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Klein EG, Schroeder K, Wessels AM, Phipps A, Japha M, Schilling T, Zimmer JA. How donanemab data address the coverage with evidence development questions. Alzheimers Dement 2024; 20:3127-3140. [PMID: 38323738 PMCID: PMC11032520 DOI: 10.1002/alz.13700] [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: 10/12/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 02/08/2024]
Abstract
The Centers for Medicare & Medicaid Services (CMS) established a class-based National Coverage Determination (NCD) for monoclonal antibodies directed against amyloid for Alzheimer's disease (AD) with patient access through Coverage with Evidence Development (CED) based on three questions. This review, focused on donanemab, answers each of these CED questions with quality evidence. TRAILBLAZER-ALZ registration trials are presented with supporting literature and real-world data to answer CED questions for donanemab. TRAILBLAZER-ALZ registration trials demonstrated that donanemab significantly slowed cognitive and functional decline in amyloid-positive early symptomatic AD participants, and lowered their risk of disease progression while key safety risks occurred primarily within the first 6 months and then declined. Donanemab meaningfully improved health outcomes with a manageable safety profile in an early symptomatic AD population, representative of Medicare populations across diverse practice settings. The donanemab data provide the necessary level of evidence for CMS to open a reconsideration of their NCD. HIGHLIGHTS: Donanemab meaningfully improved outcomes in trial participants with early symptomatic Alzheimer's disease. Comorbidities in trial participants were consistent with the Medicare population. Co-medications in trial participants were consistent with the Medicare population. Risks associated with treatment tended to occur in the first 6 months. Risks of amyloid-related imaging abnormalities were managed with careful observation and magnetic resonance imaging monitoring.
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Affiliation(s)
- Eric G. Klein
- Global Medical Affairs, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Krista Schroeder
- Research and Development, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Alette M. Wessels
- Research and Development, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Adam Phipps
- Lilly Value and Access, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Maureen Japha
- Corporate Affairs, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Traci Schilling
- Global Medical Affairs, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
| | - Jennifer A. Zimmer
- Research and Development, Eli Lilly and CompanyLilly Corporate CenterIndianapolisIndianaUSA
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Chandler J, Georgieva M, Desai U, Done N, Gomez-Lievano A, Ye W, Zhao A, Eid D, Hilts A, Kirson N, Schilling T. Impact of Differential Rates of Disease Progression in Amyloid-Positive Early Alzheimer's Disease: Findings from a Longitudinal Cohort Analysis. J Prev Alzheimers Dis 2024; 11:320-328. [PMID: 38374738 DOI: 10.14283/jpad.2024.28] [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] [Indexed: 02/21/2024]
Abstract
BACKGROUND There is limited literature regarding the impact of differential rates of disease progression on longitudinal outcomes in individuals with early Alzheimer's disease (AD) and confirmed brain amyloid pathology. OBJECTIVES To describe the underlying characteristics and long-term outcomes associated with different rates of disease progression among amyloid-positive individuals with early symptomatic AD. DESIGN Retrospective observational study. SETTING Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) in the United States (06/2005-11/2021). PARTICIPANTS Individuals with a clinical assessment of mild cognitive impairment or dementia and Clinical Dementia Rating® Dementia Staging Instrument Sum of Boxes (CDR-SB) score 0.5-9.0 (inclusive; first visit defined as the index date) and confirmed amyloid positivity. Participants were stratified into No Progression (change ≤0), Slower Progression (0< change <2.0 points), Median Progression (2.0-point change), and Faster Progression (change >2.0 points) cohorts based on the observed distribution of changes in CDR-SB score between the index and first subsequent visit. MEASUREMENTS For each cohort, the functional and neuropsychiatric outcomes were described at index and each subsequent visit for up to five years, and least-square (LS) mean changes from baseline were estimated using linear mixed-effects models adjusting for baseline demographic and clinical characteristics. RESULTS Among 1,263 participants included in the analysis, the mean±standard deviation (SD) age at index was 72.7±9.7 years and 55.3% were males. Demographic characteristics and comorbidity profiles at index were similar across cohorts. However, at index, the Faster Progression (N=279) cohort had higher CDR-SB and Functional Assessment Questionnaire (FAQ) scores compared with the No Progression (N=474), Slower Progression (N=297), and Median Progression (N=213) cohorts. Adjusting for baseline characteristics, at year 5 after index the FAQ score increased by 23.6 points for Faster Progression cohort and 10.4, 15.8, and 19.2 points for the No, Slower, and Median Progression cohorts, respectively. The corresponding increases in Neuropsychiatric Inventory Questionnaire (NPI-Q) scores were 6.7 points for the Faster Progression cohort, and by 1.3, 3.1, and 8.3 points, for the No, Slower, and Median Progression cohorts, respectively. CONCLUSIONS Despite similar demographic and clinical profiles at baseline, amyloid-positive individuals with greater deterioration based on CDR-SB early in the AD trajectory continue to experience worse functional and behavioral outcomes over time than those with more gradual deterioration in this metric.
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Affiliation(s)
- J Chandler
- Urvi Desai, PhD, Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA 02199, USA, Phone: +1-617-425-8315,
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Chandler J, Done N, Desai U, Georgieva M, Gomez-Lievano A, Ye W, Zhao A, Eid D, Hilts A, Kirson N, Schilling T. Potential Implications of Slowing Disease Progression in Amyloid-Positive Early Alzheimer's Disease: Estimates from Real-World Data. J Prev Alzheimers Dis 2024; 11:310-319. [PMID: 38374737 DOI: 10.14283/jpad.2024.27] [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] [Indexed: 02/21/2024]
Abstract
BACKGROUND Emerging therapies have shown promising results for slowing the progression of Alzheimer's disease (AD). However, the potential impact of these therapies on real-world outcomes remains to be explored. OBJECTIVE To examine the impact of slowing AD progression on functional abilities and behavioral symptoms. DESIGN Retrospective observational study. SETTING Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) in the United States (06/2005-11/2021, primary analysis) and the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (09/2005-03/2022, sensitivity analysis) were used. PARTICIPANTS Individuals with mild cognitive impairment (MCI) or mild dementia, Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score 0.5-9.0 (inclusive; first visit defined as the index date), and confirmed amyloid positivity were identified in NACC. In ADNI, individuals with at least one clinical center visit with a clinical assessment of MCI or mild dementia and confirmed amyloid positivity were identified. MEASUREMENTS Hypothetical effects of slowing disease progression as assessed by CDR-SB on functional and behavioral outcomes including the Functional Activities Questionnaire (FAQ) score, Neuropsychiatric Inventory Questionnaire (NPI-Q) score, and the probability of complete dependence over five years were evaluated using multivariable regression among NACC participants, separately for the subgroups with MCI and mild dementia at baseline, respectively. For the ADNI sensitivity analysis, the hypothetical effects of slowing disease progression were evaluated for FAQ score using multivariable regression among the MCI participants only. RESULTS Compared with natural disease progression, slowing progression by 20% over five years for NACC participants with MCI and mild dementia, respectively, would result in 1.7-point (10.8%) and 1.6-point (12.9%) less deterioration based on FAQ; 0.5-point (20.3%) and 0.5-point (19.3%) less deterioration based on NPI-Q; 4.7 percentage-point (22.2%) and 10.1 percentage-point (21.6%) lower probability of complete dependence. Among ADNI participants, delaying disease progression by 20% or 30% over 4 years would avert deterioration based on FAQ of 1.1 points (20.4%) and 1.6 points (29.6%), respectively, compared to natural disease progression. CONCLUSIONS Slowing early AD progression could result in preservation of functional and behavioral attributes and functional autonomy for longer.
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Affiliation(s)
- J Chandler
- Urvi Desai, PhD, Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA 02199, USA, Phone: +1-617-425-8315,
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Georgiou-Karistianis N, Corben LA, Reetz K, Adanyeguh IM, Corti M, Deelchand DK, Delatycki MB, Dogan I, Evans R, Farmer J, França MC, Gaetz W, Harding IH, Harris KS, Hersch S, Joules R, Joers JJ, Krishnan ML, Lax M, Lock EF, Lynch D, Mareci T, Muthuhetti Gamage S, Pandolfo M, Papoutsi M, Rezende TJR, Roberts TPL, Rosenberg JT, Romanzetti S, Schulz JB, Schilling T, Schwarz AJ, Subramony S, Yao B, Zicha S, Lenglet C, Henry PG. A natural history study to track brain and spinal cord changes in individuals with Friedreich's ataxia: TRACK-FA study protocol. PLoS One 2022; 17:e0269649. [PMID: 36410013 PMCID: PMC9678384 DOI: 10.1371/journal.pone.0269649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Drug development for neurodegenerative diseases such as Friedreich's ataxia (FRDA) is limited by a lack of validated, sensitive biomarkers of pharmacodynamic response in affected tissue and disease progression. Studies employing neuroimaging measures to track FRDA have thus far been limited by their small sample sizes and limited follow up. TRACK-FA, a longitudinal, multi-site, and multi-modal neuroimaging natural history study, aims to address these shortcomings by enabling better understanding of underlying pathology and identifying sensitive, clinical trial ready, neuroimaging biomarkers for FRDA. METHODS 200 individuals with FRDA and 104 control participants will be recruited across seven international study sites. Inclusion criteria for participants with genetically confirmed FRDA involves, age of disease onset ≤ 25 years, Friedreich's Ataxia Rating Scale (FARS) functional staging score of ≤ 5, and a total modified FARS (mFARS) score of ≤ 65 upon enrolment. The control cohort is matched to the FRDA cohort for age, sex, handedness, and years of education. Participants will be evaluated at three study visits over two years. Each visit comprises of a harmonized multimodal Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) scan of the brain and spinal cord; clinical, cognitive, mood and speech assessments and collection of a blood sample. Primary outcome measures, informed by previous neuroimaging studies, include measures of: spinal cord and brain morphometry, spinal cord and brain microstructure (measured using diffusion MRI), brain iron accumulation (using Quantitative Susceptibility Mapping) and spinal cord biochemistry (using MRS). Secondary and exploratory outcome measures include clinical, cognitive assessments and blood biomarkers. DISCUSSION Prioritising immediate areas of need, TRACK-FA aims to deliver a set of sensitive, clinical trial-ready neuroimaging biomarkers to accelerate drug discovery efforts and better understand disease trajectory. Once validated, these potential pharmacodynamic biomarkers can be used to measure the efficacy of new therapeutics in forestalling disease progression. CLINICAL TRIAL REGISTRATION ClinicalTrails.gov Identifier: NCT04349514.
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Affiliation(s)
- Nellie Georgiou-Karistianis
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- * E-mail:
| | - Louise A. Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Isaac M. Adanyeguh
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Manuela Corti
- Powell Gene Therapy Centre, University of Florida, Gainesville, Florida, United States of America
| | - Dinesh K. Deelchand
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Martin B. Delatycki
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Rebecca Evans
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Jennifer Farmer
- Friedreich’s Ataxia Research Alliance (FARA), Downingtown, Pennsylvania, United States of America
| | - Marcondes C. França
- Department of Neurology, University of Campinas, Campinas, Sao Paulo, Brazil
| | - William Gaetz
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Ian H. Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Karen S. Harris
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Steven Hersch
- Neurology Business Group, Eisai Inc., Nutley, New Jersey, United States of America
| | | | - James J. Joers
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Michelle L. Krishnan
- Translational Medicine, Novartis Institutes for Biomedical Research, Cambridge, MA, United States of America
| | | | - Eric F. Lock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - David Lynch
- Department of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Thomas Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States of America
| | - Sahan Muthuhetti Gamage
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Massimo Pandolfo
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | | | | | - Timothy P. L. Roberts
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Jens T. Rosenberg
- McKnight Brain Institute, Department of Neurology, University of Florida, Gainesville, Florida, United States of America
| | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Jörg B. Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Traci Schilling
- PTC Therapeutics, Inc, South Plainfield, New Jersey, United States of America
| | - Adam J. Schwarz
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Sub Subramony
- McKnight Brain Institute, Department of Neurology, University of Florida, Gainesville, Florida, United States of America
| | - Bert Yao
- PTC Therapeutics, Inc, South Plainfield, New Jersey, United States of America
| | - Stephen Zicha
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Christophe Lenglet
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
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Bergkvist M, Stephens C, Schilling T, Wang A, Yu X, Goodwin E, Golden L, Kristensen A, Klein M. Aromatic L-amino acid decarboxylase deficiency: a systematic review. Future Neurology 2022. [DOI: 10.2217/fnl-2022-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aim: To gain greater knowledge regarding the natural history of aromatic L-amino acid decarboxylase (AADC) deficiency, a genetic disorder that causes severe deficits in motor and cognitive development. Materials & methods: A systematic literature review was performed of all case reports and clinical studies published through December 2019 of patients with AADC deficiency. The data were summarized descriptively. Results: The search identified 94 publications that described 237 unique patients. Mean (standard deviation) age at diagnosis was 3.2 (±5.7) years and 16 deaths were reported. Most patients (57%) received the standard of care therapies, which showed limited efficacy in this patient population. Conclusion: AADC deficiency is a devastating disease and prospectively defined natural history studies are warranted to further understand this disease.
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Affiliation(s)
| | | | | | - Antonia Wang
- PTC Therapeutics, Inc., South Plainfield, NJ 07080, USA
| | - Xiaojin Yu
- PTC Therapeutics, Inc., South Plainfield, NJ 07080, USA
| | | | - Lee Golden
- PTC Therapeutics, Inc., South Plainfield, NJ 07080, USA
| | | | - Matthew Klein
- PTC Therapeutics, Inc., South Plainfield, NJ 07080, USA
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Erdmann N, Schilling T, Lehmann T, Zagoya C, Hentschel J, Mainz J. WS05.1 Dynamics of inflammatory mediators during airway infection in cystic fibrosis patients and healthy controls – serial non-invasive upper airway sampling by nasal lavage. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00939-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Otte K, Kühne NM, Furrer AD, Baena Lozada LP, Lutz VT, Schilling T, Hertel R. A CRISPR-Cas9 tool to explore the genetics of Bacillus subtilis phages. Lett Appl Microbiol 2020; 71:588-595. [PMID: 32615024 DOI: 10.1111/lam.13349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/26/2022]
Abstract
Here, we present pRH030, a new CRISPR-Cas9 tool for the genetic engineering of Bacillus phages and beyond. It is based on the Streptococcus pyogenes cas9 with its native constitutive promoter, tracrRNA, and a gRNA precursor. The constitutive expression of Cas9 was conducive to the inactivation of viral attackers and enhanced phage mutagenesis efficiency up to 100%. The gRNA precursor can be built up to an artificial CRISPR array with up to 5 spacers (target sequences) assembled from ordinary oligonucleotides and directly cloned into pRH030. Required time and resources remain comparable to a single gRNA cloning. These properties make pRH030 an attractive new system for the modification of Bacillus phages and qualify it for research beyond genetic construction.
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Affiliation(s)
- K Otte
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - N M Kühne
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - A D Furrer
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - L P Baena Lozada
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - V T Lutz
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - T Schilling
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
| | - R Hertel
- Department of Genomic and Applied Microbiology and Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, Göttingen, Germany
- FG Synthetic Microbiology, Institute of Biotechnology, BTU Cottbus-Senftenberg, Senftenberg, Germany
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Bültmann M, Schilling T. Computation of the solid-liquid interfacial free energy in hard spheres by means of thermodynamic integration. Phys Rev E 2020; 102:042123. [PMID: 33212611 DOI: 10.1103/physreve.102.042123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/18/2020] [Indexed: 11/07/2022]
Abstract
We used a thermodynamic integration scheme, which is specifically designed for disordered systems, to compute the interfacial free energy of the solid-liquid interface in the hard-sphere model. We separated the bulk contribution to the total free energy from the interface contribution, performed a finite-size scaling analysis, and obtained for the (100)-interface γ=0.591(11)k_{B}Tσ^{-2}.
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Affiliation(s)
- M Bültmann
- Physikalisches Institut, Albert-Ludwigs-Universitt, 79104 Freiburg, Germany
| | - T Schilling
- Physikalisches Institut, Albert-Ludwigs-Universitt, 79104 Freiburg, Germany
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Caroff SN, Mu F, Ayyagari R, Schilling T, Abler V, Carroll B. Hospital utilization rates following antipsychotic dose reduction in mood disorders: implications for treatment of tardive dyskinesia. BMC Psychiatry 2020; 20:365. [PMID: 32652964 PMCID: PMC7353680 DOI: 10.1186/s12888-020-02748-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The relative benefits and risks of long-term maintenance treatment with antipsychotics have not been well studied in patients with bipolar disorder and major depressive disorder. For example, while antipsychotic dose reduction has been recommended in the management of serious side effects associated with antipsychotics, there is limited evidence on the impact of lowering doses on the course of underlying mood disorders. METHODS This retrospective cohort study analyzed the impact of antipsychotic dose reduction in patients with bipolar disorder or major depressive disorder. Medical claims from six US states over a 6-year period were analyzed for patients with ≥10% or ≥ 30% reductions in antipsychotic dose (cases) and compared using survival analyses with matched controls receiving a stable dosage. Outcomes included hospitalizations for disease-specific mood disorders, other psychiatric disorders and all-cause emergency room visits, and claims for tardive dyskinesia. RESULTS A total of 23,992 patients with bipolar disorder and 17,766 with major depressive disorder had a ≥ 10% dose reduction, while 19,308 and 14,728, respectively, had a ≥ 30% dose reduction. In multivariate analyses, cases with a ≥ 10% dose reduction had a significantly increased risk of disease-specific admission (bipolar disorder: hazard ratio [95% confidence interval], 1.22 [1.15-1.31]; major depressive disorder: 1.22 [1.11-1.34]), other psychiatric admission (bipolar disorder: 1.19 [1.13-1.24]; major depressive disorder: 1.17 [1.11-1.23]), all-cause admission (bipolar disorder: 1.17 [1.12-1.23]; major depressive disorder: 1.11 [1.05-1.16]), and all-cause emergency room visits (bipolar disorder: 1.09 [1.05-1.13]; major depressive disorder: 1.07 [1.02-1.11]) (all P < 0.01). Similar results were observed following an ≥30% dose reduction. Dose reduction was not associated with decreased claims for tardive dyskinesia. CONCLUSIONS Patients with mood disorders who had antipsychotic dose reductions showed small but statistically significant increases in all-cause and mental health-related hospitalizations, which may lead to increased healthcare costs. These results highlight the need for additional long-term studies of the necessity and safety of maintenance antipsychotic treatment in mood disorders.
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Affiliation(s)
- Stanley N. Caroff
- grid.25879.310000 0004 1936 8972Department of Psychiatry, Corporal Michael J. Crescenz VA Medical Center and the Perelman School of Medicine at the University of Pennsylvania, 3900 Woodland Avenue, Philadelphia, PA 19104 USA
| | - Fan Mu
- grid.417986.50000 0004 4660 9516Analysis Group, 111 Huntington Ave, Boston, MA 02199 USA
| | - Rajeev Ayyagari
- grid.417986.50000 0004 4660 9516Analysis Group, 111 Huntington Ave, Boston, MA 02199 USA
| | - Traci Schilling
- grid.418488.90000 0004 0483 9882Teva Pharmaceuticals, 145 Brandywine Pkwy, West Chester, PA 19380 USA
| | - Victor Abler
- grid.418488.90000 0004 0483 9882Teva Pharmaceuticals, 145 Brandywine Pkwy, West Chester, PA 19380 USA
| | - Benjamin Carroll
- grid.418488.90000 0004 0483 9882Teva Pharmaceuticals, 145 Brandywine Pkwy, West Chester, PA 19380 USA
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Muntoni F, Desguerre I, Guglieri M, Osorio AN, Kirschner J, Tulinius M, Buccella F, Elfring G, Werner C, Schilling T, Trifillis P, Zhang O, Delage A, Santos CL, Mercuri E. Ataluren use in patients with nonsense mutation Duchenne muscular dystrophy: patient demographics and characteristics from the STRIDE Registry. J Comp Eff Res 2019; 8:1187-1200. [DOI: 10.2217/cer-2019-0086] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Strategic Targeting of Registries and International Database of Excellence (STRIDE) is an ongoing, multicenter registry providing real-world evidence regarding ataluren use in patients with nonsense mutation Duchenne muscular dystrophy (DMD) in clinical practice (NCT02369731). Here, we describe the initial demographic characteristics of the registry population. Patients & methods: Patients will be followed up from enrollment for ≥5 years or until study withdrawal. Results & conclusion: As of 9 July 2018, 213 DMD boys were enrolled from 11 countries. Mean (standard deviation) ages at first symptoms and at study treatment start were 2.7 (1.7) years and 9.8 (3.7) years, respectively. Corticosteroids were used by 190 patients (89.2%) before data cut-off. Mean (standard deviation) ataluren exposure was 639.0 (362.9) days. Six patients withdrew. STRIDE is the first drug registry for patients with DMD and represents the largest real-world registry of patients with nmDMD to date.
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Affiliation(s)
- Francesco Muntoni
- Dubowitz Neuromuscular Centre & MRC Centre for Neuromuscular Diseases, University College London, Institute of Child Health & Great Ormond Street Hospital for Children Foundation Trust, 30 Guildford Street, London WC1N 1EH, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, Great Ormond Street Hospital Trust, London, UK
| | - Isabelle Desguerre
- APHP Necker – Enfants Malades Hospital, Paris V Descartes University, Neuromuscular Network FILNEMUS, Paris, France
| | - Michela Guglieri
- The John Walton Muscular Dystrophy Research Centre, Newcastle University & Newcastle Upon Tyne Hospitals, Newcastle Upon Tyne, UK
| | - Andrés Nascimento Osorio
- Hospital Sant Joan de Déu Unidad de Patología Neuromuscular, Universidad de Barcelona, CIBERER, ISCIII, Barcelona, Spain
| | - Janbernd Kirschner
- Medical Center – University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Már Tulinius
- Department of Pediatrics, Gothenburg University, Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | | | - Gary Elfring
- PTC Therapeutics Inc., South Plainfield, NJ 07080-2449, USA
| | | | | | | | - Olivia Zhang
- PTC Therapeutics Inc., South Plainfield, NJ 07080-2449, USA
| | | | | | - Eugenio Mercuri
- Department of Pediatric Neurology, Catholic University, Rome, Italy
- Centro Clinico Nemo, Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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11
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McEvoy J, Park T, Schilling T, Terasawa E, Ayyagari R, Carroll B. The burden of tardive dyskinesia secondary to antipsychotic medication use among patients with mental disorders. Curr Med Res Opin 2019; 35:1205-1214. [PMID: 30638073 DOI: 10.1080/03007995.2019.1569871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To assess the impact of developing tardive dyskinesia (TD), both with and without other pre-existing extrapyramidal symptoms (EPS), on healthcare resource utilization (HRU) among patients with mental disorders receiving antipsychotic medications. Methods: Data on patients receiving antipsychotics who had schizophrenia, major depressive disorder or bipolar disorder were extracted from a Medicaid claims database. Separate cohorts of TD patients with and without other EPS ("TD + EPS" and "TD non-EPS") were constructed and matched to patients in a non-TD/EPS control cohort at a ∼1:5 ratio. HRU outcomes were assessed using descriptive statistics and difference-in-differences techniques over baseline and follow-up periods defined as the 6 months before and after TD development, respectively. Results: The TD + EPS (n = 289) and TD non-EPS (n = 394) cohorts were matched with 1398 and 1922 control patients, respectively. The percentage of patients with all-cause and mental-disorder-related inpatient admissions increased from baseline to follow-up in the TD + EPS (12.8% and 12.5%, respectively) and TD non-EPS (16.0% and 13.5%) cohorts; by contrast, slight decreases (∼3%) in these outcomes were observed in the matched controls. Difference-in-differences analyses demonstrated that development of TD was associated with a statistically significant increase of ∼15-19% in the percentage of patients with all-cause and mental-disorder-related inpatient admissions/visits. The within-cohort change from baseline to follow-up in the use of potential drugs for TD or EPS was similar between the TD cohorts and their matched controls. Conclusions: This study demonstrates a significant economic burden associated with developing TD, as captured by increased HRU including inpatient admissions and ER visits.
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Affiliation(s)
| | - Tyson Park
- b Teva Pharmaceutical Industries , Malvern , PA , USA
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12
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Abstract
High-density percolation is the formation of a system spanning cluster of vertices with at least m occupied neighbors. We discuss high-density percolation on the modified Bethe lattice in terms of the theory of large random graphs with arbitrary degree distributions. Using the formalism of generating functions, we derive expressions for the cluster size distribution, the percolation threshold, the percolation probability, and the mean size of finite clusters. We show that the critical exponents β=γ=1. Additionally, numerical solutions and simulation results for the percolation probability and mean size of finite clusters are compared for illustration.
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Affiliation(s)
- C Widder
- Physikalisches Institut Albert-Ludwigs-Universität Freiburg, Hermann-Herder-Strasse 3, 79104 Freiburg, Germany
| | - T Schilling
- Physikalisches Institut Albert-Ludwigs-Universität Freiburg, Hermann-Herder-Strasse 3, 79104 Freiburg, Germany
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13
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Kuhnhold A, Giesen SM, Schilling T. Compression of a suspension of helical Yukawa rods. Mol Phys 2018. [DOI: 10.1080/00268976.2018.1471232] [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: 10/16/2022]
Affiliation(s)
- A. Kuhnhold
- Institute of Physics, University of Freiburg, Freiburg (Breisgau), Germany
| | - S. M. Giesen
- Faculty of Chemistry, University of Marburg, Marburg, Germany
| | - T. Schilling
- Institute of Physics, University of Freiburg, Freiburg (Breisgau), Germany
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14
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Muntoni F, Desguerre I, Guglieri M, Mercuri E, Nascimento Osorio A, Kirschner J, Tulinius M, Buccello F, Delage A, Elfring G, Werner C, Schilling T, Trifillis P. DMD CLINICAL THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.140] [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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15
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Abstract
By means of computer simulations and kinetic rate equations, we study the formation of a film of rod-like particles which are deposited on a substrate. The rod-rod interactions are hard with a short-range attraction of variable strength and width, and the rod-substrate interactions favor lying rods with a variable strength. For a rod aspect ratio of 5 and deposition of up to an equivalent of one monolayer of standing rods, we demonstrate a rich variety of growth modes upon variation of the three interaction parameters. We formulate rate equations for the time evolution of densities of islands composed of standing, lying, and mixed rods. Input parameters such as diffusion constants, island capture numbers, and rod reorientation free energies are extracted from simulations, while rod reorientation attempt frequencies remain as free parameters. Numerical solutions of the rate equations in a simple truncation show rough qualitative agreement with the simulations for the early stage of film growth but an extension to later stages requires to go significantly beyond this simple truncation.
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Affiliation(s)
- M Dixit
- Université du Luxembourg, Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, L-1511 Luxembourg, Luxembourg
| | - T Schilling
- Physikalisches Institut, Albert-Ludwigs-Universität, 79104 Freiburg, Germany
| | - M Oettel
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D-72076 Tübingen, Germany
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Kaufeld T, Foerster KA, Schilling T, Kielstein JT, Kaufeld J, Shrestha M, Haller HG, Haverich A, Schmidt BMW. Preoperative serum uric acid predicts incident acute kidney injury following cardiac surgery. BMC Nephrol 2018; 19:161. [PMID: 29973162 PMCID: PMC6031174 DOI: 10.1186/s12882-018-0970-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/26/2018] [Indexed: 12/01/2022] Open
Abstract
Background Acute kidney injury (AKI) following cardiac surgery is a frequent complication and several risk factors increasing its incidence have already been characterized. This study evaluates the influence of preoperative increased serum uric acid (SUA) levels in comparison with other known risk factors on the incidence of AKI following cardiac surgery. Methods During a period of 5 month, 247 patients underwent elective coronary artery bypass grafting, valve replacement/ repair or combined bypass and valve surgery. Datas were prospectively analyzed. Primary endpoint was the incidence of AKI as defined by the AKI criteria comparing patients with preoperative serum uric acid (SUA) levels below versus above the median. Multivariate logistic regression analysis was used to identify independent predictors of postoperative AKI. Results Thirty (12.1%) of the 247 patients developed postoperative AKI, 24 of 30 (80%) had preoperative SUA- levels above the median (≥373 μmol/l) (OR: 4.680, CI 95% 1.840; 11.904, p = 0.001). In the multivariate analysis SUA levels above the median (OR: 5.497, CI 95% 1.772; 17.054, p = 0.003), cardiopulmonary bypass (CPB) time > 90 min (OR: 4.595, CI 95% 1.587; 13.305, p = 0.005), cardiopulmonary bypass (CPB) > 30 kg/m2 (OR: 3.208, CI 95% 1.202; 8.562; p = 0.02), and preoperative elevated serum-creatinine levels (OR: 1.015, CI 95% 1.001; 1.029, p = 0.04) were independently associated with postoperative AKI. Conclusions Serum uric acid is an independent risk marker for AKI after cardiac surgery. From all evaluated factors it showed the highest odds ratio.
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Affiliation(s)
- T Kaufeld
- Department of Heart, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - K A Foerster
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany
| | - T Schilling
- Department of Heart, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - J T Kielstein
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany
| | - J Kaufeld
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany
| | - M Shrestha
- Department of Heart, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - H G Haller
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany
| | - A Haverich
- Department of Heart, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - B M W Schmidt
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany
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17
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Linder R, Zeidler J, Verheyen F, von der Schulenburg JMG, Haverich A, Schilling T. Guidelines versus reality: is coronary stent application in three-vessel disease standard or the exception? Eur J Health Econ 2018; 19:821-830. [PMID: 28823011 DOI: 10.1007/s10198-017-0924-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 08/07/2017] [Indexed: 06/07/2023]
Abstract
The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively. The impact of age, sex, and comorbidity on each patient's revascularisation procedure was investigated as well. There was no significant difference in the rate of PCI between the groups. In conclusion, the hypothesis that patients with a coronary three-vessel disease are not always treated according to the recommendations of the national guidelines could not be disproved by this study. Finally, the results of this study suggest that the best revascularisation strategy for each patient with two- and three-vessel disease should be decided upon by an interdisciplinary discussion between both cardiologists and cardiac surgeons.
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Affiliation(s)
- Roland Linder
- Wissenschaftliches Institut der Techniker Krankenkasse (WINEG), Bramfelder Straße 140, 22305, Hamburg, Germany.
| | - J Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - F Verheyen
- Wissenschaftliches Institut der Techniker Krankenkasse (WINEG), Bramfelder Straße 140, 22305, Hamburg, Germany
| | - J-M Graf von der Schulenburg
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - A Haverich
- Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - T Schilling
- Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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18
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Abstract
We present a Monte Carlo simulation study of suspensions of hard ellipsoids of revolution. Based on the spatial fluctuations of the orientational order, we have computed the Frank elastic constants for prolate and oblate ellipsoids and compared them to the affine transformation model. The affine transformation model predicts the right order of magnitude of the twist and bend constant but not of the splay constant. In addition, we report the observation of a stable nematic phase at an aspect ratio as low as 2.5.
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Affiliation(s)
- S Heymans
- Université du Luxembourg, Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, L-1511 Luxembourg, Luxembourg
| | - T Schilling
- Institute of Physics, University of Freiburg, Hermann-Herder-Strasse 3, D-79104 Freiburg, Germany
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19
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Wedler K, Mersmann J, Schuster S, Stadelmeyer U, Stork G, Schwarz C, Machner M, Krebs A, Petri B, Fuchs A, Scharf J, Friesdorf M, Swistun H, Glien P, Weiß C, Dietz-Wittstock M, Dormann P, Schilling T, Walcher F. Positionspapier zur Stärkung und Weiterentwicklung der Notfallpflege in deutschen Notaufnahmen. Notf Rett Med 2017. [DOI: 10.1007/s10049-017-0333-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Klopotek M, Hansen-Goos H, Dixit M, Schilling T, Schreiber F, Oettel M. Monolayers of hard rods on planar substrates. II. Growth. J Chem Phys 2017; 146:084903. [DOI: 10.1063/1.4976308] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M. Klopotek
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - H. Hansen-Goos
- Institut für Theoretische Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - M. Dixit
- Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, Université du Luxembourg L-1511 Luxembourg, Luxembourg
| | - T. Schilling
- Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, Université du Luxembourg L-1511 Luxembourg, Luxembourg
| | - F. Schreiber
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - M. Oettel
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
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Affiliation(s)
- A. Kuhnhold
- Theory of Soft Condensed Matter, Physics and Materials Science Research Unit, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
| | - T. Schilling
- Theory of Soft Condensed Matter, Physics and Materials Science Research Unit, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
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Oettel M, Klopotek M, Dixit M, Empting E, Schilling T, Hansen–Goos H. Monolayers of hard rods on planar substrates. I. Equilibrium. J Chem Phys 2016; 145:074902. [DOI: 10.1063/1.4960618] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M. Oettel
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - M. Klopotek
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - M. Dixit
- Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
| | - E. Empting
- Institut für Angewandte Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
| | - T. Schilling
- Theory of Soft Condensed Matter, Physics and Materials Sciences Research Unit, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
| | - H. Hansen–Goos
- Institut für Theoretische Physik, Eberhard Karls Universität Tübingen, D–72076 Tübingen, Germany
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23
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Neubauer S, Zeidler J, Schilling T, Engel S, Linder R, Verheyen F, Haverich A, von der Schulenburg JM. Eignung und Anwendung von GKV-Routinedaten zur Überprüfung von Versorgungsleitlinien am Beispiel der Indikation Linksherzinsuffizienz. Gesundheitswesen 2016; 78:e135-e144. [DOI: 10.1055/s-0042-100727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- S. Neubauer
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - J. Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - T. Schilling
- Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Medizinische Hochschule Hannover, Hannover
| | - S. Engel
- WINEG, Techniker Krankenkasse, Hamburg
| | - R. Linder
- WINEG, Techniker Krankenkasse, Hamburg
| | | | - A. Haverich
- Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Medizinische Hochschule Hannover, Hannover
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Cohen AP, Dorosz S, Schofield AB, Schilling T, Sloutskin E. Structural Transition in a Fluid of Spheroids: A Low-Density Vestige of Jamming. Phys Rev Lett 2016; 116:098001. [PMID: 26991202 DOI: 10.1103/physrevlett.116.098001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Indexed: 06/05/2023]
Abstract
A thermodynamically equilibrated fluid of hard spheroids is a simple model of liquid matter. In this model, the coupling between the rotational degrees of freedom of the constituent particles and their translations may be switched off by a continuous deformation of a spheroid of aspect ratio t into a sphere (t=1). We demonstrate, by experiments, theory, and computer simulations, that dramatic nonanalytic changes in structure and thermodynamics of the fluids take place, as the coupling between rotations and translations is made to vanish. This nonanalyticity, reminiscent of a second-order liquid-liquid phase transition, is not a trivial consequence of the shape of an individual particle. Rather, free volume considerations relate the observed transition to a similar nonanalyticity at t=1 in structural properties of jammed granular ellipsoids. This observation suggests a deep connection to exist between the physics of jamming and the thermodynamics of simple fluids.
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Affiliation(s)
- A P Cohen
- Physics Department and Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan 5290002, Israel
| | - S Dorosz
- Research Unit for Physics and Materials Science, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
| | - A B Schofield
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - T Schilling
- Research Unit for Physics and Materials Science, Université du Luxembourg, L-1511 Luxembourg, Luxembourg
| | - E Sloutskin
- Physics Department and Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan 5290002, Israel
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Deniz E, Röper G, Reiss N, Rojas Hernandez S, Hanke SJ, Cebotari S, Optenhöfel J, Avsar M, Schilling T, Haverich A, Schmitto JD. Digital Stethoskope System-VADoskope: A New Diagnostic Tool to Detect Thrombus Formation. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Hauser RA, Eliaz R, Eyal E, Abler V, Schilling T. Symptomatic efficacy of rasagiline in early PD: A meta-analysis. Parkinsonism Relat Disord 2016. [DOI: 10.1016/j.parkreldis.2015.10.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Brinkers M, Pfau G, Schilling T, Meyer F. [The Risks of Perioperative Addiction to Benzodiazepines in the Elderly: What the Surgeon Needs to Know]. Zentralbl Chir 2015; 141:75-81. [PMID: 26670380 DOI: 10.1055/s-0041-107198] [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: 10/22/2022]
Abstract
BACKGROUND In Germany, more than one million people use benzodiazepines on a regular basis. The majority of them is older than 60 years and take low-dose benzodiazepines for sleep disorders. This does not necessarily induce tolerance, but may result in problems such as falling, seizures or delirium if benzodiazepines are discontinued or taken on a long-term basis. Therefore, benzodiazepines can be associated with problems before, during and after surgery, in particular in the elderly. This narrative review aims to describe the clinical relevance for daily practice. KEY POINTS 1. The high-dose use of drugs that induce addiction with possible parallel consumption of other drugs is clinically important. Even more relevant, however, is the large number of elderly people taking benzodiazepines periodically and in low doses for sleep disturbances. 2. Low-dose addiction of benzodiazepines is defined as daily use of less than 20 mg of a diazepam equivalent. 3. Short-acting benzodiazepines can promote addiction; long-acting benzodiazepines produce hangover effects. 4. During a hospital stay, rapid discontinuation induces withdrawal symptoms; continuous prescription may result in incidents and increases the risk of postoperative delirium. CONCLUSION For the intake and continuous prescription there are four basic rules:Well-defined indication, correct dosage, short application, no sudden discontinuation.
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Affiliation(s)
- M Brinkers
- Klinik für Anästhesiologie & Intensivtherapie, Universitätsklinikum Magdeburg A. ö. R., Deutschland
| | - G Pfau
- Klinik für Anästhesiologie & Intensivtherapie, Universitätsklinikum Magdeburg A. ö. R., Deutschland
| | - T Schilling
- Klinik für Anästhesiologie & Intensivtherapie, Universitätsklinikum Magdeburg A. ö. R., Deutschland
| | - F Meyer
- Klinik für Allgemein-, Viszeral- & Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Deutschland
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Hentschel J, Schilling T, Arnold C, Jahnsen W, Hünniger K, Hipler UC, Pfister W, Sonnemann J, Lehmann T, Mainz J. ePS06.4 Upper airway infection and inflammation in CF and healthy controls during exacerbation and stable phases. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Thiel M, Schilling T, Gey DC, Ziegler R, Collery P, Keppler BK. Tris(8-quinolinolato)gallium(III), a Novel Orally Applied Antitumor Gallium Compound. ACTA ACUST UNITED AC 2015. [DOI: 10.1159/000425857] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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Bauer M, Schilling T, Weidling M, Hartung D, Biskup C, Wriggers P, Wacker F, Bach FW, Haverich A, Hassel T. Geometric adaption of biodegradable magnesium alloy scaffolds to stabilise biological myocardial grafts. Part I. J Mater Sci Mater Med 2014; 25:909-916. [PMID: 24264726 DOI: 10.1007/s10856-013-5100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 11/14/2013] [Indexed: 06/02/2023]
Abstract
Synthetic patch materials currently in use have major limitations, such as high susceptibility to infections and lack of contractility. Biological grafts are a novel approach to overcome these limitations, but do not always offer sufficient mechanical durability in early stages after implantation. Therefore, a stabilising structure based on resorbable magnesium alloys could support the biological graft until its physiologic remodelling. To prevent early breakage in vivo due to stress of non-determined forming, these scaffolds should be preformed according to the geometry of the targeted myocardial region. Thus, the left ventricular geometry of 28 patients was assessed via standard cardiac magnetic resonance imaging (MRI). The resulting data served as a basis for a finite element simulation (FEM). Calculated stresses and strains of flat and preformed scaffolds were evaluated. Afterwards, the structures were manufactured by abrasive waterjet cutting and preformed according to the MRI data. Finally, the mechanical durability of the preformed and flat structures was compared in an in vitro test rig. The FEM predicted higher durability of the preformed scaffolds, which was proven in the in vitro test. In conclusion, preformed scaffolds provide extended durability and will facilitate more widespread use of regenerative biological grafts for surgical left ventricular reconstruction.
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Affiliation(s)
- M Bauer
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Lise-Meitner-Str. 1, 30823, Garbsen, Germany,
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Kaufeld K, Schilling T, Hinz C, Brandes G, Cebotari S, Tudorache I, Mogaldea A, Bach FW, Hassel T, Biskup C, Bauer M, Hilfiker A, Haverich A. Decellularized aortic allograft stabilized by an absorbable magnesium scaffold for substitution of the descending aorta. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mogaldea A, Hilfiker A, Schilling T, Haverich A. Tissue engineering of regenerative cardiovascular patch material based on decellularized pericardium. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schilling T, Kozian A. Which factors determine prognosis after ventilator-associated pneumothorax in mechanically ventilated patients? Minerva Anestesiol 2014; 80:3-4. [PMID: 24226499] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- T Schilling
- Cardiac and Thoracic Anaesthesia, Department of Anaesthesiology and Intensive Care Medicine, Otto-von-Guericke-University, Magdeburg, Germany -
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Nigro B, Grimaldi C, Miller MA, Ryser P, Schilling T. Depletion-interaction effects on the tunneling conductivity of nanorod suspensions. Phys Rev E Stat Nonlin Soft Matter Phys 2013; 88:042140. [PMID: 24229148 DOI: 10.1103/physreve.88.042140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 09/25/2013] [Indexed: 06/02/2023]
Abstract
We study by simulation and theory how the addition of insulating spherical particles affects the conductivity of fluids of conducting rods, modeled by spherocylinders. The electrical connections are implemented as tunneling processes, leading to a more detailed and realistic description than a discontinuous percolation approach. We find that the spheres enhance the tunneling conductivity for a given concentration of rods and that the enhancement increases with rod concentration into the regime where the conducting network is well established. By reformulating the network of rods using a critical path analysis, we quantify the effect of depletion-induced attraction between the rods due to the spheres. Furthermore, we show that our conductivity data are quantitatively reproduced by an effective-medium approximation, which explicitly relates the system tunneling conductance to the structure of the rod-sphere fluid.
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Affiliation(s)
- B Nigro
- LPM, Ecole Polytechnique Fédérale de Lausanne, Station 17, Case Postale 1015 Lausanne, Switzerland
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Bauer M, Biskup C, Schilling T, Haverich A, Bach FW, Maier HJ, Hassel T. Influence of Shot Peening on Surface Roughness and Invitro Load Cycles of Magnesium Alloys. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-C/bmt-2013-4060/bmt-2013-4060.xml. [PMID: 24042742 DOI: 10.1515/bmt-2013-4060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Runowski T, Schilling T, Heinz D, Buchaly C. PTT - eine Projektinitiative zur Lösung betriebsnaher komplexer Fragestellungen unter Einbeziehung von Betrieb, Prozessentwicklung und Unit Operations. CHEM-ING-TECH 2013. [DOI: 10.1002/cite.201250687] [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: 11/08/2022]
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Schilling T, Kretzschmar M, Hachenberg T, Hedenstier-Na G, Kozian A. The immune response to one-lung-ventilation is not affected by repeated alveolar recruitment manoeuvres in pigs. Minerva Anestesiol 2013; 79:590-603. [PMID: 23449239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Acute lung injury after thoracic surgery relates to alveolar inflammation induced by one-lung ventilation (OLV) and surgical manipulation. However, alveolar recruitment manoeuvres (ARM), conventional ventilation, and airway manipulation may increase alveolar trauma. This study evaluates pulmonary immune effects of these co-factors in a porcine model. METHODS Twenty-two piglets (27.3 kg) were randomised to spontaneous breathing (N.=4), two-lung ventilation (TLV, N.=6), OLV with propofol (6 mg/kg/h, N.=6) or desflurane anesthesia (1MAC, N.=6). Mechanical ventilation settings were constant throughout the experiment: VT=10 mL/kg, FIO2=0.4, PEEP=5 cmH2O. OLV was performed by left-sided bronchial blockade. Thoracic surgery was simulated for 60 min. ARM (airway pressure of 40 mbar for 10 s) was applied before and after each airway manipulation. Cytokines and mRNA-expression were assessed by immunoassays and semi-quantitative RT-PCR in alveolar lavage fluids, serum and tissue samples prior to and after OLV (TLV in controls). RESULTS Repetitive ARM and TLV induced no significant proinflammatory effects. OLV enhanced cytokine release but less with desflurane inhalation than propofol infusion (median (IQR) [pg/mL], dependent lung): Interleukin-8: TLV 44 (17) to 68 (35), propofol 82 (17) to 494 (231), desflurane 89 (30) to 282 (44). Likewise, serum cytokines were different: tumour necrosis factor-a: TLV 37 (13) to 62 (7), propofol 55 (39) to 94 (60), desflurane 43 (33) to 41 (25). Expression of interleukin-8-mRNA increased after OLV, but mRNA expression was not modulated by anesthetics. CONCLUSION ARM, standard TLV and repetitive BAL do not additionally contribute to lung injury resulting from OLV for thoracic surgery in healthy porcine lungs. OLV induces expression of interleukin-8-mRNA in alveolar cells, which is not modulated by different anesthetic drugs.
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Affiliation(s)
- T Schilling
- Department of Anesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Germany.
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Weidling M, Besdo S, Schilling T, Bauer M, Hassel T, Haverich A, Wriggers P. Finite element simulation of myocardial stabilising structures and development of new designs. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-C/bmt-2013-4061/bmt-2013-4061.xml. [DOI: 10.1515/bmt-2013-4061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oettel M, Dorosz S, Berghoff M, Nestler B, Schilling T. Description of hard-sphere crystals and crystal-fluid interfaces: a comparison between density functional approaches and a phase-field crystal model. Phys Rev E Stat Nonlin Soft Matter Phys 2012; 86:021404. [PMID: 23005760 DOI: 10.1103/physreve.86.021404] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Indexed: 06/01/2023]
Abstract
In materials science the phase-field crystal approach has become popular to model crystallization processes. Phase-field crystal models are in essence Landau-Ginzburg-type models, which should be derivable from the underlying microscopic description of the system in question. We present a study on classical density functional theory in three stages of approximation leading to a specific phase-field crystal model, and we discuss the limits of applicability of the models that result from these approximations. As a test system we have chosen the three-dimensional suspension of monodisperse hard spheres. The levels of density functional theory that we discuss are fundamental measure theory, a second-order Taylor expansion thereof, and a minimal phase-field crystal model. We have computed coexistence densities, vacancy concentrations in the crystalline phase, interfacial tensions, and interfacial order parameter profiles, and we compare these quantities to simulation results. We also suggest a procedure to fit the free parameters of the phase-field crystal model. Thereby it turns out that the order parameter of the phase-field crystal model is more consistent with a smeared density field (shifted and rescaled) than with the shifted and rescaled density itself. In brief, we conclude that fundamental measure theory is very accurate and can serve as a benchmark for the other theories. Taylor expansion strongly affects free energies, surface tensions, and vacancy concentrations. Furthermore it is phenomenologically misleading to interpret the phase-field crystal model as stemming directly from Taylor-expanded density functional theory.
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Affiliation(s)
- M Oettel
- Johannes Gutenberg-Universität Mainz, Institut für Physik, WA 331, D-55099 Mainz, Germany
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Gok Oguz E, Olmaz R, Turgutalp K, Muslu N, Sungur MA, Kiykim A, Van Biesen W, Vanmassenhove J, Glorieux G, Vanholder R, Chew S, Forster K, Kaufeld T, Kielstein J, Schilling T, Haverich A, Haller H, Schmidt B, Hu P, Liang X, Liang X, Chen Y, LI R, Jiang F, LI Z, Shi W, Lim CCW, Lim CCW, Chia CML, Tan AK, Tan CS, Hu P, Liang X, Liang X, Chen Y, LI R, Jiang F, LI Z, Shi W, Ng R, Subramani S, Chew S, Perez de Jose A, Bernis Carro C, Madero Jarabo R, Bustamante J, Sanchez Tomero JA, Chung W, Ro H, Chang JH, Lee HH, Jung JY, Vanmassenhove J, Van Biesen W, Glorieux G, Vanholder R, Fazzari L, Giuliani A, Scrivano J, Pettorini L, Benedetto U, Luciani R, Roscitano A, Napoletano A, Coclite D, Cordova E, Punzo G, Sinatra R, Mene P, Pirozzi N, Shavit L, Shavit L, Manilov R, Algur N, Wiener-Well Y, Slotki I, Pipili C, Pipili C, Vrettou CS, Avrami K, Economidou F, Glynos K, Ioannidou S, Markaki V, Douka E, Nanas S, De Pascalis A, De Pascalis A, Cofano P, Proia S, Valletta A, Vitale O, Russo F, Buongiorno E, Filiopoulos V, Biblaki D, Lazarou D, Chrysis D, Fatourou M, Lafoyianni S, Vlassopoulos D, Zakiyanov O, Kriha V, Vachek J, Svarcova J, Zima T, Tesar V, Kalousova M, Kaushik M, Kaushik M, Ronco C, Cruz D, Zhang L, Zhang W, Zhang W, Chen N, Ejaz AA, Kambhampati G, Ejaz N, Dass B, Lapsia V, Arif AA, Asmar A, Shimada M, Alsabbagh M, Aiyer R, Johnson R, Chen TH, Chang CH, Chang MY, Tian YC, Hung CC, Fang JT, Yang CW, Chen YC, Cantaluppi V, Quercia AD, Figliolini F, Giacalone S, Pacitti A, Gai M, Guarena C, Leonardi G, Leonardi G, Biancone L, Camussi G, Segoloni GP, De Cal M, Lentini P, Clementi A, Virzi GM, Scalzotto E, Ronco C, Lacquaniti A, Lacquaniti A, Donato V, Fazio MR, Lucisano S, Cernaro V, Lupica R, Buemi M, Turgutalp K, Helvaci I, Anik E, Kiykim A, Wani M, Wani DI, Bhat DMA, Banday DK, Najar DMS, Reshi DAR, Palla DNA, Turgutalp K, Kiykim A, Helvaci I, Iglesias P, Olea T, Vega-Cabrera C, Heras M, Bajo MA, Del Peso G, Arias MJ, Selgas R, Diez JJ, Daher E, Costa PL, Pereira ENS, Santos RDP, Abreu KL, Silva Junior G, Pereira EDB, Raimundo M, Crichton S, Syed Y, Martin J, Whiteley C, Bennett D, Ostermann M, Gjyzari A, Thereska N, Koroshi A, Barbullushi M, Kodra S, Idrizi A, Strakosha A, Petrela E, Raimundo M, Crichton S, Syed Y, Martin J, Lemmich Smith J, Bennett D, Ostermann M, Klimenko A, Tuykhmenev E, Villevalde S, Kobalava Z, Avdoshina S, Villevalde S, Tyukhmenev E, Efremovtseva M, Kobalava Z, Hayashi H, Hayashi H, Suzuki S, Kataoka K, Kondoh Y, Taniguchi H, Sugiyama D, Nishimura K, Sato W, Maruyama S, Matsuo S, Yuzawa Y, Geraldine D, Muriel F, Alexandre H, Eric R, Fu P, Zhang L, Pozzato M, Ferrari F, Cecere P, Mesiano P, Vallero A, Livigni S, Quarello F, Hudier L, Decaux O, Haddj-Elmrabet A, Mandart L, Lino-Daniel M, Bridoux F, Renaudineau E, Sawadogo T, Le Pogamp P, Vigneau C, Famee D, Koo HM, Oh HJ, Han SH, Choi KH, Kang SW, Mehdi M, Nicolas M, Mariat C, Shah P, Kute VB, Vanikar A, Gumber M, Patel H, Trivedi H, Pipili C, Pipili C, Manetos C, Vrettou CS, Poulaki S, Tripodaki ES, Papastylianou A, Routsi C, Nanas S, Uchida K, Kensuke U, Yamagata K, Saitou C, Okada M, Chita G, Davies M, Veriawa Y, Naicker S, Mukhopadhyay P, Mukherjee D, Mishra R, Kar M, Zickler D, Wesselmann H, Schindler R, Gutierrez* E, Egido J, Rubio-Navarro A, Buendia I, Blanco-Colio LM, Toldos O, Manzarbeitia F, De Lorenzo A, Sanchez R, Praga^ M, Moreno^ JA, Kim MY, Kang NR, Jang HR, Lee JE, Huh W, Kim YG, Kim DJ, Hong SC, Kim JS, Oh HY, Okamoto T, Kamata K, Naito S, Tazaki H, Kan S, Anne-Kathrin LG, Matthias K, Speer T, Andreas L, Heinrich G, Thomas V, Poppleton A, Danilo F, Matthias K, Lai CF, Wu VC, Shiao CC, Huang TM, Wu KD, Bedford M, Farmer C, Irving J, Stevens P, Patera F, Patera F, Mattozzi F, Battistoni S, Fagugli RM, Park MY, Choi SJ, Kim JG, Hwang SD, Xie H, Chen H, Xu S, He Q, Liu J, Hu W, Liu Z, Dalboni M, Blaya R, Quinto BM, Narciso R, Oliveira M, Monte J, Durao M, Cendoroglo M, Batista M, Hanemann AL, Liborio A, Daher E, Martins A, Pinheiro MCC, Silva Junior G, Meneses G, De Paula Pessoa R, Sousa M, Bezerra FSM, Albuquerque PLMM, Lima JB, Lima CB, Veras MDSB, Silva Junior G, Daher E, Nemoto Matsui T, Totoli C, Cruz Andreoli MC, Vilela Coelho MP, Guimaraes de Souza NK, Ammirati AL, De Carvalho Barreto F, Ferraz Neto BH, Fortunato Cardoso Dos Santos B, Abraham A, Abraham G, Mathew M, Duarte PMA, Duarte FB, Barros EM, Castro FQS, Silva Junior G, Daher E, Palomba H, Castro I, Sousa SR, Jesus AN, Romano T, Burdmann E, Yu L, Kwon SH, You JY, Hyun YK, Woo SA, Jeon JS, Noh HJ, Han DC, Tozija L, Tozija L, Petronievic Z, Selim G, Nikolov I, Stojceva-Taneva O, Cakalaroski K, Lukasz A, Beneke J, Schmidt B, Kielstein J, Haller H, Menne J, Schiffer M, Polanco N, Hernandez E, Gutierrez E, Gutierrez Millet V, Gonzalez Monte E, Morales E, Praga M, Francisco Javier L, Nuria GF, Jose Maria MG, Bes Rastrollo M, Angioi A, Conti M, Cao R, Atzeni A, Pili G, Matta V, Murgia E, Melis P, Binda V, Pani A, Thome* F, Leusin F, Barros E, Morsch C, Balbinotto A, Pilla C, Premru V, Buturovic-Ponikvar J, Ponikvar R, Marn-Pernat A, Knap B, Kovac J, Gubensek J, Kersnic B, Krnjak L, Prezelj M, Granatova J, Havrda M, Hruskova Z, Kratka K, Remes O, Mokrejsova M, Bolkova M, Lanska V, Rychlik I, Uniacke MD, Lewis RJ, Harris S, Roderick P, Thome* F, Balbinotto A, Barros E, Morsch C, Martin N, Ulrich K, Jan B, Jorn B, Reinhard B, Jan K, Hermann H, Meyer Tobias F, Leyla R, Schmidt Bernhard MW, Harald S, Jurgen S, Tanja K, Menne J, Mario S, Jan B, Jan B, Sang Hi E, Leyla R, Claus M, Frank V, Aleksej S, Sengul S, Jan K, Jorn B, Reinhard B, Meyer Tobias F, Schmidt Bernhard MW, Mario S, Martin N, Ulrich K, Robert S, Karin W, Tanja K, Hermann H, Menne J, Leyla R, Leyla R, Jan K, Jan B, Reinhard B, Feikah G, Hermann H, Tanja K, Ulrich K, Menne Tobias F, Claus M, Martin N, Mario S, Schmidt Bernhard MW, Harald S, Jurgen S, Menne J, Claus M, Claus M, Jan K, Jan B, Reinhard B, Feikah G, Hermann H, Ulrich K, Menne Tobias F, Meyer Tobias N, Martin N, Leyla R, Schmidt Bernhard MW, Harald S, Jurgen S, Tanja K, Mario S, Menne J, Kielstein J, Beutel G, Fleig S, Steinhoff J, Meyer T, Hafer C, Bramstedt J, Busch V, Vischedyk M, Kuhlmann U, Ries W, Mitzner S, Mees S, Stracke S, Nurnberger J, Gerke P, Wiesner M, Sucke B, Abu-Tair M, Kribben A, Klause N, Schindler R, Merkel F, Schnatter S, Dorresteijn E, Samuelsson O, Brunkhorst R, Stec-Hus Registry G, Reising A, Hafer C, Kielstein J, Schmidt B, Bange FC, Hiss M, Vetter F, Kielstein J, Beneke J, Bode-Boger SM, Martens-Lobenhoffer J, Schiffer M, Schmidt BMW, Haller H, Menne J, Kielstein JT, Shin HS, Jung YS, Rim H. AKI - Clinical. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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HARTUNG D, Schilling T, Tudorache I, Cebotari S, Kaufeld T, Hinz C, Biskup C, Hassel T, Bach FW, Wacker F, Haverich A. Magnetresonanztomographie (MRT) zur Beurteilung von dezellularisierten Aortenprothesen im Großtiermodell. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nigro B, Grimaldi C, Miller MA, Ryser P, Schilling T. Tunneling conductivity in composites of attractive colloids. J Chem Phys 2012; 136:164903. [DOI: 10.1063/1.4705307] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Baraki H, Al Ahmad A, Schilling T, Pichlmaier M, Martens A, Haverich A, Kutschka I. Are universal rRNA gene PCR and sequencing tests an alternative to conventional culture analysis for infected alloplastic implants? Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297905] [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: 10/14/2022]
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Schilling T, Biskup C, Brandes G, Hinz C, Kaufeld KT, Cebotari S, Tudorache I, Hassel T, Bach FW, Haverich A. Stabilizing decellularized allogeneic aortic grafts by magnesium clips. First results of a large animal trial. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297522] [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: 10/14/2022]
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Bauer M, Hassel T, Biskup C, Hartung D, Schilling T, Weidling M, Wriggers P, Wacker F, Bach FW, Haverich A. Geometric adaption of resorbable myocardial stabilizing structures based on the magnesium alloys LA63 and ZEK100 for the support of myocardial grafts on the left ventricle. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4214] [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: 11/15/2022]
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Buchbinder S, Bärtsch U, Müller M, Zorn M, Nawroth PP, Schilling T. A novel missense mutation T101N in the melanocortin-4 receptor gene associated with obesity. Genet Mol Res 2011; 10:1042-9. [PMID: 21710454 DOI: 10.4238/vol10-2gmr948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mutations in the melanocortin-4 receptor (MC4R) are associated with severe obesity, independent of their effect on cortisol or thyroid-stimulating hormone levels. We examined a morbidly obese male (BMI = 62 kg/m²) with a binge-eating disorder and eight family members for mutations in the MC4R gene and potential differences in leptin levels. Fifty healthy individuals served as controls. Sequence analysis revealed a novel heterozygous missense mutation (c.302 C>A, p.T101N) located in the second transmembrane domain of the receptor, which was not detected in controls. The Fisher exact test revealed an association between the T101N mutation and history of obesity (P < 0.05) in the family. The Kruskal-Wallis test showed an association between the mutation and the leptin/BMI ratio (P < 0.05), while there was no association between the T101N mutation and diabetes or arterial hypertension in the family. Although the available family was small, we could show a significant association between the heterozygous T101N mutation and obesity.
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Affiliation(s)
- S Buchbinder
- Department of Internal Medicine 1 and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
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Schilling T, Dorosz S, Schöpe HJ, Opletal G. Crystallization in suspensions of hard spheres: a Monte Carlo and molecular dynamics simulation study. J Phys Condens Matter 2011; 23:194120. [PMID: 21525557 DOI: 10.1088/0953-8984/23/19/194120] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The crystallization of a metastable melt is one of the most important non-equilibrium phenomena in condensed matter physics, and hard sphere colloidal model systems have been used for several decades to investigate this process by experimental observation and computer simulation. Nevertheless, there is still an unexplained discrepancy between the simulation data and experimental nucleation rate densities. In this paper we examine the nucleation process in hard spheres using molecular dynamics and Monte Carlo simulation. We show that the crystallization process is mediated by precursors of low orientational bond-order and that our simulation data fairly match the experimental data sets.
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Affiliation(s)
- T Schilling
- Theory of Soft Condensed Matter, Université du Luxembourg, Luxembourg, Luxembourg
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Schilling T, Schmid F. Erratum: “Computing absolute free energies of disordered structures by molecular simulation” [J. Chem. Phys. 131, 231102 (2009)]. J Chem Phys 2011. [DOI: 10.1063/1.3582906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Tissue engineering of bioartificial myocardial tissue will become an increasingly important therapeutic approach in the near future but supply of oxygen and nutrients as well as evacuation of metabolic products represent a critical obstacle in tissues with a thickness of 100 µm and above. Viability of seeded cells in the myocardial patch is positively correlated with its function and thus early sufficient vascularization is mandatory. The choice of substrate, structure of matrices, specific cellular seeding and addition of growth factors contribute to this necessary vascularization process.This review article gives an overview of the current state of research on recent myocardial tissue engineering utilizing natural and solid substrates (urinary bladder, gall bladder, small intestine, stomach, peritoneum, omentum, uterus, skeletal muscle, diaphragm and cardiac muscle) with a special focus on the results of vascularization of bioartificial tissue for each approach.
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Affiliation(s)
- T Schilling
- Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie , Medizinischen Hochschule Hannover, Carl-Neuberg-Strasse 1, Hannover, Germany.
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