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Schild R, Carvajal Abreu K, Büscher A, Kanzelmeyer N, Lezius S, Krupka K, Weitz M, Prytula A, Printza N, Berta L, Saygılı SK, Sellier-Leclerc AL, Spartà G, Marks SD, Kemper MJ, König S, Topaloglu R, Müller D, Klaus G, Weber S, Oh J, Herden U, Carraro A, Dello Strologo L, Ariceta G, Hoyer P, Tönshoff B, Pape L. Favorable Outcome After Single-kidney Transplantation From Small Donors in Children: A Match-controlled CERTAIN Registry Study. Transplantation 2024:00007890-990000000-00739. [PMID: 38685197 DOI: 10.1097/tp.0000000000004993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND Kidney transplantation (KTx) from small donors is associated with inferior graft survival in registry studies, whereas single-center studies show favorable results. METHODS We compared 175 pediatric KTx from small donors ≤20 kg (SDKTx) with 170 age-matched recipients from adult donors (ADKTx) from 20 centers within the Cooperative European Paediatric Renal Transplant Initiative registry. Graft survival and estimated glomerular filtration rate (eGFR) were analyzed by Cox regression and mixed models. Detailed data on surgical and medical management were tested for association with graft survival. RESULTS One-year graft survival was lower after SDKTx compared with ADKTx (90.9% versus 96.5%; odds ratio of graft loss, 2.92; 95% confidence interval [CI], 1.10-7.80; P = 0.032), but 5-y graft survival was comparable (90.9% versus 92.7%; adjusted hazard ratio of graft loss 1.9; 95% CI, 0.85-4.25; P = 0.119). SDKTx recipients had an annual eGFR increase of 8.7 ± 6.2 mL/min/1.73 m² compared with a decrease of 6.9 ± 5.7 mL/min/1.73 m² in ADKTx recipients resulting in a superior 5-y eGFR (80.5 ± 25.5 in SDKTx versus 65.7 ± 23.1 mL/min/1.73 m² in ADKTx; P = 0.008). At 3 y posttransplant, eGFR after single SDKTx was lower than after en bloc SDKTx (86.6 ± 20.4 versus 104.6 ± 35.9; P = 0.043) but superior to ADKTx (68.1 ± 23.9 mL/min/1.73 m²). Single-kidney SDKTx recipients had a lower rate of hypertension at 3 y than ADKTx recipients (40.0% versus 64.7%; P = 0.008). CONCLUSIONS Compared with ADKTx, 5-y graft function is superior in SDKTx and graft survival is similar, even when performed as single KTx. Utilizing small donor organs, preferably as single kidneys in experienced centers, is a viable option to increase the donor pool for pediatric recipients.
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Affiliation(s)
- Raphael Schild
- Department of Pediatric Nephrology, Pediatric Hepatology and Pediatric Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karla Carvajal Abreu
- Department of Pediatrics, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Büscher
- Department of Pediatrics II, University Hospital of Essen, University of Essen-Duisburg, Essen, Germany
| | - Nele Kanzelmeyer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Susanne Lezius
- Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Kai Krupka
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - Marcus Weitz
- Department of General Pediatrics and Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Agnieszka Prytula
- Paediatric Nephrology and Rheumatology Department, Ghent University Hospital, Ghent, Belgium
| | - Nikoleta Printza
- Pediatric Nephrology Unit, First Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - László Berta
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Seha Kamil Saygılı
- Division of Pediatric Nephrology, Department of Pediatrics, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie Pédiatrique, Hôpital Femme Mère Enfant, HCL, Bron Cedex, France
| | - Giuseppina Spartà
- Pediatric Nephrology, University Children's Hospital Zürich, Zurich, Switzerland
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Markus J Kemper
- Department of Pediatrics, Asklepios Klinik Nord Heidberg, Hamburg, Germany
| | - Sabine König
- Department of General Pediatrics, University Hospital Muenster, Muenster, Germany
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Dominik Müller
- Pediatric Nephrology, Charité Children's Hospital, Berlin, Germany
| | - Günter Klaus
- Department of Pediatrics II, University Children's Hospital, Philipps-University Marburg, Marburg, Germany
| | - Stefanie Weber
- Department of Pediatrics II, University Children's Hospital, Philipps-University Marburg, Marburg, Germany
| | - Jun Oh
- Department of Pediatric Nephrology, Pediatric Hepatology and Pediatric Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uta Herden
- Department of Visceral Transplantation, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Andrea Carraro
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - Luca Dello Strologo
- Renal Transplant Unit, Bambino Gesù Children's Research Hospital IRCCS, Rome, Italy
| | - Gema Ariceta
- Division of Pediatric Nephrology, Hospital Universitari Vall d' Hebron, Barcelona, Spain
| | - Peter Hoyer
- Department of Pediatrics II, University Hospital of Essen, University of Essen-Duisburg, Essen, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, University of Essen-Duisburg, Essen, Germany
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Jakwerth CA, Weckmann M, Illi S, Charles H, Zissler UM, Oelsner M, Guerth F, Omony J, Nemani SSP, Grychtol R, Dittrich AM, Skevaki C, Foth S, Weber S, Alejandre Alcazar MA, van Koningsbruggen-Rietschel S, Brock R, Blau S, Hansen G, Bahmer T, Rabe KF, Brinkmann F, Kopp MV, Chaker AM, Schaub B, von Mutius E, Schmidt-Weber CB. 17q21 Variants Disturb Mucosal Host Defense in Childhood Asthma. Am J Respir Crit Care Med 2024; 209:947-959. [PMID: 38064241 DOI: 10.1164/rccm.202305-0934oc] [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: 05/30/2023] [Accepted: 12/07/2023] [Indexed: 03/13/2024] Open
Abstract
Rationale: The strongest genetic risk factor for childhood-onset asthma, the 17q21 locus, is associated with increased viral susceptibility and disease-promoting processes.Objectives: To identify biological targets underlying the escalated viral susceptibility associated with the clinical phenotype mediated by the 17q21 locus.Methods: Genome-wide transcriptome analysis of nasal brush samples from 261 children (78 healthy, 79 with wheezing at preschool age, 104 asthmatic) within the ALLIANCE (All-Age-Asthma) cohort, with a median age of 10.0 (range, 1.0-20.0) years, was conducted to explore the impact of their 17q21 genotype (SNP rs72163891). Concurrently, nasal secretions from the same patients and visits were collected, and high-sensitivity mesoscale technology was employed to measure IFN protein levels.Measurements and Main Results: This study revealed that the 17q21 risk allele induces a genotype- and asthma/wheeze phenotype-dependent enhancement of mucosal GSDMB expression as the only relevant 17q21-encoded gene in children with preschool wheeze. Increased GSDMB expression correlated with the activation of a type-1 proinflammatory, cell-lytic immune, and natural killer signature, encompassing key genes linked to an IFN type-2-signature (IFNG, CXCL9, CXCL10, KLRC1, CD8A, GZMA). Conversely, there was a reduction in IFN type 1 and type 3 expression signatures at the mRNA and protein levels.Conclusions: This study demonstrates a novel disease-driving mechanism induced by the 17q21 risk allele. Increased mucosal GSDMB expression is associated with a cell-lytic immune response coupled with compromised airway immunocompetence. These findings suggest that GSDMB-related airway cell death and perturbations in the mucosal IFN signature account for the increased vulnerability of 17q21 risk allele carriers to respiratory viral infections during early life, opening new options for future biological interventions.The All-Age-Asthma (ALLIANCE) cohort is registered at www.clinicaltrials.gov (pediatric arm, NCT02496468).
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Affiliation(s)
- Constanze A Jakwerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Markus Weckmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Sabina Illi
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Helen Charles
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ulrich M Zissler
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Madlen Oelsner
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ferdinand Guerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Jimmy Omony
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Sai Sneha Priya Nemani
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Ruth Grychtol
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Anna-Maria Dittrich
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Chrysanthi Skevaki
- Member of the German Center for Lung Research (DZL), Germany
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics and
| | - Svenja Foth
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Stefanie Weber
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Miguel A Alejandre Alcazar
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Lung Health and Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, Giessen, Germany
- Translational Experimental Pediatrics, Experimental Pulmonology, Department of Pediatrics
- Center for Molecular Medicine Cologne and Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases, and
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Silke van Koningsbruggen-Rietschel
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Robert Brock
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Samira Blau
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Gesine Hansen
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
- Cluster of Excellence 2115 (RESIST), Hannover Medical School, Hanover, Germany
| | - Thomas Bahmer
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- Internal Medicine Department I, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Klaus F Rabe
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- LungenClinic Grosshansdorf GmbH and Medical Clinics, Christian Albrechts University, Kiel, Germany
| | - Folke Brinkmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Matthias Volkmar Kopp
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Adam M Chaker
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, Technical University of Munich, Munich, Germany
| | - Bianca Schaub
- Member of the German Center for Lung Research (DZL), Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Erika von Mutius
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
| | - Carsten B Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
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3
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Unnikrishnan G, Ilzhöfer P, Scholz A, Hölzl C, Götzelmann A, Gupta RK, Zhao J, Krauter J, Weber S, Makki N, Büchler HP, Pfau T, Meinert F. Coherent Control of the Fine-Structure Qubit in a Single Alkaline-Earth Atom. Phys Rev Lett 2024; 132:150606. [PMID: 38682979 DOI: 10.1103/physrevlett.132.150606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/11/2024] [Indexed: 05/01/2024]
Abstract
We report on the first realization of a novel neutral atom qubit encoded in the spin-orbit coupled metastable states ^{3}P_{0} and ^{3}P_{2} of a single ^{88}Sr atom trapped in an optical tweezer. Raman coupling of the qubit states promises rapid single-qubit rotations on par with the fast Rydberg-mediated two-body gates. We demonstrate preparation, readout, and coherent control of the qubit. In addition to driving Rabi oscillations bridging an energy gap of more than 17 THz using a pair of phase-locked clock lasers, we also carry out Ramsey spectroscopy to extract the transverse qubit coherence time T_{2}. When the tweezer is tuned into magic trapping conditions, which is achieved in our setup by tuning the tensor polarizability of the ^{3}P_{2} state via an external control magnetic field, we measure T_{2}=1.2 ms. A microscopic quantum mechanical model is used to simulate our experiments including dominant noise sources. We identify the main constraints limiting the observed coherence time and project improvements to our system in the immediate future. Our Letter opens the door for a so-far-unexplored qubit encoding concept for neutral atom-based quantum computing.
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Affiliation(s)
- G Unnikrishnan
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - P Ilzhöfer
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - A Scholz
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - C Hölzl
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - A Götzelmann
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - R K Gupta
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - J Zhao
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - J Krauter
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - S Weber
- Institute for Theoretical Physics III and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - N Makki
- Institute for Theoretical Physics III and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - H P Büchler
- Institute for Theoretical Physics III and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - T Pfau
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - F Meinert
- 5. Physikalisches Institut and Center for Integrated Quantum Science and Technology, Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
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Ruttkowski L, Wallot I, Korell M, Daur E, Seipelt P, Leonhardt A, Weber S, Mand N. Case report: Febrile infection-related epilepsy syndrome in a 14-year-old girl with multiple organ failure and lethal outcome. Front Neurosci 2024; 18:1255841. [PMID: 38505775 PMCID: PMC10948546 DOI: 10.3389/fnins.2024.1255841] [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: 07/09/2023] [Accepted: 02/07/2024] [Indexed: 03/21/2024] Open
Abstract
We report a case of an otherwise healthy 14-year-old girl with febrile infection-related epilepsy syndrome (FIRES), multiple organ failure (MOF), and ultimately a lethal outcome. This is a rare case of FIRES with MOF and consecutive death. Only a few cases have been described in the literature. The adolescent girl was initially admitted to our pediatric emergency department with a first episode of generalized tonic-clonic seizures after a short history of fever a week before admission. Seizures progressed rapidly into refractory status epilepticus without any evidence of the underlying cause, and treatment subsequently had to be escalated to thiopental anesthesia. Since the initial diagnostics showed no promising leads, the rare syndrome of FIRES was suspected, representing a catastrophic epileptic encephalopathy linked to a prior benign febrile infection. Methylprednisolone, intravenous immunoglobulins, and a ketogenic diet were initiated. Respiratory, circulatory, kidney, and liver failure developed during treatment, requiring increasing intensive care. Multiple attempts to deescalate antiepileptic treatment resulted in recurrent status epilepticus. A cranial MRI on the 10th day of treatment revealed diffuse brain edema and no cerebral perfusion. The patient was declared dead on the 11th day of treatment. FIRES should be taken into account in previously healthy children with a new onset of difficult-to-treat seizures after a short febrile infection when no other cause is apparent. First-line treatment, besides seizure control, is the early initiation of immunomodulatory therapy and the start of a ketogenic diet. As treatment is difficult and MOF may develop, patients should be transferred to a specialized children's hospital providing full intensive care.
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Affiliation(s)
- Lars Ruttkowski
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Ines Wallot
- Pediatric Neurology, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Marie Korell
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Elke Daur
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Peter Seipelt
- Pediatric Neurology, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Andreas Leonhardt
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Stefanie Weber
- Pediatric Nephrology, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - Nadine Mand
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
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Schneider K, Heß S, Weber S. [Known challenges and new possibilities of real-world data]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:129-130. [PMID: 38180504 PMCID: PMC10834567 DOI: 10.1007/s00103-023-03826-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Katharina Schneider
- Forschungsdatenzentrum Gesundheit, Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
| | - Steffen Heß
- Forschungsdatenzentrum Gesundheit, Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
| | - Stefanie Weber
- Abteilung "Kodiersysteme und Register", Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
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Weber S. [The impact of primary data quality and interoperability on the analysis of real-world data]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:195-202. [PMID: 38177604 PMCID: PMC10834610 DOI: 10.1007/s00103-023-03824-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
Abstract
Real-world data is increasingly becoming the focus of healthcare research in the context of digitization. The timely availability of large amounts of data gives hope that research questions can be answered quickly without additional data collection and that a direct benefit for the care of people can be achieved. Especially in acute care situations, such as heat waves or a pandemic, this can be crucial. But real-world data depend quite significantly on the quality and intent of data collection. It is also influenced by determinations on semantic and syntactic standards that are made for primary data - often considering different use cases. In the context of different initiatives on national and international levels, a holistic view on data collection and evaluation and a regular feedback mechanism between data evaluation and specifications for the collection should be established. By including requirements for secondary data evaluation in the definition processes for data collection, the informative value of the data for research can be increased in the long term.In this discussion paper, the activities for standardized data collection in the context of the digitization initiatives and the corresponding European approaches are first presented. After outlining the effects of these activities on the possibilities and difficulties of data consolidation for the analysis of real-world data, the article calls for an ongoing discourse between the different areas.
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Affiliation(s)
- Stefanie Weber
- Abteilung "Kodiersysteme und Register" (K), Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
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7
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Angin C, Mazzucato M, Weber S, Kirch K, Abdel Khalek W, Ali H, Maiella S, Olry A, Jannot AS, Rath A. Coding undiagnosed rare disease patients in health information systems: recommendations from the RD-CODE project. Orphanet J Rare Dis 2024; 19:28. [PMID: 38280999 PMCID: PMC10822150 DOI: 10.1186/s13023-024-03030-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND In European Union countries, any disease affecting less than 5 people in 10,000 is considered rare. As expertise is scarce and rare diseases (RD) are complex, RD patients can remain undiagnosed for many years. The period of searching for a diagnosis, called diagnostic delay, sometimes leads to a diagnostic dead end when the patient's disease is impossible to diagnose after undergoing all available investigations. In recent years, extensive efforts have been made to support the implementation of ORPHA nomenclature in health information systems (HIS) so as to allow RD coding. Until recently, the nomenclature only encompassed codes for specific RD. Persons suffering from a suspected RD who could not be diagnosed even after full investigation, could not be coded with ORPHAcodes. The recognition of the RD status is necessary for patients, even if they do not have a precise diagnosis. It can facilitate reimbursement of care, be socially and psychologically empowering, and grant them access to scientific advances. RESULTS The RD-CODE project aimed at making those patients identifiable in HIS in order to produce crucial epidemiological data. Undiagnosed patients were defined as patients for whom no clinically-known disorder could be confirmed by an expert center after all reasonable efforts to obtain a diagnosis according to the state-of-the-art and diagnostic capabilities available. Three recommendations for the coding of undiagnosed RD patients were produced by a multi-stakeholder panel of experts: 1/ Capture the diagnostic ascertainment for all rare disease cases; 2/ Use the newly created ORPHAcode (ORPHA:616874 "Rare disorder without a determined diagnosis after full investigation"), available in the Orphanet nomenclature: as the code is new, guidelines are essential to ensure its correct and homogeneous use for undiagnosed patients' identification in Europe and beyond; 3/ Use additional descriptors in registries. CONCLUSIONS The recommendations can now be implemented in HIS (electronic health records and/or registries) and could be a game-changer for patients, clinicians and researchers in the field, enabling assessment of the RD population, including undiagnosed patients, adaptation of policy measures including financing for care and research programs, and to improved access of undiagnosed patients to research programs.
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Affiliation(s)
- Céline Angin
- French National Rare Disease Registry (BNDMR), Greater Paris University Hospitals (AP-HP), 33 Boulevard de Picpus, 75012, Paris, France.
| | - Monica Mazzucato
- RD Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy
| | | | | | | | - Houda Ali
- Inserm, US14-Orphanet, Paris, France
| | | | | | - Anne-Sophie Jannot
- French National Rare Disease Registry (BNDMR), Greater Paris University Hospitals (AP-HP), 33 Boulevard de Picpus, 75012, Paris, France
- Centre de Recherche Des Cordeliers Paris, Université Paris Cité, HeKA INSERM, INRIA Paris, Paris, France
| | - Ana Rath
- Inserm, US14-Orphanet, Paris, France
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8
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Peng H, Huang TW, Jiang K, Li R, Wu CN, Yu MY, Riconda C, Weber S, Zhou CT, Ruan SC. Coherent Subcycle Optical Shock from a Superluminal Plasma Wake. Phys Rev Lett 2023; 131:145003. [PMID: 37862653 DOI: 10.1103/physrevlett.131.145003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/30/2023] [Accepted: 08/31/2023] [Indexed: 10/22/2023]
Abstract
We propose exploiting the superluminal plasma wake for coherent Cherenkov radiation by injecting a relativistic electron beam (REB) into a plasma with a slowly varying density up-ramp. Using three-dimensional particle-in-cell and far-field time-domain radiation simulations, we show that an isolated subcycle pulse is coherently emitted towards the Cherenkov angle by bubble-sheath electrons successively at the rear of the REB-induced superluminal plasma wake. A theoretical model based on a superluminal current dipole has been developed to interpret such coherent radiation, and agrees well with the simulation results. This radiation has ultrashort attosecond-scale duration and high intensity, and exhibits excellent directionality with ultralow angular divergence and stable carrier envelope phase. Its intensity increases with the square of the propagation length and its central frequency can be easily tuned over a wide range, from the far infrared to the ultraviolet.
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Affiliation(s)
- H Peng
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - T W Huang
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - K Jiang
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - R Li
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - C N Wu
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - M Y Yu
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - C Riconda
- LULI, Sorbonne Université, CNRS, École Polytechnique, CEA, F-75252 Paris, France
| | - S Weber
- Extreme Light Infrastructure ERIC, ELI Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - C T Zhou
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
| | - S C Ruan
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, and College of Engineering Physics, Shenzhen Technology University, Shenzhen 518118, China
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9
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Eckelmann BJ, Blitzer GC, Smilowitz JB, Trask D, Weiss M, Weber S, Abbott D, Varley P, Neuman H, Maloney JD, Hinshaw JL, Morris BA, Merfeld E, Howard SP, Bradley KA, Baschnagel AM, Bassetti MF, Hennessey DW, Morris Z. Initial Results of a Phase II Trial of Hypofractionated Radiation Therapy for Inoperable Soft Tissue Sarcoma. Int J Radiat Oncol Biol Phys 2023; 117:S147-S148. [PMID: 37784374 DOI: 10.1016/j.ijrobp.2023.06.564] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For patients with soft tissue sarcoma (STS) who cannot or choose not to have surgery, radiation can provide local tumor control in both palliative and definitive settings. Conventionally fractionated radiation provides modest (< 50%) rates of local control (LC) for STS at 2 years. To our knowledge, no prospective studies to date have evaluated the safety and efficacy of dose-escalated hypofractionated radiation therapy as treatment of inoperable STS. We hypothesized that dose-escalated, hypofractionated radiation therapy (RT) for inoperable STS could achieve higher rates of LC than reported in trials of conventionally fractionated RT. MATERIALS/METHODS An IRB-approved single institution prospective phase II clinical trial of dose-escalated, hypofractionated RT as local control for STS was designed and completed planned accrual. Exclusion criteria included anti-cancer systemic therapy within the preceding two weeks. Patients underwent hypofractionated RT utilizing either CT-guided radiation (24, 50%) or MRI-guided radiation treatments (24, 50%). Data on patient characteristics, RT dose and fractionation, LC, toxicity, and overall survival (OS) was collected. The primary endpoint was local tumor control (stable, partial, or complete response according to RECIST) at 2-years after completion of radiation. Secondary endpoints were acute and late toxicity, rates of complete response, 5-year local tumor control, and progression-free and overall survival. Acute toxicity was graded on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale during treatment and at 3 months following RT. RESULTS Forty-eight patients were enrolled, 17 with non-metastatic localized disease and 31 with metastatic disease. Median patient age was 64. Twenty-five men and 23 women were treated. Ninety-six total lesions were treated (36 lung, 7 extremity, 37 abdominopelvic, 16 other). Radiation dose per fraction ranged from 6-12 Gy for a total of 1-12 fractions (median dose was 52.5 Gy in 6 fractions. Median patient follow-up is 8.6 months (range 1 - 36 months). Six patients (13%) did not complete initial 3-month follow-up imaging. Of the 40 patients who have undergone 3-month follow up imaging, 32 (80%) had stable disease, 5 (12.5%) had partial response, 0 had complete response, and 3 (7.5%) had disease progression. Median PFS was 17.2 months at time of last follow up. Median OS was 12.9 months at time of last follow up. Twenty-five patients (52%) experienced an acute toxicity likely or possibly related to radiation. Three (6%) patients experienced CTACE grade 3 or greater treatment-related toxicity (pain, weakness, decreased range of motion, dermatitis). CONCLUSION In this initial report of a prospective, single-institution clinical trial of hypofractionated RT for STS not undergoing resection, we report low rates of acute grade 3 or greater toxicity and high rates of tumor response. We will continue to follow these patients to assess late toxicity and durability of tumor control.
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Affiliation(s)
- B J Eckelmann
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - G C Blitzer
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - J B Smilowitz
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - D Trask
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - M Weiss
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - S Weber
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - D Abbott
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - P Varley
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - H Neuman
- Department of Surgical Oncology, University of Wisconsin, Madison, WI
| | - J D Maloney
- University of Wisconsin, Department of Cardiothoracic Surgery, Madison, WI
| | - J L Hinshaw
- Department of Radiology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - B A Morris
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - E Merfeld
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - S P Howard
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - K A Bradley
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - A M Baschnagel
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - M F Bassetti
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - D W Hennessey
- Department of Orthopedic and Rehabilitation, University of Wisconsin, Madison, WI
| | - Z Morris
- University of Wisconsin - Madison, Madison, WI
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10
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Menon H, Morris BA, Eckelmann BJ, Weber S, Ronnekleiv-Kelly SM, Varley P, Abbott D, Zafar NN, Kelly KJ, Vidri RJ, Minter R, Patel MA, Lubner S, Uboha N, Loconte N, Deming DA, Kratz JD, Bassetti MF. Neoadjuvant Stereotactic MR-Guided Ablative Radiation Therapy (SMART) and Surgical Outcomes in Patients with Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e325. [PMID: 37785155 DOI: 10.1016/j.ijrobp.2023.06.2370] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The benefit of neoadjuvant radiation therapy for patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC) remains unclear. Stereotactic MR-guided adaptive radiation therapy (SMART) treatment to ablative doses is a newer technique that is well tolerated and has increased local control in unresectable pancreatic cancer. For resectable pancreatic cancer, neoadjuvant SMART has the potential to decrease local recurrence risk and positive margin rates. However, there is concern for perioperative risks associated with ablative dose treatments. We report the efficacy and safety of surgical resection in patients who have received neoadjuvant SMART at our institution. MATERIALS/METHODS We conducted a retrospective analysis of all consecutive patients diagnosed with PDAC who had noted vascular involvement of the celiac axis, superior mesenteric, and/or portal vessels between January 2016 and December 2022 at a single, high-volume, academic institution. Perioperative events were defined according to the Clavien-Dindo classification. The Kaplan Meier method was applied to estimate disease free survival (DFS) and overall survival (OS). RESULTS Seventeen patients with PDAC and vessel involvement at time of diagnosis who received SMART were included. Median follow-up time was 14.3 months; all patients underwent surgery, at a median time after radiation of 28 days (range: 15 - 90). Median length of postoperative stay was 7 days (range: 3 - 15). Five patients (29%) underwent vascular resection. Fifteen patients (88%) achieved R0 resection, with two R1 resections noted at the SMA and pancreatic neck respectively. Seven patients (41%) had adverse events attributable to surgery, with the majority being defined as abscess or infection (n = 5; 29%). One (6%) Clavien-Dindo grade III or higher toxicity was observed - a cortical cerebrovascular event following surgery. No major bleeding events requiring surgical intervention were noted. At time of event censorship, there were no observable locoregional failures. The median DFS and OS were not reached; however, 1-year DFS and OS were 62% and 87%, respectively. CONCLUSION Neoadjuvant SMART appears to be safe, with low rates of surgical complications and promising outcomes. Further identification of patients for this approach requires additional investigation.
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Affiliation(s)
- H Menon
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - B A Morris
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - B J Eckelmann
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - S Weber
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - S M Ronnekleiv-Kelly
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - P Varley
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - D Abbott
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - N N Zafar
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - K J Kelly
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - R J Vidri
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - R Minter
- Department of Surgical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - M A Patel
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - S Lubner
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - N Uboha
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - N Loconte
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - D A Deming
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - J D Kratz
- Department of Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - M F Bassetti
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
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11
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Mazzucato M, Pozza LVD, Facchin P, Angin C, Agius F, Cavero-Carbonell C, Corrochano V, Hanusova K, Kirch K, Lambert D, Lucano C, Maiella S, Panzaru M, Rusu C, Weber S, Zurriaga O, Zvolsky M, Rath A. ORPHAcodes use for the coding of rare diseases: comparison of the accuracy and cross country comparability. Orphanet J Rare Dis 2023; 18:267. [PMID: 37667299 PMCID: PMC10476382 DOI: 10.1186/s13023-023-02864-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/20/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Estimates of rare disease (RD) population impact in terms of number of affected patients and accurate disease definition is hampered by their under-representation in current coding systems. This study tested the use of a specific RD codification system (ORPHAcodes) in five European countries/regions (Czech Republic, Malta, Romania, Spain, Veneto region-Italy) across different data sources over the period January 2019-September 2021. RESULTS Overall, 3133 ORPHAcodes were used to describe RD diagnoses, mainly corresponding to the disease/subtype of disease aggregation level of the Orphanet classification (82.2%). More than half of the ORPHAcodes (53.6%) described diseases having a very low prevalence (< 1 case per million), and most commonly captured rare developmental defects during embryogenesis (31.3%) and rare neurological diseases (17.6%). ORPHAcodes described disease entities more precisely than corresponding ICD-10 codes in 83.4% of cases. CONCLUSIONS ORPHAcodes were found to be a versatile resource for the coding of RD, able to assure easiness of use and inter-country comparability across population and hospital databases. Future research on the impact of ORPHAcoding as to the impact of numbers of RD patients with improved coding in health information systems is needed to inform on the real magnitude of this public health issue.
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Affiliation(s)
- Monica Mazzucato
- RD Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy.
| | | | - Paola Facchin
- RD Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy
| | - Cèline Angin
- French National Rare Disease Registry (BNDMR), Greater Paris University Hospitals (AP-HP), Paris, France
| | | | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | | | - Katerina Hanusova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | | | | | | | | | - Monica Panzaru
- Grigore T Popa-University of Medicine and Pharmacy, Iasi, Romania
| | - Cristina Rusu
- Grigore T Popa-University of Medicine and Pharmacy, Iasi, Romania
| | | | - Oscar Zurriaga
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Miroslav Zvolsky
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Ana Rath
- Inserm US14 - Orphanet, Paris, France.
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12
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Wasser F, Zähter Ş, Sokol M, Rivers M, Atzeni S, Condamine FP, Cristoforetti G, Fauvel G, Fischer N, Gizzi LA, Hannasch A, Hesse M, Laštovička T, Lutz P, Rubovič P, Schaumann G, Schott N, Singh RL, Theobald W, Weber S, Ditmire T, Forner T, Roth M. Full aperture backscatter diagnostics for characterization of laser plasma instabilities at the extreme light infrastructure (ELI) beamlines. Rev Sci Instrum 2023; 94:093503. [PMID: 37737696 DOI: 10.1063/5.0153874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023]
Abstract
We report on the commissioning of a full aperture backscatter diagnostics station for the kilojoule, nanosecond high repetition rate L4n laser operating at a wavelength of 527 nm at the Extreme Light Infrastructure (ELI) - Beamlines, Dolni Brezany, Czech Republic. Light scattered back from laser-plasma interaction into the cone of the final focusing lens is captured and split into different channels to measure the signatures of laser plasma instabilities from stimulated Brillouin scattering, stimulated Raman scattering, and two plasmon decay with respect to back scattered energy, its spectrum, and its temporal profile. The performance was confirmed in a commissioning experiment with more than 800 shots at laser intensities ranging from 0.5 × 1013 to 1.1 × 1015 W cm-2. These diagnostics are permanently installed at ELI Beamlines, and can be used to understand the details of laser-plasma interactions in experiments with kJ and 527 nm light. The large number of shots that can be collected in an experimental campaign will allow us to study the details of the laser-plasma interaction with a high level of confidence.
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Affiliation(s)
- F Wasser
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- IU Internationale Hochschule GmbH, Darmstädter Landstrasse 110, 60598 Frankfurt am Main, Germany
| | - Ş Zähter
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Sokol
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Rivers
- University of Texas, 110 Inner Campus Dr., Austin, Texas 78712, USA
| | - S Atzeni
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - F P Condamine
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | | | - G Fauvel
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - N Fischer
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - L A Gizzi
- Intense Laser Irradiation Laboratory, INO-CNR, Pisa, Italy
| | - A Hannasch
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Hesse
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - T Laštovička
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - P Lutz
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - P Rubovič
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - G Schaumann
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - N Schott
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- Technische Universität Darmstadt, Schlossgartenstrasse 9, 64289 Darmstadt, Germany
| | - R L Singh
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - W Theobald
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - S Weber
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - T Ditmire
- University of Texas, 110 Inner Campus Dr., Austin, Texas 78712, USA
| | - T Forner
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Roth
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- Technische Universität Darmstadt, Schlossgartenstrasse 9, 64289 Darmstadt, Germany
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13
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Nasrah S, Radi A, Daberkow JK, Hummler H, Weber S, Seaayfan E, Kömhoff M. MAGED2 Depletion Promotes Stress-Induced Autophagy by Impairing the cAMP/PKA Pathway. Int J Mol Sci 2023; 24:13433. [PMID: 37686237 PMCID: PMC10488052 DOI: 10.3390/ijms241713433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Melanoma-associated antigen D2 (MAGED2) plays an essential role in activating the cAMP/PKA pathway under hypoxic conditions, which is crucial for stimulating renal salt reabsorption and thus explaining the transient variant of Bartter's syndrome. The cAMP/PKA pathway is also known to regulate autophagy, a lysosomal degradation process induced by cellular stress. Previous studies showed that two members of the melanoma-associated antigens MAGE-family inhibit autophagy. To explore the potential role of MAGED2 in stress-induced autophagy, specific MAGED2-siRNA were used in HEK293 cells under physical hypoxia and oxidative stress (cobalt chloride, hypoxia mimetic). Depletion of MAGED2 resulted in reduced p62 levels and upregulation of both the autophagy-related genes (ATG5 and ATG12) as well as the autophagosome marker LC3II compared to control siRNA. The increase in the autophagy markers in MAGED2-depleted cells was further confirmed by leupeptin-based assay which concurred with the highest LC3II accumulation. Likewise, under hypoxia, immunofluorescence in HEK293, HeLa and U2OS cell lines demonstrated a pronounced accumulation of LC3B puncta upon MAGED2 depletion. Moreover, LC3B puncta were absent in human fetal control kidneys but markedly expressed in a fetal kidney from a MAGED2-deficient subject. Induction of autophagy with both physical hypoxia and oxidative stress suggests a potentially general role of MAGED2 under stress conditions. Various other cellular stressors (brefeldin A, tunicamycin, 2-deoxy-D-glucose, and camptothecin) were analyzed, which all induced autophagy in the absence of MAGED2. Forskolin (FSK) inhibited, whereas GNAS Knockdown induced autophagy under hypoxia. In contrast to other MAGE proteins, MAGED2 has an inhibitory role on autophagy only under stress conditions. Hence, a prominent role of MAGED2 in the regulation of autophagy under stress conditions is evident, which may also contribute to impaired fetal renal salt reabsorption by promoting autophagy of salt-transporters in patients with MAGED2 mutation.
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Affiliation(s)
- Sadiq Nasrah
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
| | - Aline Radi
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
| | - Johanna K. Daberkow
- Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany;
| | - Helmut Hummler
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
| | - Stefanie Weber
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
| | - Elie Seaayfan
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
| | - Martin Kömhoff
- Department of Pediatrics, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany; (S.N.); (A.R.); (H.H.); (S.W.)
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14
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Keil C, Köhler S, Sass B, Schulze M, Kalmus G, Belfort M, Schmitt N, Diehl D, King A, Groß S, Sutton CD, Joyeux L, Wege M, Nimsky C, Whitehead WE, Uhl E, Huisman TAGM, Neubauer BA, Weber S, Hummler H, Axt-Fliedner R, Bedei I. Implementation and Assessment of a Laparotomy-Assisted Three-Port Fetoscopic Spina Bifida Repair Program. J Clin Med 2023; 12:5151. [PMID: 37568553 PMCID: PMC10419476 DOI: 10.3390/jcm12155151] [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: 06/25/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Open spina bifida (OSB) is a congenital, non-lethal malformation with multifactorial etiology. Fetal therapy can be offered under certain conditions to parents after accurate prenatal diagnostic and interdisciplinary counseling. Since the advent of prenatal OSB surgery, various modifications of the original surgical techniques have evolved, including laparotomy-assisted fetoscopic repair. After a two-year preparation time, the team at the University of Giessen and Marburg (UKGM) became the first center to provide a three-port, three-layer fetoscopic repair of OSB via a laparotomy-assisted approach in the German-speaking area. We point out that under the guidance of experienced centers and by intensive multidisciplinary preparation and training, a previously described and applied technique could be transferred to a different setting.
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Affiliation(s)
- Corinna Keil
- Department of Prenatal Medicine and Fetal Therapy, Philipps University, 35043 Marburg, Germany
| | - Siegmund Köhler
- Department of Prenatal Medicine and Fetal Therapy, Philipps University, 35043 Marburg, Germany
| | - Benjamin Sass
- Department of Neurosurgery, Philipps University, 35043 Marburg, Germany
| | - Maximilian Schulze
- Department of Neuroradiology, Philipps University, 35043 Marburg, Germany
| | - Gerald Kalmus
- Department of Anesthesiology and Intensive Care Medicine, Philipps University, 35043 Marburg, Germany
| | - Michael Belfort
- Department of Obstetrics and Gynecology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children’s Fetal Center, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Nicolas Schmitt
- Department of Anesthesiology and Intensive Care Medicine, Philipps University, 35043 Marburg, Germany
| | - Daniele Diehl
- Department of Pediatric Neurology, Justus-Liebig University Giessen, 35392 Giessen, Germany
| | - Alice King
- Texas Children’s Fetal Center, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
- Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stefanie Groß
- Department of Pediatric Neurology, Justus-Liebig University Giessen, 35392 Giessen, Germany
| | - Caitlin D. Sutton
- Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Luc Joyeux
- Texas Children’s Fetal Center, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
- Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mirjam Wege
- Division of Neonatology, University Children’s Hospital Marburg, 35043 Marburg, Germany
| | | | - Wiliam E. Whitehead
- Texas Children’s Fetal Center, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Neurosurgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Eberhard Uhl
- Department of Neurosurgery, Justus-Liebig University, 35390 Giessen, Germany
| | - Thierry A. G. M. Huisman
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bernd A. Neubauer
- Department of Pediatric Neurology, Justus-Liebig University Giessen, 35392 Giessen, Germany
| | - Stefanie Weber
- Division of Pediatric Nephrology and Transplantation, University Children’s Hospital Marburg, 35043 Marburg, Germany
| | - Helmut Hummler
- Division of Neonatology, University Children’s Hospital Marburg, 35043 Marburg, Germany
| | - Roland Axt-Fliedner
- Department of Prenatal Medicine and Fetal Therapy, Justus-Liebig University Giessen, 35390 Giessen, Germany
| | - Ivonne Bedei
- Department of Prenatal Medicine and Fetal Therapy, Justus-Liebig University Giessen, 35390 Giessen, Germany
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15
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Zech F, Weber S, Dietenberger H, Zhang L, Noettger S, Volcic M, Bergner T, Read C, Sparrer KMJ, Barth TFE, Kirchhoff F. SARS-CoV-2 inhibition and specific targeting of infected cells by VSV particles carrying the ACE2 receptor. Signal Transduct Target Ther 2023; 8:208. [PMID: 37211548 DOI: 10.1038/s41392-023-01492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/27/2023] [Accepted: 05/06/2023] [Indexed: 05/23/2023] Open
Affiliation(s)
- Fabian Zech
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany.
| | - Stefanie Weber
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | | | - Linyun Zhang
- Institute of Pathology, Ulm University, Ulm, Germany
| | - Sabrina Noettger
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Meta Volcic
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Tim Bergner
- Central Facility for Electron Microscopy, Ulm University, Ulm, Germany
| | - Clarissa Read
- Central Facility for Electron Microscopy, Ulm University, Ulm, Germany
| | | | | | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany.
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16
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Nitte CM, Dobelke F, König J, Konrad M, Becker K, Kamp-Becker I, Weber S. Review of neurodevelopmental disorders in patients with HNF1B gene variations. Front Pediatr 2023; 11:1149875. [PMID: 36969268 PMCID: PMC10034397 DOI: 10.3389/fped.2023.1149875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023] Open
Abstract
This review investigates the association between neurodevelopmental disorders (NDD) and variations of the gene HNF1B. Heterozygous intragenetic mutations or heterozygous gene deletions (17q12 microdeletion syndrome) of HNF1B are the cause of a multi-system developmental disorder, termed renal cysts and diabetes syndrome (RCAD). Several studies suggest that in general, patients with genetic variation of HNF1B have an elevated risk for additional neurodevelopmental disorders, especially autism spectrum disorder (ASD) but a comprehensive assessment is yet missing. This review provides an overview including all available studies of patients with HNF1B mutation or deletion with comorbid NDD with respect to the prevalence of NDDs and in how they differ between patients with an intragenic mutation or 17q12 microdeletion. A total of 31 studies was identified, comprising 695 patients with variations in HNF1B, (17q12 microdeletion N = 416, mutation N = 279). Main results include that NDDs are present in both groups (17q12 microdeletion 25.2% vs. mutation 6.8%, respectively) but that patients with 17q12 microdeletions presented more frequently with any NDDs and especially with learning difficulties compared to patients with a mutation of HNF1B. The observed prevalence of NDDs in patients with HNF1B variations seems to be higher than in the general population, but the validity of the estimated prevalence must be deemed insufficient. This review shows that systematical research of NDDs in patients with HNF1B mutations or deletions is lacking. Further studies regarding neuropsychological characteristics of both groups are needed. NDDs might be a concomitant of HFN1B-related disease and should be considered in clinical routine and scientific reports.
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Affiliation(s)
- Clara Marie Nitte
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
- Correspondence: Clara Nittel
| | - Frederike Dobelke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Jens König
- Department of General Pediatrics, University Children’s Hospital, Münster, Germany
| | - Martin Konrad
- Department of General Pediatrics, University Children’s Hospital, Münster, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Stefanie Weber
- Department of Pediatric and Adolescent Medicine, Philipps University, Marburg, Germany
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Mand N, Donath C, Leonhardt A, Weber S, Kömhoff M. Case report: Rhabdomyolysis in children in acute and chronic disease-a challenging condition in pediatric emergency medicine. Front Pediatr 2023; 11:1070465. [PMID: 36969298 PMCID: PMC10034202 DOI: 10.3389/fped.2023.1070465] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/17/2023] [Indexed: 03/29/2023] Open
Abstract
Rhabdomyolysis is a challenging condition in pediatric emergency departments (PED): It ranges from asymptomatic illness with isolated elevation of creatine kinase (CK) levels to a life-threatening condition associated with extreme elevations in CK, electrolyte imbalances, circulatory failure (CF), acute kidney injury (AKI), and multi-organ disease. Most common causes of rhabdomyolysis are viral myositis and trauma, hereditary metabolic myopathies must be considered when facing rhabdomyolysis in early childhood. We report two cases of severe rhabdomyolysis with CF in our PED, thereby summarizing first-line management of rhabdomyolysis.
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Affiliation(s)
- N. Mand
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
- Correspondence: N. Mand
| | - C. Donath
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - A. Leonhardt
- Pediatric Intensive Care, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - S. Weber
- Pediatric Nephrology, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
| | - M. Kömhoff
- Pediatric Nephrology, Department of Pediatrics, Philipps-University Marburg, Marburg, Germany
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18
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Weber S, Kuhn J. [Guardrails instead of barriers]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:103-104. [PMID: 36723717 PMCID: PMC9891190 DOI: 10.1007/s00103-022-03646-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Stefanie Weber
- Abteilung "Kodiersysteme und Register", Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
| | - Joseph Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstr. 2, 85764, Oberschleißheim, Deutschland.
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19
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Weber S. High Seroprevalence in Children and Adolescents. Dtsch Arztebl Int 2022; 119:763-764. [PMID: 36700366 PMCID: PMC9884840 DOI: 10.3238/arztebl.m2022.0361] [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] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Stefanie Weber
- Center for Pediatric Medicine, University Hospital Marburg,*Zentrum für Kinder- und Jugendmedizin Universitätsklinikum Marburg Baldingerstr., 35033 Marburg, Germany
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20
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Seaayfan E, Nasrah S, Quell L, Radi A, Kleim M, Schermuly RT, Weber S, Laghmani K, Kömhoff M. Reciprocal Regulation of MAGED2 and HIF-1α Augments Their Expression under Hypoxia: Role of cAMP and PKA Type II. Cells 2022; 11:3424. [PMID: 36359819 PMCID: PMC9655371 DOI: 10.3390/cells11213424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 09/10/2023] Open
Abstract
Hypoxia stabilizes the transcription factor HIF-1α, which promotes the transcription of many genes essential to adapt to reduced oxygen levels. Besides proline hydroxylation, expression of HIF-1α is also regulated by a range of other posttranslational modifications including phosphorylation by cAMP-dependent protein kinase A (PKA), which stabilizes HIF-1α. We recently demonstrated that MAGED2 is required for cAMP generation under hypoxia and proposed that this regulation may explain the transient nature of antenatal Bartter syndrome (aBS) due to MAGED2 mutations. Consequently, we sought to determine whether hypoxic induction of HIF-1α requires also MAGED2. In HEK293 and HeLa cells, MAGED2 knock-down impaired maximal induction of HIF-1α under physical hypoxia as evidenced by time-course experiments, which showed a signification reduction of HIF-1α upon MAGED2 depletion. Similarly, using cobalt chloride to induce HIF-1α, MAGED2 depletion impaired its appropriate induction. Given the known effect of the cAMP/PKA pathway on the hypoxic induction of HIF-1α, we sought to rescue impaired HIF-1α induction with isoproterenol and forskolin acting upstream and downstream of Gαs, respectively. Importantly, while forskolin induced HIF-1α above control levels in MAGED2-depleted cells, isoproterenol had no effect. To further delineate which PKA subtype is involved, we analyzed the effect of two PKA inhibitors and identified that PKA type II regulates HIF-1α. Interestingly, MAGED2 mRNA and protein were also increased under hypoxia by a cAMP mimetic. Moreover, MAGED2 protein expression also required HIF-1α. Thus, our data provide evidence for reciprocal regulation of MAGED2 and HIF-1α under hypoxia, revealing therefore a new regulatory mechanism that may further explain the transient nature of aBS caused by MAGED2 mutations.
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Affiliation(s)
- Elie Seaayfan
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Sadiq Nasrah
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Lea Quell
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Aline Radi
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Maja Kleim
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Ralph T. Schermuly
- Department of Internal Medicine, Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig-University, 35392 Giessen, Germany
| | - Stefanie Weber
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
| | - Kamel Laghmani
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, CNRS, ERL8228, F-75006 Paris, France
| | - Martin Kömhoff
- University Children’s Hospital, Philipps University, 35043 Marburg, Germany
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21
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Prytula A, Shroff R, Krupka K, Deschepper E, Bacchetta J, Ariceta G, Awan A, Benetti E, Büscher A, Berta L, Carraro A, Christian M, Dello Strologo L, Doerry K, Haumann S, Klaus G, Kempf C, Kranz B, Oh J, Pape L, Pohl M, Printza N, Rubik J, Schmitt CP, Shenoy M, Spartà G, Staude H, Sweeney C, Weber L, Weber S, Weitz M, Haffner D, Tönshoff B. Hyperparathyroidism Is an Independent Risk Factor for Allograft Dysfunction in Pediatric Kidney Transplantation. Kidney Int Rep 2022; 8:81-90. [PMID: 36644359 PMCID: PMC9832060 DOI: 10.1016/j.ekir.2022.10.018] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/15/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Little is known about the consequences of deranged chronic kidney disease-mineral and bone disorder (CKD-MBD) parameters on kidney allograft function in children. We examined a relationship between these parameters over time and allograft outcome. Methods This registry study from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) collected data at baseline, months 1, 3, 6, 9, and 12 after transplant; and every 6 months thereafter up to 5 years. Survival analysis for a composite end point of graft loss or estimated glomerular filtration rate (eGFR) ≤30 ml/min per 1.73 m2 or a ≥50% decline from eGFR at month 1 posttransplant was performed. Associations of parathyroid hormone (PTH), calcium, phosphate, and 25-hydroxyvitamin D (25(OH)D) with allograft outcome were investigated using conventional stratified Cox proportional hazards models and further verified with marginal structural models with time-varying covariates. Results We report on 1210 patients (61% boys) from 16 European countries. The composite end point was reached in 250 grafts (21%), of which 11 (4%) were allograft losses. In the conventional Cox proportional hazards models adjusted for potential confounders, only hyperparathyroidism (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.82-4.74) and hyperphosphatemia (HR, 1.94; 95% CI, 1.28-2.92) were associated with the composite end point. Marginal structural models showed similar results for hyperparathyroidism (HR, 2.74; 95% CI, 1.71-4.38), whereas hyperphosphatemia was no longer significant (HR, 1.35; 95% CI, 0.87-2.09), suggesting that its association with graft dysfunction can be ascribed to a decline in eGFR. Conclusion Hyperparathyroidism is a potential independent risk factor for allograft dysfunction in children.
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Affiliation(s)
- Agnieszka Prytula
- Department of Pediatric Nephrology and Rheumatology, Ghent University Hospital, Ghent, Belgium
- Correspondence: Agnieszka Prytula, Department of Pediatric Nephrology and Rheumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium.
| | - Rukshana Shroff
- Renal Unit, University College London Great Ormond Street Hospital, London, United Kingdom
| | - Kai Krupka
- Department of Pediatrics I, University Children’s Hospital Heidelberg, Heidelberg, Germany
| | - Ellen Deschepper
- Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Justine Bacchetta
- Reference Center for Rare Renal Diseases, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, Hospices Civils de Lyon, France
| | - Gema Ariceta
- Pediatric Nephrology. University Hospital Vall d’ Hebron, Barcelona, Spain
| | - Atif Awan
- Department of Nephrology and Transplantation, Temple Street, Dublin, Ireland
| | - Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women’s and Children’s Health, Padua University Hospital, Padua, Italy
| | - Anja Büscher
- Department of Pediatrics II, University Hospital of Essen, Essen, Germany
| | - László Berta
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Andrea Carraro
- Pediatric Nephrology, Dialysis and Transplant Unit, Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women’s and Children’s Health, Padua University Hospital, Padua, Italy
| | | | - Luca Dello Strologo
- Renal Transplant Unit, Bambino Gesù Children’s Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Katja Doerry
- Department of Pediatric Nephrology and Transplantation, University Children’s Hospital, University Medical Center Hamburg/Eppendorf, Hamburg, Germany
| | - Sophie Haumann
- Pediatric Nephrology, Children’s and Adolescents’ Hospital, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Guenter Klaus
- KfH-Pediatric Kidney Center and Department of Pediatrics, Philipps-University of Marburg, Marburg, Germany
| | - Caroline Kempf
- Department of Pediatric Gastroenterology, Nephrology and Metabolism, Charité–University Medicine Berlin, Berlin, Germany
| | | | - Jun Oh
- Department of Pediatric Nephrology and Transplantation, University Children’s Hospital, University Medical Center Hamburg/Eppendorf, Hamburg, Germany
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, Essen, Germany
| | - Martin Pohl
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nikoleta Printza
- Pediatric Nephrology Unit, Pediatric Department I, Hippokration General Hospital, Aristotle University, Thessaloniki, Greece
| | - Jacek Rubik
- Department of Nephrology, Kidney Transplantation and Arterial Hypertension, Children’s Memorial Health Institute, Warsaw, Poland
| | - Claus Peter Schmitt
- Department of Pediatrics I, University Children’s Hospital Heidelberg, Heidelberg, Germany
| | - Mohan Shenoy
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Giuseppina Spartà
- Department of Pediatric Nephrology, University Children’s Hospital Zurich, Zurich, Switzerland
| | | | - Clodagh Sweeney
- Department of Nephrology and Transplantation, Temple Street, Dublin, Ireland
| | - Lutz Weber
- Pediatric Nephrology, Children’s and Adolescents’ Hospital, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Stefanie Weber
- KfH-Pediatric Kidney Center and Department of Pediatrics, Philipps-University of Marburg, Marburg, Germany
| | - Marcus Weitz
- Department of General Pediatrics and Hematology/Oncology, University Children’s Hospital Tuebingen, Tuebingen, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children’s Hospital Heidelberg, Heidelberg, Germany
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22
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Günthner R, Knipping L, Jeruschke S, Satanoskij R, Lorenz-Depiereux B, Hemmer C, Braunisch MC, Riedhammer KM, Ćomić J, Tönshoff B, Tasic V, Abazi-Emini N, Nushi-Stavileci V, Buiting K, Gjorgjievski N, Momirovska A, Patzer L, Kirschstein M, Gross O, Lungu A, Weber S, Renders L, Heemann U, Meitinger T, Büscher AK, Hoefele J. Renal X-inactivation in female individuals with X-linked Alport syndrome primarily determined by age. Front Med (Lausanne) 2022; 9:953643. [PMID: 36341250 PMCID: PMC9630586 DOI: 10.3389/fmed.2022.953643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/21/2022] [Indexed: 08/29/2023] Open
Abstract
X-linked Alport syndrome (AS) caused by hemizygous disease-causing variants in COL4A5 primarily affects males. Females with a heterozygous state show a diverse phenotypic spectrum ranging from microscopic hematuria to end-stage kidney disease (ESKD) and extrarenal manifestations. In other X-linked diseases, skewed X-inactivation leads to preferential silencing of one X-chromosome and thus can determine the phenotype in females. We aimed to show a correlation between X-inactivation in blood and urine-derived renal cells and clinical phenotype of females with a heterozygous disease-causing variant in COL4A5 compared to healthy controls. A total of 56 females with a heterozygous disease-causing COL4A5 variant and a mean age of 31.6 ± 18.3 SD years were included in this study. A total of 94% had hematuria, 62% proteinuria >200 mg/day, yet only 7% had decreased eGFR. Using human androgen receptor assay X-inactivation was examined in blood cells of all 56 individuals, in urine-derived cells of 27 of these individuals and in all healthy controls. X-inactivation did not correlate with age of first manifestation, proteinuria or eGFR neither in blood, nor in urine. The degree of X-inactivation showed a moderate association with age, especially in urine-derived cells of the patient cohort (rho = 0.403, p = 0.037). Determination of X-inactivation allelity revealed a shift of X-inactivation toward the COL4A5 variant bearing allele. This is the first study examining X-inactivation of urine-derived cells from female individuals with AS. A correlation between phenotype and X-inactivation could not be observed suspecting other genetic modifiers shaping the phenotype in female individuals with AS. The association of X-inactivation with age in urine-derived cells suggests an escape-mechanism inactivating the COL4A5 variant carrying allele in female individuals with AS.
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Affiliation(s)
- Roman Günthner
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Lea Knipping
- Pediatric Nephrology, University Hospital Essen, Essen, Germany
| | | | - Robin Satanoskij
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | | | - Clara Hemmer
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Matthias C. Braunisch
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Korbinian M. Riedhammer
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jasmina Ćomić
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children’s Hospital Heidelberg, Heidelberg, Germany
| | - Velibor Tasic
- University Children’s Hospital, Medical Faculty of Skopje, Skopje, North Macedonia
| | - Nora Abazi-Emini
- University Children’s Hospital, Medical Faculty of Skopje, Skopje, North Macedonia
| | | | - Karin Buiting
- Institute for Human Genetics, University Hospital Essen, Essen, Germany
| | - Nikola Gjorgjievski
- University Hospital of Nephrology, Faculty of Medicine, University “Ss Cyril and Methodius,” Skopje, North Macedonia
| | | | - Ludwig Patzer
- Department of Pediatrics, Children’s Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany
| | | | - Oliver Gross
- Clinic for Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Adrian Lungu
- Fundeni Clinical Institute, Pediatric Nephrology Department, Bucharest, Romania
| | - Stefanie Weber
- Department of Pediatrics II, University Children’s Hospital, Philipps-University Marburg, Marburg, Germany
| | - Lutz Renders
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Uwe Heemann
- Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Anja K. Büscher
- Pediatric Nephrology, University Hospital Essen, Essen, Germany
| | - Julia Hoefele
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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23
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Lauder L, Bergmann M, Paitazoglou C, Ozdemir R, Iliadis C, Bartunek J, Lauten A, Keller T, Weber S, Sievert H, Anker SD, Mahfoud F. Impact of atrial flow regulator implantation on survival in patients with heart failure with reduced and preserved ejection fraction: a post-hoc analysis of the PRELIEVE study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
This analysis aims to assess the theoretical impact of atrial flow regulator implantation on mortality by comparing the observed survival rate with the median predicted probability for one-year survival.
Methods
The prospective, multicentre, open-label, non-randomised PRELIEVE study assessed the safety and efficacy of the atrial flow regulator in patients with symptomatic HFrEF (left ventricular ejection fraction (LVEF) ≥15% and <40%) or HFpEF (LVEF ≥40% and <70%) and elevated PCWP (≥15mmHg at rest or ≥25mmHg during exercise). In this analysis, after the first 60 patients completed twelve months of follow-up, the theoretical impact of atrial flow regulator implantation on survival was assessed by comparing the observed mortality rate with the median predicted probability for one-year mortality. Each subject's risk of mortality was predicted from individual baseline data using the Meta-Analysis Global Group in Chronic HF (MAGGIC) prognostic model.
Results
A total of 87 patients had undergone successful device implantation for the treatment of HFrEF (53%) and HFpEF (47%). Sixty patients had a complete twelve-month follow-up. The median follow-up was 351 days (interquartile range [IQR] 202–370). A total of six (7%) patients died during follow-up (8.6 deaths per 100 patient-years; 95% confidence interval [CI] 2.7 to 15.5), all of which had HFrEF. The median predicted mortality rate for the overall study population was 12.2 deaths per 100 patient-years (95% CI 10.2 to 14.7). While the observed mortality rate (0 deaths per 100 patient-years) was significantly lower than the median predicted mortality rate (9.3 deaths per 100 patient-years; 95% CI 8.4 to 11.1) in patients with HFpEF (−9.3 deaths per 100 patient-years; 95% CI −11.1 to −8.4), there was no difference in patients with HFrEF (−3.6 deaths per 100 patient-years; 95% CI −9.5 to 3.0) (Figure 1). Four deaths were HF-related deaths (5.7 HF-related deaths per 100 patient-years; 95% CI 1.4 to 11.9; 10.8 HF-related deaths per 100 patient-years; 95% CI 2.5 to 23.1 in the HFrEF subgroup).
Conclusion
In patients with HFpEF, the mortality rate following atrial flow regulator implantation was lower than the predicted mortality rate. These findings need to be confirmed by larger randomised, controlled trials.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Occlutech International AB
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Affiliation(s)
- L Lauder
- University hospital of Saarland (UKS) , Homburg , Germany
| | - M Bergmann
- Cardiologicum Hamburg , Hamburg , Germany
| | - C Paitazoglou
- Schleswig-Holstein University Clinic, Lubeck Campus, University Heart Center Lübeck , Luebeck , Germany
| | - R Ozdemir
- Bezmialem University, Department of Cardiology , Istanbul , Turkey
| | - C Iliadis
- Heart Center at the University of Cologne, Department of Cardiology, Pulmonology, Angiology and Intensive Care Medicine , Cologne , Germany
| | - J Bartunek
- Olv Hospital Aalst, Cardiovascular Center , Aalst , Belgium
| | - A Lauten
- HELIOS Clinic Erfurt, Department of General and Interventional Cardiology , Erfurt , Germany
| | - T Keller
- ACOMED statistik , Leipzig , Germany
| | - S Weber
- ACOMED statistik , Leipzig , Germany
| | - H Sievert
- CardioVascular Center Frankfurt , Frankfurt , Germany
| | - S D Anker
- Berlin Institute of Health Center for Regenerative Therapies , Berlin , Germany
| | - F Mahfoud
- University hospital of Saarland (UKS) , Homburg , Germany
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24
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Chan MMY, Sadeghi-Alavijeh O, Lopes FM, Hilger AC, Stanescu HC, Voinescu CD, Beaman GM, Newman WG, Zaniew M, Weber S, Ho YM, Connolly JO, Wood D, Maj C, Stuckey A, Kousathanas A, Kleta R, Woolf AS, Bockenhauer D, Levine AP, Gale DP. Diverse ancestry whole-genome sequencing association study identifies TBX5 and PTK7 as susceptibility genes for posterior urethral valves. eLife 2022; 11:74777. [PMID: 36124557 PMCID: PMC9512401 DOI: 10.7554/elife.74777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 08/15/2022] [Indexed: 12/12/2022] Open
Abstract
Posterior urethral valves (PUV) are the commonest cause of end-stage renal disease in children, but the genetic architecture of this rare disorder remains unknown. We performed a sequencing-based genome-wide association study (seqGWAS) in 132 unrelated male PUV cases and 23,727 controls of diverse ancestry, identifying statistically significant associations with common variants at 12q24.21 (p=7.8 × 10-12; OR 0.4) and rare variants at 6p21.1 (p=2.0 × 10-8; OR 7.2), that were replicated in an independent European cohort of 395 cases and 4151 controls. Fine mapping and functional genomic data mapped these loci to the transcription factor TBX5 and planar cell polarity gene PTK7, respectively, the encoded proteins of which were detected in the developing urinary tract of human embryos. We also observed enrichment of rare structural variation intersecting with candidate cis-regulatory elements, particularly inversions predicted to affect chromatin looping (p=3.1 × 10-5). These findings represent the first robust genetic associations of PUV, providing novel insights into the underlying biology of this poorly understood disorder and demonstrate how a diverse ancestry seqGWAS can be used for disease locus discovery in a rare disease.
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Affiliation(s)
- Melanie MY Chan
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
| | | | - Filipa M Lopes
- Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchesterUnited Kingdom
| | - Alina C Hilger
- Children's Hospital, University of BonnBonnGermany
- Institute of Human Genetics, University of BonnBonnGermany
| | - Horia C Stanescu
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
| | - Catalin D Voinescu
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
| | - Glenda M Beaman
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation TrustManchesterUnited Kingdom
- Evolution and Genomic Sciences, School of Biological Sciences, University of ManchesterManchesterUnited Kingdom
| | - William G Newman
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation TrustManchesterUnited Kingdom
- Evolution and Genomic Sciences, School of Biological Sciences, University of ManchesterManchesterUnited Kingdom
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona GóraZielona GoraPoland
| | - Stefanie Weber
- Department of Pediatric Nephrology, University of MarburgMarburgGermany
| | - Yee Mang Ho
- Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchesterUnited Kingdom
| | - John O Connolly
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
- Department of Adolescent Urology, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Dan Wood
- Department of Adolescent Urology, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Carlo Maj
- Center for Human Genetics, University of MarburgMarburgGermany
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty, University of BonnBonnGermany
| | - Alexander Stuckey
- Genomics England, Queen Mary University of LondonLondonUnited Kingdom
| | | | | | - Robert Kleta
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
- Nephrology Department, Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - Adrian S Woolf
- Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchesterUnited Kingdom
- Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Detlef Bockenhauer
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
- Nephrology Department, Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - Adam P Levine
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
- Research Department of Pathology, University College LondonLondonUnited Kingdom
| | - Daniel P Gale
- Department of Renal Medicine, University College LondonLondonUnited Kingdom
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25
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Kohl S, Avni FE, Boor P, Capone V, Clapp WL, De Palma D, Harris T, Heidet L, Hilger AC, Liapis H, Lilien M, Manzoni G, Montini G, Negrisolo S, Pierrat MJ, Raes A, Reutter H, Schreuder MF, Weber S, Winyard PJD, Woolf AS, Schaefer F, Liebau MC. Definition, diagnosis and clinical management of non-obstructive kidney dysplasia: a consensus statement by the ERKNet Working Group on Kidney Malformations. Nephrol Dial Transplant 2022; 37:2351-2362. [PMID: 35772019 PMCID: PMC9681917 DOI: 10.1093/ndt/gfac207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Indexed: 12/31/2022] Open
Abstract
Kidney dysplasia is one of the most frequent causes of chronic kidney failure in children. While dysplasia is a histological diagnosis, the term 'kidney dysplasia' is frequently used in daily clinical life without histopathological confirmation. Clinical parameters of kidney dysplasia have not been clearly defined, leading to imprecise communication amongst healthcare professionals and patients. This lack of consensus hampers precise disease understanding and the development of specific therapies. Based on a structured literature search, we here suggest a common basis for clinical, imaging, genetic, pathological and basic science aspects of non-obstructive kidney dysplasia associated with functional kidney impairment. We propose to accept hallmark sonographic findings as surrogate parameters defining a clinical diagnosis of dysplastic kidneys. We suggest differentiated clinical follow-up plans for children with kidney dysplasia and summarize established monogenic causes for non-obstructive kidney dysplasia. Finally, we point out and discuss research gaps in the field.
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Affiliation(s)
- Stefan Kohl
- Department of Pediatrics, University Hospital of Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Fred E Avni
- Department of Pediatric Imaging, Jeanne de Flandre Hospital, Lille University Hospitals, Lille Cedex, France
| | - Peter Boor
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany,Medical Clinic II (Nephrology and Immunology), University Hospital RWTH Aachen, Aachen, Germany
| | - Valentina Capone
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - William L Clapp
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Diego De Palma
- Nuclear Medicine Unit, Circolo Hospital and Macchi Foundation, ASST-settelaghi, Varese, Italy
| | - Tess Harris
- The Polycystic Kidney Disease Charity, London, UK
| | - Laurence Heidet
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France,APHP, Service de Néphrologie Pédiatrique, Centre de Référence MARHEA, Hôpital universitaire Necker-Enfants malades, Paris, France
| | - Alina C Hilger
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany,Research Center On Rare Kidney Diseases (RECORD), University Hospital Erlangen, Erlangen, Germany
| | - Helen Liapis
- Nephrology Center, Ludwig Maximilian University (LMU), Munich, Germany
| | - Marc Lilien
- Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gianantonio Manzoni
- Pediatric Urology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy,Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Susanna Negrisolo
- Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Marie-Jeanne Pierrat
- Federation of European Patient Groups affected by Rare/Genetic Kidney Diseases (FEDERG), Brussels, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology and Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Heiko Reutter
- Research Center On Rare Kidney Diseases (RECORD), University Hospital Erlangen, Erlangen, Germany,Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatric and Adolescent Medicine, Friedrich-Alexander-Universitat Erlangen-Nürnberg, Erlangen, Germany
| | - Michiel F Schreuder
- Department of Pediatric Nephrology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Stefanie Weber
- Department of Pediatric Nephrology, Marburg Kidney Research Center, Philipps University, Marburg, Germany
| | - Paul J D Winyard
- University College London Great Ormond Street, Institute of Child Health, London, UK
| | - Adrian S Woolf
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK,Royal Manchester Children's Hospital, Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
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26
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Rovas G, Mand N, Mueller CE, Weber S, Stuck BA, Birk R. [Midnasal stenosis: A rare differential diagnosis to choanal atresia]. Laryngorhinootologie 2022; 101:902-905. [PMID: 35688437 DOI: 10.1055/a-1820-7338] [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: 10/18/2022]
Affiliation(s)
- Georgios Rovas
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Nadine Mand
- Klinik für Kinder- und Jugendmedizin I, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Cornelia Emika Mueller
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Stefanie Weber
- Klinik für Kinder- und Jugendmedizin I, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Boris A Stuck
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Richard Birk
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
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27
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König JC, Karsay R, Gerß J, Schlingmann KP, Dahmer-Heath M, Telgmann AK, Kollmann S, Ariceta G, Gillion V, Bockenhauer D, Bertholet-Thomas A, Mastrangelo A, Boyer O, Lilien M, Decramer S, Schanstra J, Pohl M, Schild R, Weber S, Hoefele J, Drube J, Cetiner M, Hansen M, Thumfart J, Tönshoff B, Habbig S, Liebau MC, Bald M, Bergmann C, Pennekamp P, Konrad M. Refining Kidney Survival in 383 Genetically Characterized Patients With Nephronophthisis. Kidney Int Rep 2022; 7:2016-2028. [PMID: 36090483 PMCID: PMC9459005 DOI: 10.1016/j.ekir.2022.05.035] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Nephronophthisis (NPH) comprises a group of rare disorders accounting for up to 10% of end-stage kidney disease (ESKD) in children. Prediction of kidney prognosis poses a major challenge. We assessed differences in kidney survival, impact of variant type, and the association of clinical characteristics with declining kidney function. Methods Data was obtained from 3 independent sources, namely the network for early onset cystic kidney diseases clinical registry (n = 105), an online survey sent out to the European Reference Network for Rare Kidney Diseases (n = 60), and a literature search (n = 218). Results A total of 383 individuals were available for analysis: 116 NPHP1, 101 NPHP3, 81 NPHP4 and 85 NPHP11/TMEM67 patients. Kidney survival differed between the 4 cohorts with a highly variable median age at onset of ESKD as follows: NPHP3, 4.0 years (interquartile range 0.3–12.0); NPHP1, 13.5 years (interquartile range 10.5–16.5); NPHP4, 16.0 years (interquartile range 11.0–25.0); and NPHP11/TMEM67, 19.0 years (interquartile range 8.7–28.0). Kidney survival was significantly associated with the underlying variant type for NPHP1, NPHP3, and NPHP4. Multivariate analysis for the NPHP1 cohort revealed growth retardation (hazard ratio 3.5) and angiotensin-converting enzyme inhibitor (ACEI) treatment (hazard ratio 2.8) as 2 independent factors associated with an earlier onset of ESKD, whereas arterial hypertension was linked to an accelerated glomerular filtration rate (GFR) decline. Conclusion The presented data will enable clinicians to better estimate kidney prognosis of distinct patients with NPH and thereby allow personalized counseling.
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28
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Donath C, Leonhardt A, Stibane T, Sitter H, Weber S, Mand N. P114 The effect of simulation-based training on airway management in simulated pediatric resuscitation. Resuscitation 2022. [DOI: 10.1016/s0300-9572(22)00524-x] [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: 11/24/2022]
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29
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Eser P, Gonzalez-Jaramillo N, Weber S, Femiano R, Werner C, Casanova F, Bano A, Franco OH, Wilhelm M. Comparison of the 2010 and 2020 World Health Organization guidelines on physical activity in patients with percutaneous coronary interventions early after hospital discharge. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Swiss heart foundation
Background
Physical activity (PA) is inversely associated with mortality and adverse outcome in patients with cardiovascular disease, and can be objectively measured by accelerometry. In 2020, the World Health Organization (WHO) has updated their recommendations on PA for adults including those with chronic conditions, omitting the 10 min bout criterion.[1] The aim of this study was to determine the proportions of cardiac patients immediately after hospital discharge from percutaneous coronary interventions (PCI) who fulfil the old [2] and updated WHO PA criteria, and compare the results with established step-based cut-off values.
Methods
Patients after PCI for acute or chronic coronary syndrome with a maximal age of 80 and eligible for ambulatory cardiac rehabilitation were recruited for this observational single centre study. They were provided with a wrist-worn tri-axial accelerometer without display that recorded movement data starting from the day following hospital discharge for the subsequent 18 days. Acceleration data was analysed with the widely used free GGIR package. The proportions of patients fulfilling recommendations for moderate to vigorous PA (MVPA) were determined according to the 2010 and 2020 WHO guidelines as well as 7,500 [3] and 10,000 steps.[4]
Results
159 patients (41%) participated in this study. Data from 135 patients (85%), who had at least 7 days of ≥12 h wear-time were included in the analyses. Their median age was 62 (1st quartile 56, 3rd quartile 68), 22 (16%) were women, and 15 and 120 patients had a CCS and ACS, respectively. Their median wear time was 18 (16, 18) days. 102 (75.6%) had at least 30 min of MVPA on an average day and hence fulfilled the 2020 WHO guidelines. When MVPA was determined using the 2010 WHO guidelines, which only counted MVPA of bouts of at least 10 min, only 23 patients (17.8%) achieved at least 30 min of MVPA on an average day (Figure 1). 67.4% of our patients achieved ≥7,500 steps/d and 71 patients (52.6%) performed ≥10,000 steps/d.
Conclusion
In cardiac patients early after PCI most of the MVPA was accumulated in bouts shorter than 10 min. Applying the 2010 and 2020 WHO PA criteria to objectively measured PA led to a fourfold discrepancy. The 7,500 step cut-off corresponded with the 2020 WHO recommendations. Since achievement of intensity- or step-based cut-offs is greatly dependent on device type, wearing location, data sampling and analysis, it is currently poorly defined and not suited for patient classification and counselling. The clinical implication of this observation will be assessed in a cardiovascular outcome analysis.
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Affiliation(s)
- P Eser
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
| | - N Gonzalez-Jaramillo
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - S Weber
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - R Femiano
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - C Werner
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Rehabilitation Engineering Laboratory, Zurich, Switzerland
| | - F Casanova
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
| | - A Bano
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - OH Franco
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - M Wilhelm
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
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30
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Hemker K, Herbolzheimer M, Sehmsdorf T, Hoffeld K, Peter L, Hax J, Weber S. Erratum: YOUngsters O&U expandieren – junge Orthopäden und Unfallchirurgen auf dem Vormarsch. Z Orthop Unfall 2022. [DOI: 10.1055/a-1761-9561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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van der Zanden LFM, Maj C, Borisov O, van Rooij IALM, Quaedackers JSLT, Steffens M, Schierbaum L, Schneider S, Waffenschmidt L, Kiemeney LALM, de Wall LLL, Heilmann S, Hofmann A, Gehlen J, Schumacher J, Szczepanska M, Taranta-Janusz K, Kroll P, Krzemien G, Szmigielska A, Schreuder MF, Weber S, Zaniew M, Roeleveld N, Reutter H, Feitz WFJ, Hilger AC. Genome-wide association study in patients with posterior urethral valves. Front Pediatr 2022; 10:988374. [PMID: 36238604 PMCID: PMC9552614 DOI: 10.3389/fped.2022.988374] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Congenital lower urinary tract obstructions (LUTO) are most often caused by posterior urethral valves (PUV), a male limited anatomical obstruction of the urethra affecting 1 in 4,000 male live births. Little is known about the genetic background of PUV. Here, we report the largest genome-wide association study (GWAS) for PUV in 4 cohorts of patients and controls. The final meta-analysis included 756 patients and 4,823 ethnicity matched controls and comprised 5,754,208 variants that were genotyped or imputed and passed quality control in all 4 cohorts. No genome-wide significant locus was identified, but 33 variants showed suggestive significance (P < 1 × 10-5). When considering only loci with multiple variants residing within < 10 kB of each other showing suggestive significance and with the same effect direction in all 4 cohorts, 3 loci comprising a total of 9 variants remained. These loci resided on chromosomes 13, 16, and 20. The present GWAS and meta-analysis is the largest genetic study on PUV performed to date. The fact that no genome-wide significant locus was identified, can be explained by lack of power or may indicate that common variants do not play a major role in the etiology of PUV. Nevertheless, future studies are warranted to replicate and validate the 3 loci that yielded suggestive associations.
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Affiliation(s)
- Loes F M van der Zanden
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Carlo Maj
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty, University of Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty, University of Bonn, Bonn, Germany
| | - Iris A L M van Rooij
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | | | - Luca Schierbaum
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Sophia Schneider
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lea Waffenschmidt
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lambertus A L M Kiemeney
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Liesbeth L L de Wall
- Division of Pediatric Urology, Department of Urology, Radboud Institute for Molecular Life Sciences, Radboudumc Amalia Children's Hospital, Nijmegen, Netherlands
| | - Stefanie Heilmann
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Aybike Hofmann
- Department of Pediatric Urology, Clinic St. Hedwig, University Medical Center Regensburg, Regensburg, Germany
| | - Jan Gehlen
- Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | | | - Maria Szczepanska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | | | - Pawel Kroll
- Neurourology Unit, Pediatric Surgery and Urology Clinic, Poznań, Poland
| | - Grazyna Krzemien
- Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Szmigielska
- Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Michiel F Schreuder
- Department of Pediatric Nephrology, Radboud Institute for Molecular Life Sciences, Radboudumc Amalia Children's Hospital, Nijmegen, Netherlands
| | - Stefanie Weber
- University Children Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, Zielona Góra, Poland
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Heiko Reutter
- Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Wout F J Feitz
- Division of Pediatric Urology, Department of Urology, Radboud Institute for Molecular Life Sciences, Radboudumc Amalia Children's Hospital, Nijmegen, Netherlands
| | - Alina C Hilger
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany.,Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.,Research Center on Rare Kidney Diseases, University Hospital Erlangen, Erlangen, Germany
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Drösler SE, Weber S, Chute CG. ICD-11 extension codes support detailed clinical abstraction and comprehensive classification. BMC Med Inform Decis Mak 2021; 21:278. [PMID: 34753461 PMCID: PMC8577174 DOI: 10.1186/s12911-021-01635-2] [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] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background The new International Classification of Diseases—11th revision (ICD-11) succeeds ICD-10. In the three decades since ICD-10 was released, demands for detailed information on the clinical history of a morbid patient have increased. Methods ICD-11 has now implemented an addendum chapter X called “Extension Codes”. This chapter contains numerous codes containing information on concepts including disease stage, severity, histopathology, medicaments, and anatomical details. When linked to a stem code representing a clinical state, the extension codes add significant detail and allow for multidimensional coding. Results This paper discusses the purposes and uses of extension codes and presents three examples of how extension codes can be used in coding clinical detail. Conclusion ICD-11 with its extension codes implemented has the potential to improve precision and evidence based health care worldwide.
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Affiliation(s)
- Saskia E Drösler
- Faculty of Health Care, Niederrhein University of Applied Sciences, Reinarzstr 49, 47805, Krefeld, Germany.
| | - Stefanie Weber
- Federal Institute for Drugs and Medical Devices, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Germany
| | - Christopher G Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, 2024 E Monument St, Suite 1-200, Baltimore, MD, 21287, USA
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Harrison JE, Weber S, Jakob R, Chute CG. ICD-11: an international classification of diseases for the twenty-first century. BMC Med Inform Decis Mak 2021; 21:206. [PMID: 34753471 PMCID: PMC8577172 DOI: 10.1186/s12911-021-01534-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/20/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The International Classification of Diseases (ICD) has long been the main basis for comparability of statistics on causes of mortality and morbidity between places and over time. This paper provides an overview of the recently completed 11th revision of the ICD, focusing on the main innovations and their implications. MAIN TEXT Changes in content reflect knowledge and perspectives on diseases and their causes that have emerged since ICD-10 was developed about 30 years ago. Changes in design and structure reflect the arrival of the networked digital era, for which ICD-11 has been prepared. ICD-11's information framework comprises a semantic knowledge base (the Foundation), a biomedical ontology linked to the Foundation and classifications derived from the Foundation. ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS) is the primary derived classification and the main successor to ICD-10. Innovations enabled by the new architecture include an online coding tool (replacing the index and providing additional functions), an application program interface to enable remote access to ICD-11 content and services, enhanced capability to capture and combine clinically relevant characteristics of cases and integrated support for multiple languages. CONCLUSIONS ICD-11 was adopted by the World Health Assembly in May 2019. Transition to implementation is in progress. ICD-11 can be accessed at icd.who.int.
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Affiliation(s)
- James E Harrison
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Stefanie Weber
- Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | | | - Christopher G Chute
- Schools of Medicine, Public Health and Nursing, JohnsHopkins University, Baltimore, MD, USA
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Blitzer G, Yadav P, Bayouth J, Smilowitz J, Trask D, Weiss M, Weber S, Abbott D, Varley P, Neuman H, Maloney J, Hinshaw J, Morris B, Merfeld E, Howard S, Bradley K, Baschnagel A, Bassetti M, Parkes A, Hennessey D, Morris Z. Interim Results of a Phase II Trial on Hypofractionated Radiation Therapy for Inoperable Soft Tissue Sarcoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chmielak L, Mujica Roncery L, Niederhofer P, Weber S, Theisen W. CrMnFeCoNi high entropy alloys with carbon and nitrogen: mechanical properties, wear and corrosion resistance. SN Appl Sci 2021. [DOI: 10.1007/s42452-021-04814-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractThe use of interstitial elements has been a key factor for the development of different kinds of steels. However, this aspect has been little explored in the field of high entropy alloys (HEAs). In this investigation, the effect of carbon and nitrogen in a near-equiatomic CrMnFeCoNi HEA is studied, analyzing their impact on the microstructure, and mechanical properties from 77K to 673K, as well as wear, and corrosion resistance. Carbon and nitrogen are part of the FCC solid solution and contribute to the formation of precipitates. An increase in the yield and ultimate tensile strength accompanied with a decrease in the ductility are the main effects of C and N. The impact toughness of the interstitial-free material is higher than that of C and C+N alloyed systems. Compared to CrNi and CrMn austenitic steels, the wear resistance of the alloys at room temperature is rather low. The surface corrosion resistance of HEAs is comparable to austenitic steels; nevertheless HEAs are more susceptible to pitting in chloride containing solutions.
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Keil C, Bedei I, Sommer L, Koemhoff M, Axt-Fliedner R, Köhler S, Weber S. Fetal therapy of LUTO (lower urinary tract obstruction) - a follow-up observational study. J Matern Fetal Neonatal Med 2021; 35:8536-8543. [PMID: 34652254 DOI: 10.1080/14767058.2021.1988562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Fetal megacystis (MC) can be severe and is mainly caused by fetal lower urinary tract obstruction (LUTO). Mortality of fetal LUTO can be high as a result of pulmonary hypoplasia and/or (chronic) renal insufficiency. Several technical procedures for vesicoamniotic shunting (VAS) were developed to improve fetal MC outcomes. MATERIAL AND METHODS We present the outcome of nine fetuses with MC who received VAS in the prenatal period (14 + 6 to 27 + 6 weeks GA) using the Somatex® intrauterine shunt system. MC was defined as an increased longitudinal measurement of the bladder >15 mm. The median follow-up time after birth was 18 months. RESULTS Eight Fetuses had uncomplicated VAS intervention. One case developed PPROM 24 h after VAS leading to abortion. Pregnancy was later terminated in further two cases. All six live-born infants received intensive care treatment. Invasive-mechanical ventilation was necessary in one case who died 24 h post-partum of severe cardiac depression. Five infants who survived the follow-up time developed chronic renal insufficiency (CRI), with one infant developing end-stage renal failure requiring peritoneal dialysis. CONCLUSION Overall, 5 of 9 LUTO fetuses (55%) undergoing VAS with the Somatex® intrauterine shunt system showed long-term survival beyond the neonatal period of 28 d (5/9; 55%) with varying morbidity.
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Affiliation(s)
- Corinna Keil
- Division of Prenatal Medicine and Therapy, Department of Obstetrics and Perinatal Medicine, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Ivonne Bedei
- Division of Prenatal Medicine and Therapy, Department of Obstetrics and Perinatal Medicine, University Hospital Giessen, Liebig University Giessen, Giessen, Germany
| | - Lara Sommer
- University Children Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Martin Koemhoff
- University Children Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Roland Axt-Fliedner
- Division of Prenatal Medicine and Therapy, Department of Obstetrics and Perinatal Medicine, University Hospital Giessen, Liebig University Giessen, Giessen, Germany
| | - Siegmund Köhler
- Division of Prenatal Medicine and Therapy, Department of Obstetrics and Perinatal Medicine, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Stefanie Weber
- University Children Hospital Marburg, Philipps University Marburg, Marburg, Germany
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Fontbonne A, Teme B, Callejon S, Weber S, Guyoux A, Trompezinski S. 314 Complementary photoprotective antioxidant effect of sun filters and a combination of active molecules in a model of irradiated human keratinocytes. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nikolaizik W, Wuensch L, Bauck M, Gross V, Sohrabi K, Weissflog A, Hildebrandt O, Koehler U, Weber S. Pilot study on nocturnal monitoring of crackles in children with pneumonia. ERJ Open Res 2021; 7:00284-2021. [PMID: 34853781 PMCID: PMC8628192 DOI: 10.1183/23120541.00284-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The clinical diagnosis of pneumonia is usually based on crackles at auscultation, but it is not yet clear what kind of crackles are the characteristic features of pneumonia in children. Lung sound monitoring can be used as a "longtime stethoscope". Therefore, it was the aim of this pilot study to use a lung sound monitor system to detect crackles and to differentiate between fine and coarse crackles in children with acute pneumonia. The change of crackles during the course of the disease shall be investigated in a follow-up study. PATIENTS AND METHODS Crackles were recorded overnight from 22:00 to 06:00 h in 30 children with radiographically confirmed pneumonia. The data for a total of 28 800 recorded 30-s epochs were audiovisually analysed for fine and coarse crackles. RESULTS Fine crackles and coarse crackles were recognised in every patient with pneumonia, but the number of epochs with and without crackles varied widely among the different patients: fine crackles were detected in 40±22% (mean±sd), coarse crackles in 76±20%. The predominant localisation of crackles as recorded during overnight monitoring was in accordance with the radiographic infiltrates and the classical auscultation in most patients. The distribution of crackles was fairly equal throughout the night. However, there were time periods without any crackle in the single patients so that the diagnosis of pneumonia might be missed at sporadic auscultation. CONCLUSION Nocturnal monitoring can be beneficial to reliably detect fine and coarse crackles in children with pneumonia.
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Affiliation(s)
- Wilfried Nikolaizik
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Lisa Wuensch
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Monika Bauck
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Volker Gross
- Faculty of Health Sciences, University of Applied Sciences, Giessen, Germany
| | - Keywan Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Giessen, Germany
| | | | - Olaf Hildebrandt
- Division of Respiratory and Critical Care Medicine, Philipps-University, Marburg, Germany
| | - Ulrich Koehler
- Division of Respiratory and Critical Care Medicine, Philipps-University, Marburg, Germany
| | - Stefanie Weber
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
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Pellay F, Fontbonne A, Tisserand J, Lecland N, Weber S, Benoit I, Perrier E, Trompezinski S, Guyoux A. 150 Skin proteom protection through the chaperone-like activity of an A. agilis extract. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.153] [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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Schierbaum LM, Schneider S, Herms S, Sivalingam S, Fabian J, Reutter H, Weber S, Merz WM, Tkaczyk M, Miklaszewska M, Sikora P, Szmigielska A, Krzemien G, Zachwieja K, Szczepanska M, Taranta-Janusz K, Kroll P, Polok M, Zaniew M, Hilger AC. Genome-Wide Survey for Microdeletions or -Duplications in 155 Patients with Lower Urinary Tract Obstructions (LUTO). Genes (Basel) 2021; 12:genes12091449. [PMID: 34573432 PMCID: PMC8468665 DOI: 10.3390/genes12091449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 01/28/2023] Open
Abstract
Lower urinary tract obstruction (LUTO) is, in most cases, caused by anatomical blockage of the bladder outlet. The most common form are posterior urethral valves (PUVs), a male-limited phenotype. Here, we surveyed the genome of 155 LUTO patients to identify disease-causing CNVs. Raw intensity data were collected for CNVs detected in LUTO patients and 4.392 healthy controls using CNVPartition, QuantiSNP and PennCNV. Overlapping CNVs between patients and controls were discarded. Additional filtering implicated CNV frequency in the database of genomic variants, gene content and final visual inspection detecting 37 ultra-rare CNVs. After, prioritization qPCR analysis confirmed 3 microduplications, all detected in PUV patients. One microduplication (5q23.2) occurred de novo in the two remaining microduplications found on chromosome 1p36.21 and 10q23.31. Parental DNA was not available for segregation analysis. All three duplications comprised 11 coding genes: four human specific lncRNA and one microRNA. Three coding genes (FBLIM1, SLC16A12, SNCAIP) and the microRNA MIR107 have previously been shown to be expressed in the developing urinary tract of mouse embryos. We propose that duplications, rare or de novo, contribute to PUV formation, a male-limited phenotype.
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Affiliation(s)
- Luca M. Schierbaum
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
| | - Sophia Schneider
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
| | - Stefan Herms
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
- Human Genomics Research Group, Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Sugirthan Sivalingam
- Institute for Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, 53127 Bonn, Germany;
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty, University of Bonn, 53127 Bonn, Germany
- Core Unit for Bioinformatics Data Analysis, Medical Faculty, University of Bonn, 53127 Bonn, Germany
| | - Julia Fabian
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
| | - Heiko Reutter
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
- Department of Neonatology and Pediatric Intensive Care, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Stefanie Weber
- Department of Pediatrics, University Hospital Marburg, 35033 Marburg, Germany;
| | - Waltraut M. Merz
- Department of Obstetrics and Prenatal Medicine, University of Bonn, 53127 Bonn, Germany;
| | - Marcin Tkaczyk
- Department of Pediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-428 Łódź, Poland;
- Department of Pediatrics, Cardiology and Immunology, Medical University of Łódź, 93-428 Łódź, Poland
| | - Monika Miklaszewska
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, 31-007 Krakow, Poland; (M.M.); (K.Z.)
| | - Przemyslaw Sikora
- Department of Pediatric Nephrology Medical University of Lublin, 20-059 Lublin, Poland;
| | - Agnieszka Szmigielska
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.S.); (G.K.)
| | - Grazyna Krzemien
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.S.); (G.K.)
| | - Katarzyna Zachwieja
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, 31-007 Krakow, Poland; (M.M.); (K.Z.)
| | - Maria Szczepanska
- Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Katarzyna Taranta-Janusz
- Department of Pediatrics and Nephrology, Medical University of Białystok, 15-089 Białystok, Poland;
| | - Pawel Kroll
- Neurourology Unit, Pediatric Surgery and Urology Clinic, 61-701 Poznań, Poland;
- Neurourology Unit, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Marcin Polok
- Department of Pediatric Surgery and Urology, University of Zielona Góra, 65-417 Zielona Góra, Poland;
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, 65-417 Zielona Góra, Poland;
| | - Alina C. Hilger
- Institute of Human Genetics, University Hospital of Bonn, 53127 Bonn, Germany; (L.M.S.); (S.S.); (S.H.); (J.F.); (H.R.)
- Department of Neonatology and Pediatric Intensive Care, University Hospital Erlangen, 91054 Erlangen, Germany
- Correspondence:
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Weber S, Heitmann KU. [Interoperability in healthcare: also prescribed for digital health applications (DiGA)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1262-1268. [PMID: 34532746 PMCID: PMC8445009 DOI: 10.1007/s00103-021-03414-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
Digitale Gesundheitsanwendungen (DiGA) sind eines der Räder im Getriebe des digitalen Gesundheitswesens. Wie alle anderen kommunizierenden Anwendungen müssen DiGA interoperabel sein, damit das ganze System reibungslos funktioniert. Dabei muss Interoperabilität auf 4 verschiedenen Ebenen gegeben sein, dies sind: funktionale und fachinhaltliche Anforderungen; strukturelle und semantische Anforderungen; Anforderungen an Sicherheit und Transport und organisatorische Anforderungen. In Deutschland wurde in den letzten Jahren ein großer Sprung in ein digitales Gesundheitswesen initiiert, verstärkt durch die Erfahrungen aus der COVID-19-Pandemie. Aktuelle Gesetzgebungen zielen auf eine Festlegung von Standards und einheitlichen Abläufen und etablieren damit den benötigten verbindlichen Rahmen für ein Gesamtkonzept in der Digitalisierung. Interoperable DiGA können mit den anderen Systemen im Gesundheitswesen kommunizieren, wenn es die PatientInnen wünschen. Möglich sind z. B. der Anschluss an die elektronische Patientenakte (ePA) und eine damit einhergehende Datenspende für Forschungszwecke. So können PatientInnen nicht nur direkt von dem positiven Versorgungseffekt einer DiGA profitieren, sondern auch indirekt durch die Datenspende zur Forschung und damit zur Verbesserung des Gesundheitswesens beitragen.
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Affiliation(s)
- Stefanie Weber
- Abteilung "Kodiersysteme", Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Deutschland.
| | - Kai U Heitmann
- health innovation hub, Bundesministerium für Gesundheit, Berlin, Deutschland
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Uscătescu LC, Kronbichler L, Stelzig-Schöler R, Pearce BG, Said-Yürekli S, Reich LA, Weber S, Aichhorn W, Kronbichler M. Effective Connectivity of the Hippocampus Can Differentiate Patients with Schizophrenia from Healthy Controls: A Spectral DCM Approach. Brain Topogr 2021; 34:762-778. [PMID: 34482503 PMCID: PMC8556208 DOI: 10.1007/s10548-021-00868-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/22/2021] [Indexed: 12/01/2022]
Abstract
We applied spectral dynamic causal modelling (Friston et al. in Neuroimage 94:396–407. 10.1016/j.neuroimage.2013.12.009, 2014) to analyze the effective connectivity differences between the nodes of three resting state networks (i.e. default mode network, salience network and dorsal attention network) in a dataset of 31 male healthy controls (HC) and 25 male patients with a diagnosis of schizophrenia (SZ). Patients showed increased directed connectivity from the left hippocampus (LHC) to the: dorsal anterior cingulate cortex (DACC), right anterior insula (RAI), left frontal eye fields and the bilateral inferior parietal sulcus (LIPS & RIPS), as well as increased connectivity from the right hippocampus (RHC) to the: bilateral anterior insula (LAI & RAI), right frontal eye fields and RIPS. In SZ, negative symptoms predicted the connectivity strengths from the LHC to: the DACC, the left inferior parietal sulcus (LIPAR) and the RHC, while positive symptoms predicted the connectivity strengths from the LHC to the LIPAR and from the RHC to the LHC. These results reinforce the crucial role of hippocampus dysconnectivity in SZ pathology and its potential as a biomarker of disease severity.
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Affiliation(s)
- Lavinia Carmen Uscătescu
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Lisa Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Renate Stelzig-Schöler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Brandy-Gale Pearce
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Sarah Said-Yürekli
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | | | - Stefanie Weber
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Martin Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
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Weber S, Ramirez CM, Weiser B, Burger H, Doerfler W. SARS-CoV-2 worldwide replication drives rapid rise and selection of mutations across the viral genome: a time-course study - potential challenge for vaccines and therapies. EMBO Mol Med 2021; 13:e14062. [PMID: 33931941 PMCID: PMC8185546 DOI: 10.15252/emmm.202114062] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 11/09/2022] Open
Abstract
Scientists and the public were alarmed at the first large viral variant of SARS-CoV-2 reported in December 2020. We have followed the time course of emerging viral mutants and variants during the SARS-CoV-2 pandemic in ten countries on four continents. We examined > 383,500 complete SARS-CoV-2 nucleotide sequences in GISAID (Global Initiative of Sharing All Influenza Data) with sampling dates extending until April 05, 2021. These sequences originated from ten different countries: United Kingdom, South Africa, Brazil, United States, India, Russia, France, Spain, Germany, and China. Among the 77 to 100 novel mutations, some previously reported mutations waned and some of them increased in prevalence over time. VUI2012/01 (B.1.1.7) and 501Y.V2 (B.1.351), the so-called UK and South Africa variants, respectively, and two variants from Brazil, 484K.V2, now called P.1 and P.2, increased in prevalence. Despite lockdowns, worldwide active replication in genetically and socio-economically diverse populations facilitated selection of new mutations. The data on mutant and variant SARS-CoV-2 strains provided here comprise a global resource for easy access to the myriad mutations and variants detected to date globally. Rapidly evolving new variant and mutant strains might give rise to escape variants, capable of limiting the efficacy of vaccines, therapies, and diagnostic tests.
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Affiliation(s)
- Stefanie Weber
- Institute for Clinical and Molecular VirologyFriedrich‐Alexander University (FAU)ErlangenGermany
| | | | - Barbara Weiser
- Department of MedicineUniversity of CaliforniaDavis, SacramentoCAUSA
| | - Harold Burger
- Department of MedicineUniversity of CaliforniaDavis, SacramentoCAUSA
| | - Walter Doerfler
- Institute for Clinical and Molecular VirologyFriedrich‐Alexander University (FAU)ErlangenGermany
- Institute of GeneticsUniversity of CologneCologneGermany
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Schlingmann KP, Renigunta A, Hoorn EJ, Forst AL, Renigunta V, Atanasov V, Mahendran S, Barakat TS, Gillion V, Godefroid N, Brooks AS, Lugtenberg D, Lake J, Debaix H, Rudin C, Knebelmann B, Tellier S, Rousset-Rouvière C, Viering D, de Baaij JHF, Weber S, Palygin O, Staruschenko A, Kleta R, Houillier P, Bockenhauer D, Devuyst O, Vargas-Poussou R, Warth R, Zdebik AA, Konrad M. Defects in KCNJ16 Cause a Novel Tubulopathy with Hypokalemia, Salt Wasting, Disturbed Acid-Base Homeostasis, and Sensorineural Deafness. J Am Soc Nephrol 2021; 32:1498-1512. [PMID: 33811157 PMCID: PMC8259640 DOI: 10.1681/asn.2020111587] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 11/11/2020] [Accepted: 02/04/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The transepithelial transport of electrolytes, solutes, and water in the kidney is a well-orchestrated process involving numerous membrane transport systems. Basolateral potassium channels in tubular cells not only mediate potassium recycling for proper Na+,K+-ATPase function but are also involved in potassium and pH sensing. Genetic defects in KCNJ10 cause EAST/SeSAME syndrome, characterized by renal salt wasting with hypokalemic alkalosis associated with epilepsy, ataxia, and sensorineural deafness. METHODS A candidate gene approach and whole-exome sequencing determined the underlying genetic defect in eight patients with a novel disease phenotype comprising a hypokalemic tubulopathy with renal salt wasting, disturbed acid-base homeostasis, and sensorineural deafness. Electrophysiologic studies and surface expression experiments investigated the functional consequences of newly identified gene variants. RESULTS We identified mutations in the KCNJ16 gene encoding KCNJ16, which along with KCNJ15 and KCNJ10, constitutes the major basolateral potassium channel of the proximal and distal tubules, respectively. Coexpression of mutant KCNJ16 together with KCNJ15 or KCNJ10 in Xenopus oocytes significantly reduced currents. CONCLUSIONS Biallelic variants in KCNJ16 were identified in patients with a novel disease phenotype comprising a variable proximal and distal tubulopathy associated with deafness. Variants affect the function of heteromeric potassium channels, disturbing proximal tubular bicarbonate handling as well as distal tubular salt reabsorption.
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Affiliation(s)
- Karl P. Schlingmann
- Department of General Pediatrics, Pediatric Nephrology, University Children’s Hospital, Munster, Germany
| | - Aparna Renigunta
- Department of Pediatric Nephrology, Marburg Kidney Research Center, Philipps University, Marburg, Germany
| | - Ewout J. Hoorn
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Anna-Lena Forst
- Department of Physiology, Medical Cell Biology, University of Regensburg, Regensburg, Germany
| | - Vijay Renigunta
- Department of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps University, Marburg, Germany
| | - Velko Atanasov
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Sinthura Mahendran
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | | | - Valentine Gillion
- Division of Nephrology, Saint-Luc Academic Hospital, Université Catholique Louvain, Brussels, Belgium
| | - Nathalie Godefroid
- Division of Pediatric Nephrology, Saint-Luc Academic Hospital, Université Catholique Louvain, Brussels, Belgium
| | - Alice S. Brooks
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dorien Lugtenberg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jennifer Lake
- Department of Physiology, Mechanism of Inherited Kidney Disorders, University of Zurich, Zurich, Switzerland
| | - Huguette Debaix
- Department of Physiology, Mechanism of Inherited Kidney Disorders, University of Zurich, Zurich, Switzerland
| | - Christoph Rudin
- Department of Pediatric Nephrology, University Children’s Hospital, Basel, Switzerland
| | - Bertrand Knebelmann
- Department of Nephrology-Transplantation, Assistance Publique Hôpitaux de Paris, Hôpital Necker, Paris, France,Reference Center for Hereditary Kidney and Childhood Diseases (MAladies Renales Hereditaires de l'Enfant et de l'Adulte), Paris, France
| | - Stephanie Tellier
- Department of Pediatric Nephrology, and Rheumatology, French Reference Center of Rare Renal Diseases (SORARE), CHU Toulouse, Toulouse, France,Division of Rheumatology, Department of Pediatrics, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Caroline Rousset-Rouvière
- Department of Multidisciplinary Pediatrics, Pediatric Nephrology Unit, La Timone, University Hospital of Marseille, Marseille, France
| | - Daan Viering
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen H. F. de Baaij
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefanie Weber
- Department of Pediatric Nephrology, Marburg Kidney Research Center, Philipps University, Marburg, Germany
| | - Oleg Palygin
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alexander Staruschenko
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin,Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
| | - Robert Kleta
- Department of Renal Medicine, University College London, London, United Kingdom,Department of Paediatric Nephrology, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom
| | - Pascal Houillier
- Reference Center for Hereditary Kidney and Childhood Diseases (MAladies Renales Hereditaires de l'Enfant et de l'Adulte), Paris, France,Department of Physiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France,Department of Renal Physiology, Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Université de Paris, Centre National de la Recherche Scientifique, Paris, France
| | - Detlef Bockenhauer
- Department of Renal Medicine, University College London, London, United Kingdom,Department of Paediatric Nephrology, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom
| | - Olivier Devuyst
- Division of Nephrology, Saint-Luc Academic Hospital, Université Catholique Louvain, Brussels, Belgium,Department of Physiology, Mechanism of Inherited Kidney Disorders, University of Zurich, Zurich, Switzerland
| | - Rosa Vargas-Poussou
- Reference Center for Hereditary Kidney and Childhood Diseases (MAladies Renales Hereditaires de l'Enfant et de l'Adulte), Paris, France,Department of Renal Physiology, Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Université de Paris, Centre National de la Recherche Scientifique, Paris, France,Department of Genetics, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Richard Warth
- Department of Physiology, Medical Cell Biology, University of Regensburg, Regensburg, Germany
| | - Anselm A. Zdebik
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom,Department of Renal Medicine, University College London, London, United Kingdom
| | - Martin Konrad
- Department of General Pediatrics, Pediatric Nephrology, University Children’s Hospital, Munster, Germany
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Condamine FP, Jourdain N, Hernandez JC, Taylor M, Bohlin H, Fajstavr A, Jeong TM, Kumar D, Laštovička T, Renner O, Weber S. High-repetition rate solid target delivery system for PW-class laser-matter interaction at ELI Beamlines. Rev Sci Instrum 2021; 92:063504. [PMID: 34243562 DOI: 10.1063/5.0053281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/11/2021] [Indexed: 06/13/2023]
Abstract
L3-HAPLS (High-repetition-rate Advanced Petawatt Laser System) at ELI (Extreme Light Infrastructure) Beamlines currently delivers 0.45 PW pulses (12 J in 27 fs) at 3.3 Hz repetition rate. A fresh target surface for every shot was placed at the laser focus using an in-house tape target system designed to withstand large laser intensities and energies. It has been tested for different material thicknesses (25 and 7.6 µm), while L3-HAPLS delivered laser shots for energies ranging from 1 to 12 J. A technical description of the tape target system is given. The device can be used in diverse geometries needed for laser-matter interaction studies by providing an ≈300° free angle of view on the target in the equatorial plane. We show experimental data demonstrating the shot-to-shot stability of the device. An x-ray crystal spherical spectrometer was set up to measure the Kα yield stability, while a GHz H-field probe was used to check the shot-to-shot electromagnetic pulse generation. Finally, we discuss short and mid-term future improvements of the tape target system for efficient user operation.
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Affiliation(s)
- F P Condamine
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - N Jourdain
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - J-C Hernandez
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - M Taylor
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - H Bohlin
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - A Fajstavr
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - T M Jeong
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - D Kumar
- Department of Radiation and Chemical Physics, Institute of Physics of the Czech Academy of Sciences, 18200 Prague, Czech Republic
| | - T Laštovička
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - O Renner
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
| | - S Weber
- ELI-Beamlines Center, Institute of Physics, Czech Academy of Sciences, 25241 Dolní Brežany, Czech Republic
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Shaukat I, Bakhos-Douaihy D, Zhu Y, Seaayfan E, Demaretz S, Frachon N, Weber S, Kömhoff M, Vargas-Poussou R, Laghmani K. New insights into the role of endoplasmic reticulum-associated degradation in Bartter Syndrome Type 1. Hum Mutat 2021; 42:947-968. [PMID: 33973684 DOI: 10.1002/humu.24217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/12/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
Mutations in Na-K-2Cl co-transporter, NKCC2, lead to type I Bartter syndrome (BS1), a life-threatening kidney disease. Yet, our knowledge of the molecular regulation of NKCC2 mutants remains poor. Here, we aimed to identify the molecular pathogenic mechanisms of one novel and three previously reported missense NKCC2 mutations. Co-immunolocalization studies revealed that all NKCC2 variants are not functional because they are not expressed at the cell surface due to retention in the endoplasmic reticulum (ER). Cycloheximide chase assays together with treatment by protein degradation and mannose trimming inhibitors demonstrated that the defect in NKCC2 maturation arises from ER retention and associated degradation (ERAD). Small interfering RNA (siRNA) knock-down experiments revealed that the ER lectin OS9 is involved in the ERAD of NKCC2 mutants. 4-phenyl butyric acid (4-PBA) treatment mimicked OS9 knock-down effect on NKCC2 mutants by stabilizing their immature forms. Importantly, out of the four studied mutants, only one showed an increased protein maturation upon treatment with glycerol. In summary, our study reveals that BS1 is among diseases linked to the ERAD pathway. Moreover, our data open the possibility that maturation of some ER retained NKCC2 variants is correctable by chemical chaperones offering, therefore, promising avenues in elucidating the molecular pathways governing the ERAD of NKCC2 folding mutants.
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Affiliation(s)
- Irfan Shaukat
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Dalal Bakhos-Douaihy
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Yingying Zhu
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Elie Seaayfan
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Sylvie Demaretz
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Nadia Frachon
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Stefanie Weber
- Division of Pediatric Nephrology and Transplantation, University Children's Hospital, Philipps-University, Marburg, Germany
| | - Martin Kömhoff
- Division of Pediatric Nephrology and Transplantation, University Children's Hospital, Philipps-University, Marburg, Germany
| | | | - Kamel Laghmani
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
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Kronbichler L, Stelzig-Schöler R, Lenger M, Weber S, Pearce BG, Reich LA, Aichhorn W, Kronbichler M. Preserved intention understanding during moral judgments in schizophrenia. PLoS One 2021; 16:e0251180. [PMID: 34010340 PMCID: PMC8133419 DOI: 10.1371/journal.pone.0251180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/22/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Although there is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition. We investigated whether patients with SSD showed altered moral judgments in a story task where the protagonist either had a neutral or malicious intention towards another person. This paradigm examined whether SSD relates to altered moral cognition in general or specifically to impaired integration of prior information (such as beliefs) in moral judgments. METHODS 23 patients and 32 healthy controls read vignettes created in a 2 x 2 design. The protagonist in each story either had a neutral or negative intention towards another person which, as a result, either died (negative outcome) or did not die (neutral outcome). Participants rated the moral permissibility of the protagonist's action. Standard null hypothesis significance testing and equivalent Bayes analyses are reported. RESULTS Schizophrenia patients did not differ significantly in permissibility ratings from healthy controls. This finding was supported by the Bayes analyses which favoured the null hypothesis. Task performance was not related to symptom severity or medication. CONCLUSIONS The current findings do not support the notion that moral judgments are deficient in schizophrenia. Furthermore, the current study shows that patients do not have observable difficulties in integrating the protagonist's belief in the rating of the moral permissibility of the action-outcome.
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Affiliation(s)
- Lisa Kronbichler
- Neuroscience Institute, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Renate Stelzig-Schöler
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Stefanie Weber
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Brandy-Gale Pearce
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Luise-Antonia Reich
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Martin Kronbichler
- Neuroscience Institute, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
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Shaukat I, Bakhos-Douaihy D, Zhu Y, Seaayfan E, Demaretz S, Frachon N, Weber S, Kömhoff M, Vargas-Poussou R, Laghmani K. New insights into the role of endoplasmic reticulum-associated degradation in Bartter Syndrome Type 1. Hum Mutat 2021. [PMID: 33973684 DOI: 10.1002/humu.24217.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mutations in Na-K-2Cl co-transporter, NKCC2, lead to type I Bartter syndrome (BS1), a life-threatening kidney disease. Yet, our knowledge of the molecular regulation of NKCC2 mutants remains poor. Here, we aimed to identify the molecular pathogenic mechanisms of one novel and three previously reported missense NKCC2 mutations. Co-immunolocalization studies revealed that all NKCC2 variants are not functional because they are not expressed at the cell surface due to retention in the endoplasmic reticulum (ER). Cycloheximide chase assays together with treatment by protein degradation and mannose trimming inhibitors demonstrated that the defect in NKCC2 maturation arises from ER retention and associated degradation (ERAD). Small interfering RNA (siRNA) knock-down experiments revealed that the ER lectin OS9 is involved in the ERAD of NKCC2 mutants. 4-phenyl butyric acid (4-PBA) treatment mimicked OS9 knock-down effect on NKCC2 mutants by stabilizing their immature forms. Importantly, out of the four studied mutants, only one showed an increased protein maturation upon treatment with glycerol. In summary, our study reveals that BS1 is among diseases linked to the ERAD pathway. Moreover, our data open the possibility that maturation of some ER retained NKCC2 variants is correctable by chemical chaperones offering, therefore, promising avenues in elucidating the molecular pathways governing the ERAD of NKCC2 folding mutants.
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Affiliation(s)
- Irfan Shaukat
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Dalal Bakhos-Douaihy
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Yingying Zhu
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Elie Seaayfan
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Sylvie Demaretz
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Nadia Frachon
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
| | - Stefanie Weber
- Division of Pediatric Nephrology and Transplantation, University Children's Hospital, Philipps-University, Marburg, Germany
| | - Martin Kömhoff
- Division of Pediatric Nephrology and Transplantation, University Children's Hospital, Philipps-University, Marburg, Germany
| | | | - Kamel Laghmani
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris, France.,CNRS, ERL8228, Paris, France
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Eberhart L, Geldner G, Kowark A, Zucker TP, Kreuer S, Przemeck M, Huljic S, Koch T, Keller T, Weber S, Kranke P. Treatment of intraoperative hypotension with cafedrine/theodrenaline versus ephedrine : A prospective, national, multicenter, non-interventional study-the HYPOTENS trial. Anaesthesist 2021; 70:298-307. [PMID: 33170310 PMCID: PMC8026467 DOI: 10.1007/s00101-020-00877-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sympathomimetic drugs are a therapeutic cornerstone for the management of hypotensive states like intraoperative hypotension (IOH). While cafedrine/theodrenaline (C/T) is widely used in Germany to restore blood pressure in patients with IOH, more research is required to compare its effectiveness with alternatives such as ephedrine (E) that are more commonly available internationally. METHODS HYPOTENS (NCT02893241, DRKS00010740) was a prospective, national, multicenter, open-label, two-armed, non-interventional study that compared C/T with E for treatment of IOH. We describe a prospectively defined cohort of patients ≥50 years old with comorbidities undergoing general anesthesia induced with propofol and fentanyl. Primary objectives were to examine treatment precision, rapidity of onset and the ability to restore blood pressure without relevant increases in heart rate. Secondary endpoints were treatment satisfaction and the number of required additional boluses or other accompanying measures. RESULTS A total of 1496 patients were included in the per protocol analysis. Overall, effective stabilization of blood pressure was achieved with both C/T and E. Post-hoc analysis showed that blood pressure increase from baseline was more pronounced with C/T. Fewer additional boluses or other accompanying measures were required in the C/T arm. The incidence of tachycardia was comparable between groups. Post-hoc analysis showed that E produced dose-dependent elevated heart rate values. By contrast, heart rate remained stable in patients treated with C/T. Physicians reported a higher level of treatment satisfaction with C/T, with a higher proportion of anesthetists rating treatment precision and rapidity of onset as good or very good when compared with E. CONCLUSION Neither drug was superior in restoring blood pressure levels; however, post-hoc analyses suggested that treatment is more goal-orientated and easier to control with C/T. Heart rate was shown to be more stable with C/T and fewer additional interventions were required to restore blood pressure, which could have contributed to the increased treatment satisfaction reported by anesthetists using C/T.
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Affiliation(s)
- L Eberhart
- Department of Anesthesiology & Intensive Care, Philipps University Marburg, Baldingerstraße 1, 35033, Marburg, Germany.
| | - G Geldner
- Clinic for Intensive Care, Emergency Medicine and Pain Therapy, Hospital Ludwigsburg, Ludwigsburg, Germany
| | - A Kowark
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - T-P Zucker
- Department of Anesthesiology, Intensive Care and Pain Therapy, Academic Teaching Hospital Traunstein, Traunstein, Germany
| | - S Kreuer
- Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Saarland, Homburg, Germany
| | - M Przemeck
- Department of Anesthesiology and Intensive Care, DIAKOVERE Annastift, Hannover, Germany
| | | | - T Koch
- Department of Anesthesiology & Intensive Care, Philipps University Marburg, Baldingerstraße 1, 35033, Marburg, Germany
| | - T Keller
- ACOMED Statistik, Leipzig, Germany
| | - S Weber
- ACOMED Statistik, Leipzig, Germany
| | - P Kranke
- Department of Anesthesia and Critical Care, University Hospital Würzburg, Würzburg, Germany
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50
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Abstract
Die medizinische Versorgung von Patienten, die im Zusammenhang mit der pandemischen Coronaviruserkrankung 2019 („coronavirus disease 2019“, COVID-19) erkrankt sind, stellt für die staatlichen Gesundheitssysteme weltweit eine große Herausforderung dar. Das Virus mit dem Namen „severe acute respiratory syndrome coronavirus 2“ (SARS-CoV-2) zeigt eine hohe Organspezifität zu den unteren Atemwegen. Da bislang weder eine wirksame Therapie noch Impfung gegen das Virus existieren, kommt der diagnostischen Früherkennung eine große Bedeutung zu. Durch den spezifischen Aspekt der überwiegend im peripheren Lungenparenchym beginnenden Infektion ist die Lungensonographie als bildgebende Diagnostikmethode geeignet, Verdachtsfälle bereits im Frühstadium der Erkrankung als solche zu identifizieren. Serielle Ultraschalluntersuchungen an Patienten mit bestätigter Infektion können bettseitig und zeitnah Veränderungen im betroffenen Lungengewebe nachweisen. Dieser Artikel fasst das diagnostische Potenzial der Lungensonographie im Hinblick auf Screening und therapeutische Entscheidungsfindung bei Patienten mit vermuteter oder bestätigter SARS-CoV-2-Pneumonie zusammen.
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Affiliation(s)
- A Seibel
- Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Diakonie Klinikum Jung-Stilling, 57074, Siegen, Deutschland.
| | - W Heinz
- Klinik für Innere Medizin II, Helios Klinik Rottweil, Rottweil, Deutschland
| | - C-A Greim
- Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Klinikum Fulda, Fulda, Deutschland
| | - S Weber
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Heilig Geist-Krankenhaus, Köln, Deutschland
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