389/fpsyt.2020.00811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022] Open
Abstract
Fatigue is a common and disabling symptom in patients with Multiple Sclerosis (PwMS). Its pathogenesis, however, is still not fully understood. Potential psychological roots, in particular, have received little attention to date. The present study examined the association of childhood adversities, specific trait characteristics, and MS disease characteristics with fatigue symptoms utilizing path analysis. Five hundred and seventy-one PwMS participated in an online survey. Standardized psychometric tools were applied. The Childhood Trauma Questionnaire (CTQ) served to assess childhood adversities. Trait variables were alexithymia (Toronto Alexithymia Scale; TAS-26) and early maladaptive schemas (Young Schema Questionnaire; YSQ). Current pathology comprised depression (Beck's Depression Inventory FastScreen; BDI-FS) and anxiety symptoms (State-Trait Anxiety Inventory; STAI-state), as well as physical disability (Patient determined Disease Steps; PDDS). The Fatigue Scale for Motor and Cognitive Functions (FSMC) was the primary outcome variable measuring fatigue. PwMS displayed high levels of fatigue and depression (mean FSMC score: 72; mean BDI-II score: 18). The final path model revealed that CTQ emotional neglect and emotional abuse remained as the only significant childhood adversity variables associated with fatigue. There were differential associations for the trait variables and current pathology: TAS-26, the YSQ domain impaired autonomy and performance, as well as all current pathology measures had direct effects on fatigue symptoms, accounting for 28.2% of the FSMC variance. Bayesian estimation also revealed indirect effects from the two CTQ subscales on FSMC. The final model fitted the data well, also after a cross-validation check and after replacing the FSMC with the Chalder Fatigue Questionnaire (CFQ). This study suggests an association psychological factors on fatigue in Multiple Sclerosis. Childhood adversities, as well as specific trait characteristics, seem to be associated with current pathology and fatigue symptoms. The article discusses potential implications and limitations.
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Affiliation(s)
- Gesa E A Pust
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany.,ZIST, Penzberg, Germany
| | - Christian Dettmers
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany
| | - Jennifer Randerath
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany
| | - Anne C Rahn
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Neurology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Roger Schmidt
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Lurija Institute for Rehabilitation and Health Sciences at the University of Konstanz, Schmieder Foundation for Sciences and Research, Allensbach, Germany.,Klinik für Psychosomatik und Konsiliarpsychiatrie, Departement Innere Medizin, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Stefan M Gold
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Department of Psychosomatic Medicine, Campus Benjamin Franklin, Berlin, Germany
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Hoffmann JA, Bareuther L, Schmidt R, Dettmers C. The relation between memory and decision-making in multiple sclerosis patients. Mult Scler Relat Disord 2020; 37:101433. [PMID: 32173000 DOI: 10.1016/j.msard.2019.101433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/21/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Impairments in long-term and working memory are widespread in Multiple Sclerosis (MS), setting on in early disease stages. These memory impairments may limit patients' ability to take informed and competent medical decisions, too. In healthy populations, memory abilities predict decision quality across a wide range of tasks. These studies suggest that higher working memory capacity supports decisions in cognitively taxing tasks, whereas better semantic memory facilitates decisions in tasks requiring knowledge retrieval. In individuals with MS, previous studies have linked less accurate decisions to memory deficits and reduced executive functioning, too. However, these studies focussed on decisions under risk and did not broadly assess decision making skills. We aimed to fill this gap in a cross-sectional study. METHODS Hundred thirty-seven participants with MS were recruited during their stay in an MS specialized rehabilitation centre. In a first test session, participants completed a standardized test battery for working memory and semantic memory, the inventory for memory diagnostics. In a second test session, participants filled out the Adult Decision Making Competence battery (A-DMC). This version of the A-DMC measured decision making competence on five subscales: Resistance to Framing Effects, Under/Overconfidence, Applying Decision Rules, Consistency in Risk Perception, and Resistance to Sunk Cost Effects. In addition, participants were screened for depression and cognitive fatigue. RESULTS Working memory was impaired in most participants, whereas semantic memory was not impaired. To understand which memory abilities underlie distinct components of decision making in people with MS, we used structural equation modelling. Replicating previous findings in a healthy sample, working memory capacity was associated with the ability to recall semantic knowledge. Participants with lower working memory capacity were less resistant to framing effects and adhered to decision rules less. In contrast, participants with worse semantic memory assessed their own knowledge less accurately, perceived risks less consistently, and made more errors in applying decision rules. Cognitive fatigue and depression unlikely explain these relationships. CONCLUSIONS Taken together, our study suggests that the memory problems, frequently reported in MS patients, may reach out to higher-order cognitive functions, such as decision making skills. Supporting shared decision-making and patient autonomy within MS thus requires to take memory impairments into account and to match the information provided to the patient's memory abilities.
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Affiliation(s)
- Janina A Hoffmann
- Department of Psychology, University of Bath, United Kingdom; Department of Psychology, University of Konstanz, Germany.
| | - Lena Bareuther
- Department of Psychology, University of Konstanz, Germany; Zentralinstitut fuer Seelische Gesundheit, Mannheim, Germany
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Klein J, Lorke M, Florian M, Sigger F, Sigl L, Rey S, Wierzbowski J, Cerne J, Müller K, Mitterreiter E, Zimmermann P, Taniguchi T, Watanabe K, Wurstbauer U, Kaniber M, Knap M, Schmidt R, Finley JJ, Holleitner AW. Site-selectively generated photon emitters in monolayer MoS 2 via local helium ion irradiation. Nat Commun 2019; 10:2755. [PMID: 31227692 PMCID: PMC6588625 DOI: 10.1038/s41467-019-10632-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/22/2019] [Indexed: 11/08/2022] Open
Abstract
Quantum light sources in solid-state systems are of major interest as a basic ingredient for integrated quantum photonic technologies. The ability to tailor quantum emitters via site-selective defect engineering is essential for realizing scalable architectures. However, a major difficulty is that defects need to be controllably positioned within the material. Here, we overcome this challenge by controllably irradiating monolayer MoS2 using a sub-nm focused helium ion beam to deterministically create defects. Subsequent encapsulation of the ion exposed MoS2 flake with high-quality hBN reveals spectrally narrow emission lines that produce photons in the visible spectral range. Based on ab-initio calculations we interpret these emission lines as stemming from the recombination of highly localized electron-hole complexes at defect states generated by the local helium ion exposure. Our approach to deterministically write optically active defect states in a single transition metal dichalcogenide layer provides a platform for realizing exotic many-body systems, including coupled single-photon sources and interacting exciton lattices that may allow the exploration of Hubbard physics.
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Affiliation(s)
- J Klein
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany.
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany.
| | - M Lorke
- Institut für Theoretische Physik, Universität Bremen, P.O. Box 330 440,, 28334, Bremen, Germany
- Bremen Center for Computational Materials Science, University of Bremen, Am Fallturm 1, 28359, Bremen, Germany
| | - M Florian
- Institut für Theoretische Physik, Universität Bremen, P.O. Box 330 440,, 28334, Bremen, Germany
| | - F Sigger
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany
| | - L Sigl
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - S Rey
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - J Wierzbowski
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - J Cerne
- Department of Physics, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
| | - K Müller
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - E Mitterreiter
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - P Zimmermann
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
| | - T Taniguchi
- National Institute for Materials Science, Tsukuba, Ibaraki, 305-0044, Japan
| | - K Watanabe
- National Institute for Materials Science, Tsukuba, Ibaraki, 305-0044, Japan
| | - U Wurstbauer
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany
| | - M Kaniber
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany
| | - M Knap
- Department of Physics and Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | - R Schmidt
- Max-Planck-Institut für Quantenoptik, 85748, Garching, Germany
| | - J J Finley
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany.
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany.
| | - A W Holleitner
- Walter Schottky Institut and Physik Department, Technische Universität München, Am Coulombwall 4, 85748, Garching, Germany.
- Nanosystems Initiative Munich (NIM), Schellingstr. 4, 80799, Munich, Germany.
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Accorsi G, Reis R, Schmidt R, Nobrega L, Beolchi A, Vieira M, Andrade C. Surgical morbidity associated with learning curve of sentinel lymph node technique in early stage cervical cancer treatment. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.334] [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: 10/26/2022]
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Vernooij MW, Pizzini FB, Schmidt R, Smits M, Yousry TA, Bargallo N, Frisoni GB, Haller S, Barkhof F. Dementia imaging in clinical practice: a European-wide survey of 193 centres and conclusions by the ESNR working group. Neuroradiology 2019; 61:633-642. [PMID: 30852630 PMCID: PMC6511357 DOI: 10.1007/s00234-019-02188-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/12/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Through a European-wide survey, we assessed the current clinical practice of imaging in the primary evaluation of dementia, with respect to standardised imaging, evaluation and reporting. METHODS An online questionnaire was emailed to all European Society of Neuroradiology (ESNR) members (n = 1662) and non-members who had expressed their interest in ESNR activities in the past (n = 6400). The questionnaire featured 42 individual items, divided into multiple choice, single best choice and free text answers. Information was gathered on the context of the practices, available and preferred imaging modalities, applied imaging protocols and standards for interpretation, reporting and communication. RESULTS A total of 193 unique (non-duplicate) entries from the European academic and non-academic institutions were received from a total of 28 countries. Of these, 75% were neuroradiologists, 12% general radiologists and 11% (neuro) radiologists in training. Of responding centres, 38% performed more than five scans/week for suspected dementia. MRI was primarily used in 72% of centres. Over 90% of centres acquired a combination of T2w, FLAIR, T1w, DWI and T2*w sequences. Visual rating scales were used in 75% of centres, most often the Fazekas and medial temporal atrophy scale; 32% of respondents lacked full confidence in their use. Only 23% of centres performed volumetric analysis. A minority of centres (28%) used structured reports. CONCLUSIONS Current practice in dementia imaging is fairly homogeneous across Europe, in terms of image acquisition and image interpretation. Hurdles identified include training on the use of visual rating scales, implementation of volumetric assessment and structured reporting.
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Affiliation(s)
- M W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - F B Pizzini
- Neuroradiology, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy
| | - R Schmidt
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | - M Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - T A Yousry
- Lysholm Department of Neuroradiology, UCL Institute of Neurology, London, UK
| | - N Bargallo
- Magnetic Resonance Image Core Facility, IDIBAPS and Center of Diagnostic Image (CDIC), Hospital Clinic, Barcelona, Spain
| | - G B Frisoni
- University Hospitals and University of Geneva, Geneva, Switzerland
| | - S Haller
- CIRD - Centre d'Imagerie Rive Droite|, Geneva, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - F Barkhof
- Lysholm Department of Neuroradiology, UCL Institute of Neurology, London, UK
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam UMC, Amsterdam, The Netherlands
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Castro B, Mengatto MF, Vieira M, Andrade C, Cintra G, Tsunoda A, Schmidt R, Reis R. Evaluation of early removal of indwelling urinary catheter (IDUC) after radical surgery in cervical cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Joos A, Leiprecht N, Wiesand K, Schmidt R, Hartmann A. Integrated inpatient rehabilitation for patients with Functional Neurological Symptom Disorder (FNSD) - A specific group therapy. J Psychosom Res 2019; 120:102-104. [PMID: 30929699 DOI: 10.1016/j.jpsychores.2019.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 11/16/2022]
Affiliation(s)
- A Joos
- Kliniken Schmieder, Departments of Psychotherapeutic Neurology in Gailingen and Konstanz, Auf dem Berg, 78262 Gailingen, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 8, 79104 Freiburg, Germany.
| | - N Leiprecht
- Kliniken Schmieder, Departments of Psychotherapeutic Neurology in Gailingen and Konstanz, Auf dem Berg, 78262 Gailingen, Germany
| | - K Wiesand
- Kliniken Schmieder, Departments of Psychotherapeutic Neurology in Gailingen and Konstanz, Auf dem Berg, 78262 Gailingen, Germany
| | - R Schmidt
- Kliniken Schmieder, Departments of Psychotherapeutic Neurology in Gailingen and Konstanz, Auf dem Berg, 78262 Gailingen, Germany
| | - A Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 8, 79104 Freiburg, Germany
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Katzendobler S, Haunreiter L, Zander L, Schmidt R, Andrulat A, Münch K, Hanusch C, Napieralski R, Petri I, Ettl J. Abstract OT1-05-05: REASSURE- Effects of Reiki as supportive treatment during chemotherapy of breast cancer: A prospective, randomized, controlled clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-05-05] [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: Every seventh to eighth woman is diagnosed with breast cancer in her life. Next to surgery and radiotherapy most of them receive (neo)adjuvant chemotherapy, which comes along with adverse effects. Complementary and alternative medicine (CAM) like Reiki can reduce these effects. Reiki is a Far Eastern method that promotes healing on a physical, mental and emotional level and activates self-healing powers. REASSURE examines the effects of Reiki on quality of life and taxane-induced polyneuropathy during chemotherapy.
Methods: REASSURE is a prospective, randomized, controlled, two-armed clinical trial, in which patients with breast cancer receive chemotherapy and Reiki (18 times) or chemotherapy and sport (18 times). During chemotherapy and before and after every Reiki- or sport-session the patients fill out standardized questionnaires (e.g. FACT/GOG-NTX Version 4). Primary endpoint is the comparison of quality of life at the end of chemotherapy between Reiki and sport based on the FACT/GOG-NTX score by T-Test. Secondary endpoint is the comparison of the taxane-induced polyneuropathy at the end of chemotherapy between the two groups. Also short-term effects before and after the Reiki- and sport-session will be examined. A power of 1-β = 0.8, a bilateral probability of error of α = 0.05, a minimum relevant difference deltaθ = 4 and a pooled standard deviation of 11 for the two-sided T-Test result in case numbers of 2 x 120 = 240 patients.
Conclusion: REASSURE is the most comprehensive prospective study to the effects and the feasibility of Reiki on breast cancer patients during chemotherapy so far.
Since July 2015, 138 patients have been enrolled at three different centers. Currently 63 patients in total (39 patients of the Reiki-group and 24 patients of the sport-group) have completed the study. 24 Reiki-patients and 36 sport-patients are counted as dropouts because of reasons like incomplete data records, discontinuation of chemotherapy, not enough time or energy for Reiki- or sport-sessions or other reasons.
Sponsor: This is a collaborative study of the Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany, Rotkreuzklinikum München, Frauenklinik, Munich, Germany, Department of Gynaecology, Städtisches Klinikum München Harlaching, Munich, Germany and the ProReiki – der Berufsverband e.V., Berlin, Germany.
Contact Information: For further information contact Sophie Katzendobler via sophie.katzendobler@gmail.com or the leading physician Dr. Johannes Ettl via johannes.ettl@tum.de.
Citation Format: Katzendobler S, Haunreiter L, Zander L, Schmidt R, Andrulat A, Münch K, Hanusch C, Napieralski R, Petri I, Ettl J. REASSURE- Effects of Reiki as supportive treatment during chemotherapy of breast cancer: A prospective, randomized, controlled clinical trial [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 OT1-05-05.
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Affiliation(s)
- S Katzendobler
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - L Haunreiter
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - L Zander
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - R Schmidt
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - A Andrulat
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - K Münch
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - C Hanusch
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - R Napieralski
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - I Petri
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
| | - J Ettl
- Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany; Rotkreuzklinikum München, Frauenklinik, Munich, Germany; Städtisches Klinikum München Harlaching, Munich, Germany; ProReiki – der Berufsverband e.V., Berlin, Germany
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Willbur JF, Fall ML, Byrne AM, Chapman SA, McCaghey MM, Mueller BD, Schmidt R, Chilvers MI, Mueller DS, Kabbage M, Giesler LJ, Conley SP, Smith DL. Validating Sclerotinia sclerotiorum Apothecial Models to Predict Sclerotinia Stem Rot in Soybean (Glycine max) Fields. Plant Dis 2018; 102:2592-2601. [PMID: 30334675 DOI: 10.1094/pdis-02-18-0245-re] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In soybean, Sclerotinia sclerotiorum apothecia are the sources of primary inoculum (ascospores) critical for Sclerotinia stem rot (SSR) development. We recently developed logistic regression models to predict the presence of apothecia in irrigated and nonirrigated soybean fields. In 2017, small-plot trials were established to validate two weather-based models (one for irrigated fields and one for nonirrigated fields) to predict SSR development. Additionally, apothecial scouting and disease monitoring were conducted in 60 commercial fields in three states between 2016 and 2017 to evaluate model accuracy across the growing region. Site-specific air temperature, relative humidity, and wind speed data were obtained through the Integrated Pest Information Platform for Extension and Education (iPiPE) and Dark Sky weather networks. Across all locations, iPiPE-driven model predictions during the soybean flowering period (R1 to R4 growth stages) explained end-of-season disease observations with an accuracy of 81.8% using a probability action threshold of 35%. Dark Sky data, incorporating bias corrections for weather variables, explained end-of-season disease observations with 87.9% accuracy (in 2017 commercial locations in Wisconsin) using a 40% probability threshold. Overall, these validations indicate that these two weather-based apothecial models, using either weather data source, provide disease risk predictions that both reduce unnecessary chemical application and accurately advise applications at critical times.
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Affiliation(s)
- Jaime F Willbur
- Department of Plant Pathology, University of Wisconsin-Madison
| | - Mamadou L Fall
- Saint-Jean-sur-Richelieu Research and Development Centre, Agriculture and Agri-Food Canada, Saint-Jean-sur-Richelieu, QC, Canada; and Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing
| | - Adam M Byrne
- Department of Plant, Soil and Microbial Sciences, Michigan State University
| | - Scott A Chapman
- Department of Plant Pathology, University of Wisconsin-Madison
| | | | - Brian D Mueller
- Department of Plant Pathology, University of Wisconsin-Madison
| | - Roger Schmidt
- Nutrient and Pest Management, University of Wisconsin-Madison
| | - Martin I Chilvers
- Department of Plant, Soil and Microbial Sciences, Michigan State University
| | - Daren S Mueller
- Department of Plant Pathology and Microbiology, Iowa State University, Ames
| | - Mehdi Kabbage
- Department of Plant Pathology, University of Wisconsin-Madison
| | - Loren J Giesler
- Department of Plant Pathology, University of Nebraska-Lincoln
| | | | - Damon L Smith
- Department of Plant Pathology, University of Wisconsin-Madison
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Wallesch CW, Marx P, Tegenthoff M, Widder B, Schwerdtfeger K, du Mesnil de Rochemont R, Schmidt R, Neumann-Zielke L, Schwalbe M. [Guideline "Legal evaluation after closed brain injury in adulthood"]. Fortschr Neurol Psychiatr 2018; 86:635-653. [PMID: 30359998 DOI: 10.1055/a-0677-7068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In 2005 and 2013, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Evaluation) together with other societies developed and consented guidelines fort the legal evaluation of patients with closed head injuries and published them trough the National Working Group of Scientific Medical Societies and in this journal. Five years later, a revision was necessary, this was developed on the higher S2 k level of consent through a Delphi conference.
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Rolf D, Schmidt R, Möllers M, Oelmeier de Murcia K, Braun J, Hammer K, Klockenbusch W, Schmitz R. Untersuchung des Strain und der Dyssynchromie bei unauffälligen Feten mittels Speckle Tracking Echokardiografie – Vergleich von drei unterschiedlichen Ultraschallsonden. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671447] [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] Open
Affiliation(s)
- D Rolf
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
| | - R Schmidt
- University of Münster, Institute of Biostatistics and Clinical Research, Münster, Deutschland
| | - M Möllers
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
| | | | - J Braun
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
| | - K Hammer
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
| | - W Klockenbusch
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
| | - R Schmitz
- University of Münster, Obstetrics and Gynecology, Münster, Deutschland
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Roberts A, Shah M, Schmidt R. Sex differences in euploid rates between day 5 and day 6 blastocyst expansion in IVF/PGT-A cycles. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.217] [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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Iorgulescu JB, Ferris S, Agarwal A, Casavilca Zambrano S, Hill DA, Schmidt R, Perry A. Non-meningothelial meningeal tumours with meningioangiomatosis-like pattern of spread. Neuropathol Appl Neurobiol 2018; 44:743-746. [PMID: 29495087 DOI: 10.1111/nan.12481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/22/2018] [Indexed: 01/14/2023]
Affiliation(s)
- J B Iorgulescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S Ferris
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - A Agarwal
- Department of Pathology, Mercy Hospital, St. Louis, MO, USA
| | - S Casavilca Zambrano
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - D A Hill
- Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - R Schmidt
- Division of Neuropathology, Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA
| | - A Perry
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
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Affiliation(s)
- S. Mitzner
- Division of Nephrology, Department of Medicine, University of Rostock, Rostock - Germany
| | - J. Stange
- Division of Nephrology, Department of Medicine, University of Rostock, Rostock - Germany
| | - J. Freytag
- Division of Nephrology, Department of Medicine, University of Rostock, Rostock - Germany
| | - S. Lindemann
- Division of Nephrology, Department of Medicine, University of Rostock, Rostock - Germany
| | - R. Schmidt
- Division of Nephrology, Department of Medicine, University of Rostock, Rostock - Germany
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Berti G, Engelbrecht G, Fingberg J, Kohring G, Middleton SE, Schmidt R, Benkner S. GEMSS: Grid-infrastructure for Medical Service Provision. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633941] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law.
Methods:
The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view.
Results:
A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillofacial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction.
Conclusions:
The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.
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Burkhardt B, Faldum A, Schmidt R. Adaptive Designs with Discrete Test Statistics and Consideration of Overrunning. Methods Inf Med 2018; 54:434-46. [DOI: 10.3414/me14-02-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 09/09/2015] [Indexed: 01/08/2023]
Abstract
Summary
Background: Interim analyses are used in clinical trials in order to enable early decisions for medical, ethical, and economic reasons. However, it appears unfeasible to stop a trial during such an interim analysis. New patients will thus enter the trial while the interim analysis is ongoing. Moreover, depending on the event kinetics of the specific disease, the trial design, and the corresponding endpoints, some patients might still be unevaluable at the interim analysis due to not yet completed follow-up. Occur-rence of these types of patients is characteristic for sequentially analyzed trials. Such patients are referred to as interim patients. In trials with multiple primary endpoints, another type of interim patients occurs. If some but not all null hypotheses can be rejected at the interim analysis, the trial might be continued to a second stage in order to answer the remaining questions. These second stage patients, however, provide new data to all trial questions including the already rejected ones and thus formally act as interim patients regarding the already rejected null hypotheses. Although all kinds of interim patients are not part of the interim analysis, the data collected on those patients have to be sent to the office of regulatory affairs and will be analyzed. If a smaller or contrasting treatment effect is observed in interim patients, this might lead to a withdrawal of an earlier superiority proof.
Objectives: Presently, interim patients and their data are usually not considered in the confirmatory test. We offer a strategy to deal with interim patients in sequentially analyzed trials with discrete test statistics. The method covers sequentially analyzed single-and multi-arm trials with one or multiple primary endpoints.
Methods: When planning adaptive designs, it is common practice to assume that the stage-wise p-values are independent and standard uniformly distributed under the null hypothesis. In the context of discrete test statistics, this implies conservative tests. We provide an algorithm which iteratively optimizes an initially given design while adjusting for both discreteness of test statistics and interim patients. The algorithm is described verbally, graphically and formally to facilitate immediate implementation in computer software.
Results: The optimized design exploits the aspired significance level better and is more powerful than the initial one. The algorithm applies to fixed sample and planned flexible adaptive designs for single- and multi-arm trials with one or multiple primary endpoints. The benefit increases with the number of interim patients.
Conclusions: When planning a trial with interim analyses, the rules for decisions must be adjusted to interim patients. Otherwise, the test procedure is conservative resulting in loss of power. This is essential in situations where the number of interim patients is important compared to the first stage, particularly in trials with multiple primary endpoints.
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Zeuner KE, Schmidt R, Schwingenschuh P. [Clinical and cognitive aspects of functional (psychogenic) tremor]. Nervenarzt 2018; 89:400-407. [PMID: 29327097 DOI: 10.1007/s00115-017-0476-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Functional (psychogenic) tremor is the most common functional movement disorder. Characteristic clinical features, so called red flags, can help to make the clinical distinction of this type from other tremor disorders. The most common features include the variability of frequency and amplitude. Clinical examination should include different types of distraction including motor or cognitive tasks or testing the influence of suggestibility on tremor amplitude, frequency or direction. Patients often report sudden onset and remissions that may last for months or even years. In some cases, the tremor is only present in highly specific situations. Although functional tremor shares characteristics with voluntary actions, patients experience their abnormal movements as involuntary. Recent experimental approaches have revealed an impairment in sense of agency. The diagnosis can be supported by neurophysiological measurements including accelerometry, which achieved a sensitivity of 89.5% and a specificity of 95.9% in a validated test battery, thus providing a useful additional diagnostic tool. Psychotherapeutic treatment is indicated in patients with and without evident psychological symptoms. A specific physiotherapeutic approach for functional tremor is re-trainment.
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Affiliation(s)
- K E Zeuner
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität Kiel, Arnold-Heller-Str. 3, Haus 41, 24105, Kiel, Deutschland.
| | - R Schmidt
- Psychotherapeutische Neurologie, Kliniken Schmieder, Neurologisches Fach- und Rehabilitationskrankenhaus, Konstanz, Deutschland
| | - P Schwingenschuh
- Universitätsklinik für Neurologie, Medizinische Universität Graz, Graz, Österreich
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Kienle J, Rockstroh B, Fiess J, Schmidt R, Popov T, Steffen-Klatt A. Variation of Functional Neurological Symptoms and Emotion Regulation with Time. Front Psychiatry 2018; 9:35. [PMID: 29487543 PMCID: PMC5816796 DOI: 10.3389/fpsyt.2018.00035] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/29/2018] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The present study addressed the variation of emotion regulation in the context of functional neurological symptom disorder (FNSD) by examining changes of functional neurological symptoms (FNS), general psychological strain, alexithymia, emotion regulation strategies, and cortical correlates of emotion regulation in the context of a standard inpatient treatment program. METHODS AND MATERIALS Self-report data on FNS, general psychological strain, alexithymia, emotion regulation strategies, and cortical correlates of an experimentally induced emotion regulation task (participants either passively watched unpleasant and neutral pictures or regulated their emotional response to unpleasant pictures using pre-trained reappraisal, while an electroencephalogram was recorded) were compared between 19 patients with FNSD and 19 healthy comparison participants (HC) before and after a 4-week standard treatment protocol that included a combination of (individual and group) psychotherapies and functional treatments (such as physiotherapy) or a 4-week interval in HC, respectively. RESULTS General psychological strain did not decrease significantly in FNSD patients. Changes in emotion regulation in FNSD patients were constrained to an increase in self-reported use of cognitive reappraisal strategies. Subjective symptom intensity in FNSD patients varied with alexithymia pretreatment, but did not decrease significantly. Cortical activity in the time and frequency-domain distinguished passive watching of neutral and unpleasant pictures and regulating emotional responses upon unpleasant pictures from passively watching them without difference between groups and/or time. DISCUSSION Over the investigated time interval, augmented habitual cognitive emotion regulation suggests an alleviation of emotion processing deficits, but no significant symptom decrease. More controlled and prolonged treatment studies would be needed to determine whether and how a specific contribution of treatment-related changes of emotion regulation and FNS might be inferred.
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Affiliation(s)
- Johanna Kienle
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Johanna Fiess
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Tzvetan Popov
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Schmidt R, Palitzsch KD. [Severe emergencies in patients with diabetes]. MMW Fortschr Med 2017; 159:77-82. [PMID: 29230741 DOI: 10.1007/s15006-017-0398-4] [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] [Indexed: 11/28/2022]
Affiliation(s)
| | - Klaus-Dieter Palitzsch
- Klinik für Endokrinologie, Diabetologie, Angiologie und Innere Medizin, Notfallzentrum, Klinikum Neuperlach - Städt., Klinikum München GmbH, Oskar-Maria-Graf-Ring 51, D-81737, München, Deutschland.
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Schmidt R, Pilz S, Lindemann I, Damm C, Hufenbach J, Helth A, Geissler D, Henss A, Rohnke M, Calin M, Zimmermann M, Eckert J, Lee M, Gebert A. Powder metallurgical processing of low modulus β-type Ti-45Nb to bulk and macro-porous compacts. POWDER TECHNOL 2017. [DOI: 10.1016/j.powtec.2017.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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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Koinig KA, Büsing N, Wille A, Sattler B, Schmidt R, Psenner R. Diatom communities in the ice cover of an alpine lake — their influence on pH reconstruction from fossil diatom assemblages. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/03680770.1998.11901426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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