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Hildenbrand T, Kuhn S, Everad F, Hassepaß F, Neudert M, Offergeld C. [Views of assistant professors on digital transformation in otorhinolaryngology education : Current status and perspectives in undergraduate and advanced training]. HNO 2024; 72:303-309. [PMID: 38587662 PMCID: PMC11045641 DOI: 10.1007/s00106-024-01468-1] [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] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Digital transformation in curricular teaching in medicine comprises the use of digital teaching and learning formats as well as the transfer of digital skills for medical staff. Concepts of knowledge transfer and competency profiles also have to be adapted and transferred in advanced training due to necessary changes. OBJECTIVE The aim of this study was an evaluation of the current state of digital transformation in otorhinolaryngology teaching in undergraduate and advanced training at otorhinolaryngology departments of university medical centers in Germany. MATERIALS AND METHODS A questionnaire with nine questions on digital transformation was sent to the assistant professors of 37 national university ENT departments. The anonymous survey was conducted online via the online platform SurveyMonkey®. RESULTS Of the contacted assistant professors, 86.5% participated in the survey. Teaching sessions on digital skills for medical students are part of the curriculum in only 25% of ENT departments. Digital teaching formats are used by half of the departments in undergraduate training. Only 56.25% of the assistant professors receive support to realize the changes required by digital transformation. In 40.62% of departments, the issue of digital transformation is broached during advanced training, but only 28.12% use digital teaching methods to train junior doctors. CONCLUSION Aspects of digital transformation are implemented mainly in undergraduate education, partly driven by the COVID 19 pandemic. Overall, there is still considerable backlog in undergraduate and advanced training in ENT.
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Affiliation(s)
- T Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - S Kuhn
- Institut für Digitale Medizin, Universitätsklinikum Gießen-Marburg & Philipps-Universität Marburg, Marburg, Deutschland
| | - F Everad
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - F Hassepaß
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - M Neudert
- Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
| | - C Offergeld
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Offergeld C, Kuhn S, Kromeier J, Heermann S, Widder A, Flayyih O, Everad F, Knopf A, Albrecht T, Burkhardt V, Hildenbrand T, Ramackers W. [Is the use of virtual reality in otorhinolaryngology teaching automatically positively rated by students? : A questionnaire-based evaluation among students]. HNO 2024; 72:367-374. [PMID: 38578464 PMCID: PMC11045625 DOI: 10.1007/s00106-024-01453-8] [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] [Accepted: 01/29/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Analogous to the situation in other disciplines, digital ENT teaching made significant progress during the pandemic. Most ENT clinics nationwide were able to offer a complete virtual teaching program in time. Innovative teaching methods were also used early on. This was recognized in student teaching evaluations. Due to the expansion of virtual reality (VR) in medical teaching, even greater satisfaction should be expected through improved teaching quality. MATERIALS AND METHODS Surveys were performed with students (n = 180) of the ENT block internship in the summer semester of 2023. The aim of the evaluation was to determine the students' satisfaction with and subjective effectiveness of the newly implemented VR digital teaching method for teaching ear anatomy and coniotomy. A survey was also carried out among resident physicians. RESULTS The ENT teaching was perceived favorably by the students, with an average rating of 11.7 out of 15. The learning effectiveness and the value of VR in the ENT learning portfolio was evaluated varyingly by the students. The physicians' assessment was different, with a more positive perception. CONCLUSION Virtual reality represents an innovative component in the teaching portfolio of otolaryngology. This new teaching method is viewed and accepted as a future-oriented tool. Remarkably, the physicians involved voted consistently positively, while the students gave more critical assessments and pointed out limitations in the individual and subjective areas. These findings are in contrast to the further development of innovative teaching methods demanded by student interest groups.
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Affiliation(s)
- C Offergeld
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - S Kuhn
- Institut für Digitalisierung in der Medizin, Universitätsklinikum Gießen-Marburg, Marburg, Deutschland
| | - J Kromeier
- Klinik für Radiologie, St. Josef-Krankenhaus Freiburg, Freiburg, Deutschland
| | - S Heermann
- Institut für Anatomie und Zellbiologie, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - A Widder
- Studiendekanat der Med. Fak., Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - O Flayyih
- Studiendekanat der Med. Fak., Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - F Everad
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - A Knopf
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - T Albrecht
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - V Burkhardt
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - T Hildenbrand
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - W Ramackers
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
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Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Schade A, Bader A, Huber T, Kuhn S, Czyszanowski T, Pfenning A, Rygała M, Smołka T, Motyka M, Sęk G, Hartmann F, Höfling S. Monolithic high contrast grating on GaSb/AlAsSb based epitaxial structures for mid-infrared wavelength applications. Opt Express 2023; 31:16025-16034. [PMID: 37157690 DOI: 10.1364/oe.487119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We demonstrate monolithic high contrast gratings (MHCG) based on GaSb/AlAs0.08Sb0.92 epitaxial structures with sub-wavelength gratings enabling high reflection of unpolarized mid-infrared radiation at the wavelength range from 2.5 to 5 µm. We study the reflectivity wavelength dependence of MHCGs with ridge widths ranging from 220 to 984 nm and fixed 2.6 µm grating period and demonstrate that peak reflectivity of above 0.7 can be shifted from 3.0 to 4.3 µm for ridge widths from 220 to 984 nm, respectively. Maximum reflectivity of up to 0.9 at 4 µm can be achieved. The experiments are in good agreement with numerical simulations, confirming high process flexibility in terms of peak reflectivity and wavelength selection. MHCGs have hitherto been regarded as mirrors enabling high reflection of selected light polarization. With this work, we show that thoughtfully designed MHCG yields high reflectivity for both orthogonal polarizations simultaneously. Our experiment demonstrates that MHCGs are promising candidates to replace conventional mirrors like distributed Bragg reflectors to realize resonator based optical and optoelectronic devices such as resonant cavity enhanced light emitting diodes and resonant cavity enhanced photodetectors in the mid-infrared spectral region, for which epitaxial growth of distributed Bragg reflectors is challenging.
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Rothweiler R, Kuhn S, Stark T, Heinemann S, Hoess A, Fuessinger MA, Brandenburg LS, Roelz R, Metzger MC, Hubbe U. Development of a new critical size defect model in the paranasal sinus and first approach for defect reconstruction-An in vivo maxillary bone defect study in sheep. J Mater Sci Mater Med 2022; 33:76. [PMID: 36264396 PMCID: PMC9584845 DOI: 10.1007/s10856-022-06698-9] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Fractures of the paranasal sinuses often require surgical intervention. Persisting bone defects lead to permanent visible deformities of the facial contours. Bone substitutes for reconstruction of defects with simultaneous induction of new bone formation are not commercially available for the paranasal sinus. New materials are urgently needed and have to be tested in their future area of application. For this purpose critical size defect models for the paranasal sinus have to be developed. A ≥2.4 cm large bilateral circular defect was created in the anterior wall of the maxillary sinus in six sheep via an extraoral approach. The defect was filled with two types of an osteoconductive titanium scaffold (empty scaffold vs. scaffold filled with a calcium phosphate bone cement paste) or covered with a titanium mesh either. Sheep were euthanized after four months. All animals performed well, no postoperative complications occured. Meshes and scaffolds were safely covered with soft tissue at the end of the study. The initial defect size of ≥2.4 cm only shrunk minimally during the investigation period confirming a critical size defect. No ingrowth of bone into any of the scaffolds was observed. The anterior wall of the maxillary sinus is a region with low complication rate for performing critical size defect experiments in sheep. We recommend this region for experiments with future scaffold materials whose intended use is not only limited to the paranasal sinus, as the defect is challenging even for bone graft substitutes with proven osteoconductivity. Graphical abstract.
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Affiliation(s)
- R Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - S Kuhn
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - T Stark
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - S Heinemann
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - A Hoess
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - M A Fuessinger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - L S Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - R Roelz
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - M C Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - U Hubbe
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
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Kuhn S, Lehmann K, Verthein U. Evaluation der 3. Verordnung zur Änderung der
Betäubungsmittel-Verschreibungsverordnung (3.BtMVVÄndV):
Ergebnisse im Überblick. Suchttherapie 2022. [DOI: 10.1055/s-0042-1755972] [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] [Indexed: 03/22/2023]
Affiliation(s)
- S Kuhn
- Universitätsklinikum Hamburg-Eppendorf, Zentrum für
Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS),
Hamburg
| | - K Lehmann
- Universitätsklinikum Hamburg-Eppendorf, Zentrum für
Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS),
Hamburg
| | - U Verthein
- Universitätsklinikum Hamburg-Eppendorf, Zentrum für
Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS),
Hamburg
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Lehmann K, Kuhn S, Verthein U. Substitutionsbehandlung Opioidabhängiger unter der
COVID-19-Pandemie. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756101] [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] [Indexed: 03/22/2023]
Affiliation(s)
- K Lehmann
- Zentrum für Interdisziplinäre Suchtforschung der
Universität Hamburg, Hamburg
| | - S Kuhn
- Zentrum für Interdisziplinäre Suchtforschung der
Universität Hamburg, Hamburg
| | - U Verthein
- Zentrum für Interdisziplinäre Suchtforschung der
Universität Hamburg, Hamburg
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Hubbe U, Beiser S, Kuhn S, Stark T, Hoess A, Cristina-Schmitz H, Vasilikos I, Metzger MC, Rothweiler R. A fully ingrowing implant for cranial reconstruction: Results in critical size defects in sheep using 3D-printed titanium scaffold. Biomater Adv 2022; 136:212754. [PMID: 35929289 DOI: 10.1016/j.bioadv.2022.212754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/15/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 06/15/2023]
Abstract
Current alloplastic materials such as PMMA, titanium or PEEK don't show relevant bone ingrowth into the implant when used for cranioplasty, ceramic implants have the drawback being brittle. New materials and implant designs are urgently needed being biocompatible, stable enough for cranioplasty and stimulating bone formation. In an in vivo critical size sheep model circular cranial defects (>2.4 cm) were covered with three different types of a 3D-printed porous titanium scaffolds with multidirectional, stochastically distributed architecture (uncoated scaffold, hydroxyapatite-coated scaffold, uncoated scaffold filled with a calcium phosphate bone cement paste containing β-TCP granules). An empty titanium mesh served as control. Among the different investigated setups the hydroxyapatite-coated scaffolds showed a surprisingly favourable performance. Push-out tests revealed a 2.9 fold higher force needed in the hydroxyapatite-coated scaffolds compared to the mesh group. Mean CT density at five different points inside the scaffold was 2385HU in the hydroxyapatite-coated group compared to 1978HU in the uncoated scaffold at nine months. Average lateral bone ingrowth after four months in the hydroxyapatite-coated scaffold group was up to the implant center, 12.1 mm on average, compared to 2.8 mm in the control group covered with mesh only. These properties make the investigated scaffold with multidirectional, stochastically distributed structure superior to all products currently on the market. The study gives a good idea of what future materials for cranioplasty might look like.
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Affiliation(s)
- U Hubbe
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - S Beiser
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - S Kuhn
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, Freiburg 79111, Germany.
| | - T Stark
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, Freiburg 79111, Germany.
| | - A Hoess
- INNOTERE GmbH, Meissner Str. 191, Radebeul, 01445, Germany
| | - H Cristina-Schmitz
- Division of Experimental Surgery, Center for Experimental Models and Transgenic Services, Germany; Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
| | - I Vasilikos
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - M C Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg 79106, Germany.
| | - R Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg 79106, Germany.
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Goebel TA, Nold J, Hupel C, Kuhn S, Haarlammert N, Schreiber T, Matzdorf C, Imogore TO, Krämer RG, Richter D, Tünnermann A, Nolte S. Ultrashort pulse written fiber Bragg gratings as narrowband filters in multicore fibers. Appl Opt 2021; 60:D43-D51. [PMID: 34263827 DOI: 10.1364/ao.421089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/13/2021] [Indexed: 06/13/2023]
Abstract
We present the inscription of narrow-linewidth fiber Bragg gratings (FBGs) into different types of multicore fibers (MCFs) using ultrashort laser pulses and the phase mask technique, which can act as notch filters. Such filters are required, e.g., to suppress light emitted by hydroxyl in the Earth's upper atmosphere, which disturbs ground-based observation of extraterrestrial objects in the near infrared. However, the inscription into a commercially available seven-core fiber showed a quite large core-to-core deviation of the resonance wavelength of up to 0.45 nm. Two options are presented to overcome this: first, we present the photo-treatment of the FBGs to tune the resonance wavelength, which allows for sufficient resonance shifts. Second, adapted MCFs containing 12 cores, arranged on a circle, are fabricated. For this, two different fabrication procedures were investigated, namely, the mechanical drilling of the preform for a rod-in-tube version as well as a stack-and-draw approach. Both adapted MCFs yielded significant improvements with core-to-core wavelength variations of the FBGs of only about 0.18 nm and 0.11 nm, respectively, sufficient to fulfill the requirements for astronomical filter applications as discussed above.
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Offergeld C, Ketterer M, Neudert M, Hassepaß F, Weerda N, Richter B, Traser L, Becker C, Deeg N, Knopf A, Wesarg T, Rauch AK, Jakob T, Ferver F, Lang F, Vielsmeier V, Hackenberg S, Diensthuber M, Praetorius M, Hofauer B, Mansour N, Kuhn S, Hildenbrand T. ["Online from tomorrow on please": comparison of digital framework conditions of curricular teaching at national university ENT clinics in times of COVID-19 : Digital teaching at national university ENT clinics]. HNO 2020; 69:213-220. [PMID: 32929523 PMCID: PMC7490113 DOI: 10.1007/s00106-020-00939-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
Hintergrund Die Corona-Krise beeinflusst nicht nur das professionelle Handeln, sondern auch die Lehre an den Universitäten. Schlagworte wie „E-Learning“ und „Digitalisierung“ suggerieren die Möglichkeit innovativer, ad hoc verfügbarer Lösungsansätze für die Lehre in der aktuellen COVID-19-Situation. Die aktuelle Umstellung auf digitale Lehre ist aber nicht primär durch eine didaktische Sinnhaftigkeit oder institutionelle Strategie, sondern durch äußere Notwendigkeit geprägt. Ziel der Arbeit Ziel der Arbeit war die Erfassung der Lehrsituation an nationalen Universitäts-HNO-Kliniken und akademischen Lehrkrankenhäusern zu Beginn des virtuellen Corona-Sommersemesters 2020. Material und Methode Ein eigens erstellter Fragebogen zur jeweiligen lokalen Situation, den örtlichen Rahmenbedingungen sowie zu bundesweiten Szenarien wurde an alle 39 nationalen Universitäts-HNO-Kliniken und 20 akademischen Lehrkrankenhäuser mit HNO-Hauptabteilung versandt. Ergebnisse Die ausgefüllten Fragebögen von 31 Universitätskliniken (UK) und 10 akademische Lehrkrankenhäuser (ALK) gingen in die Auswertung ein. Es zeigten sich offensichtliche Diskrepanzen zwischen verfügbaren Ressourcen und tatsächlich verfügbaren digitalisierten Lehrinhalten. Weitere Kritikpunkte offenbarten sich in Bezug auf die Kommunikation mit der Medizinischen Fakultät, die digitale Infrastruktur und insbesondere in der oftmals mangelnden Kollaboration mit den zentralen Supportstrukturen, wie Medien‑, Didaktik- und Rechenzentren. Schlussfolgerung Es gibt durchaus positive Beispiele für eine gelungene Überführung der Präsenzlehre in das ausschließlich virtuelle Sommersemester 2020 innerhalb der Universitäts-HNO-Kliniken. Mehrheitlich aber überwiegen kritische Einschätzungen der Lehrbeauftragten bzw. Ärztlichen Direktoren gegenüber der aktuellen Lehrsituation. Eine zeitkritische strategische Weiterentwicklung ist dringend erforderlich.
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Affiliation(s)
- C Offergeld
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland.
| | - M Ketterer
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - M Neudert
- Univ.-HNO-Klinik, Med. Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - F Hassepaß
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Weerda
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - B Richter
- Institut für Musikermedizin, Med. Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - L Traser
- Institut für Musikermedizin, Med. Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - C Becker
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Deeg
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - A Knopf
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Wesarg
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - A-K Rauch
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Jakob
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - F Ferver
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - F Lang
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - V Vielsmeier
- Univ.-HNO-Klinik, Med. Fakultät, Universität Regensburg, Regensburg, Deutschland
| | - S Hackenberg
- Univ.-HNO-Klinik, Med. Fakultät, Julius-Maximilians-Universität, Würzburg, Deutschland
| | - M Diensthuber
- Univ.-HNO-Klinik, Med. Fakultät, , Goethe Universität, Frankfurt/M, Deutschland
| | - M Praetorius
- Univ.-HNO-Klinik, Med. Fakultät, Ruprecht-Karls-Universität, Heidelberg, Deutschland
| | - B Hofauer
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Mansour
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - S Kuhn
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin, Johannes Gutenberg-Universität, Mainz, Deutschland
| | - T Hildenbrand
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
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Abstract
BACKGROUND The need for application expertise in natural language processing (NLP) is increasing in radiology. This way, in a complementary fashion to structured reporting using templates, the necessary database for quality assurance and continuous process optimization can be generated. OBJECTIVE Possibilities and challenges of the application of NLP from the radiology point of view are explained. MATERIALS AND METHODS The requirements and expectations for NLP systems are identified and demonstrated using a case study. RESULTS For an effective use of this technology, NLP tasks for the interpretation of text using RadLex, an intuitive usage and feedback option as well as transparent quality of the NLP results are important. DISCUSSION Using suitable NLP systems, targeted information can be extracted from large amounts of free text with manageable manual effort and high quality.
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Affiliation(s)
- F Jungmann
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - S Kuhn
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - I Tsaur
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - B Kämpgen
- Empolis Information Management GmbH, Kaiserslautern, Deutschland
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Greenfield J, Bruyère-Garnier K, Mehler D, Appelmann P, Kuhn S, Rommens P, Lafon Y. Influence of implant and screw type on local bone strain field: a preliminary study. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714972] [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: 10/24/2022]
Affiliation(s)
- J. Greenfield
- Université Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, Lyon, France
- Department of Orthopaedics and Traumatology, University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - K. Bruyère-Garnier
- Université Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - D. Mehler
- Department of Orthopaedics and Traumatology, University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - P. Appelmann
- Department of Orthopaedics and Traumatology, University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - S. Kuhn
- Department of Orthopaedics and Traumatology, University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - P.M Rommens
- Department of Orthopaedics and Traumatology, University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Y. Lafon
- Université Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, Lyon, France
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Schreiber T, Kuhn S, Feldkamp G, Schwuchow A, Schuster K, Hein S, Eberhardt R, Tünnermann A. Micro-fluorescence lifetime and spectral imaging of ytterbium doped laser materials. Opt Express 2018; 26:32417-32432. [PMID: 30645409 DOI: 10.1364/oe.26.032417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/22/2018] [Indexed: 06/09/2023]
Abstract
We present the application of a confocal fluorescence microscope to the analysis of Yb-doped solid-state laser materials, with examples of Yb-doped crystals, photonic crystal fibers and fiber preforms made with different manufacturing processes. Beside the fluorescence lifetime image itself, a microscopic spectral fluorescence emission analysis is presented and spatially resolved emission cross sections are obtained. Doping concentration and its distributions and other laser optical parameters are measured, which help to analyze manufacturing steps. Further properties like photodarkening and saturation are addressed.
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15
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Fransen S, Fransaer J, Kuhn S. Current and concentration distributions in electrochemical microreactors: Numerical calculations and asymptotic approximations for self-supported paired synthesis. Electrochim Acta 2018. [DOI: 10.1016/j.electacta.2018.08.082] [Citation(s) in RCA: 8] [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: 11/27/2022]
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16
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Ferreira J, Castro F, Rocha F, Kuhn S. Protein crystallization in a droplet-based microfluidic device: Hydrodynamic analysis and study of the phase behaviour. Chem Eng Sci 2018. [DOI: 10.1016/j.ces.2018.06.066] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dreyer T, Kuhn S, Jelsma J, Heithorst N, Schilling D, Sievert W, Multhoff G, Wege AK, Kiechle M, Bronger H. Das Chemokin CX3CL1 erhöht die Immuninfiltration, reduziert Tumorwachstum und -metastasierung und verbessert die Trastuzumab-Therapie in vitro und in vivo. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- T Dreyer
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - S Kuhn
- Klinikum rechts der Isar, TU München, Institut für Klinische Chemie und Pathobiochemie, München, Deutschland
| | - J Jelsma
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - N Heithorst
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - D Schilling
- Klinikum rechts der Isar, TU München, Klinik für Strahlentherapie, München, Deutschland
| | - W Sievert
- Klinikum rechts der Isar, TU München, Klinik für Strahlentherapie, München, Deutschland
| | - G Multhoff
- Klinikum rechts der Isar, TU München, Klinik für Strahlentherapie, München, Deutschland
| | - AK Wege
- Universität Regensburg, Frauenklinik, München, Deutschland
| | - M Kiechle
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - H Bronger
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
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18
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Bronger H, Dreyer T, Demlehner J, Kuhn S, Kraeft S, Multhoff G, Kiechle M. CXCL9 wird durch den COX-Inhibitor Indomethacin aus Mammakarzinomzellen freigesetzt und hemmt das Tumorwachstum in vivo. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- H Bronger
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - T Dreyer
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - J Demlehner
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - S Kuhn
- Klinikum rechts der Isar, TU München, Institut für Klinische Chemie und Pathobiochemie, München, Deutschland
| | - S Kraeft
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
| | - G Multhoff
- Klinikum rechts der Isar, TU München, Klinik für Strahlentherapie, München, Deutschland
| | - M Kiechle
- Klinikum rechts der Isar, TU München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland
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19
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Vogt M, Meschede S, Seitz N, Kuhn S, Lutz M. Betrieb chemischer Speichertechnologien in einem Unternehmensverbund. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Vogt
- IUTA e.V; Luftreinhaltung und Aerosole; Bliersheimer Straße 58 60 47229 Duisburg Deutschland
| | - S. Meschede
- IUTA e.V; Luftreinhaltung und Aerosole; Bliersheimer Straße 58 60 47229 Duisburg Deutschland
| | - N. Seitz
- Technische Universität München; Forschungsinstitut Unternehmensführung, Logistik und Produktion; Leopoldstraße 145 80804 München Deutschland
| | - S. Kuhn
- Technische Universität München; Forschungsinstitut Unternehmensführung, Logistik und Produktion; Leopoldstraße 145 80804 München Deutschland
| | - M. Lutz
- Technische Universität München; Forschungsinstitut Unternehmensführung, Logistik und Produktion; Leopoldstraße 145 80804 München Deutschland
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20
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Schulze J, Kuhn S, Hendrikx S, Schulz-Siegmund M, Polte T, Aigner A. Spray-Dried Nanoparticle-in-Microparticle Delivery Systems (NiMDS) for Gene Delivery, Comprising Polyethylenimine (PEI)-Based Nanoparticles in a Poly(Vinyl Alcohol) Matrix. Small 2018; 14:e1701810. [PMID: 29430833 DOI: 10.1002/smll.201701810] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 05/30/2017] [Revised: 11/28/2017] [Indexed: 05/28/2023]
Abstract
Nucleic acid-based therapies rely on efficient formulations for nucleic acid protection and delivery. As nonviral strategies, polymeric and lipid-based nanoparticles have been introduced; however, biological efficacy and biocompatibility as well as poor storage properties due to colloidal instability and their unavailability as ready-to-use systems are still major issues. Polyethylenimine is the most widely explored and promising candidate for gene delivery. Polyethylenimine-based polyplexes and their combination with liposomes, lipopolyplexes, are efficient for DNA or siRNA delivery in vitro and in vivo. In this study, a highly potent spray-dried nanoparticle-in-microparticle delivery system is presented for the encapsulation of polyethylenimine-based polyplexes and lipopolyplexes into poly(vinyl alcohol) microparticles, without requiring additional stabilizing agents. This easy-to-handle gene delivery device allows prolonged nanoparticle storage and protection at ambient temperature. Biological analyses reveal further advantages regarding profoundly reduced cytotoxicity and enhanced transfection efficacies of polyethylenimine-based nanoparticles from the nanoparticle-in-microparticle delivery system over their freshly prepared counterparts, as determined in various cell lines. Importantly, this nanoparticle-in-microparticle delivery system is demonstrated as ready-to-use dry powder to be an efficient device for the inhalative delivery of polyethylenimine-based lipopolyplexes in vivo, as shown by transgene expression in mice after only one administration.
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Affiliation(s)
- Jan Schulze
- Rudolf Boehm-Institute for Pharmacology and Toxicology, Clinical Pharmacology, University of Leipzig, Haertelstrasse 16 - 18, Leipzig, D-04107, Germany
| | - Stephanie Kuhn
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research Leipzig - UFZ, Leipzig, D-04318, Germany
| | - Stephan Hendrikx
- Pharmaceutical Technology, Institute of Pharmacy, University of Leipzig, Leipzig, D-04107, Germany
| | - Michaela Schulz-Siegmund
- Pharmaceutical Technology, Institute of Pharmacy, University of Leipzig, Leipzig, D-04107, Germany
| | - Tobias Polte
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research Leipzig - UFZ, Leipzig, D-04318, Germany
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, D-04103, Germany
| | - Achim Aigner
- Rudolf Boehm-Institute for Pharmacology and Toxicology, Clinical Pharmacology, University of Leipzig, Haertelstrasse 16 - 18, Leipzig, D-04107, Germany
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Ehlmann BL, Edgett KS, Sutter B, Achilles CN, Litvak ML, Lapotre MGA, Sullivan R, Fraeman AA, Arvidson RE, Blake DF, Bridges NT, Conrad PG, Cousin A, Downs RT, Gabriel TSJ, Gellert R, Hamilton VE, Hardgrove C, Johnson JR, Kuhn S, Mahaffy PR, Maurice S, McHenry M, Meslin PY, Ming DW, Minitti ME, Morookian JM, Morris RV, O'Connell-Cooper CD, Pinet PC, Rowland SK, Schröder S, Siebach KL, Stein NT, Thompson LM, Vaniman DT, Vasavada AR, Wellington DF, Wiens RC, Yen AS. Chemistry, mineralogy, and grain properties at Namib and High dunes, Bagnold dune field, Gale crater, Mars: A synthesis of Curiosity rover observations. J Geophys Res Planets 2017; 122:2510-2543. [PMID: 29497589 DOI: 10.1002/2016je005225] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 05/25/2023]
Abstract
The Mars Science Laboratory Curiosity rover performed coordinated measurements to examine the textures and compositions of aeolian sands in the active Bagnold dune field. The Bagnold sands are rounded to subrounded, very fine to medium sized (~45-500 μm) with ≥6 distinct grain colors. In contrast to sands examined by Curiosity in a dust-covered, inactive bedform called Rocknest and soils at other landing sites, Bagnold sands are darker, less red, better sorted, have fewer silt-sized or smaller grains, and show no evidence for cohesion. Nevertheless, Bagnold mineralogy and Rocknest mineralogy are similar with plagioclase, olivine, and pyroxenes in similar proportions comprising >90% of crystalline phases, along with a substantial amorphous component (35% ± 15%). Yet Bagnold and Rocknest bulk chemistry differ. Bagnold sands are Si enriched relative to other soils at Gale crater, and H2O, S, and Cl are lower relative to all previously measured Martian soils and most Gale crater rocks. Mg, Ni, Fe, and Mn are enriched in the coarse-sieved fraction of Bagnold sands, corroborated by visible/near-infrared spectra that suggest enrichment of olivine. Collectively, patterns in major element chemistry and volatile release data indicate two distinctive volatile reservoirs in Martian soils: (1) amorphous components in the sand-sized fraction (represented by Bagnold) that are Si-enriched, hydroxylated alteration products and/or H2O- or OH-bearing impact or volcanic glasses and (2) amorphous components in the fine fraction (<40 μm; represented by Rocknest and other bright soils) that are Fe, S, and Cl enriched with low Si and adsorbed and structural H2O.
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Ehlmann BL, Edgett KS, Sutter B, Achilles CN, Litvak ML, Lapotre MGA, Sullivan R, Fraeman AA, Arvidson RE, Blake DF, Bridges NT, Conrad PG, Cousin A, Downs RT, Gabriel TSJ, Gellert R, Hamilton VE, Hardgrove C, Johnson JR, Kuhn S, Mahaffy PR, Maurice S, McHenry M, Meslin P, Ming DW, Minitti ME, Morookian JM, Morris RV, O'Connell‐Cooper CD, Pinet PC, Rowland SK, Schröder S, Siebach KL, Stein NT, Thompson LM, Vaniman DT, Vasavada AR, Wellington DF, Wiens RC, Yen AS. Chemistry, mineralogy, and grain properties at Namib and High dunes, Bagnold dune field, Gale crater, Mars: A synthesis of Curiosity rover observations. J Geophys Res Planets 2017; 122:2510-2543. [PMID: 29497589 PMCID: PMC5815393 DOI: 10.1002/2017je005267] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 05/31/2023]
Abstract
The Mars Science Laboratory Curiosity rover performed coordinated measurements to examine the textures and compositions of aeolian sands in the active Bagnold dune field. The Bagnold sands are rounded to subrounded, very fine to medium sized (~45-500 μm) with ≥6 distinct grain colors. In contrast to sands examined by Curiosity in a dust-covered, inactive bedform called Rocknest and soils at other landing sites, Bagnold sands are darker, less red, better sorted, have fewer silt-sized or smaller grains, and show no evidence for cohesion. Nevertheless, Bagnold mineralogy and Rocknest mineralogy are similar with plagioclase, olivine, and pyroxenes in similar proportions comprising >90% of crystalline phases, along with a substantial amorphous component (35% ± 15%). Yet Bagnold and Rocknest bulk chemistry differ. Bagnold sands are Si enriched relative to other soils at Gale crater, and H2O, S, and Cl are lower relative to all previously measured Martian soils and most Gale crater rocks. Mg, Ni, Fe, and Mn are enriched in the coarse-sieved fraction of Bagnold sands, corroborated by visible/near-infrared spectra that suggest enrichment of olivine. Collectively, patterns in major element chemistry and volatile release data indicate two distinctive volatile reservoirs in Martian soils: (1) amorphous components in the sand-sized fraction (represented by Bagnold) that are Si-enriched, hydroxylated alteration products and/or H2O- or OH-bearing impact or volcanic glasses and (2) amorphous components in the fine fraction (<40 μm; represented by Rocknest and other bright soils) that are Fe, S, and Cl enriched with low Si and adsorbed and structural H2O.
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Jahreis S, Kuhn S, Madaj AM, Bauer M, Polte T. Mold metabolites drive rheumatoid arthritis in mice via promotion of IFN-gamma- and IL-17-producing T cells. Food Chem Toxicol 2017; 109:405-413. [DOI: 10.1016/j.fct.2017.09.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 01/15/2023]
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Averbeck M, Kuhn S, Bühligen J, Götte M, Simon JC, Polte T. Syndecan-1 regulates dendritic cell migration in cutaneous hypersensitivity to haptens. Exp Dermatol 2017; 26:1060-1067. [PMID: 28453867 DOI: 10.1111/exd.13374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2014] [Indexed: 01/18/2023]
Abstract
In human dendritic cells (DCs), we previously demonstrated in vitro that syndecan-1 (SDC1) is downregulated during maturation correlating with enhanced motility. We investigated the effects of SDC1 on DC migration in vivo during TNCB(2,4,6-trinitro-1-chlorobenzene)-induced cutaneous hypersensitivity reaction (CHS) in mice. We show that DC in SDC1-deficient mice migrated faster and at a higher rate to lymph nodes draining the hapten-painted skin. Adoptive transfer of SDC1-deficient hapten- and fluorochrome-labelled DC into wild-type (WT) mice led to increased and faster migration of DC to paracortical lymph nodes, and to a stronger CHS compared to WT DC. In SDC1-/- mice, CCR7 remains longer on the DC surface within the first 15-minutes maturation (after LPS-induced maturation). In addition, a time-dependent upregulation of CCL2, CCL3, VCAM1 and talin was found during maturation in SDC1-/- DC. However, no difference in T-cell-stimulating capacity of SDC1-deficient DC was found compared to WT DC. Mechanistically, SDC1-deficient DC showed enhanced migration towards CCL21 and CCL19. This may result from functional overexpression of CCR7 in SDC1-/- DC. Increased and accelerated migration of otherwise functionally intact SDC1-deficient DC leads to an exacerbated CHS. Based on our results, we conclude that SDC1 on DC negatively regulates DC migration.
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Affiliation(s)
- Marco Averbeck
- Department of Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Stephanie Kuhn
- Department of Environmental Immunology, UFZ - Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany
| | - Johannes Bühligen
- Department of Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Martin Götte
- Department of Gynecology and Obstetrics, Münster University Hospital, Münster, Germany
| | - Jan C Simon
- Department of Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Tobias Polte
- Department of Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig, Leipzig, Germany
- Department of Environmental Immunology, UFZ - Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany
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Fitzsimmons D, Kloseck M, Kuhn S. DESIGNING AGE-INTEGRATED COMMUNITIES: LESSONS FROM A NATURALLY OCCURRING RETIREMENT COMMUNITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M. Kloseck
- Western University, London, Ontario, Canada,
| | - S. Kuhn
- University of Cambridge, Cambridge, United Kingdom
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Beier F, Hupel C, Kuhn S, Hein S, Nold J, Proske F, Sattler B, Liem A, Jauregui C, Limpert J, Haarlammert N, Schreiber T, Eberhardt R, Tünnermann A. Single mode 4.3 kW output power from a diode-pumped Yb-doped fiber amplifier. Opt Express 2017; 25:14892-14899. [PMID: 28789071 DOI: 10.1364/oe.25.014892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/22/2017] [Indexed: 06/07/2023]
Abstract
We investigate the average power scaling of two diode-pumped Yb-doped fiber amplifiers emitting a diffraction-limited beam. The first fiber under investigation with a core diameter of 30 µm was able to amplify a 10 W narrow linewidth seed laser up to 2.8 kW average output power before the onset of transverse mode instabilities (TMI). A further power scaling was achieved using a second fiber with a smaller core size (23µm), which allowed for a narrow linewidth output power of 3.5 kW limited by stimulated Brillouin scattering (SBS). We mitigated SBS using a spectral broadening mechanism, which allowed us to further increase the output power to 4.3 kW only limited by the available pump power. Up to this power level, a high slope efficiency of 90% with diffraction-limited beam quality and without any sign of TMI or stimulated Raman scattering for a spectral dynamic range of higher than -80 dB was obtained.
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Karlas T, Weise L, Kuhn S, Krenzien F, Mehdorn M, Petroff D, Linder N, Schaudinn A, Busse H, Keim V, Pratschke J, Wiegand J, Splith K, Schmelzle M. Correlation of cell-free DNA plasma concentration with severity of non-alcoholic fatty liver disease. J Transl Med 2017; 15:106. [PMID: 28521774 PMCID: PMC5437653 DOI: 10.1186/s12967-017-1208-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/04/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The assessment of fibrosis and inflammatory activity is essential to identify patients with non-alcoholic fatty liver disease (NAFLD) at risk for progressive disease. Serum markers and ultrasound-based methods can replace liver biopsy for fibrosis staging, whereas non-invasive characterization of inflammatory activity remains a clinical challenge. Cell-free DNA (cfDNA) is a novel non-invasive biomarker for assessing cellular inflammation and cell death, which has not been evaluated in NAFLD. METHODS Patients and healthy controls from two previous studies were included. NAFLD disease activity and severity were non-invasively characterized by liver stiffness measurement (transient elastography, TE) including steatosis assessment with controlled attenuation parameter (CAP), single-proton magnetic resonance spectroscopy (1H-MRS) for determination of hepatic fat fraction, aminotransferases and serum ferritin. cfDNA levels (90 and 222 bp fragments) were analyzed using quantitative real-time PCR. RESULTS Fifty-eight NAFLD patients (age 62 ± 11 years, BMI 28.2 ± 3.5 kg/m2) and 13 healthy controls (age 38 ± 12 years, BMI 22.4 ± 2.1 kg/m2) were included. 90 bp cfDNA levels were significantly higher in NAFLD patients compared to healthy controls: 3.7 (1.3-23.1) vs. 2.9 (1.4-4.1) ng/mL (p = 0.014). In the NAFLD cohort, circulating cfDNA correlated significantly with disease activity and severity, especially in patients with elevated liver stiffness (n = 13, 22%) compared to cases with TE values ≤7 kPa: cf90 bp 6.05 (2.41-23.13) vs. 3.16 (1.29-7.31) ng/mL (p < 0.001), and cf222 bp 14.41 (9.27-22.90) vs. 11.32 (6.05-18.28) ng/mL (p = 0.0041). CONCLUSIONS Cell-free DNA plasma concentration correlates with established non-invasive markers of NAFLD activity and severity. Therefore, cfDNA should be further evaluated as biomarker for identifying patients at risk for progressive NAFLD.
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Affiliation(s)
- Thomas Karlas
- 0000 0000 8517 9062grid.411339.dDepartment of Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
- 0000 0001 2230 9752grid.9647.cIFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Lara Weise
- 0000 0001 2230 9752grid.9647.cMedical Faculty, Leipzig University, Leipzig, Germany
| | - Stephanie Kuhn
- 0000 0004 0492 3830grid.7492.8Department Environmental Immunology, Helmholtz Centre for Environmental Research GmbH-UFZ, Leipzig, Germany
| | - Felix Krenzien
- 0000 0001 2218 4662grid.6363.0Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Mehdorn
- 0000 0000 8517 9062grid.411339.dDepartment of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - David Petroff
- 0000 0001 2230 9752grid.9647.cClinical Trial Centre, Leipzig University, Leipzig, Germany
| | - Nicolas Linder
- 0000 0000 8517 9062grid.411339.dDepartment of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Alexander Schaudinn
- 0000 0000 8517 9062grid.411339.dDepartment of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Harald Busse
- 0000 0000 8517 9062grid.411339.dDepartment of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Volker Keim
- 0000 0000 8517 9062grid.411339.dDepartment of Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Johann Pratschke
- 0000 0001 2218 4662grid.6363.0Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Wiegand
- 0000 0000 8517 9062grid.411339.dDepartment of Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Katrin Splith
- 0000 0001 2218 4662grid.6363.0Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Moritz Schmelzle
- 0000 0001 2218 4662grid.6363.0Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Schütze N, Trojandt S, Kuhn S, Tomm JM, von Bergen M, Simon JC, Polte T. Allergen-Induced IL-6 Regulates IL-9/IL-17A Balance in CD4+ T Cells in Allergic Airway Inflammation. J Immunol 2016; 197:2653-64. [PMID: 27574298 DOI: 10.4049/jimmunol.1501599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 08/02/2016] [Indexed: 12/21/2022]
Abstract
IL-9-secreting Th9 cells have been considered to play a pivotal role in the pathogenesis of atopic diseases. To what extent IL-9-producing cells are induced or regulated by sensitization with naturally occurring allergens is not yet clear. Naturally occurring allergens are capable of inducing IL-6 production in dendritic cells (DCs). Whether allergen-induced IL-6 supports a Th9 subtype by increasing IL-9 production, as observed in in vitro studies, or rather favors Th17 differentiation is not finally resolved. Therefore, in the present study we have investigated the impact of IL-6 on the Th9/Th17 balance depending on the predominant cytokine milieu and, additionally, in vivo using a DC-driven murine asthma model. In vitro, IL-6 increases Th9 cells under strong IL-4 and TGF-β activation, whereas under moderate IL-4 and TGF-β activation the presence of IL-6 shifts naive CD4(+) cells to Th17 cells. To induce allergic airway inflammation, OVA-pulsed DCs from IL-6-deficient or wild-type donors were adoptively transferred into BALB/c mice. Recipients receiving IL-6-producing wild-type DCs showed a significant decrease of Th9- and IL-4-producing Th2 cells but an increase of Th17 cells in lung tissue in comparison with recipients sensitized with IL-6-deficient DCs. Our data suggest that the IL-6-mediated reduction of Th2-related IL-4 leads to a decline of the Th9 immune response and allows Th17 differentiation.
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Affiliation(s)
- Nicole Schütze
- Leipzig Research Center for Civilization Diseases, Junior Research Group on Pathogenesis of New Allergies, Leipzig University Medical Center, 04103 Leipzig, Germany; Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, 04103 Leipzig, Germany;
| | - Stefanie Trojandt
- Leipzig Research Center for Civilization Diseases, Junior Research Group on Pathogenesis of New Allergies, Leipzig University Medical Center, 04103 Leipzig, Germany; Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Stephanie Kuhn
- Department of Environmental Immunology, UFZ-Helmholtz Center for Environmental Research, 04318 Leipzig, Germany
| | - Janina M Tomm
- Department of Proteomics, UFZ-Helmholtz Center for Environmental Research, 04318 Leipzig, Germany
| | - Martin von Bergen
- Department of Proteomics, UFZ-Helmholtz Center for Environmental Research, 04318 Leipzig, Germany; Department of Metabolomics, UFZ-Helmholtz Center for Environmental Research, 04318 Leipzig, Germany; and Department of Chemistry and Bioscience, Aalborg University, 9220 Aalborg, Denmark
| | - Jan C Simon
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Tobias Polte
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, 04103 Leipzig, Germany; Department of Environmental Immunology, UFZ-Helmholtz Center for Environmental Research, 04318 Leipzig, Germany
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Pridjian G, Sirois PA, McRae S, Hinckley AF, Rasmussen SA, Kissinger P, Buekens P, Hayes EB, O’Leary D, Kuhn S, Swan KF, Xiong X, Wesson DM. Prospective study of pregnancy and newborn outcomes in mothers with West nile illness during pregnancy. Birth Defects Res A Clin Mol Teratol 2016; 106:716-23. [PMID: 27223334 PMCID: PMC5008687 DOI: 10.1002/bdra.23523] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND A previous case report of West Nile virus (WNV) illness during pregnancy suggested that WNV could be a cause of congenital defects. We performed a prospective, longitudinal cohort study of pregnant women with WNV illness to increase our knowledge of the effects of WNV illness during pregnancy. METHODS Participants were enrolled in 2005 to 2008 from pregnant women with serologically confirmed WNV illness reported to the Centers for Disease Control and Prevention. Comparison was made to WNV-uninfected women, matched on maternal age and enrollment month. Pregnancy and newborn data were collected; cord blood WNV serology was obtained. Pediatric exams and the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) were performed. RESULTS Twenty-eight WNV-infected mothers and 25 WNV-uninfected mothers participated. Maternal demographics were similar except for a higher rate of planned pregnancies, education, and household income in the WNV-uninfected mothers. There were no differences in pregnancy and delivery characteristics except that infected mothers had a higher incidence of febrile illnesses and used more medications. Birth weight, length, head circumference, and rate of congenital malformations were similar in babies born to WNV-infected and -uninfected mothers. Follow-up physical exams were generally normal. The Bayley-III assessments, available for 17 children born to mothers with WNV illness, showed performance at or above age level across domains. CONCLUSION The risk for adverse pregnancy and newborn outcomes in women experiencing WNV illness in pregnancy appears to be low, but future studies with larger numbers are needed to rule out a small risk. Birth Defects Research (Part A) 106:716-723, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | | | | | | | | | - Edward B. Hayes
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Dan O’Leary
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Stephanie Kuhn
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Xu Xiong
- Tulane University, New Orleans, Louisiana
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Kreitner KF, Kuhn S. Muss das CT immer im Schockraum integriert sein? Das Mainzer Modell. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581753] [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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31
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Beier F, Hupel C, Nold J, Kuhn S, Hein S, Ihring J, Sattler B, Haarlammert N, Schreiber T, Eberhardt R, Tünnermann A. Narrow linewidth, single mode 3 kW average power from a directly diode pumped ytterbium-doped low NA fiber amplifier. Opt Express 2016; 24:6011-6020. [PMID: 27136795 DOI: 10.1364/oe.24.006011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report on a newly designed and fabricated ytterbium-doped large mode area fiber with an extremely low NA (~0.04) and related systematic investigations on fiber parameters that crucially influence the mode instability threshold. The fiber is used to demonstrate a narrow linewidth, continuous wave, single mode fiber laser amplifier emitting a maximum output power of 3 kW at a wavelength of 1070 nm without reaching the mode-instability threshold. A high slope efficiency of 90 %, excellent beam quality, high temporal stability, and an ASE suppression of 70 dB could be reached with a signal linewidth of only 170 pm.
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Tsatrafyllis N, Bergues B, Schröder H, Veisz L, Skantzakis E, Gray D, Bodi B, Kuhn S, Tsakiris GD, Charalambidis D, Tzallas P. The ion microscope as a tool for quantitative measurements in the extreme ultraviolet. Sci Rep 2016; 6:21556. [PMID: 26868370 PMCID: PMC4751500 DOI: 10.1038/srep21556] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/22/2016] [Indexed: 11/16/2022] Open
Abstract
We demonstrate a tool for quantitative measurements in the extreme ultraviolet (EUV) spectral region measuring spatially resolved atomic ionization products at the focus of an EUV beam. The ionizing radiation is a comb of the 11(th)-15(th) harmonics of a Ti:Sapphire femtosecond laser beam produced in a Xenon gas jet. The spatial ion distribution at the focus of the harmonics is recorded using an ion microscope. Spatially resolved single- and two-photon ionization products of Argon and Helium are observed. From such ion distributions single- and two-photon generalized cross sections can be extracted by a self-calibrating method. The observation of spatially resolved two-EUV-photon ionization constitutes an initial step towards future single-shot temporal characterization of attosecond pulses.
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Affiliation(s)
- N. Tsatrafyllis
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
- Department of Physics, University of Crete, PO Box 2208, GR71003 Heraklion (Crete), Greece
| | - B. Bergues
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - H. Schröder
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - L. Veisz
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
- Department of Physics, Umeå University, SE-901 87 Umeå, Sweden
| | - E. Skantzakis
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
| | - D. Gray
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
| | - B. Bodi
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
- Wigner Research Center for Physics, 1121 Budapest, Hungary
| | - S. Kuhn
- ELI Attosecond Light Pulse Source, ELI-Hu Kft., Dugonics ter 13, 6720 Szeged, Hungary
| | - G. D. Tsakiris
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - D. Charalambidis
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
- Department of Physics, University of Crete, PO Box 2208, GR71003 Heraklion (Crete), Greece
- ELI Attosecond Light Pulse Source, ELI-Hu Kft., Dugonics ter 13, 6720 Szeged, Hungary
| | - P. Tzallas
- Foundation for Research and Technology - Hellas, Institute of Electronic Structure & Laser, PO Box 1527, GR71110 Heraklion (Crete), Greece
- ELI Attosecond Light Pulse Source, ELI-Hu Kft., Dugonics ter 13, 6720 Szeged, Hungary
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Greenfield JRF, Kuhn S, Mehler D, Puel F, Rommens PM. Biomechanical evaluation of a new treatment method for distal tibia fractures. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:1952-3. [DOI: 10.1080/10255842.2015.1069582] [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: 10/23/2022]
Affiliation(s)
- J. R. F. Greenfield
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
- GRESPI EA 4694/Faculty of Sport Sciences, University of Reims Champagne-Ardenne, Reims, France
| | - S. Kuhn
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - D. Mehler
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - F. Puel
- GRESPI EA 4694/Faculty of Sport Sciences, University of Reims Champagne-Ardenne, Reims, France
| | - P. M. Rommens
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
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Schmidt CS, Schulte B, Seo H, Kuhn S, O'Donnell A, Kriston L, Verthein U, Reimer J. Meta-analysis on the Effectiveness of Alcohol Screening and Brief Interventions for Patients in Emergency Care Settings. Suchttherapie 2015. [DOI: 10.1055/s-0035-1557664] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kuhn S, Verthein U, Holzbach R, Dirmaier J, Mokhar A. Benzodiazepine und Z-Substanzen – Einnahmeverhalten und Motive bei älteren Menschen. Suchttherapie 2015. [DOI: 10.1055/s-0035-1557552] [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: 10/23/2022]
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Kuhn S, Appelmann P, Pairon P, Gruszka D, Rommens PM. Retrograde tibial nail: anatomical implantation and surgical feasibility study. Acta Chir Orthop Traumatol Cech 2015; 82:203-208. [PMID: 26317291] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE OF THE STUDY The treatment of distal tibial fractures requires a stable fixation while minimizing the secondary trauma to the soft tissues by the surgical approach and implant. The experimental Retrograde Tibial Nail is currently investigated as a minimally invasive alternative to plating and antegrade nailing. The purpose of this study was to evaluate the surgical feasibility in a cadaver model for all distal tibial fracture types generally considered treatable by nailing. MATERIAL AND METHODS Five different fracture types (AO/OTA 43-A1/A2/A3 and 43-C1/C2) were created on separate cadaveric limbs. In simple fractures (AO/OTA 43-A1/A2/A3) primary nailing was performed. In intraarticular fractures (AO/OTA 43-C1/2) reduction of the articular block and lag screw fixation was performed before nailing. Intraoperative complications, quality of reduction, fluoroscopy duration and operative time were evaluated. RESULTS Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps. Retrograde nailing is possible in fractures with simple intraarticular involvement after primary lag screw fixation. The duration of surgery averaged 51.8 minutes (range 40-62 min). No major complications occurred during nailing. CONCLUSIONS The minimally invasive retrograde nail combines a minimally invasive local osteosynthesis with the ability to adequately fix extraarticular and simple intraarticular distal tibial fractures. The results suggests that retrograde tibia nailing is a promising new concept for the treatment of distal tibia fractures. Key words: minimally invasive surgery, tibia, metaphyseal fractures, intramedullary nailing, retrograde nailing.
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Affiliation(s)
- S Kuhn
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
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Kuhn S, Knirsch M, Rüttiger L, Kasperek S, Winter H, Freichel M, Flockerzi V, Knipper M, Engel J. Ba2+currents in inner and outer hair cells of mice lacking the voltage-dependent Ca2+channel subunits β3 or β4. Channels (Austin) 2014; 3:366-76. [DOI: 10.4161/chan.3.5.9774] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pairon P, Ossendorf C, Kuhn S, Hofmann A, Rommens PM. Intramedullary nailing after external fixation of the femur and tibia: a review of advantages and limits. Eur J Trauma Emerg Surg 2014; 41:25-38. [PMID: 26038163 DOI: 10.1007/s00068-014-0448-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE AND METHODS External fixation is a safe option for stabilisation of extremity lesions in the polytraumatised patient as well as in fractures with severe soft tissue damage. Nevertheless, long-term-complications are to be expected when external fixation is chosen as a definitive treatment. The purpose of this review article is twofold: primarily, to define the rationale of a procedural change from an external fixator to an intramedullary nail; secondarily, to assess the possible advantages and pitfalls of a single- or two-staged procedure. RESULTS AND CONCLUSIONS External fixation of the femur is recommended in multiply injured patients who are critically ill to avoid an additional inflammatory response caused by the surgical trauma of primary nailing. The conversion towards nailing must be done as soon as the clinical condition of the patient has been stabilised. Stable polytraumatised patients do not benefit from initial stabilisation with an external fixator and should immediately be treated with a definitive osteosynthesis. In tibial fractures, external fixation followed by intramedullary nailing is recommendable in fractures with severe soft tissue injuries. Conversion should be done as soon as the soft tissues allow before pin-tract infections occur and performed in a one-staged procedure.
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Affiliation(s)
- P Pairon
- Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstrasse 1, 55131, Mainz, Germany,
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Boggild AK, Geduld J, Libman M, Ward BJ, McCarthy A, Hajek J, Ghesquiere W, Vincelette J, Kuhn S, Freedman DO, Kain KC. Travel-acquired infections in Canada: CanTravNet 2011-2012. Can Commun Dis Rep 2014; 40:313-325. [PMID: 29769859 PMCID: PMC5864452 DOI: 10.14745/ccdr.v40i16a01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Important gaps remain in our knowledge of the infectious diseases people acquire while travelling and the impact of pathogens imported by Canadian travellers. OBJECTIVE To provide a surveillance update of illness in a cohort of returned Canadian travellers and new immigrants. METHODS Data on returning Canadian travellers and new immigrants presenting to a CanTravNet site between September 2011 and September 2012 were extracted and analyzed by destination, presenting symptoms, common and emerging infectious diseases and disease severity. RESULTS During the study period, 2283 travellers and immigrants presented to a CanTravNet site, 88% (N=2004) of whom were assigned a travel-related diagnosis. Top three destinations for non-immigrant travellers were India (N=132), Mexico (N=103) and Cuba (N=89). Fifty-one cases of malaria were imported by ill returned travellers during the study period, 60% (N=30) of which were Plasmodium falciparum infections. Individuals travelling to visit friends and relatives accounted for 83% of enteric fever cases (15/18) and 41% of malaria cases (21/51). The requirement for inpatient management was over-represented among those with malaria compared to those without malaria (25% versus 2.8%; p<0.0001) and those travelling to visit friends and relatives versus those travelling for other reasons (12.1% versus 2.4%; p<0.0001). Nine new cases of HIV were diagnosed among the cohort, as well as one case of acute hepatitis B. Emerging infections among travellers included hepatitis E virus (N=6), chikungunya fever (N=4) and cutaneous leishmaniasis (N=16). Common chief complaints included gastrointestinal (N=804), dermatologic (N=440) and fever (N=287). Common specific causes of chief complaint of fever in the cohort were malaria (N=47/51 total cases), dengue fever (14/18 total cases), enteric fever (14/17 total cases) and influenza and influenza-like illness (15/21 total cases). Animal bites were the tenth most common diagnosis among tourist travellers. INTERPRETATION Our analysis of surveillance data on ill returned Canadian travellers provides a recent update to the spectrum of imported illness among travelling Canadians. Preventable travel-acquired illnesses and injuries in the cohort include malaria, enteric fever, HIV, hepatitis B, hepatitis A, influenza and animal bites. Strategies to improve uptake of preventive interventions such as malaria chemoprophylaxis, immunizations and arthropod/animal avoidance may be warranted.
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Affiliation(s)
- AK Boggild
- Tropical Disease Unit, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON
- Public Health Ontario Laboratories, Public Health Ontario, Toronto, ON
| | - J Geduld
- Travel and Migration Health Division, Public Health Agency of Canada, Ottawa, ON
| | - M Libman
- Division of Infectious Diseases, McGill University Health Centre, Montreal, QC
| | - BJ Ward
- Division of Infectious Diseases, McGill University Health Centre, Montreal, QC
| | - A McCarthy
- Tropical Medicine and International Health Clinic, Ottawa Hospital and the University of Ottawa, Ottawa, ON
| | - J Hajek
- Division of Infectious Diseases, Vancouver General Hospital and University of British Columbia, Vancouver, BC
| | - W Ghesquiere
- Infectious Diseases, Vancouver Island Health Authority and University of British Columbia, Victoria, BC
| | - J Vincelette
- Hôpital Saint-Luc du CHUM and Université de Montréal, Montréal, QC
| | - S Kuhn
- Division of Pediatric Infectious Diseases, Alberta Children’s Hospital and the University of Calgary, Calgary, AB
| | - DO Freedman
- Gorgas Center for Geographic Medicine, University of Alabama Birmingham, Birmingham, AL
| | - KC Kain
- Tropical Disease Unit, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON
- SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto, ON
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Frey D, Kayser K, Beutel T, Heidrich C, Kuhn S, Letzel S, Escobar Pinzon LC. Nackenschmerzen von Altenpflegekräften in Rheinland-Pfalz – Ergebnisse einer Querschnittserhebung. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386903] [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: 10/24/2022]
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Beutel T, Frey D, Kayser K, Letzel S, Heidrich C, Kuhn S, Escobar Pinzon LC. Prävalenz psychisch belastender Arbeitsmerkmale und Zusammenhänge zu Beanspruchungsreaktionen bei Pflegekräften in der Altenpflege. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386858] [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: 10/24/2022]
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Koessler J, Kobsar A, Kuhn S, Koessler A, Yilmaz P, Weinig E, Putz E, Boeck M, Klinker E. The effect of immunoadsorption with theImmusorbaTR‐350 column on coagulation compared to plasma exchange. Vox Sang 2014; 108:46-51. [DOI: 10.1111/vox.12191] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/13/2014] [Accepted: 07/21/2014] [Indexed: 02/06/2023]
Affiliation(s)
- J. Koessler
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - A. Kobsar
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - S. Kuhn
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - A. Koessler
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - P. Yilmaz
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - E. Weinig
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - E. Putz
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - M. Boeck
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
| | - E. Klinker
- Institute of Transfusion Medicine and Haemotherapy University of Wuerzburg Wuerzburg Germany
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Wurst F, Kuhn S. Sucht und Alter. Suchttherapie 2014. [DOI: 10.1055/s-0034-1385849] [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: 10/24/2022]
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Ruppert C, Kuhn S, Bernemann I, Klopp N, Gaede K, Koch I, Lindner M, Anton G, Schnabel PA, Schneider M, Illig T, Muley T, Günther A. DZL-Platform Biobanking. Pneumologie 2014. [DOI: 10.1055/s-0034-1376837] [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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46
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Jäger M, Jordan C, Theilmeier A, Wortmann N, Kuhn S, Nienhaus A, Luttmann A. Analyse der Lumbalbelastung beim manuellen Bewegen von Patienten zur Prävention biomechanischer Überlastungen von Beschäftigten im Gesundheitswesen. Zbl Arbeitsmed 2014. [DOI: 10.1007/s40664-013-0010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Olt J, Mburu P, Johnson SL, Parker A, Kuhn S, Bowl M, Marcotti W, Brown SDM. The actin-binding proteins eps8 and gelsolin have complementary roles in regulating the growth and stability of mechanosensory hair bundles of mammalian cochlear outer hair cells. PLoS One 2014; 9:e87331. [PMID: 24475274 PMCID: PMC3903700 DOI: 10.1371/journal.pone.0087331] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 09/24/2013] [Accepted: 12/19/2013] [Indexed: 11/21/2022] Open
Abstract
Sound transduction depends upon mechanosensitive channels localized on the hair-like bundles that project from the apical surface of cochlear hair cells. Hair bundles show a stair-case structure composed of rows of stereocilia, and each stereocilium contains a core of tightly-packed and uniformly-polarized actin filaments. The growth and maintenance of the stereociliary actin core are dynamically regulated. Recently, it was shown that the actin-binding protein gelsolin is expressed in the stereocilia of outer hair cells (OHCs) and in its absence they become long and straggly. Gelsolin is part of a whirlin scaffolding protein complex at the stereocilia tip, which has been shown to interact with other actin regulatory molecules such as Eps8. Here we investigated the physiological effects associated with the absence of gelsolin and its possible overlapping role with Eps8. We found that, in contrast to Eps8, gelsolin does not affect mechanoelectrical transduction during immature stages of development. Moreover, OHCs from gelsolin knockout mice were able to mature into fully functional sensory receptors as judged by the normal resting membrane potential and basolateral membrane currents. Mechanoelectrical transducer current in gelsolin-Eps8 double knockout mice showed a profile similar to that observed in the single mutants for Eps8. We propose that gelsolin has a non-overlapping role with Eps8. While Eps8 is mainly involved in the initial growth of stereocilia in both inner hair cells (IHCs) and OHCs, gelsolin is required for the maintenance of mature hair bundles of low-frequency OHCs after the onset of hearing.
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MESH Headings
- Adaptor Proteins, Signal Transducing/metabolism
- Animals
- Cytoskeletal Proteins/metabolism
- Gelsolin/genetics
- Gelsolin/metabolism
- Hair Cells, Auditory, Outer/metabolism
- Hair Cells, Auditory, Outer/physiology
- Hair Cells, Auditory, Outer/ultrastructure
- Immunohistochemistry
- Mechanoreceptors/metabolism
- Mechanoreceptors/physiology
- Mechanoreceptors/ultrastructure
- Mechanotransduction, Cellular/physiology
- Mice
- Mice, Knockout
- Microfilament Proteins/metabolism
- Microscopy, Electron, Scanning
- Patch-Clamp Techniques
- Physical Stimulation
- Pyridinium Compounds
- Quaternary Ammonium Compounds
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Affiliation(s)
- Jennifer Olt
- Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom
| | - Philomena Mburu
- Medical Research Council (MRC), Mammalian Genetics Unit, Harwell, United Kingdom
| | - Stuart L. Johnson
- Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom
| | - Andy Parker
- Medical Research Council (MRC), Mammalian Genetics Unit, Harwell, United Kingdom
| | - Stephanie Kuhn
- Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom
| | - Mike Bowl
- Medical Research Council (MRC), Mammalian Genetics Unit, Harwell, United Kingdom
| | - Walter Marcotti
- Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom
- * E-mail: (WM); (SDMB)
| | - Steve D. M. Brown
- Medical Research Council (MRC), Mammalian Genetics Unit, Harwell, United Kingdom
- * E-mail: (WM); (SDMB)
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Pridjian G, Sirois P, McRae R, Hinckley A, Rasmussen S, Kissinger P, Buekens P, Hayes E, O'Leary D, Kuhn S, Swan K, Xiong X, Wesson D. 388: A prospective study of pregnancy and newborn outcomes in mothers with West Nile virus (WNV) illness during pregnancy. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.421] [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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Lehwald N, Duhme C, Wildner M, Kuhn S, Fürst G, Forbes SJ, Jonas S, Robson SC, Knoefel WT, Schmelzle M, Schulte Am Esch J. HGF and SDF-1-mediated mobilization of CD133+ BMSC for hepatic regeneration following extensive liver resection. Liver Int 2014; 34:89-101. [PMID: 23701640 DOI: 10.1111/liv.12195] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 04/04/2013] [Indexed: 02/13/2023]
Abstract
BACKGROUND The molecular mechanisms of haematopoietic stem cells (HSC) mobilization and homing to the liver after partial hepatectomy (PH) remain largely unexplored. METHODS Functional liver volume loss and regain was determined by computerized tomography (CT) volumetry in 30 patients following PH. Peripheral HSC mobilization was investigated by fluorescence-activated cell sorting (FACS) analyses and cytokine enzyme-linked immunosorbent assay assays. Migration of purified HSC towards hepatic growth factor (HGF) and stroma-derived factor-1 (SDF-1) gradients was tested in vitro. Mice after 70% PH were examined for HSC mobilization by FACS and cytokine mRNA expression in the liver. FACS-sorted HSC were administered after PH and hepatocyte proliferation was evaluated by immunohistochemical staining for Ki67. RESULTS Impaired liver function was noted after extended hepatic resection when compared to smaller resections. Patients with large liver resections were characterized by significantly higher levels of peripheral HSC which were positively correlated with the extent of resected liver volume and its regain after 3 weeks. Increased plasma levels of HGF, SDF-1 and insulin like growth factor (IGF-1) were evident within the first 6 hours post resection. Migration assays of human HSC in vitro showed a specific target-demonstrated migration towards recombinant HGF and SDF-1 gradients in a concentration and specific receptor (c-Met and CXCR4) dependent manner. The evaluation of peripheral human alpha foetoprotein expression demonstrated pronounced stemness following increased CD133(+) HSC in the course of liver regeneration following PH. Our human data were further validated in a murine model of PH and furthermore demonstrated increased hepatocyte proliferation subsequent to CD133(+) HSC treatment. CONCLUSION HGF and SDF-1 are required for effective HSC mobilization and homing to the liver after hepatic resection. These findings have significant implications for potential therapeutic strategies targeting chemotactant modulation and stem cell mobilization for liver protection and regeneration.
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Affiliation(s)
- Nadja Lehwald
- Department of Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
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50
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Kuhn S, Debus J. SP-0227: Carbon ion therapy: Establishing a routine image guided workflow. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30332-7] [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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